Childhood otitis media with effusion: six-year follow-up.

Twenty-five patients were re-evaluated six years after presenting with their first episode of otitis media with effusion. The average age at presentation was 6.2 years. Twenty-three were found on follow-up to have normal audiometry and tympanometry, and had improved or at least remained stable in school performance. Recurrences of acute middle ear disease were noted during follow-up in eight of the patients, specially among the six who had presented in the summer, and more frequently among the eight children who eventually had tympanostomy tubes placed. This study appears to support the concept that otherwise normal American children presenting with otitis media with effusion seem fairly uncommonly to develop severe, recurrent middle ear disease.

Childhood serous otitis media: fifteen months' observations of children untreated compared with those receiving an antihistamine-adrenergic combination.

Of 55 patients who had received, in a previously reported double-blind study, either an antihistamine-adrenergic combination or a placebo for three months for serous otitis media, 48 were followed without drug therapy for an additional year. During the follow-up period no differences were detected between the patients who had initially been treated with drugs and those who had received the placebo, as detected by audiometry, tympanometry, parental concern about hearing loss (as detected by the parents themselves or by their children's teachers or primary health care providers), school performance, or recurrences of serous otitis media.

Diagnostic and therapeutic studies in childhood serous otitis media. Results of treatment with an antihistamine-adrenergic combination.

Fifty-five children with their first recognized episodes of serous otitis media were followed over a three-month period. The efficacy of an antihistamine-adrenergic combination (diphenhydramine and pseudoephedrine), the comparative value of various diagnostic studies of middle ear function, and the prognostic importance of information obtained at the first visit were assessed. Compared double-blindly to a placebo, the pharmaceutical preparations did not appear to influence the clinical course, although more drug patients experienced lethargy or relief of symptoms not directly concerned with middle ear function (mainly upper respiratory congestion). The color and extent of motility of the tympanic membrane, but no other pneumatic otoscopic findings, were related to audiometry, whereas tympanometry correlated with the amount of motility and the presence or absence of visible fluid behind the membrane. The patients with the most severe hearing losses or with visible middle ear fluid at their initial visits improved the most, and those who began to be followed in the summer the least. The last finding may be due to a general but unexplained deterioration of childhood serous otitis media during the fall.

Treatment of sialocele: an experimental study in dogs.

A patient had a delayed complication of parotid trauma, namely a sialocele. He was successfully treated by repeated needle aspiration of the fluid. An experiment using 30 dogs was then done. On each dog, one parotid gland was used as a control, the other parotid was treated by one of three methods that the author felt would be most satisfactory. Needle aspiration was found to be the simplest and the most effective manner of treatment, because the proximal duct quickly becomes obstructed with the cessation of salivary flow, disappearance of the sialocele, and later parotid atrophy. One patient and 30 dogs are surely not conclusive proof of what would be proper treatment, but the author hopes that this paper will stimulate otolaryngologists to try this method if confronted with a similar problem.