What Does "Bilateral B Type Tympogram With Absent Reflexes" Mean?

Posted on Wed, 9 Apr 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 9 Apr 2014 Answered on

Sat, 26 Apr 2014 Last reviewed on

Question : Hello dr Finally my pead dr sent to ENT dr.ssheelu XXXXXXX fortis today. My son checked by her and asked for impedance test which gave result Bilateral b type tympogram with absent reflexes. S/o middle ear pathology. What is it mean.i attached report. Dr told it z some fluid in ear and advised adenoidectomy with fluid removal.

Answered by Dr. Sriram Nathan (35 minutes later)

hello again, This essentially just means that the adenoids has caused a block in the Eustachian tube and caused a negative pressure which makes the fluid to collect in the ear. This can be temporary or permanent and is very very common and definitely a single result is never an indication for adenoidectomy unless the hearing is reduced to more than 40 percent or decibel in either ear. If you continue the antihistamine and steroid spray the fluid levels will go down in a couple of weeks. I have even done a study on more than three hundred kids with this condition which is called the otitis media with effusion or serous otitis media and I would definitely recommend a wait and watch approach. In any case my advice is just wait for a couple of weeks and continue the medications and after that repeat the impedance test and also ask for Free field audiometry and also BERA which can quantify the amount of hearing loss. Then you can take a call on adenoidectomy which as I mentioned earlier is a relatively safe and simple surgery in any case. Make sure that when this is done the surgeon also removes the fluid by a procedure called Myringotomy and also if the fluid is very high then he must also place tubes called the ventilation tubes or Grommet. You can get back to me on this any time. Hope this helps and just don't worry! this is a common finding in every kid having even a common cold! take care regards Dr Sriram Nathan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sriram Nathan (14 hours later)

Yes sure we are going to wait this whole month and planning surgery only aftrr april...if still he suffer. Ur guidance is great and I will talk my dr about all. Antihistamines means levocetrizi or any other syrup? Im continue metaspray until april end. Doing steam inhalation. Given levocetrizi for 1 month continuesly.

Answered by Dr. Sriram Nathan (7 minutes later)

hello and always glad to help in anyway!! antihistamine like levocetrizine is good although in most of my patients I would also add Monteleukast for a couple of weeks. Your doctor will definitely know about this. In any case wait and watch and any doubts you can always get back to me regards Dr Sriram Nathan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sriram Nathan (17 minutes later)

Sorry again sir Yes Im using levocetrizi mont. Will check again after 2 weeks. Last month my XXXXXXX had swelling below right ear and pain.my pead dr told it is salivary gland infection not due to adenoid treated with antibiotic. Is that showed a sign of ear problem adue to adenoid?

Answered by Dr. Sriram Nathan (6 minutes later)

hello again, Continue the syrup....the combination is fine The swelling would probably be a node which is common in tonsil or adenoid infection and will definitely become better or go away in a week or two. It may rarely be due to salivary gland also but that's also nothing to worry about. Just continue the medication and make sure he drinks plenty of warm water, that is he is well hydrated. Even otherwise neck node swelling is common in kids and unless it is persisting or growing in size or having severe pain for long periods you have nothing to worry about. In fact such swellings are hallmarks of tonsils infections and definitely benign. regards Dr Sriram Nathan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar