Repeated tympanometric screening for middle ear disturbances in a regionally defined population of 3-year-old children singled out a group of 44 children in whom abnormal results persisted through 6 months. These children were treated by paracentesis, and the operative findings were compared with the preoperative serial tympanometry. A common finding in all these children was an extremely fluctuating tubal function which did not grow less labile during the preoperative observation despite successive exclusion of the spontaneously normalized cases. From the dynamic point of view, the flat tympanogram was the tympanometric equivalent of middle ear effusion, while a negative middle ear pressure had to be interpreted as a sign of transition to remission or progression. The viscosity of the effusion was no reliable parameter for the severity of the disease, unlike the quantity of effusion which much better reflected the preoperative duration of the tubal dysfunction as well as its tendency.

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