Chronic otitis media with effusion sequelae in children treated with tubes.
OBJECTIVE
To determine incidence and prevalence of middle ear sequelae and abnormal tympanometry results among children with chronic otitis media with effusion (OME) who received standard treatment with tympanostomy tubes.


METHODS
Prospective cohort study.


METHODS
Community clinic and academic medical center. Patients A total of 140 children followed up for 8 years after tube treatment.


METHODS
Tympanic membrane perforation, atrophy, retraction, hearing loss, myringosclerosis, low static admittance (SA) and broad-peaked tympanogram, high SA and narrow-peaked tympanogram, and negative tympanometric peak pressure.


RESULTS
Annual incidence of sequelae was typically greater during 3 to 5 years than 6 to 8 years of follow-up. Greatest increases in incidence during the 5-year follow-up were for atrophy (67%), high SA and narrow-peaked tympanogram (70%), and retraction pocket (47%). Prevalence of these sequelae also increased over time, whereas low SA and broad-peaked tympanogram and negative tympanometric peak pressure decreased during follow-up. Sequela tended to become bilateral over time, and concordance of different sequelae in the same ear was low (kappa, 0.05-0.42).


CONCLUSIONS
Annual incidence of sequelae decreased during follow-up. This finding parallels decreasing incidence of OME and tube placement as children mature and demonstrates that sequelae are more likely to develop during active acute and chronic OME. The cumulative effect of incidence resulted in few ears free of sequelae by 8 years of follow-up. Based on this cohort of healthy children with OME, although the risk of sequelae decreased over time, functional and morphologic sequelae were prevalent and may put children at risk for continuing middle ear problems as they grow into adolescence and adulthood.
Daly
Kathleen A
KA
University of Minnesota Otitis Media Research Center, University of Minnesota School of Medicine, USA. dalyx002@umn.edu
Hunter
Lisa L
LL
Lindgren
Bruce R
BR
Margolis
Robert
R
Giebink
G Scott
GS
D000158:Acoustic Impedance Tests; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000150:complications* / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome