Spontaneous course of secretory otitis and changes of the eardrum.

In 222 nonselected, otherwise healthy children, seven repetitive tympanometric screenings were performed from ages 4 to 7 years. At the last three screenings, otomicroscopy was performed and the changes of the eardrum were analyzed. At age five years 24%, at age six years 37%, and at age seven years 39% of all 444 ears had changes of the eardrum, either attic retractions of varying degrees, atrophy, and/or tympanosclerosis of the pars tensa. There was a notable correlation between eardrum abnormality, the tympanometric profile, and the frequency of acute otitis media. Some unstability of the eardrum abnormality occurred over the years, especially of attic retractions and tympanosclerosis. Treatment, especially by grommets, probably cannot prevent eardrum abnormality.