PATHOPHYSIOLOGICAL AND THERAPEUTIC CONSIDERATIONS OF OTITIS-MEDIA WITH EFFUSION FROM VIEWPOINT OF MIDDLE-EAR VENTILATION

Using nitrous oxide, we examined the gas exchange function through the middle ear mucosa in ears with otitis media with effusion (OME) in ch ildren, and found the function to be impaired in 50% of them. The size of the mastoid was significantly smaller in ears with negative gas ex change function than those with positive function? and the presence or absence of the function was even more significantly correlated with t he presence or absence of aeration in the middle ear. Furthermore, the presence or absence of aeration in ears with OME was found to be sign ificantly correlated with their prognosis (response of OME to antibiot ics treatment) and also with the presence or absence of eardrum mobili ty examined by a pneumatic otoscope. Finally, after myringotomy and re moval of effusion, the gas exchange function recovered in most of the ears with impaired function. These results indicate that the eardrum m obility test may serve as an appropriate indicator for the surgical tr eatment for OME. (C) 1998 Elsevier Science Ireland Ltd. All rights res erved.