Factors affecting resolution of otitis media with effusion in children

Abstract

There is only limited knowledge of the factors which influence the outcome of otitis media with effusion in children in the long-term. This randomized controlled study assessed the therapeutic effect of adenoidectomy and adenotonsillectomy during a 5-year follow-up. Numerous pre-treatment independent variables concerning the child's upper and lower respiratory tract, atopic status and parental habits were assessed in relation to two dependent outcome measures. These were otoscopic clearance of effusion and no peak/peak tympanometric change. A total of 222 children was studied and reviewed annually for 5 years. Four of 43 independent variables were found to be repeatedly significant in relation to outcome: (a) whether or not adenoidectomy was performed; (b) age at operation; (c) history of earache prior to operation; and (d) parental smoking habits. The results provide further evidence of a beneficial effect of adenoid removal and the importance of the age at which surgery is advised. They also suggest the need to investigate further the relationship of superadded acute suppurative otitis media with otalgia and the outcome of chronic otitis media with effusion. Finally, avoidance of parental smoking will have a beneficial effect on children's middle ear disease.

Craniofacial morphology and otitis media with effusion in children

“…We also know that breast-feeding plays an important role in craniofacial development and growth and also in the development of oro-facial muscles [22,23]. But we did not found association between otitis and breast-…”

“…A shorter vertical dimension of the face may imply in a poorer Eustachian tube dysfunction. Maw and Bawden [22] suggested that children with serous otitis media have experienced delayed craniofacial growth. Shibahara and Sando [30] describe that the insertion angle of these muscles may alter the vectors of traction in the opening of the tube.…”

Associations between symptoms, clinical findings and the short-term prognosis among children with otitis media: A cohort study

“…Previous studies with recurrent AOM or MEE as outcomes have identified different variables with impact on the diseases, e.g. type of day care [7,26] parental smoking [11,27], duration of breastfeeding [8,9,28] and socioeconomic factors [7,8]. To our knowledge no other studies have analyzed the extent to which symptoms at inclusion are associated with the short-term course of OM.…”

The aetiology of otitis media with effusion: a review

“…Adenoidectomy has been shown to be effective in improving the resolution rate of OME, 159–164 but whether this is because it removes a physical obstruction of the eustachian tube, or a source of ascending infection is a matter for debate. The presence of laterally placed adenoid tissue around the torus tubarius is associated with OME, 165 but the absolute size of the adenoids is not.…”