Application of wideband tympanometry combined with kempthorne criteria in the diagnosis of otitis media with effusion in adults: a prospective study.

Introduction: To describe clinical and audiological characteristics and evaluate the diagnostic value of wideband tympanometry (WBT) combined with Kempthorne otoscopic features in adults with otitis media with effusion (OME). Methods: A prospective descriptive study with surgical intervention was conducted on 66 ears with clinically suspected OME in patients aged ≥16 years at Can Tho University of Medicine and Pharmacy Hospital from June 2024 to October 2025. Kempthorne score >5 was used solely as an eligibility threshold. Clinical examination, rigid otoscopy, pure-tone audiometry, conventional 226-Hz tympanometry, and WBT were performed. Intraoperative middle-ear fluid at myringotomy served as the positive reference standard in 31 operated ears; the remaining 35 non-operated ears were classified as disease-negative without surgical verification (composite reference standard with partial verification). An Results: All enrolled ears had Kempthorne scores >5. Against the 66-ear composite reference dataset (31 fluid-positive, 35 assumed fluid-negative), sensitivity/specificity/AUC were 100.0%/68.2%/0.84 for standard tympanometry, 77.4%/81.8%/0.91 for WBT alone, and 93.5%/86.4%/0.94 for the combined model (McNemar Conclusion: WBT combined with specific Kempthorne morphological features provided complementary morphological and absorbance information in adult OME. However, because standard tympanometry already achieved 100% sensitivity in the operated subset, any apparent advantage of the combined model in specificity, NPV, and AUC is derived largely from the surgically unverified reference-negative subset and must be interpreted with caution in light of severe partial verification bias.