title: Pars tensa and pars flaccida retractions in persistent otitis media with effusion.
abstract: 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.
mesh_terms: 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*