Changes in the tympanic membrane in secretory otitis and its relation to chronic otitis
Tos, M.; Larsen, P.L.; Stangerup, S.E.; Siim, C.
Ugeskrift for Laeger 150(18): 1095-1100
1988
ISSN/ISBN: 0041-5782 PMID: 3368979 Document Number: 310509
A total of 117 children (194 ears) were submitted to adenotomy and tubulation on account of secretory otitits. The patients were follow-up 11-18 years after treatment in view of progression of the changes in the tympanic membrane. The average age on tubulation was four years and, on follow-up examination, 20 years. Pathological changes in the tympanic membrane were found in 63% of the ears, in the majority of cases both in the pars flaccida and the pars tensa. Abnormalities in the pars flaccida which were present in 36% consisted of various degrees of retraction:these were severe in 6% and cholesteatoma developed in 3%. Retractions of the pars flaccida forms the basis for subsequent development of cholesteatoma. Abnormalities of the pars tensa were found in 47% at the first follow-up examination 1/2-7 years after tubulation and this figure increased to 58% at the second follow-up examination 11-18 years after tubulation. The commonest abnormalities were tympanosclerosis and atrophy. Atrophy of the tympanic membrane is frequently combined with retraction which may progress to adheisve otitits which was found in 4% of the ears in this material. The risks involved in atrophic tympanic membrane and the possibility of progression to chronic ototis are discussed.