FACTORS AFFECTING RESOLUTION OF OTITIS-MEDIA WITH EFFUSION IN CHILDREN

There is only limited knowledge of the factors which influence the out come of otitis media with effusion in children in the long-term. This randomized controlled study assessed the therapeutic effect of adenoid ectomy and adenotonsillectomy during a 5-year follow-up. Numerous pre- treatment independent variables concerning the child's upper and lower respiratory tract, atopic status and parental habits were assessed in relation to two dependent outcome measures. These were otoscopic clea rance of effusion and no peak/peak tympanometric change.A total of 222 children was studied and reviewed annually for 5 years. Four of 43 in dependent variables were found to be repeatedly significant in relatio n to outcome: (a) whether or not adenoidectomy was performed; (b) age at operation; (c) history of earache prior to operation; and (d) paren tal smoking habits. The results provide further evidence of a benefici al effect of adenoid removal and the importance of the age at which su rgery is advised. They also suggest the need to investigate further th e relationship of superadded acute suppurative otitis media with otalg ia and the outcome of chronic otitis media with effusion. Finally, avo idance of parental smoking will have a beneficial effect on children's middle ear disease.