DAILY TYMPANOMETRY IN CHILDREN DURING THE COLD SEASON - ASSOCIATION OF OTITIS-MEDIA WITH UPPER RESPIRATORY-TRACT INFECTIONS

The causal association between otitis media and viral upper respirator y tract infections (URI) suggests that early intervention during the c ourse of a viral URI could prevent many episodes of otitis media. Howe ver, the feasibility of this approach can not be assessed at present s ince many aspects of the epidemiology and natural history of URI-assoc iated otitis media are undefined. To address this deficiency, daily mo nitoring of middle ear status (tympanometry) and cold symptoms and wee kly pneumatic otoscopy were done on a pilot cohort of 20 children. The se children, between the ages of 2 and 6, were followed from November 1996 to April 1997. Compliance with symptom diaries was 85%, with tymp anograms was 90%, and with weekly physician visits was 70%. During the study period, there were 53 'colds' (average 2.65 per child) and 28 n ew episodes of middle ear effusion (10 unilateral and 9 bilateral). Ov erall, 47.3% of the tympanograms were Type A, 17.2% Type C1, 9. 9.4% T ype C2, and 21.8% Type B. Children who developed MEE during the study spent more time with abnormal MEP (either MEP < - 150 or flat) during both cold and healthy days than children who did not develop MEE. Temp orally, during colds, high negative pressures preceded the development of Type B tympanograms in children who developed middle ear effusions . Children who did not develop effusions still had high negative press ures during colds, but recovered to a normal pressure within days. The se observations document the feasibility of this investigational forma t for study of the sequential changes in middle ear status before, dur ing and after a URI. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.