Spontaneous course and frequency of secretory otitis in 4-year-old children

Five repetitive tympanometric screenings performed during one year in 288 randomized, otherwise healthy 4-year-old children showed that 50% of ears changed tympanogram type between each trial. The total frequency of secretory otitis was high; thus, 32% of all 576 ears had type B at least once and 73% had either type B or C2, indicating a middle ear pressure of -200 mm H2O or lower. At three trials during at least six months, 8% had type B and 24% either type B or C2. The spontaneous improvement of secretory otitis was high, and type B improved in 78% to 88% of ears, although in some ears the type again deteriorated. Severe changes of the tympanic membrane were found in 0.5% of ears, and it is therefore advised to postpone surgical treatment of secretory otitis for three to six months.