The treatment of otitis media, with particular reference to the results of chemotherapy, has been the subject of extensive controversy in the past few years. The majority of recent reports 1 have been enthusiastic over the decrease in the duration and complications of acute suppurative otitis media under the influence of sulfonamide therapy. Many investigators believe that the decrease in the incidence of acute mastoiditis is a direct result of the increasing use of the sulfonamides. A contrary opinion has been expressed by many others.2 METHOD AND MATERIAL This survey includes observations on all patients with otitis media and mastoiditis who have been admitted to the babies' wards of the New York Post-Graduate Hospital in the years 1931 to 1941 inclusive. In this period a total of 1,992 admissions with otitis media or mastoiditis were tabulated. In a small number of these patients otitis media developed after admission to the hospital, and others had two or more admissions for repeated attacks of otitis media or mastoiditis. We felt that a complete study of the cases of the last six years, 1936 to 1941, should be done because the greatest changes have occurred in this period. There are 932 admissions (773 patients) making up this group and they were studied with a view of determining the age, sex and seasonal variation from year to year, as well as the pertinent symptoms, physical signs, laboratory data, complications, treatment and end results. The 1,030 admissions in the preceding years 1931 to 1935 have been studied only from the point of view of diagnosis, treatment and end results in order that a base line might be obtained for variations in severity of these condi¬ tions from year to year.
AGE, SEX AND SEASONAL INCIDENCEFifty-three per cent of all patients were less than 3 years of age, the ages of the remaining 47 per cent being distributed from 3 to 14 years, the upper limit for admissions to our wards. Chart 1 shows the incidence of age by years. The boys admitted numbered 417 as compared with 357 girls, a ratio of 8: 7. In the winter and spring, from December through May, 72 per cent of the cases were admitted and only 28 per cent in the remaining six months. The highest incidence occurred in March and April. Chart 2 shows the incidence of admissions by months.
SYMPTOMSThe symptoms noted are those of otitis media, mas¬ toiditis and the commonly associated and complicating illnesses of the 932 children from 1936 to 1941. The origin of each symptom, whether from otitis media, mas¬ toiditis or one of the commonly associated illnesses, is not particularly important because all are related to the same extent that the various illnesses are related. Natu¬ rally these symptoms can be considered part of a syn¬ drome of which otitis media and mastoiditis are the main causes.As might be expected, fever was the most common complaint, occurring in 67 per cent of all cases. An elevation of temperature was noted to be abnormal if it exceeded 101 F. The majority of these patients, how¬ ever, had temperatures of 102 o...
