OBJECTIVES: to present and discuss diagnostic aspects of middle ear infection with effusion at a primary health care clinic. METHODS: research was carried out using the Medline, Lilacs and SciELO databases (1994-2004). Five hundred and twenty-three articles were found, of which 30 were considered for this review. RESULTS: the study revealed considerable disparity with regard to definitions, inconsistency in terms of clinical profile and a lack of standardization of diagnostic criteria. This has contributed to inadequate diagnosis of otitis media with effusion (OME). Evidence leading to a diagnosis of effusion were: a) at least two eardrum abnormalities relating to discoloration, darkening and mobility; and/or b) tympanic membrane (MT) typically retracted, concave, and with altered coloration; and/or c) reduced mobility or absence of mobility on pneumatic otoscopy (PO). The PO was shown to be more accurate than simple otoscopy (SO), which is considered the method of choice for diagnosis of OME. When the pneumatic otoscopy is inconclusive, tympanometry may recommended, as this increases the accuracy of the diagnosis. CONCLUSIONS: in clinical practice, diagnosis of OME should be carried out principally by way of pneumatic otoscopy, to which all children suspected of having OME should be submitted. Where there is doubt, tympanometry is recommended.
Otitis media with effusion; Diagnosis; Pediatrics
