[Results of treatment with tympanostomy tubes in children with otitis media with effusion].
BACKGROUND
Otitis media with effusion is a common problem in childhood. The tympanostomy tubes is a standard treatment of persistent otitis media with effusion in children which improves hearing level. However some pathological changes of the tympanic membrane and middle ear few years after treatment are observed. The aim of the study was prevalence of middle ear sequelaes in children with persistent otitis media with effusion treated by tympanostomy tubes 4-10 years after treatment.


METHODS
The group of 61 patients aged between 1-13 with otitis media with effusion treated by tympanostomy tubes in Department of Otolaryngology Childrenís Hospital in Warsaw between 1994-2001 were controlled. 113 ears treated with tympanostomy tubes were examined 4-10 years after treatment. At the examination otomicroscope, pure-tone audiometry and tympanometry were used.


RESULTS
Out of the 113 ears after ventilation tubes insertion as a method of otitis media with effusion treatment in 83 (73%) developed one or more middle ear sequelaes. Myringosclerosis in 47 ears (41,59%), segmental atrophy in 19 ears (16,81%), atrophy in 14 ears (12,38%), disfunction of Eustachian tube in 8 ears (7,07%), otitis media with effusion in 7 ears (6,19%), perforation of tympanic membrane in 6 ears (5,3%), chronic otitis media in 2 ears (1,76%), retraction pocket in 2 ears (1,76%) and tympanostomy tube in the middle ear cavity in 1 ear (0,88%) were found. No cases of cholesteatoma were found. In 22 ears (19,46%) the conductive hearing loss was greater than 20 dB. In 4 ears (3,5%) mixed hearing loss and in 3 ears (2,6%) receptable hearing loss was diagnosed. Tympanogram type A was in 86 ears (76,1%), tympanogram type B was in 11 ears (9,7%) and tympanogram type C was in 12 ears (12,6%).


CONCLUSIONS
In children with otitis media with effusion treated with tympanostomy tubes the amount of sequelaes increased with time. In children with otitis media with effusion who started treatment with tympanostomy tubes in age to 4 years old the amount of sequelaes is less. The follow-up is recommended up to 8 years after the treatment.
Zielnik-Jurkiewicz
Beata
B
Oddział Otolaryngologiczny, Szpital Dzieciecy SZPZOZ im prof J Bogdanowicza w Warszawie.
Olszewska-Sosińska
Olga
O
Rakowska
Magdalena
M
D000158:Acoustic Impedance Tests; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000473:pathology / Q000601:surgery*; D011044:Poland; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery*