Factors affecting the results of conservative treatment of secretory otitis media in children

Abstract

Objective: There is only limited knowledge of the factors influencing the results of nonsurgical treatment of secretory otitis media (SOM). The present study was carried out to determine the effect of middle ear inflation and to examine the factors affecting the results of conservative treatment of SOM in children. Methods: A total of 158 children with SOM were randomized to either a group receiving treatment with middle ear (ME) inflation for 10 days 3/day, or to a group receiving ME inflation and antibiotics (oral Amoxicillin 50 mg/kg 3/day) for 10 days, or to a control group. A wide variety of anamnestic and clinical pre-treatment variables were assessed by administered questionnaires. Pneumo-otoscopy, tympanometry and pure-tone audiometry were performed before the treatment and at the 3rd–5th, 10th±2 and 60th±5 days of the study. For the prognostic factors, univariate analyses were first performed to determine the significant predictors, which were afterwards entered into a stepwise logistic regression model. Results: There was no difference in the effectiveness of treatment between Groups A and B, neither on the 10th (46.1% and 52.2%, respectively, controls: 9%, p<0.001) nor on the 60th day (37.3% and 42.4%, control group: 15.7%, p<0.001), of the study. The most important prognostic criteria were defined by analysing the dynamics of tympanometry (OR: 3.24) and audiometry (OR: 8.77) during conservative treatment. The results of the treatment were related to age, the duration of the disease, the previous otologic history, and the nasopharyngeal colonization and the position of the adenoids. Conclusion: The results suggest that daily middle ear inflation can be an effective treatment of SOM for children, having regard to the factors significant for the prognosis of treatment.