Abstract
In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of tympanic membranes recorded over the last 5 years, we classified acute otitis media into 5 stages, proposed the utility of this classification, and evaluated the clinical course. Subjects were 811 infants and children ranging from under 1 years to 6 years of age were treated at our clinic, under the diagnosis of acute otitis media. These included 168 under one year old, 148 one year old, 81 two years old, 147 three years old, 134 four years old, 78 five years old and 55 six years old. They were observed on days 5, 10, 14 and 20 following initial examination.
At initial examination, about half of infants age 1 year or younger were stage 4 or 5 (exacerbated), while only 25% of those between 2 and 6 years were thus classified. We concluded that once inflammation develops in acute otitis media, most cases progress at least to stage 3 regardless of age.
Among infants 1 year of age or younger, 50 to 60% recovered within 20 days, while about 25% required 2 months or more. Of those in stage 5, about 90% recovered after 2 months. Of children between 2 and 3 years in stage 1, 90% recovered within 20 days ; and even those who had progressed an advanced stage almost all recovered within 2 months.
