Hamadan nursery school which 1196 people young than 5 years old were assessed by octoscopic examinations tympanometery test and acoustic reflexes for two stages. The first stage of assessment was done in nursery school and doubted babies who were suffering of I.M.E.D. after two or three weeks, they were referred to audioly department of Imam Khoemini hospital in order to specialized assessment, also in this research. We wanted to study effects of basic factors such as: age degree of family’s eduaction, sex and exonomic situation of family’s which can help probability appearances I.M.E.D on this group.

We wanted to study the worth of otoscopic examinations tympanometery test and acoustic reflexes in distinction of those diseases.

219 out of 1196 people were suffering ear disease upper respiratory system. This number, 219 people, was divided in groups as followed:

-115 people were suffering impact ceruminum

-75 people were suffering acute secretory otitis media. 17 people were suffering subacute secretory otitis media.

-11 people were suffering eustachian tube dysfunction, and a case was suffering microcia.

Some now results were acquired: there were direct relationships between probability appearance of I.M.E.D, and age mother’s education and income while there weren’t these relationships between sex and father’s education and also the worth of tympanometery test was more than otoscopic examination in order to distinguish I.M.E.D and finally acoustic reflex test, has a high validity as a diagnostic test in determining I.M.E.D.