Effect of myringotomy on prognosis in pediatric acute otitis media.
OBJECTIVE
In children with acute otitis media (AOM), we compared clinical outcomes between groups with and without myringotomy to elucidate the effect of this procedure on long-term clinical course and prognosis.


METHODS
Fifty-nine children (29 male, 30 female) with tympanic membrane bulging or middle ear fluid (MEF) at initial presentation were assigned to one of two treatment groups. Group A received oral antibiotics and also underwent myringotomy at initial enrollment (36 cases), while group B received oral antibiotics without myringotomy (23 cases). Clinical outcomes were evaluated by otolaryngologic specialists using pneumatic otoscopy and tympanometry at 5, 10, 15, 30 days and 12 weeks and then every 2 weeks after the initial treatment. Otitis media with effusion (OME), early recurrence and recurrent AOM were used as the evaluation criteria for the prognosis.


RESULTS
In group A, 6 children (16.7%) showed transition to OME, 11 (30.6%) showed early recurrence of AOM, and 9 (25.0%) developed recurrent AOM. In group B 10, 8, and 3 (43.5%, 34.8%, and 13.0%) showed these respective adverse outcomes. While early recurrence rates and recurrent AOM rates did not differ significantly between groups, progression of OME was significantly less frequent in group A than group B (P = 0.036).


CONCLUSIONS
Lower rates of progression to OME in the group undergoing myringotomy suggested that myringotomy might be effective in preventing this outcome.
Nomura
Yuka
Y
Department of Otolaryngology, University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo 113-8655, Japan. ikehara-tky@umin.ac.jp
Ishibashi
Toshio
T
Yano
Jun
J
Ichikawa
Tomoya
T
Shinogami
Masanobu
M
Monobe
Hiroko
H
Hirai
Ryoji
R
Kaga
Kimitaka
K
D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000188:drug therapy / Q000601:surgery*; D038781:Otoscopy; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*
D000900:Anti-Bacterial Agents