Post-surgical noninvasive monitoring of middle ear in otitis media prolonged forms

Background: Prolonged forms of otitis media (OM) lead to chronic hearing loss and disability from childhood. Wide spectrum of therapeutic approaches is used in management of OM in children. Objective evaluation of the middle ear after different curative modalities will help in analysis of treatment feasibility. The objective of this article was to compare the results of middle ear noninvasive monitoring after different surgical procedures in order to select the most effective one in prolonged otitis media forms. 

Material and methods: Patients represent 150 children with prolonged OM. Analyzed treatment modalities: I – myringotomy, II – classical tympanostomy, III – modified tympanostomy. Middle ear monitoring included otoscopy and audiometry what was repeated 4 times during 2 years, otomicroscopy in 1 and 2 years and impedance audiometry in 2 years after surgery. The quality of life and general health scores were analyzed before surgery and in 1 and 2 years after surgery.

Results: Otoscopic and audiometric data showed stable improvement in 32% of children after myringotomy, 90% of children after classical tympanostomy and 97% of children after modified tympanostomy. Impedance audiometry in 2 years after surgery demonstrated complete restoration of middle ear function in 32% of children after myringotomy, in 78% of children after classical tympanostomy, and in 94% of children after modified tympanostomy. 

Conclusions: Post-surgical noninvasive monitoring demonstrated advantages of tympanostomy and especially in modified version: improvement and stability of middle ear function and low rate of otitis media persistence or recurrence.