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Purulent otitis media in children and adults
Muhammet Tekin1, Patricia A Schachern, Cemil Mutlu
1The Otitis Media Research Center, Department of Otolaryngology, University of Minnesota Medical School, Minneapolis, USA.
Abstract:
This study was designed to compare tympanic membrane (TM) and middle ear (ME) pathologies of temporal bones from children and adults with purulent otitis media (POM). Thirty-four temporal bones were used from 22 subjects ages 2 days to 76 years with histopathologic evidence of POM. There were 55 age-matched controls. Histopathologic findings of the TM and ME in children and adults with POM were compared. Clinical histories and the presence of complications were recorded. The incidence of POM was more common in male children than in females. There was a significant increase in the thickness of the posterosuperior and posteroinferior quadrants in children with POM compared to non-OM children. In adults with POM, there was a significant decrease in the thickness of the posteroinferior and anteroinferior quadrants compared to non-OM adults. Children with POM showed a significant increase in the anterioinferior and posteroinferior quadrants and the umbo compared to adults with POM. Pathology of the TM and ME occurred in adults and children, but severity was greater in children. Residual mesenchyme was frequently observed in temporal bones of children. Serious complications such as labyrinthtis and meningitis were observed more frequently in children. All cases with meningitis had labyrinthitis, previous histories of otitis media and had been treated with antibiotics. Although POM occurs in both children and adults, pathologic changes of the middle ear are more severe, and complications (labyrinthitis and meningitis) occur more often in children. Our findings suggest the need to monitor children carefully under the age of 2 years who have POM.
Insights
Purulent otitis media (POM) causes more severe middle ear pathology in children than adults. Children with POM face higher risks of serious complications like labyrinthitis and meningitis, necessitating careful monitoring.
Area of Science:
- Otolaryngology
- Pediatric Pathology
- Histopathology
Background:
- Purulent otitis media (POM) is a common infection affecting both children and adults.
- Understanding the differences in tympanic membrane (TM) and middle ear (ME) pathology between pediatric and adult POM is crucial for effective management.
- Previous studies have not fully detailed the comparative histopathologic changes and complication rates in pediatric versus adult POM.
Purpose of the Study:
- To compare the histopathologic findings of the tympanic membrane (TM) and middle ear (ME) in children and adults with purulent otitis media (POM).
- To analyze the incidence and severity of POM-related pathologies in different age groups.
- To identify differences in complication rates, such as labyrinthitis and meningitis, between children and adults with POM.
Main Methods:
- Histopathologic examination of 34 temporal bones from 22 subjects (2 days to 76 years) with confirmed POM.
- Comparison of findings with 55 age-matched controls without otitis media (OM).
- Analysis of clinical histories and recorded complications.
Main Results:
- POM was more prevalent in male children. Children with POM showed increased TM thickness in specific quadrants compared to non-OM children.
- Adults with POM exhibited decreased TM thickness in certain quadrants compared to non-OM adults.
- Children with POM had more severe TM and ME pathology, frequent residual mesenchyme, and higher rates of labyrinthitis and meningitis compared to adults with POM.
Conclusions:
- Pathologic changes in the middle ear due to POM are more severe in children than in adults.
- Children with POM have a significantly higher risk of developing serious complications like labyrinthitis and meningitis.
- Close monitoring of children, especially those under 2 years, with POM is recommended due to increased susceptibility to severe outcomes.