The use of acoustic reflectometry in the study of middle ear effusion in children suffering from acute otits media, upper respiratory tract infection and in healthy children

Abstract

Middle ear effusion is not generally a particularly significant clinical problem in children.

General practitioners want to know whether a treatment works and is safe in practice

“…Last year colleagues and I reported another study on the occurrence and importance of middle ear effusion 4. With careful clinical observation and follow up, and using acoustic reflectometry as an objective measurement, we found that middle ear effusion is common.…”

Middle ear effusion among children diagnosed and treated actively for acute otitis media

“…Bollag et al found 36% of slightly older children to have MEE by using acoustic re¯ectometry in Switzerland (Table 1) [1]. Unfortunately, it is not possible to ®nd out how many of these children were earlier undiagnosed in these studies.…”

Diagnostic Criteria for Otitis media in Children

“…chronic suppurative otitis media with or without cholesteatoma) and to prevent impaired hearing caused by middle ear effusion. A more conservative approach with watchful waiting has been chosen in some other countries [4,5]. Although recurrent acute otitis media does not seem to cause any permanent hearing loss [9] and there is no overall consensus that middle ear effusion would have long-term effects on language and learning [2], the acute complications and chronic suppurative otitis media and cholesteatoma [10] have become rare in our country concurrently with the use of this active strategy.…”

“…inflammtion of the tympanic membrane with a relatively normal mobility, is usually present in the early stages of acute otitis media, and some authors regard it as part of acute otitis media [3,5]. We think that although children with this type of finding may need surveillance, they should not be regarded as having acute otitis media, but mere acute upper respiratory tract infection, and that the finding of middle ear effusion should be an essential part of the diagnostic criteria for acute otitis media.…”

“…Both research and clinical work are based on precise definition and criteria for these conditions. Yet, the definition and criteria for both acute otitis media and otitis media with effusion vary greatly in different studies, which is one reason for the inconsistent results and has led to contradictory recommendations for clinicians on such basic issues as whether to diganose and treat otitis media actively [1][2][3][4][5]. The diagnostic criteria most often used for acute otitis media include one or more local or systemic symptoms and bulging and opaque tympanic membrane with limEar-related symptoms…”