A prospective study of otitis media with effusion in adults and children

Mills, R. P.; Vaughan-Jones, Richard

doi:10.1111/j.1365-2273.1992.tb01841.x

Cited by 11 publications

(12 citation statements)

References 8 publications

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“…Review and screening of initial articles plus manual crosschecks identified 63 source articles that met inclusion criteria and had extractable data. The source articles included 11 RCTs of AOM antibiotic versus placebo or no drug, 30–40 1 RCT of AOM homeopathy versus placebo, 41 9 cohort studies of restrictive antibiotics for AOM, 42–50 14 RCTs of recurrent AOM antimicrobial prophylaxis versus placebo or no drug, 51–64 1 cohort study of recurrent AOM natural history, 65 18 cohort studies of OME natural history, 66–83 2 RCT enrollment cohorts of OME therapy, 84,85 and 7 cohorts or RCT control groups of chronic OME natural history 86–92 …”

Section: Resultsmentioning

confidence: 99%

Natural history of untreated otitis media

2003

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ObjectivelHypothesis:Data from cohort studies and untreated groups in randomized controlled trials can be identified through systematic literature review and synthesized with meta-analysis to estimate natural history of acute otitis media (AOM) and otitis media with effision (OME). Study D e s i p Systematic literature review and meta-analysis. Method Source articles were identified by MEDLINE search through August 2002 plus manual crosschecks of bibliographies and published meta-analyses. Data were abstracted independently by two investigators and combined with random effects meta-analysis to estimate spontaneous resolution, 95% confidence intervals (CI), and heterogeneity. Sensitivity analysis was performed. Results: Sixty-three articles met inclusion criteria AOM symptoms improved within 24 hours without antibiotics in 61% of children (95% CI, 50-72%), rising to 80% by 2 to 3 days (95% CI, 69-%).Suppurative complications were comparable if antibiotics were withheld (0.12%) or provided (0.24%). Children entered recurrent AOM trials with a mean rate of 5.5 or more annual episodes but averaged only 2.8 annual episodes while on placebo (95% CI, 2.2-3.4). No AOM episodes occurred in 41%, and only 17% remained otitis prone (3 or more episodes). OME after untreated AOM had 59% resolution by 1 month (95% CI, 50-68%) and 74% resolution by 3 months (95% CI, 68-SO%). OME of unknown duration had 28% spontaneous resolution by 3 months (95%, CI 14-41%), rising to 42% by 6 months (95% CI, 35-49%). In contrast, chronic OME had only 26% resolution by 6 months and 33% resolution by 1 year. Conclusions: The natural history of otitis media is very favorable. Combined estimates of spontaneous resolution provide a benchmark against which to judge new or established interventions. The need for surgery in children with recurrent AOM or chronic OME should be balanced against the likelihood of timely spontaneous resolution and the potential risk of learning, language, or other adverse se-

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Section: Resultsmentioning

confidence: 99%

Natural history of untreated otitis media

2003

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“…The etiologies in adult OME include sinus infection, smoking, adenoid hypertrophy, barotraumas, NPC or radiation [11][12][13]. OME is common in both pre-irradiated and postirradiated NPC patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term result of management of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma

Liang

Twu

et al. 2010

Eur Arch Otorhinolaryngol

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The treatment of post-irradiated otitis media with effusion (OME) remains controversial. Hence the aim of this study was to understand the long-term result of management of post-irradiated OME. Eighty-five nasopharyngeal carcinoma patients with post-irradiated OME were prospectively enrolled. All were followed up with close observation and a hearing aid was advised for those with hearing loss. If patients were still bothered by aural fullness, tinnitus or hearing impairment and did not want to continue conservative treatment, tympanostomy plus aspiration was performed. Only those who had persistent OME and failed repeated tympanostomy for at least 3 months were suggested to undergo grommet insertion. After a mean follow-up of 842.1 ± 49.0 days from the completion of radiotherapy, OME was present in 45 patients (52.9%). Another 16 (18.8%) had chronic discharging ears with or without perforated eardrums. Grommets remained on the eardrums in eight patients. Among them, five were without otorrhea but discharge came from grommet tubes intermittently in three patients. Only 15 (17.6%) were free of OME, and one patient had a dry perforated eardrum. Our results showed current methods did not result in long-term resolution of some recalcitrant post-irradiated OME.

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“…In adults, OME often develops following an upper respiratory tract infection, but in these cases early spontaneous resolution of the effusion(s) is common. 23 Cohen's model for the pathogenesis of OME fits most of the known facts concerning chronic OME. However, in cases where middle-ear effusions develop following air travel, it is difficult not to accept the notion that a failure of the eustachian tube to equalise the pressure inside and outside the middle ear during descent is the cause of the problem.…”

Section: Eustachian Tube Dysfunctionmentioning

confidence: 97%

“…Both forms of the disease have a similar spontaneous resolution rate during the first two months after presentation. 23 However, in some individuals, adult OME is a more chronic condition than its childhood counterpart. On the other hand, serous effusions are more common in adults and mucoid effusions are more common in children.…”

Section: Discussionmentioning

confidence: 99%

Aetiology and pathology of otitis media with effusion in adult life

Mills

Hathorn

2016

J. Laryngol. Otol.

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Objectives: To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults.Method: A review of the English language literature from 1970 to the present was conducted.Results: The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease.Conclusion: There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

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A prospective study of otitis media with effusion in adults and children

Cited by 11 publications

References 8 publications

Natural history of untreated otitis media

Natural history of untreated otitis media

Long-term result of management of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma

Aetiology and pathology of otitis media with effusion in adult life

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