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Effect of myringotomy on prognosis in pediatric acute otitis media. 2005

Yuka Nomura, and Toshio Ishibashi, and Jun Yano, and Tomoya Ichikawa, and Masanobu Shinogami, and Hiroko Monobe, and Ryoji Hirai, and Kimitaka Kaga
Department of Otolaryngology, University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo 113-8655, Japan. ikehara-tky@umin.ac.jp

OBJECTIVE In children with acute otitis media (AOM), we compared clinical outcomes between groups with and without myringotomy to elucidate the effect of this procedure on long-term clinical course and prognosis. METHODS Fifty-nine children (29 male, 30 female) with tympanic membrane bulging or middle ear fluid (MEF) at initial presentation were assigned to one of two treatment groups. Group A received oral antibiotics and also underwent myringotomy at initial enrollment (36 cases), while group B received oral antibiotics without myringotomy (23 cases). Clinical outcomes were evaluated by otolaryngologic specialists using pneumatic otoscopy and tympanometry at 5, 10, 15, 30 days and 12 weeks and then every 2 weeks after the initial treatment. Otitis media with effusion (OME), early recurrence and recurrent AOM were used as the evaluation criteria for the prognosis. RESULTS In group A, 6 children (16.7%) showed transition to OME, 11 (30.6%) showed early recurrence of AOM, and 9 (25.0%) developed recurrent AOM. In group B 10, 8, and 3 (43.5%, 34.8%, and 13.0%) showed these respective adverse outcomes. While early recurrence rates and recurrent AOM rates did not differ significantly between groups, progression of OME was significantly less frequent in group A than group B (P = 0.036). CONCLUSIONS Lower rates of progression to OME in the group undergoing myringotomy suggested that myringotomy might be effective in preventing this outcome.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008876 Middle Ear Ventilation Ventilation of the middle ear in the treatment of secretory (serous) OTITIS MEDIA, usually by placement of tubes or grommets which pierce the TYMPANIC MEMBRANE. Grommet Insertion,Tympanostomy Tube Insertion,Ventilation, Middle Ear,Myringostomy,Tympanostomy,Ear Ventilation, Middle,Ear Ventilations, Middle,Grommet Insertions,Insertion, Grommet,Insertion, Tympanostomy Tube,Insertions, Grommet,Insertions, Tympanostomy Tube,Middle Ear Ventilations,Myringostomies,Tube Insertion, Tympanostomy,Tube Insertions, Tympanostomy,Tympanostomies,Tympanostomy Tube Insertions,Ventilations, Middle Ear
D010034 Otitis Media with Effusion Inflammation of the middle ear with a clear pale yellow-colored transudate. Middle Ear Effusion,Otitis Media, Secretory,Otitis Media, Serous,Ear Effusion, Middle,Ear Effusions, Middle,Effusion, Middle Ear,Effusions, Middle Ear,Middle Ear Effusions,Secretory Otitis Media,Serous Otitis Media
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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