Functional and Morphological Correlations in Prolonged Otitis Media in Childhood

Recurrent and persistent otitis media (OM) in childhood are characterized by prolonged and clinically different courses. The aim of this work is to study functional and morphological features in children with prolonged OM forms. Children with persistent OM with effusion and recurrent acute OM were examined by impedance audiometry, brainstem evoked response audiometry, registration of oto-acoustical emissions, pneumatic otoscopy, otomicroscopy, computer tomography and examination of surgical findings. Surgery consisted of modified version of tympanostomy. Otomicroscopical, cytological and histological examinations revealed the presence of morphological changes characteristic for chronic inflammation in part of recurrent and persistent OM. Duration of the process (more than 3 months) and previous treatment (physiotherapy and adenoidectomy) correlated with chronic changes in both groups. Prolonged OM forms present interrelated stages of the common inflammatory process in the middle ear. Functional changes, indicating the presence of OM for more than 3 months are the basis for comprehensive treatment, including tympanostomy. Modified tympanostomy permits better evacuation of pathological content from tympanic cavity and improves evaluation of morphological changes.