title: Course and long-term outcome of 'refractory' secretory otitis media.
abstract: OBJECTIVE
  The course and the long-term outcome of 'refractory' secretory otitis media (SOM), defined as continuous SOM for more than 6 years, were studied in 52 young patients. They had during childhood been treated for bilateral SOM on average for 12 years (range 6 to 26 years). The mean interval between resolution of SOM and examination was 7 years.
  
  
  METHODS
  At follow up the patients' medical records were scrutinized with regards to transmyringeal ventilation tubes, adenoidectomy, sequelae and complications, and a questionnaire was filled in to document other diseases.
  
  
  RESULTS
  The onset of SOM showed two peaks, one at the age of one year and one at the age of 3.5 years. Patients whose onset of SOM was related to an episode of acute otitis media (AOM) were younger at SOM onset than those who had no such relation. Otorrhoea and AOM episodes were more frequent during the SOM periods, with blocked or expelled tubes, than during periods with patent tubes. Cholesteatoma were seen in 3 per cent and perforations in 5 per cent of patients.
  
  
  CONCLUSIONS
  Extremely long-standing SOM does not necessarily result in myringeal perforation or cholesteatoma to a greater extent than that seen in patients with shorter durations of SOM. However, at follow up one-third of the patients reported hearing impairment and a majority felt discomfort when flying or diving.
authors.affiliation: Department of Otorhinolaryngology, Hospital of Ostersund, Ostersund, Sweden. marie.ryding@jll.se
authors.forename: Marie
authors.initials: M
authors.lastname: Ryding
authors.forename: Peter
authors.initials: P
authors.lastname: White
authors.forename: Olof
authors.initials: O
authors.lastname: Kalm
mesh_terms: D000208:Acute Disease; D000233:Adenoidectomy; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000209:etiology; D002908:Chronic Disease; D018450:Disease Progression; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation / Q000379:methods; D010034:Otitis Media with Effusion / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D018058:Tympanic Membrane Perforation / Q000209:etiology