title: Clinical characteristics of pediatric granular myringitis.
abstract: OBJECTIVE
  To determine the clinical characteristics of children with granular myringitis.
  
  
  METHODS
  Case series with chart review of children with granular myringitis.
  
  
  METHODS
  Tertiary care children's hospitals in Delaware and Florida.
  
  
  METHODS
  From July 1, 2006, to June 30, 2011, 15 patients were identified with granular myringitis based on International Classification of Diseases, Ninth Revision code 384.1 (10 male, 5 female; 10 left-sided, 5 right-sided).
  
  
  RESULTS
  Average age at onset was 10 years (range, 4-18 years). Average length of symptoms was 21 months (range, 3-48 months). Thirteen of the 15 patients (87%) had myringotomy tube placement prior to diagnosis of myringitis, and 11 had a previous perforation (73%). Eleven myringoplasties were performed on 8 (53%) patients prior to the onset of granular myringitis (5 fascia, 2 fat, 2 cartilage, 1 paper patch, and 1 at an outside hospital that was unknown). A total of 27 otolaryngologic surgical procedures were done on 14 of 15 patients. Ten patients (67%) had audiometry performed, and 6 (40%) had ear cultures. Medical treatment included ciprofloxacin and dexamethasone otic drops in all patients, oral antibiotics in 4 patients, and additional topical agents in 8 patients. Two patients had laser resurfacing, and 1 patient had surgical curettage. Five patients had long-term remission, 8 had intermittent remission, and 2 had no remission of their symptoms.
  
  
  CONCLUSIONS
  Granular myringitis is a chronic, recalcitrant disease typically preceded by myringotomy and tube placement or myringoplasty/tympanoplasty. Medical and surgical intervention is varied and often does not lead to permanent resolution of the disease.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Boston University/Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Levi
authors.forename: Julie A
authors.initials: JA
authors.lastname: Ames
authors.forename: Lyuba
authors.initials: L
authors.lastname: Gitman
authors.forename: Thierry
authors.initials: T
authors.lastname: Morlet
authors.forename: Robert C
authors.initials: RC
authors.lastname: O'Reilly
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003691:Delaware / Q000453:epidemiology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006099:Granuloma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D009225:Myringoplasty; D010031:Otitis / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D014432:Tympanic Membrane / Q000473:pathology*