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Eustachian tube function and tympanic membrane findings after chronic secretory otitis media
Marie Ryding1, Peter White, Olof Kalm
1Department of Otorhinolaryngology, Hospital of Ostersund, SE-831-83, Ostersund, Sweden. marie.ryding@jll.se
Objective:
The etiology of secretory otitis media (SOM) is multifactorial. The main factors discussed are infection and tubal dysfunction. This study aimed to detect poor tubal function and tympanic membrane pathology in young adults after extremely long-standing SOM.
Methods:
Thirty-four patients, 16-25 years old, with previous chronic SOM persisting at least 6 years (mean 11.2 years, range 6.2-18.6 years), were retrospectively examined at a mean of 18 years after their first myringotomy or tube insertion and comparison was made with 15 controls. The medical records were scrutinized, otomicroscopic examination was performed and the Eustachian tube function was studied in a mini pressure chamber.
Results:
The mean age at SOM onset was 2.4 years (range 0.5-8.4 years) and the mean period from the last myringotomy or when the last tube had disappeared to follow-up was 6.7 years (range 1.3-12.8 years). Tympanic membrane pathology was found in 76% of the ears of SOM patients and in none (0%) of controls (P<0.001). The youngest patients had more atrophy than the older patients (P<0.05) and more myringosclerosis was observed in patients with shorter interval between SOM ending and examination. The patients were found to have significantly poorer active tubal function; i.e. higher inability to equilibrate negative or negative and positive middle ear pressure, compared with controls (P<0.001). The majority of the patients (74%) still experienced some kind of discomfort in their ears at the time of examination.
Conclusions:
Still in adulthood patients with chronic SOM during childhood exhibit dysfunction of the tube and tympanic membrane pathology to a high extent.
Insights
Children with chronic secretory otitis media (SOM) often experience lasting Eustachian tube dysfunction and tympanic membrane issues into adulthood. This study confirms persistent ear problems in adults with a history of long-standing SOM.
Area of Science:
- Otolaryngology
- Pediatric Otitis Media Research
- Auditory Health
Background:
- Secretory otitis media (SOM) is a common childhood condition with multifactorial causes, including infection and Eustachian tube dysfunction.
- Chronic SOM persisting for years can potentially lead to long-term sequelae in the middle ear and auditory system.
Purpose of the Study:
- To investigate the long-term effects of chronic secretory otitis media (SOM) in young adults.
- To assess the prevalence of Eustachian tube dysfunction and tympanic membrane pathology in individuals with a history of long-standing SOM.
Main Methods:
- Retrospective examination of 34 young adults (16-25 years) with a history of chronic SOM (≥6 years).
- Comparison with 15 healthy controls.
- Evaluation included otomicroscopy, medical record review, and Eustachian tube function testing using a mini pressure chamber.
Main Results:
- 76% of SOM patients exhibited tympanic membrane pathology, compared to 0% in controls (P<0.001).
- Patients demonstrated significantly poorer active Eustachian tube function (P<0.001).
- 74% of patients reported ongoing ear discomfort in adulthood.
Conclusions:
- Chronic secretory otitis media during childhood is associated with significant Eustachian tube dysfunction and tympanic membrane pathology persisting into adulthood.
- These findings highlight the importance of long-term monitoring and management of individuals with a history of chronic SOM.