Pars tensa and pars flaccida retractions in persistent otitis media with effusion.
OBJECTIVE
In children with otitis media with effusion (OME), to investigate the incidence of, and any association, between retractions of the pars tensa and pars flaccida; to assess the effect of pars tensa and pars flaccida retractions on the hearing; to investigate risk factors for retractions; and to document the natural history of such retractions over a 12-week 'watchful aiting" period.


METHODS
Prospective, observational study.


METHODS
Sixteen departments of otolaryngology in hospitals in the U.K.


METHODS
A cohort of 1,267 children aged 3.25 to 6.75 years with confirmed OME. None had previously received surgical intervention.


METHODS
Follow-up over a "watchful waiting" period of 12 weeks.


METHODS
Otoscopy and pure-tone audiometry.


RESULTS
Retraction of the pars tensa to the incus or promontory occurred in 8% of the better-hearing ears and 10% of the poorer-hearing ears. Pars flaccida retraction to the malleus or farther occurred in 4.5% of the better-hearing ears and 5.5% of the poorer-hearing ears. Retractions were not associated with a longer history of hearing problems. Pars tensa or pars flaccida retraction in association with OME did not materially affect the hearing. Pars tensa retractions, followed up over a 12-week period, resolved in 69% of the better-hearing ears and 65% of the poorer-hearing ears. In 14% and 10% of ears, respectively, the OME had also resolved.


CONCLUSIONS
There is minimal evidence to support the concept that pars tensa or pars flaccida retractions are a strong or relevant marker for the severity or evolution of OME in children. Prospective studies over a longer period of follow-up are required to confirm this.
D000158:Acoustic Impedance Tests; D001301:Audiometry, Pure-Tone / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019370:Observation; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014432:Tympanic Membrane / Q000503:physiopathology*