Unilateral Otitis Media With Effusion Research Articles

The otological profile of a cohort of Dutch 7.5-8-year-olds.

The otological characteristics of a birth cohort of 7.5-8-year-old Dutch children are reported. Questionnaire information was available for 1004 children, while otomicroscopic, tympanometric and pure-tone audiometric data were available for 946 children. Twenty-nine per cent of the children had been treated surgically for various ENT diseases. Fifty-five per cent of the children had normal tympanic membranes, 19% mild abnormalities, and 26% moderate to severe abnormalities. At this age the prevalence of bilateral otitis media with effusion (OME), as shown by a type B tympanogram was 2.5%, while that of unilateral OME was 7%. A pure-tone average hearing level of > or = 15 dB in the better-hearing ear was found in 4% of the children. The presence of OME was associated with a mean hearing loss of 20 dB. This study shows that structural and functional middle-ear abnormalities are highly prevalent in Dutch school children.

浸出性中耳炎と鼓膜切開

Myringotomy is commonly performed in the treatment of otitis media with effusion (OME). However, it has been reported that the effect of myringotomy is limited and that OME recurs frequently after this procedure.In this investigation, the recurrence rate of OME 6 months after myringotomy and factors which affect the recurrence were examined in 94 patients with OME, aged 6 to 83 years. Forty-six patients had paranasal sinusitis, and 9 had allergic rhinitis. Nasal mucociliary function was examined with the saccharin test, described in a previous report.The recurrence rate of OME was 68.1%, similar to that in previous reports. Patients with mucoid effusions had more frequent recurrences than did those with serous effusions (p<0.01). The recurrence rate was significantly higher in children than in adults (p<0.05). Patients with OME for more than 3 months (p<0.001) or bilateral OME (p<0.001) had higher recurrence rates than did those with OME for less than 3 months or those with unilateral OME. OME recurred more frequently in patients with paranasal sinusitis (p<0.001) or allergic rhinitis (p<0.05) than in those without these nasal diseases. The incidence of markedly prolonged saccharin time (over 30 minutes) was significantly higher (p<0.001) in the recurrent group than in the cured group.

しん出性中耳炎の耳管咽頭口粘液線毛機能

The mucociliary function of the nose and eustachian tube orifice was examined by the saccharin test in 46 patients with OME (otitis media with effusion), aged 12 to 79 years, to determine whether impaired mucociliary function of these areas plays a pathogenic role in OME. The control group included 29 normal subjects, aged 20 to 70 years, who had no diseases of the nose or ears.The saccharin test of the nose was performed as reported previously, and the normal upper limit was determined to be 11 minutes. For the evaluation of mucociliary function around the eustachian tube orifice, a nasoendoscope (Olympus ENF-type P) with a thin tube and syringe attached was used to apply the saccharin solution plus gentian violet. A drop of saccharin solution could be accurately placed at the eustachian tube orifice with the nasoendoscope monitor, and the time for the subject to report a sweet taste was recorded up to 15 minutes. The normal upper limit of the saccharin time around the eustachian tube orifice was determined to be 4 minutes. Both tests were performed on the right side in the normal controls, on the side of the affected ear in patients with unilateral OME, and on the right side in patients with bilateral OME.Mucociliary function around the eustachian tube orifice was found to be impaired significantly and correlated well with that of the nose. It is therefore possible that mucociliary dysfunction of these areas increases the risk of infection via the eustachian tube or prolongs inflammation in the middle ear.