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Middle ear inflation as a treatment for secretory otitis media in children
Y Kaneko1, T Takasaka, M Sakuma
1Department of Otorhinolaryngology, Tohoku University, Sendai, Japan.
Insights
Middle ear inflation shows promise for treating secretory otitis media (SOM) in children. Treatment effectiveness varied by season, with spring showing better outcomes for some patients.
Area of Science:
- Otolaryngology
- Pediatrics
- Audiology
Background:
- Secretory otitis media (SOM) is a common condition in children.
- Effective treatment options for SOM are continually being researched.
- Understanding factors influencing treatment outcomes is crucial for clinical practice.
Purpose of the Study:
- To evaluate the efficacy of middle ear inflation for treating SOM in children.
- To investigate the influence of seasonal and aging factors on treatment outcomes.
- To compare different time sequences of tympanogram (TG) changes following inflation.
Main Methods:
- 149 children (ages 3-9) diagnosed with SOM underwent 2 months of middle ear inflation treatment (Politzer's method or modified).
- Pneumatic-otoscopic findings and type B tympanograms were used for diagnosis.
- Tympanogram changes were categorized into TG-improved and TG-unchanged groups.
Main Results:
- The TG-improved group demonstrated a significantly higher healing rate than the TG-unchanged group at 2 months.
- SOM cure rates were higher in spring compared to autumn for the TG-unchanged group.
- No significant age-related differences in healing rates were observed between 3-5 and 6-9 year-old children.
Conclusions:
- Middle ear inflation is a viable treatment for SOM, with outcomes influenced by TG response.
- Seasonal variations, particularly a higher cure rate in spring, impact SOM treatment.
- Persistent SOM (TG-unchanged) in autumn warrants more intensive treatment, especially in young children.
Abstract:
Clinical evaluations of middle ear inflation for secretory otitis media (SOM) were performed with special emphasis on the influence of seasonal and aging factors. One hundred and forty-nine children between the ages of 3 and 9 years (227 ears) were all diagnosed as SOM by pneumatic-otoscopic findings, and type B tympanogram (TG) at 3 weeks or more after the onset of acute SOM or the initial observation of SOM. Middle ears were inflated by Politzer's method or by our modified method once or twice each week for 2 months. After inflation, TG displayed two different time sequences: one group changed to the A or C type immediately after inflating the ear one or more times, but usually returned gradually to the B type (TG-improved group): and the other group remained without any changes (TG-unchanged group) for the duration of this study. The healing rate in the TG-improved group was significantly higher than in the TG-unchanged group at the 2-month endpoint. The cure rate of SOM was significantly higher in spring than in autumn in the TG-unchanged group but not in the TG-improved group. There were almost no differences between the healing rates in the 3-5 and 6-9 year-old children. When a TG-unchanged ear is found in autumn during the 2-month inflation treatment, more careful and forcible treatments should be introduced later, especially to children between the ages of 3 and 9 years.