Otitis media with Effusion(OME)has recently been increased among children.

OME is now recognized as one of the most common childhood diseases, second only

to the common cold.　

OME is a common cause of hearing impairment in children.　

The disease develops painlessly and leads to a plugging of the ears and a conductive type

of hearing impairment.

　The influence of OME on speech and language development and psycho-intellectual

behaviour of the preschool child, aged 25-80 months, has been investigated.

And for speech and language, the negative influence was most cleary demonstrated

in the youngest age children (<47months),for intelligence and activity in the older age children.

Early detection and appropriate treatment of OME are recommended to avoid such complications

as speech and language disorder.

　A number of predisposing factors associated with prolonged OME have emerged　

The most common denominators are young age, poor tubal function, poor or depressed

immunity, and a history of acute otitis media　

　In cases not responding the repeated myringotomy or the cases showing no tendency

of healing process the insertion of tympanostomy tube should be indicated.　

Tympanostomy tube treatment has been widely employed.

The longer the length of insertion of the tube, the less the rate of recurence, and this could also

be seen among older children.　

　The result of negative tratment is the development of adhesions , and inmobile tympanic membrane

and a　permanent hearing impairment. Though myringotomy of OME gets hearing inprovement ,

it could result in hearing impairment , probably due to changes in the vibratory mobility of an eardrum

Troubles of tympanostomy tube insertion

　　　　　the most common trouble is otorrhea due to recurrence of acute infection　

occlusion of the tube　

　　　　　　　　　ears with adhesion or granulation need repeated insertions of the tube　

　　　　　　　　　　　　　　　　　　　spontaneous extrusion　

　　　　　　　　　　　　　　　　　　enlargement of the perforation

　　　　　　　　　　　　　　　Effect of adenoidectomy on OME treatment　

　Adenoid has been considered to be one of the possible causes of OME.　

However ,accumulated clinical expeience has revealed that adenidectomy is not always

effective for OME.　

　Adenoidectomy is found to have no marked effect upon hearing , if the effusion in the　

middle ear is not removed completely.

Adenoidectomy is apparently not effective for clearing effusion through the Eustachian Tube.

Otitis media is a very common infectious disease of childhood, one third of the children ,　

by the third birthday , have three or more ear infections.

Identification of children at risk for middle ear infectin

　possible high risk factors

　

Family History ; type of feeding in infancy and position during feeding,

socioeconomic and cultured factors and many others.　

Early First Bout

Prematurity

Malnutrition

Allergy

Child Abuse

Because of deleterious effect of early recurrent OM on the language development　

of children ,it would be advantageous to identify children that are at risk for OM.　

The study aiming to elucidate whether or not a tympanostomy tube could prevent

the development of purulent otitis media, showed that TT can prevent and reduce bacterial

infection.　

Severe and prolonged otitis media resists any medical tratment. Even insertion of TT may

fail to normalize the middle ear if the period of intubation is insufficient.

Tympanostomy tube had to be continued as long as possible perhaps until the Eustachian tube　

restored the ventilation function of the middle ear.

We made an animation video for the help of better understunding of OME　

The contents

Anatomy of the middle ear

Necessity of myringotomy

Ventilation tube insertion

Daily care after insertion

　OM of children and facts that their mothers want to know

Q) How long does the OM, at least, take to get well? And how many times must

mothers take their children to hospital?

A) About a month (two to four weeks)

Q) Is it necessary to take my child to hospital every day until he or she gets well?

A) No, you need not.

Q) Is it necessary to have the drum cut to get well?

A) Of course not.

Myringotomy is a good method to reduce pain and difficulty in hearing instantly.

Even if a child moves about to disturb against myringotomy, the disease will

not extremely go worse.

A) With increase of my experiences (perhaps after 40 years of age),

I think I have become constantly able to differentiate at a glance of a child

if pain will be removed with myringotomy or releases automatically without it.

Q) I have many times taken my child with OME to hospital.

When will the disease of my child get well?

Patients that attracted me

＊ Here I show you each exact procedure of my patients. The phrase "that attracted me" means that I had hard experiences for the treatments.

＊ What did I consider first and why did I select that method of treatment?

＊ Although there were cases that were prolonged for the treatments, all got well. But there have been some cases that I should have another method of treatment.

I made a statistic analysis, using a computer, of 2000 children that I participated.

〈Items I checked〉

＊How long, at least, does the OM of the mild type need care to recover?

＊How many times must the patient go to hospital?

＊ Does the result of myringotomy differ from that of nonmyringotomy? If not so,

why must be myringotomy done?

＊ As you know there are great difference between mild and severe type of OM.

How does the difference between the two come from?

Is it due to the constitution of the child, or to the method of my treatment?

＊ Does the disease grow worse without treatment? Isn't there any possibility to

get well spontaneously? Isn't there any tenacious type not to be effective against

elaborate treatment?

＊As for the antibiotics that are prescribed for the OM.

#Doesn't the disease get well without it?

#How long must it be given to the patient?

#Are not so much dosage harmful?

A. OME, if it is light or middle degree in severity, gets well once between about 3 and 6 months. Even if a child in this cathegory catches cold afterwards and the disease relapses, you don't need to worry about it.

A. OME, the really most severe type, persecute distresses the mother of the child as well as the doctor. These can be classified into next 4 groups as to the age of onset and recovery.

�@ 0 → 2 years old

�A 3 → 6 years old

�B 7 → 10 years old

�C Regardless of the age of onset, not recovers after 10 years of age

Thus analysis of data means that final period of remission depend on the age of a child regardless of the treatment by a skilled doctor or that of most modern methods. If you could know the period of beginning of the disease as I showed you above, you can anticipate when the disease will get well.