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[The spontaneous course of otitis media with effusion in young children].

OBJECTIVE
Description of the natural course of otitis media with effusion (OME) in pre-school children.


DESIGN
Longitudinal follow-up study.


SETTING
Nijmegen, the Netherlands; at the children's home address.


PATIENTS AND METHODS
A cohort of 1439 children born in the period September 1982 to August 1983 and living in Nijmegen at their second birthday were invited for participation in serial tympanometric screening with a three-monthly interval. Each child was measured 9 times from age 24 to 48 months. A flat tympanogram was considered to be indicative of OME. Participation was 92%, but interpretable tympanograms were taken in 2242 ears (first round) to 1990 ears (last screening). Data of 56 children treated with grommets were excluded from analysis.


RESULTS
Longstanding OME (at least 4 flat tympanograms in a succession) was seen in 9.3% (95%-CI 7.0-11.6) of ears. In another 23.4% (20.1-26.8) of ears OME was found 2 or 3 times at subsequent screenings. Single or recurrent flat tympanograms were seen in 20.4% (17.2-23.6) and 11.6% (9.0-14.1) of the ears respectively. The probability of recovery over time was well described with a simple function of a 50% improvement every 3 months. In addition, 50% of the recovered ears showed one or more recurrences of OME.


CONCLUSION
OME appears to run a very fluctuating course with a strong representation of short disease episodes and high rates of recovery and remission. The data confirm the results of others. A common interpretation, i.e. a sharp reduction of the recovery rate after three months, appears to be false. A 50% improvement rate every 3 months fits the data equally well. This study does not provide information about the sequelae of OME at school age.