OTITIS MEDIA: A Comparative Study of the Results Obtained in Therapy Before and After the Introduction of the Sulfonamide Compounds

Abstract

IN AN attempt to evaluate the effects of sulfonamide compounds used in the treatment of otitis media, the records of all patients with this disease admitted to the Los Angeles County General Hospital during the fiscal years of 1935 and 1943 were reviewed.Only those cases of otitis media in which the ear had drained for three days or longer were accepted in this series. This period of drainage was considered to establish with certainty the diagnosis of true purulent otitis media. SERIES (BEFORE THERAPEUTIC USE OF SULFONAMIDE COMPOUNDS)This series was selected in order that the results of therapy before the general use of sulfonamide compounds began might be studied.In 1935 the admissions to the Los Angeles County General Hospital totaled 53,411. Of these, 3,212, or 6.0 per cent, were admissions to the department of otolaryngology of the hospital. Altogether, 2,189 case histories with the diagnosis of otitis media, from all departments, were reviewed in the 1935 series. This represents 4.0 per cent of the total admissions to the hospital.In 1,369, or 66.6 per cent, of the 2,189 cases in which the diagnosis was otitis media the ear drained over the three day period. Therefore, in 820, or 33.4 per cent, of the 2,189 cases the ear either did not drain or drained less than three days. Of the 1,369 acceptable cases, 1,241, or 91.1 per cent, were instances of acute, and 128, or 8.9 per cent, were instances of chronic otitis media.Acute Otitis Media.\p=m-\Of the 1,241 patients with acute otitis media, 671, or 54.1 per cent, recovered spontaneously, and 570, or 45.9 per cent, required simple mastoidectomy. The duration of drainage in the nonsurgical cases is shown in table 1. Drainage ceased in 54 per cent of the cases within two weeks.

Algorithmic management of pediatric acute mastoiditis

“…Up to this point no uniformly accepted diagnostic and therapeutic criteria have been established. Concerning its management, simple mastoidectomy has historically represented the standard surgical treatment of acute mastoiditis [2]. However, currently the rates of use of simple mastoidectomy in treating pediatric AM show considerable variations among reported series [3,4].…”

Acute mastoiditis: The role of imaging for identifying intracranial complications

“…In the preantibiotic era, between 2% and 6% of patients with AM developed suppurative intracranial complications (ICCs), with fatal outcomes in 75% of them 3. Since the introduction of antibiotics, the incidence of AM has declined 4, 5. In 1959, Palva et al reported that 0.4% of their patients with acute otitis media (AOM) developed AM,6 whereas the reported incidence during the 1980s was 0.004% 7.…”

Advanced pediatric mastoiditis with and without intracranial complications

“…Approximately 6% of patients with acute or chronic suppurative otitis media developed intracranial complications, and mortality was greater than 80% 1, 2. With the introduction of sulfonamides, there was a 50% reduction in hospitalization for acute otitis media and an 80% reduction in mastoidectomies in children 3. The advent of widespread modern antibiotic use in the 1960s to 1980s resulted in a dramatic decrease in the incidence of these complications 4.…”