Abstract
Numerous papers have been published on otitis media with effusion (OME) in children, but few have concerned the aged. The clinical featuers and prognosis of OME in the aged were assessed in this study. We reviewed 74 patients over 50 years old with OME (96 ears).
Such findings as unilateral morbidity (68%) and serous effusion were common (86%) in this aged group. It was discovered that many aged patients had highly pneumatized mastoid air cells. Air conduction hearing levels had declined an average of about 27dB in the affected ears, but bone conduction was not affected by OME. The diminished air conduction recoverd after myringotomy or ventilation tube insertion.
Recurrence of OME was observed in 40% of the 85 ears treated. Recurrence was difinitely more frequent following myringotomy and a straight tube insertion than after bobin-shape tube insertion. The recurrence rate was significantly higher in patients with large mastoid air cell systems or chronic sinusitis, and lower in patients treated with a long-term ventilation tube.
It was concluded that long-term ventilation tubes are appropriate initial treatment, especially in the aged OME patients with well-developed mastoid cells or chronic sinusitis.
