687 OTITIS MEDIA WITH EFFUSION (OME): NATURAL COURSE IN UNTREATED CHILDREN

Abstract

OME is observed in approximately 50% of patients after acute otitis media (AOM). Since concern about future dysfunction may lead to intervention such as tympanostomy tubes, it is important to gain information on the natural course of OME following AOM. To ascertain the frequency and duration of OME, 200 children < 5 years of age (110 boys and 90 girls) with AOM were enrolled in the study. All had: (1) normal tympanic membranes in the 6 weeks (w) preceding AOM; (2) OME after a 10-14 day course of antimicrobial therapy; and (3) pneumotoscopic and/or tympanometric follow-up for 16w after OME was noted. After antimicrobial therapy for AOM, 51% of children had OME. Examination at 2w intervals revealed a steadily decreasing number of children with OME: 4w, 46(23%); 6w,30 (15%); 8w,26 (13%); 12w,19 (9.5%). By the end of a 4-month follow-up, OME was observed in only 12 patients (6%). The rapid resolution noted in these patients without antecedent longstanding OME suggests that in most instances OME is a self-limiting condition. However, consistent follow-up is necessary to identify those at risk for prolonged persistence of OME.

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