Audiological aspects on treatment of SOM. Indications and results

Recent prospective epidemiology studies of unselected groups of children consistently show as main findings that up to 70-80% of all children will suffer from at least one episode of SOM, and that approx. 80% of them recover within a few months without any treatment at all. These facts call for quite new concepts in dealing with indication and treatment, and they highlight the complexity in deciding why, when, who, and how to treat the condition at the clinic. After a brief overview of the literature on record, some results are given from our long-term, still ongoing cohort-studies on SOM and related middle ear disorders, in which we have closely followed two full birth-cohorts (ca 1,000 children in the municipality of Hjørring, Denmark) from their 3rd to 10th year of life. Evaluating cost-benefit and cost-effectiveness of various treatment regimes, and taking the marked tendency to spontaneous cure into account, some guidelines for selecting, timing, and choice of therapy are set in order to minimize the imminent risk of both over- and undertreatment of children with SOM.