Grommets in otitis media: a 25-year follow up

Abstract

Background: This study is unique as it is the first study which can describe the long term sequelae of treatment of otitis media with effusion (OME) with insertion of grommets in the Primary Health Sector in Denmark.

Objectives: Eardrum pathology and hearing acuity 25 years after treatment of OME by insertion of grommets, in a private ear-, nose-, and throat practice.

Material and methods: 262 children with OME were treated from 1975 to 1978. The patients were re-examined by otomicroscopy, tympanometry and pure tone audiometry after 7.5, 12, and 25 years.

Results: Hearing level, flaccida retraction and incudo pexi was equivalent. For atrophy and myringosclerosis no equivalence was shown using 95% confidence intervals. Tympanometry was fairly unchanged.

Conclusion and significance: The insertion of a grommet in treating OME has no influence on hearing acuity in the long term. The prevalence of myringosclerosis and atrophy was unchanged in 70–80% of the eardrums. Most important is that the small increase in myringosclerosis and atrophy does not seem to influence the hearing acuity. We show that long term sequelae from the Primary Health Sector are similar to those from the Secondary Health sector.

Chinese abstract

背景：这项研究是独一无二的, 因为它是第一项描述丹麦初级卫生部门运用插入索环来治疗渗出性中耳炎(OME)导致的长期后遗症的研究。

目标：在私立耳鼻喉医院用插入索环治疗OME 25年后的耳膜病理和听力敏锐度。

材料和方法：从1975年到1978年, 共262名患有OME的儿童接受了治疗。在7.5、12和25年后, 患者再次接受了耳镜检查、鼓室压测试和纯音测听检查。

结果：听力水平、痉挛收缩和incudo pexi相当。对于萎缩和鼓室硬化, 使用95％置信区间, 未显示等效性。鼓室压测试几乎没变。

结论和意义：运用插入索环治疗OME对长期听力没有影响。70-80％的耳膜未见鼓室硬化和萎缩的发生率的变化。最重要的是, 鼓室硬化和萎缩的小幅增加似乎不会影响听力敏锐度。我们认为, 长期后遗症在初级卫生部门与二级卫生部门之间相似。

Keywords:

• children
• cognition
• tubulation
• grommets
• audiology
• otitis media
• middle ear

Acknowledgments

We wish to thank for useful suggestions and comments. This work was approved by Den Regionale Videnskabsetiske Komite, Hillerød, trial registration number 2000-1-26

Disclosure statement

No potential conflict of interest was reported by the authors.