TYMPANIC MEMBRANE ATROPHY, SCARRING, ATELECTASIS AND ATTIC RETRACTIONIN PERSISTENT, UNTREATED OTITIS-MEDIA WITH EFFUSION AND FOLLOWING VENTILATION TUBE INSERTION

Two hundred and twenty two children with persistent bilateral otitis m edia with effusion (OME) were treated with unilateral ventilation tube insertion and no treatment to the contralateral ear. The tympanic mem brane changes in the operated and unoperated ears were compared during a 12 year follow-up. Segmental atrophy resulted from tube insertion w hereas minor scarring and thickening of the pars tensa was related to the middle ear condition. Eighty three percent of untreated ears and 8 5% of those treated with tubes did not develop atelectasis. Sixty perc ent of untreated ears and 64% of treated ears did not develop attic re traction. Very few cases (1.5 and 2%) in untreated and treated ears, r espectively developed severe atelectasis. The overall duration of OME was assessed from the pre-operative history of hearing loss, the 3 mon th period of pre-operative observation and the post-operative time wit h effusion. There is a relationship between duration of the disease an d development of both atelectasis and attic retraction.