title: Rates of tympanic membrane closure in double-tympanocentesis studies.
abstract: BACKGROUND
  Data on the outcome of tympanic membrane (TM) closure after tympanocentesis in acute otitis media (AOM) patients is limited.
  
  
  OBJECTIVE
  To analyze the dynamics of TM perforation closure after 1 or 2 tympanocentesis procedures performed at diagnosis and during AOM treatment.
  
  
  METHODS
  Study population included 113 children enrolled in 4 double-tympanocentesis studies. Only the files of patients whose first and second examination were performed by the same 2 otorhinolaryngologists were analyzed. Middle ear fluid (MEF) was cultured on day 1 and days 4-6, the latter only in initially culture-positive patients. Patients were also examined on days 11-14 and followed until days 22-28.
  
  
  RESULTS
  Ninety-three (82%) patients underwent tympanocentesis on days 4-6; 103 (91%) and 95 (84%) were evaluable on days 11-14 and 22-28, respectively. One hundred seventy-three ears underwent tympanocentesis on day 1 and 139 on days 4-6. Ninety-seven (86%) patients had positive MEF cultures. One hundred fifty-three (88%) tympanocentesis procedures performed at enrollment were closed on days 4-6. No differences were recorded in the closure rates as function of patient age, previous AOM history, MEF culture positivity, pathogens isolated at enrollment, and pathogen eradication on days 4-6. The 20 eardrums still open on days 4-6 were closed on days 11-14. Eleven (9%) of the evaluable ears tapped on days 4-6 were not closed on days 11-14 and 9 of 10 were closed on days 22-28.
  
  
  CONCLUSIONS
  TM perforation closed in most cases within a few days regardless of patient and disease characteristics, and 2 consecutive tympanocentesis procedures performed at short-time intervals are associated with good TM closure rates.
authors.affiliation: Department of Otolaryngology, Soroka University Medical Center, Israel.
authors.forename: Youval
authors.initials: Y
authors.lastname: Slovik
authors.forename: Simon
authors.initials: S
authors.lastname: Raiz
authors.forename: Alberto
authors.initials: A
authors.lastname: Leiberman
authors.forename: Moshe
authors.initials: M
authors.lastname: Puterman
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000382:microbiology; D019152:Paracentesis; D013997:Time Factors; D014432:Tympanic Membrane / Q000502:physiology*; D014945:Wound Healing