![]() Incorporation of SS in clinical practice may require focused training to detect this specific examination finding. ![]() CONCLUSIONS The presence of SS may represent a useful adjunct in the detection of pediatric MEE, with high measured sensitivity and specificity. The Fleiss κ score for interrater concordance among pediatricians was 0.21 (residents) to 0.24 (staff), and that among otolaryngology residents was 0.61 (all P <. The sensitivity, specificity, positive predictive value, and negative predictive value for the SS for MEE were 100% (79/79), 93% (66/71), 94% (79/84), and 100% (64/64), respectively. ![]() Forty-nine patients (64%) had SS in at least 1 ear. RESULTS Seventy-six patients (150 ears) were included in the study. Videos taken before myringotomy were subsequently shown to independent pediatricians and otolaryngology residents to analyze interrater concordance in evaluating the presence of SS. Statistical analysis was performed to determine the value of SS as a predictor of MEE, with myringotomy as the criterion standard. Intraoperatively, the presence or absence of SS was noted before myringotomy and that of MEE was noted after myringotomy. Theres at least one success story of someone using Dexamethasone through ear tubes or a wick instead. I got steroid injections for Ménière’s disease. An observational screening test study was performed prospectively with enrollment of consecutive pediatric patients scheduled for tympanostomy tube placement. Cause of Tinnitus: Noise Induced, Prednisone (drones), Barotrauma (distortions) Brian P said. METHODS The SS was defined as a dull gray appearance of the tympanic membrane with engorged vasculature in an arrangement similar to the spokes of a bicycle wheel, covering 50% or more of the inferior tympanic membrane by area. OBJECTIVE To determine the prevalence and diagnostic usefulness of the "spoke sign" (SS), a specific otoscopic finding, in detecting the presence of pediatric middle ear effusion (MEE).
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