DOES THE TYPE OF MIDDLE-EAR ASPIRATE HAVE ANY PROGNOSTIC-SIGNIFICANCEIN OTITIS-MEDIA WITH EFFUSION IN CHILDREN

Two hundred and twenty-two children with chronic, bilateral middle ear effusions were assessed during a 2 year follow-up period. At initial myringotomy the middle ear aspirate was found to be serous in 44 child ren and mucoid in 178 children. Evaluation at 1 and 2 years post-opera tively showed no difference in otoscopic fluid clearance or mean heari ng threshold at either follow-up time in relation to either type of fl uid. There was no greater need for ventilation tube reinsertion in eit her group during the overall follow-up period. There was found to be n o significant difference between the children with serous or mucoid ef fusions in relation to a range of pre-operative and operative variable s. The study suggests that outcome in terms of fluid clearance and hea ring thresholds is independent of the fluid type and there appears no greater need for revision ventilation tube insertion in relation to th e findings at myringotomy. The type of effusion found on aspiration pr ior to ventilation tube insertion has no prognostic value. Children wi th serous fluid should be managed in an identical manner to those in w hich the fluid is thicker and mucoid in character.