Abstract
BackgroundIn otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI).MethodsWe classified the collective 1,012 ears from 506 patients into six groups: grade 0 (no effusion), grade I (scant effusion, but abnormal), grade II (effusion less than half of the tympanic cavity), grade III (effusion over half of the tympanic cavity, with air bubbles), grade IV (complete effusion), and grade V (retracted tympanic membrane or hemotympanum without air bubbles).ResultsThe mean age at VTI was 5.2 (±2.9) years and mean duration between diagnosis and operation was 4.1 (±1.8) months. Between the grades, the nature of the middle ear effusion was also significantly different (p < 0.001). The duration of ventilation tube retention after VTI was significantly different when compared between two groups: grade I-IV and grade V (p = 0.019). Our results showed that the recurrence rate, as well as rate of revision VTI, increased as the grade increased (p < 0.001).ConclusionsThe new grading system of OME using endoscopic otoscope evaluation had a significant correlation with the age at VTI, the nature of middle ear effusion, the recurrence rate of OME, and the rate of revision VTI.
Highlights
In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate
The prognosis of OME after ventilation tube insertion (VTI) surgery was associated with the clinical manifestation such as the age at the time of VTI, the concurrent adenoidectomy, duration of ventilation tube retention, postoperative otorrhea, and early extrusion of the ventilation tube [8]
According to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) guidelines [2] and the Korean clinical practice guideline: otitis media in children [4], patients with OME which has persisted longer than 3 months were considered subjects to VTI
Summary
In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI). Endoscopic otoscopes, which use technology of digital acquisition and image storage, can be used by otorhinolaryngologists, and other physicians after some basic training. They provide reliable medical photos that make it possible to compare the status of OME between patients or OME development over time in the same patient.
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