Background. Middle ear pathology, either otitis media with effusion or
tubal dysfunction, is frequently seen in day-care centre children. Re
cognition and early treatment of this condition is crucial to the prev
ention of chronic otitis media, which is a major cause of hearing loss
in later life. Objectives. We aimed to reveal the incidence of silent
otitis media in day-care centre children and to determine the predisp
osing factors, risk factors and the awareness of the parents of the mi
ddle ear disease of their children. Method. Two hundred and thirteen c
hildren, aged 3-6 years, were screened in four daycare centres. A ques
tionnaire was prepared that would reveal the predisposing factors. Inf
ormation was gathered from both the parents and teachers. Children wer
e examined by otoscopy, pneumotoscopy, tympanometry and X-rays for sin
us pathology. Results. Forty-three of 213 children had middle ear path
ology; 39 of them were confirmed by tympanometry; 56.1% of children ha
d some degree of sinus pathology. We revealed that, although most of t
he children do not have the risk factors, they develop middle ear path
ology. Among the parents, 81.4% of them were unaware of the condition.
Conclusion. Early diagnosis of middle ear pathologies is necessary fo
r prevention of future complications. In early stages the condition is
silent. We emphasize the importance of the primary care physician's r
ole in diagnosing the early stages of middle ear pathologies and recom
mend that teaching of otoscopic and pneumotoscopic skills should be pa
rt of the training for family physicians.