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Disappearance of middle ear effusion in acute otitis media monitored daily with tympanometry
Marjo Renko1, Tero Kontiokari, Katariina Jounio-Ervasti
1Department of Paediatrics, University of Oulu, Oulu, Finland. marjo.renko@oulu.fi
Background:
Disappearance of middle ear effusion is one of the most important outcomes in the treatment of acute otitis media (AOM).
Aim:
To evaluate the duration of effusion in AOM treated by antimicrobials and to find factors influencing it.
Methods:
Parents of 90 children with AOM monitored daily the disappearance of effusion with tympanometry. The children were randomly allocated to be treated with either oral amoxicillin or cefuroxime-axetil for 10 d. Daily monitoring lasted for 14 d or until the tympanogram was normal (curve A or C) in both ears. Pneumatic otoscopy was carried out every 2 wk.
Results:
Normal tympanograms were obtained after a median time of 7.5 d (range 1-58 d) among 75 successfully monitored patients. In two-thirds (69%) of them, effusion resolved in 14 d. The median duration of effusion did not differ significantly between the two treatment groups (8 vs 7 days, p=0.7). The children who had unilateral AOM cured more rapidly than those with bilateral AOM (5 vs 19 d, p<0.001). In logistic regression analysis adjusted for age, bilaterality explained treatment failure at 2 wk with an odds ratio of 28.1 (95% CI 4.6-169.5, p<0.001).
Conclusion:
The choice of antimicrobials did not influence the duration of middle ear effusion, which was much shorter than had been thought previously. Children with unilateral AOM were cured much more quickly than those with bilateral AOM.
Insights
The duration of middle ear effusion in acute otitis media (AOM) was shorter than previously believed. Unilateral AOM resolved faster than bilateral AOM, regardless of antimicrobial choice.
Area of Science:
- Otolaryngology
- Pediatrics
- Infectious Diseases
Background:
- Middle ear effusion resolution is a key treatment outcome for acute otitis media (AOM).
- Understanding effusion duration is crucial for effective AOM management.
Purpose of the Study:
- To determine the time course of middle ear effusion disappearance in children with AOM.
- To identify factors influencing effusion resolution duration in AOM patients.
Main Methods:
- A study involving 90 children diagnosed with AOM.
- Daily tympanometry monitoring for effusion resolution over 14 days.
- Randomized treatment with oral amoxicillin or cefuroxime-axetil for 10 days.
Main Results:
- Median effusion resolution time was 7.5 days (range 1-58 days) in 75 patients.
- Two-thirds of patients achieved effusion resolution within 14 days.
- Unilateral AOM resolved significantly faster (5 days) than bilateral AOM (19 days), irrespective of antibiotic treatment.
Conclusions:
- Antimicrobial choice (amoxicillin vs. cefuroxime-axetil) did not impact middle ear effusion duration.
- Effusion resolution in AOM occurred more rapidly than previously assumed.
- Unilateral AOM demonstrates a significantly faster recovery profile compared to bilateral AOM.
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