PERSISTENCE OF MIDDLE-EAR EFFUSION AFTER ACUTE OTITIS-MEDIA IN CHILDREN

We observed the frequent occurrence of persistent middle-ear effusion in children with acute otitis media and followed them according to standard procedures for otologic diagnosis. We performed a life-table analysis to identify risk factors for such persistent disease. Sixty-two patients were free of middle-ear effusion at one or more clinic visits two to 13 weeks after presentation and were considered cured; 45 had effusion at all clinic visits during this period and were defined as having persistent effusion. The life-table analysis showed that the relative risk for persistence was 3.8 times higher in children less than 24 months of age as compared with children 24 months of age or older (P<0.001) and that this risk was 2.8 times greater for white as compared with black children (P<0.01). Other factors examined were not identified as significant risk factors. Persistent middle-ear effusion may be associated with impaired hearing and appears to be the most important sequela of otitis media. (N Engl J Med 300:1121–1123, 1979) OTITIS media is the most common diagnosis made at office visits to pediatricians.1 Its ocome is therefore of considerable interest. There is concern not only about the morbidity of acute episodes but also about the subsequent persistence of the middle-ear effusion that is seen in many children. The purpose of this study was to determine the characteristics of children who suffer from delayed resolution of acute otitis media. Materials and Methods One hundred and twenty-three children two months to 12 years of age were admitted to an otitis media study clinic. We examined 107 of them on one or more. © 1979, Massachusetts Medical Society. All rights reserved.