Tympanometry: Best practice guidelines [2, 3] recommend pneumatic otoscopy and tympanometry for the diagnosis of OME. Tympanometry is a non-invasive test measuring tympanic membrane movement and middle ear air pressure — a proxy for determining the presence of middle ear effusion — and is depicted in graphical form (tympanogram). Tympanograms are classified as type A, B, C1, C2, or C3. Peaked type A and C1 tympanograms indicate the absence of effusion consistent with normal middle ears. A flat type B trace is diagnostic of middle ear effusion in the absence of pain and/or a bulging or perforated tympanic membrane. Type C2 and C3 peaked traces are characterised by significant negative middle ear pressure and are considered equivocal and cannot be used to either diagnose or exclude OME [4, 5].