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Published on: May 23, 2021
Effect of myringotomy on prognosis in pediatric acute otitis media
Yuka Nomura1, Toshio Ishibashi, Jun Yano
1Department of Otolaryngology, University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo 113-8655, Japan. ikehara-tky@umin.ac.jp
Insights
Myringotomy, a surgical procedure, may help prevent the progression of otitis media with effusion (OME) in children with acute otitis media (AOM). This intervention showed lower OME rates compared to antibiotic treatment alone.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Acute otitis media (AOM) is a common childhood infection.
- The long-term clinical course and prognosis of AOM can be influenced by treatment strategies.
- Myringotomy is a procedure involving incision of the tympanic membrane.
Purpose of the Study:
- To compare clinical outcomes in children with AOM treated with or without myringotomy.
- To determine the effect of myringotomy on the long-term prognosis of AOM.
- To evaluate the incidence of otitis media with effusion (OME), early recurrence, and recurrent AOM.
Main Methods:
- A study involving 59 children diagnosed with AOM.
- Children were divided into two groups: Group A (antibiotics + myringotomy) and Group B (antibiotics alone).
- Clinical outcomes were assessed via otoscopy and tympanometry over a 12-week period.
Main Results:
- Progression to OME was significantly less frequent in the myringotomy group (16.7%) compared to the non-myringotomy group (43.5%) (P = 0.036).
- Early recurrence rates (30.6% vs. 34.8%) and recurrent AOM rates (25.0% vs. 13.0%) did not show significant differences between the groups.
- Myringotomy was associated with a reduced risk of developing OME post-AOM.
Conclusions:
- Myringotomy may be an effective intervention for preventing the progression of OME in children with AOM.
- The procedure showed a significant benefit in reducing OME development.
- Further research may explore the role of myringotomy in managing AOM complications.
Objective:
In children with acute otitis media (AOM), we compared clinical outcomes between groups with and without myringotomy to elucidate the effect of this procedure on long-term clinical course and prognosis.
Methods:
Fifty-nine children (29 male, 30 female) with tympanic membrane bulging or middle ear fluid (MEF) at initial presentation were assigned to one of two treatment groups. Group A received oral antibiotics and also underwent myringotomy at initial enrollment (36 cases), while group B received oral antibiotics without myringotomy (23 cases). Clinical outcomes were evaluated by otolaryngologic specialists using pneumatic otoscopy and tympanometry at 5, 10, 15, 30 days and 12 weeks and then every 2 weeks after the initial treatment. Otitis media with effusion (OME), early recurrence and recurrent AOM were used as the evaluation criteria for the prognosis.
Results:
In group A, 6 children (16.7%) showed transition to OME, 11 (30.6%) showed early recurrence of AOM, and 9 (25.0%) developed recurrent AOM. In group B 10, 8, and 3 (43.5%, 34.8%, and 13.0%) showed these respective adverse outcomes. While early recurrence rates and recurrent AOM rates did not differ significantly between groups, progression of OME was significantly less frequent in group A than group B (P = 0.036).
Conclusions:
Lower rates of progression to OME in the group undergoing myringotomy suggested that myringotomy might be effective in preventing this outcome.
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