The surgical management of otitis media with effusion in childhood

Abstract

Objectives: To assess the surgical management for otits media with efusion in childhood,within the North Argyll and Clyde region in Scotland. Methods: A prospective study was designed to assess the management of the condition.The study was conducted over 5 years, between 1996 and 2001. During this time 384 procedures were carried out on 296 patients. Sixty-one patients underwent more than one procedures. Results: The age of the patients varied from 2 to 16 years with a mean of 6 and a median of 6. Unilateral grommet insertion was performed in 80 patients (27%). Within this group the need for a second operation for contra lateral grommet insertion 3 to 6 months postoperatively was common. Eighteen patients (8%) had a worse postoperative PTA than their preoperative one. In 12 (5%) the PTA remained unchanged. The rest of the patients showed an improvement varying from 5 to 50 db with a mean of 14 db and a median of 15 db. Complications following the procedures were noticed in 10 patients (3.4%) and these included 3 patients with perforations following grommet insertion and 6 patients with recurrent acute otitis media and discharge. Conclusion: Although grommet insertion is a quick and safe procedure, it is not completely without risks or complications. The authors recommend that otolaryngologists in Scotland follow the SIGN guidelines.The clinicians could also consider close observation with repeated audiograms and tympanograms, and the option of a temporary hearing aid for controversial cases.