Factors affecting the results of nonsurgical treatment of secretory otitis media in adults.
OBJECTIVE
There is only limited knowledge of the factors influencing the results of nonsurgical treatment of secretory otitis media (SOM) in adults. The present study was carried out to determine the effect of the middle ear (ME) inflation and to clear up the factors affecting the results of conservative treatment of SOM.


METHODS
A total of 198 adult patients were randomized to either a group receiving treatment with ME inflation for 10 days or to a group receiving ME inflation and antibiotics (oral Amoxicillin 500 mg 3/day) for 10 days or to a control group. A wide variety of anamnestic and clinical pre-treatment variables were assessed by administered questionnaires. Pneumo-otoscopy, tympanometry and pure-tone audiometry were performed before the treatment and at the 3-5th, 10th+/-2 and 60th+/-5 day of the study. For the prognostic factors, univariate analyses were first performed to determine the significant predictors, which were afterwards entered into a stepwise logistic regression model.


RESULTS
The effectiveness of treatment was 50.6% in Group A and 58.7% in Group B (control group-11%, P<0.001). The results of treatment were stable and were found unchanged 6 weeks after the treatment. The most important prognostic criteria were defined by analyzing the dynamics of tympanometry (OR, 2.17) and audiometry (OR, 10.27) during conservative treatment. The results of the treatment were related to the mastoid pneumatization, the pathology of paranasal sinuses, the previous history of SOM, the age, and the pre-treatment otoscopic data.


CONCLUSIONS
The results suggest, that daily ME inflation can be effective treatment for adults patients with SOM having regard to the factors significant for the prognosis of treatment.
Lesinskas
Eugenijus
E
Department of Otorhinolaryngology, Vilnius University Hospital Santariskiu klinikos, Vilnius University, Santariskiu 2, 2021 Vilnius, Lithuania. e.lesinskas@santa.lt
D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000379:methods*; D016017:Odds Ratio; D010034:Otitis Media with Effusion / Q000628:therapy*; D010406:Penicillins / Q000627:therapeutic use*; D011379:Prognosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D010406:Penicillins; D000658:Amoxicillin