Course and long-term outcome of ’refractory’ secretory otitis media

• Published in: Journal of laryngology and otology Vol. 119; no. 2; pp. 113 - 118
• Main Authors: Ryding, Marie, White, Peter, Kalm, Olof
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.02.2005
• Subjects: (RF) Otorhinolaryngology; Acute Disease; Adenoidectomy; Adolescent; Adult; Age; Age of Onset; assessment (Health care); Biological and medical sciences; Child; Child, Preschool; Cholesteatoma, Middle Ear - etiology; Chronic Disease; Clinical Medicine; Complications; Disease Progression; Ear diseases; Ears & hearing; Follow-Up Studies; Hearing Disorders - etiology; Hearing loss; Humans; Infant; Infections; Klinisk medicin; Medical and Health Sciences; Medical records; Medical sciences; Medicin och hälsovetenskap; Middle Ear Ventilation - methods; Otitis Media With Effusion; Otitis Media with Effusion - complications; Otitis Media with Effusion - diagnosis; Otitis Media with Effusion - surgery; Oto-rhino-laryngologi; Otorhinolaryngology; Otorhinolaryngology. Stomatology; outcome; Outcome Assessment (Health Care); Prognosis; Questionnaires; Retrospective Studies; Tympanic Membrane Perforation - etiology; Ventilation; Sweden; Otitis Media With Effusion; Outcome Assessment (Health Care); Complications; Disease Progression; Human; Otitis Media with Effusion; Prognosis; Middle ear disease; Long term; Secretory otitis media; Care; ENT disease; Complication; Evolution
• ISSN: 0022-2151; 1748-5460; 1748-5460
• DOI: 10.1258/0022215053420059

Objective: The course and the long-term outcome of ’refractory’ secretory otitis media (SOM), defined as continuous SOM for more than 6 years, were studied in 52 young patients. They had during childhood been treated for bilateral SOM on average for 12 years (range 6 to 26 years). The mean interval between resolution of SOM and examination was 7 years. Methods: At follow up the patients’ medical records were scrutinized with regards to transmyringeal ventilation tubes, adenoidectomy, sequelae and complications, and a questionnaire was filled in to document other diseases. Results: The onset of SOM showed two peaks, one at the age of one year and one at the age of 3.5 years. Patients whose onset of SOM was related to an episode of acute otitis media (AOM) were younger at SOM onset than those who had no such relation. Otorrhoea and AOM episodes were more frequent during the SOM periods, with blocked or expelled tubes, than during periods with patent tubes. Cholesteatoma were seen in 3 per cent and perforations in 5 per cent of patients. Conclusions: Extremely long-standing SOM does not necessarily result in myringeal perforation or cholesteatoma to a greater extent than that seen in patients with shorter durations of SOM. However, at follow up one-third of the patients reported hearing impairment and a majority felt discomfort when flying or diving.