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Late effects on ear disease in otitis-prone children: a long-term follow-up study
1Department of Otorhinolaryngology, University of Lund, Malmö General Hospital, Sweden.
Insights
Otitis-prone children often continue to experience acute and secretory otitis media, with many requiring surgery. Continuous ENT specialist follow-up is crucial for middle ear normalization.
Area of Science:
- Pediatric Otolaryngology
- Otolaryngology Research
- Middle Ear Disease Studies
Background:
- Otitis-prone children are characterized by recurrent acute otitis media (AOM) episodes.
- A cohort born between 1978-1981 with over 11 AOM episodes was studied.
- Previous otitis media history significantly impacts long-term middle ear health.
Purpose of the Study:
- To assess the long-term progression of middle ear conditions in otitis-prone children.
- To evaluate the effectiveness of ongoing otolaryngological management.
- To identify key indicators for stable middle ear normalization.
Main Methods:
- Longitudinal study of 88 otitis-prone children (initial exam 1984-85, follow-up 1990-92).
- Medical history review of ear, nose, and throat diseases.
- Clinical examinations including otomicroscopy, tympanometry, and audiometry.
Main Results:
- 69% experienced recurrent AOM, 46% had persistent secretory otitis media (SOM).
- 34% underwent surgery, commonly for ventilation tubes.
- Tympanic membrane health improved (35% to 60% normal), but scarring/tympanosclerosis increased (13% to 27%).
- Audiometry showed limited correlation with tympanic membrane pathology.
Conclusions:
- Otitis-prone children require sustained management by an ear, nose, and throat specialist.
- Continuous follow-up is essential until stable middle ear normalization is achieved.
- Early and consistent intervention can improve long-term outcomes for recurrent ear infections.
Abstract:
A group of 88 otitis-prone children, 66% boys and 34% girls, born in 1978-81 with more than 11 episodes of acute otitis media, were examined in 1984-85. Seventy-four of the children (with the same distribution of sex) were reexamined in 1990-92. Their medical history of ear, nose and throat diseases was studied and an examination, including otomicroscopy, tympanometry and audiometry, was performed. Fifty-one (69%) continued to have episodes of acute otitis media during the follow-up period and 34 (46%) continued to have episodes of secretory otitis media. Surgery had been performed during this period in 25 (34%) and most common was the need for ventilation tubes. The condition of the tympanic membranes showed improvement for many children. In 1984-85, 31 (35%) of the children had normal tympanic membranes and in 1990-92, 44 (60%). Scar/tympanosclerosis was more common at the follow-up examination: 11 (13%) vs. 20 (27%). In 1984-85 one child was found to have a central perforation and in 1990-92, 5 children were found to have adhesive otitis, chronic secretory otitis or central perforation. No cases of cholesteatomas were found in 1984-85 or in 1990-92. Audiometry was found to be a poor indicator of ear-drum pathology The results support the opinion that otitis-prone children should be treated and continuously followed by an ear, nose and throat specialist until a stable normalization of the middle-car is observed.