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Resolution of middle ear effusion in newborns
D G Roberts1, C E Johnson, S A Carlin
1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Archives of Pediatrics & Adolescent Medicine
|August 1, 1995
Summary
Middle ear effusion (MEE) in newborns typically resolves within 72 hours. Pneumatic otoscopy shows excellent agreement for diagnosing MEE in neonates after the initial nursery period.
Area of Science:
- Neonatal care
- Otolaryngology
- Pediatric audiology
Background:
- Middle ear effusion (MEE) is common in newborns.
- Accurate diagnosis and understanding the natural history of MEE in neonates are crucial for appropriate management.
- Pneumatic otoscopy, tympanometry, and acoustic reflex measurements are used to evaluate the middle ear.
Purpose of the Study:
- To determine the natural history of middle ear effusion (MEE) in newborns.
- To compare the diagnostic efficacy of pneumatic otoscopy, tympanometry, and acoustic reflex measurements for MEE in neonates.
Main Methods:
- A descriptive natural history study was conducted in a county hospital nursery and pediatric clinic.
- Sixty-eight healthy, full-term neonates were evaluated daily for up to 3 days using otoscopy, tympanometry, and acoustic reflex measurements.
- Follow-up evaluations were performed at 2 weeks and 2 months of age.
Main Results:
- All neonates presented with MEE in both ears within the first 3 hours of life.
- By day 3, MEE resolved in 73% of ears via otoscopy, 88% via acoustic reflex, and 92% via tympanometry.
- At 2 weeks, 13% of ears showed MEE, primarily newly acquired and asymptomatic. Interobserver agreement for otoscopy was excellent at 2 weeks and 2 months.
Conclusions:
- Middle ear effusion in neonates generally resolves within 72 hours.
- Pneumatic otoscopy demonstrates excellent interobserver agreement for diagnosing MEE in neonates after the nursery discharge.
- MEE diagnosed later in infancy is often new and asymptomatic.