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Middle ear effusion among children diagnosed and treated actively for acute otitis media
T Kontiokari1, M Niemelä, M Uhari
1Department of Paediatrics, University of Oulu, Finland. tero.kontiokari@oulu.fi
Insights
Active diagnosis and treatment of acute otitis media in daycare children significantly reduces middle ear effusion. This proactive approach minimizes effusion cases, potentially preventing hearing impairment in young children.
Area of Science:
- Pediatrics
- Otolaryngology
- Public Health
Background:
- Middle ear effusion is common in young children, particularly those attending daycare.
- Acute otitis media (AOM) is a frequent diagnosis in pediatric care, often leading to middle ear effusion (MEE).
- Effective management strategies for AOM and MEE are crucial for preventing long-term complications like hearing loss.
Purpose of the Study:
- To determine the point prevalence of middle ear effusion in daycare attendees.
- To evaluate the impact of active diagnosis and treatment of acute otitis media on the occurrence of middle ear effusion.
- To identify the proportion of children with asymptomatic or previously undiagnosed middle ear effusion.
Main Methods:
- A cross-sectional study involving 850 children aged 0.6 to 6.9 years attending daycare centers.
- Screening using mini-tympanometry performed by trained nurses.
- Diagnostic confirmation of middle ear effusion via pneumatic otoscopy by a pediatrician when indicated.
Main Results:
- The point prevalence of middle ear effusion was 7.1% (60 children), with 2.7% having bilateral effusion.
- Acute otitis media was diagnosed in 3.2% of children, and otitis media with effusion in 3.9%.
- Only a small percentage of children with effusion (0.2% bilateral, 1.4% unilateral) were asymptomatic and previously unidentified.
Conclusions:
- Active diagnosis and treatment of acute otitis media are highly effective in reducing middle ear effusion.
- This management approach appears to prevent significant middle ear effusion that could lead to hearing impairment.
- Early detection and intervention are key in managing middle ear conditions in daycare populations.
Unlabelled:
We assessed the point prevalence of middle ear effusion among day care children in an area where acute otitis media is diagnosed, treated and followed actively. Minitympanometry was used to screen 850 day care centre attendants aged 0.6 to 6.9 years (mean 3.7 years). Tympanometry was performed by two trained nurses at the day care centres and pneumatic otoscopy was done by a paediatrician when effusion was suspected. We found 60 (7.1%) children to have middle ear effusion, which was bilateral in 23 (2.7%) cases. Of the children with bilateral effusion 13 had respiratory symptoms fulfilling the criteria of acute otitis media, 8 of them had experienced acute otitis media during the past 3 weeks and were diagnosed to have otitis media with effusion, and only 2 (0.2%) were asymptomatic children not identified earlier. Of the 37 (4.4%) children with unilateral effusion, 14 had acute otitis media and 23 otitis media with effusion, of whom 12 children (1.4%) had not been identified earlier. The point prevalence of acute otitis media was 3.2% and that of otitis media with effusion 3.9%.
Conclusion:
We conclude that active diagnosis and treatment of acute otitis media practically eliminates such middle ear effusion that could cause significant hearing impairment.