Zielhuis G A, Schilder A, van den Broek P
Katholieke Universiteit, afd. Epidemiologie, Nijmegen.
Ned Tijdschr Geneeskd. 1991 Sep 21;135(38):1754-7.
Description of the natural course of otitis media with effusion (OME) in pre-school children.
Longitudinal follow-up study.
Nijmegen, the Netherlands; at the children's home address.
A cohort of 1439 children born in the period September 1982 to August 1983 and living in Nijmegen at their second birthday were invited for participation in serial tympanometric screening with a three-monthly interval. Each child was measured 9 times from age 24 to 48 months. A flat tympanogram was considered to be indicative of OME. Participation was 92%, but interpretable tympanograms were taken in 2242 ears (first round) to 1990 ears (last screening). Data of 56 children treated with grommets were excluded from analysis.
Longstanding OME (at least 4 flat tympanograms in a succession) was seen in 9.3% (95%-CI 7.0-11.6) of ears. In another 23.4% (20.1-26.8) of ears OME was found 2 or 3 times at subsequent screenings. Single or recurrent flat tympanograms were seen in 20.4% (17.2-23.6) and 11.6% (9.0-14.1) of the ears respectively. The probability of recovery over time was well described with a simple function of a 50% improvement every 3 months. In addition, 50% of the recovered ears showed one or more recurrences of OME.
OME appears to run a very fluctuating course with a strong representation of short disease episodes and high rates of recovery and remission. The data confirm the results of others. A common interpretation, i.e. a sharp reduction of the recovery rate after three months, appears to be false. A 50% improvement rate every 3 months fits the data equally well. This study does not provide information about the sequelae of OME at school age.
描述学龄前儿童中耳积液（OME）的自然病程。
纵向随访研究。
荷兰奈梅亨；在儿童家庭住址。
邀请了1982年9月至1983年8月期间出生且在两岁时居住在奈梅亨的1439名儿童参与每三个月一次的系列鼓室图筛查。每个儿童在24至48个月龄期间测量9次。平坦鼓室图被认为提示中耳积液。参与率为92%，但可解读的鼓室图在2242耳（第一轮）至1990耳（最后一次筛查）中获取。56名接受鼓膜切开置管术治疗的儿童的数据被排除在分析之外。
9.3%（95%置信区间7.0 - 11.6）的耳出现长期中耳积液（连续至少4次平坦鼓室图）。在另外23.4%（20.1 - 26.8）的耳中，在后续筛查中发现中耳积液2或3次。分别有20.4%（17.2 - 23.6）和11.6%（9.0 - 14.1）的耳出现单次或反复平坦鼓室图。随着时间推移恢复的概率可用每3个月改善50%的简单函数很好地描述。此外，50%恢复的耳出现了一次或多次中耳积液复发。
中耳积液似乎病程波动很大，短病程发作占比高，恢复和缓解率也高。数据证实了其他人的结果。一种常见的解释，即三个月后恢复率急剧下降，似乎是错误的。每3个月50%的改善率同样符合数据。本研究未提供关于学龄期中耳积液后遗症的信息。
