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Secretory otitis media—A retrospective general practice survey

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Abstract

The general practice records of 68 children with secretory otitis media (SOM) were studied. A control group was matched one-for-one on the basis of sex, year of birth and general practice list. The SOM group had twice the incidence of recorded atopy, twice the incidence of recorded previous upper respiratory tract infections (URTI), and three times the incidence of recorded attacks of acute otitis media (AOM) compared with the control group. The recorded antibiotic treatment of URTI and AOM in the two groups was similar. Antihistamines and decongestants were seldom recorded in the treatment of AOM. The higher incidence of atopy found in the children with SOM prompts the suggestion that antihistamines and decongestants used by general practitioners in the routine treatment of AOM and URTI might help prevent the development of SOM. A prospective double-blind trial along these lines seems desirable.

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... Children with chronic secretory otitis media (SOM) have more episodes of acute suppurative otitis media (AOM) than age-matched controls (Schutte et al. 1981). It is not, however, clear whether incomplete resolution of AOM leads to SOM, or whether the presence of a middle ear effusion predisposes to bouts of acute infection. ...
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One hundred and forty-four ears (72 patients), forming part of the computer controlled respiratory allergy group of the University of Turku, were analyzed with tympanometry and audiometry to diagnose secretory otitis media. Effusion was found in 3 ears (2 patients) and a pathological tympanogram in a total of 15 ears (10 patients). The incidence of secretory otitis media was 3% and of pathological tympanograms 14%. This study supports the opinion that immediate allergy is not an aetiological factor in secretory otitis media.
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• In 108 children (184 ears) with chronic secretory otitis treated with grommets, the condition at one-to-five years follow-up was compared with that at five-to-eight years follow-up. At the latter time, hearing was extremely good, 97.5% of the ears having a speech reception threshold (SRT) of 20 dB or less. However, only 67% of patients could be classified as cured by normal tympanometry. The remaining ears showed a negative middle-ear pressure of 100 to 300 mm H2O (25%), recurrent accumulation of secretion (1.6%), adhesive otitis (3.3%), perforation (1.7%), or cholesteatoma (1%). The eardrum was normal in 44% of patients, while in 25% it was diffusely atrophic, lax, or retracted. (Arch Otolaryngol 102:672-675, 1976)