Exudative otitis media, grommets and cholesteatoma

The number of operations for cholesteatoma, together with the number of cases undergoing insertion of ventilation tubes in the Tayside region of Scotland between 1966 and 1986 have been studied. During this period there has been a sixty fold increase in the use of ventilation tubes, but the incidence of cholesteatoma surgery has only varied between 0.94 and 1.88 operations per 10,000 of population per year. The mean annual incidence of cholesteatoma during this period was 1.32 cases per 10,000 of population. The results indicate that there has been neither a rise nor a fall in the incidence of cholesteatoma in Tayside despite a considerable increase in the use of ventilation tubes.

Section: Introductionmentioning

confidence: 99%

Has the increasing use of grommets influenced the frequency of surgery for cholesteatoma?

Padgham¹,

Mills²,

Christmas³

1989

“…Little more attention was paid to this observation until the 1970s, when at least one specialist (Thomson, 1974) recommended teaching 'mother and child how to blow the nose efficiently'. Lescouflair (1975) described the poor ENT hygiene provided by parents as a 'primary evil', without explaining just what was expected of them.…”

Section: (C) Ent Hygienementioning

confidence: 99%

Causes of glue ear

Black

1985

Over the past one hundred years medical views on the cause of glue ear have frequently changed. The medical literature was reviewed to see if these changes reflected advances in the level of scientific support for different causes. This revealed that only a few of the many proposed causes command any scientific support. An explanation for the changing pattern of views on the aetiology of glue ear was therefore sought by considering secular changes in medical knowledge and belief in general. This suggested that the views held on the cause of glue ear at any given time are influenced and largely determined by the prevailing knowledge and beliefs of medicine as a whole. This phenomenon is not peculiar to glue ear--though conditions about which there is considerable uncertainty are probably more susceptible to such influences.

“…In the last 30 years, the insertion of ventilation tubes has become the standard surgical treatment for otitis media with effusion. Some authors have reported epidemiological data which suggest that grommets might prevent the progression of retraction pockets to cholesteatoma formation (Thomson, 1974;Pfaltz, 1988). However, other authors have not confirmed this observation (Padgham et al, 1989;Roland et al, 1992) and have highlighted the hazards of relying on epidemiological data.…”

Section: Introductionmentioning

confidence: 99%

Tympanic membrane atelectasis in childhood otitis media with effusion

Tay

Mills

1995

A prospective study on the dynamics of tympanic membrane atelectasis during the treatment for glue ear was performed in a sample of 115 ears of 83 children aged between one and 11 years. The progression in the degree of pars tensa atelectasis was analysed in relation to six potentially relevant factors. Multivariate analysis showed that the factor with the most predictive value on the progression of the pars tensa retraction was the grade of atelectasis at initial detection (p<0.0001). The use of grommets did not have any significant influence on the outcome grade of atelectasis. There was an association between previous grommet insertion and localized retractions in the inferior segment of the pars tensa (P<0.0001). However, localized retractions in the postero-superior quadrant were not associated with previous grommet insertion (P<0.02). Although the hearing thresholds of atelectatic ears were significantly worse than normal ears especially at 4 kHz (p<0.006), the difference was less than 5 dB.