4] An analysis of previous studies estimated the point prevalence of middle-ear effusion
on screening as 20.
Paradise, MD, pediatrician and otitis media expert at Children's and professor of Pediatrics and Otolaryngology at the University of Pittsburgh School of Medicine, and fellow researchers found that in otherwise healthy children younger than 3 years of age who have persistent middle-ear effusion, prompt insertion of the tubes did not improve developmental outcomes at age 6.
Before 3 years of age, 429 children with persistent middle-ear effusion were randomly assigned to have tympanostomy tubes inserted either promptly or up to nine months later if effusion persisted.
An adenoidectomy can be performed to relieve the nasal obstruction while a myringotomy and ventilation tube insertion can be done for the middle-ear effusion.
If a blocked nose is associated with a middle-ear effusion, the physician should suspect possible nasopharyngeal malignancy and the patient should be referred to an ENT specialist for biopsy.
The abbreviated definition of AOM is "the presence of middle-ear effusion
in conjunction with the rapid onset of one or more signs or symptoms of inflammation of the middle ear.
These new guidelines offer clear recommendations for diagnosing AOM, which include an evaluation of the child's history of acute onset, signs of middle-ear effusion
(fluid in the middle-ear) and presence of middle-ear inflammation.
Erythema of the tympanic membrane without a middle-ear effusion
is called acute myringitis, often mistaken for AOM.
provides evidence to support the use of a cautious approach in referring young children with middle-ear effusion
to receive tympanostomy tubes.
The trial started when there were serious concerns in the USA--but no real evidence--that persistent middle-ear effusion
could cause irreversible damage to a child's ability to learn.
CHL in children may be due to congenital malformations of the outer/middle ear, wax impaction, persistent middle-ear effusions
Should we aspirate middle-ear effusions
prior to insertion of ventilation tubes?