Surgery for glue ear: the English epidemic wanes.

OBJECTIVES

To describe the progress of the epidemic of surgery for glue ear since 1983 and trends in the use of different operative procedures.

DESIGN

Analysis of routine hospital data.

SETTING

Thirteen health districts in the Oxford and East Anglian regions.

MAIN MEASURES

Annual rates of surgery in children under 10 years of age.

RESULTS

The rate of surgery for glue ear reached a peak in 1986 since when it has declined by 12.6%. The rate peaked in all 13 districts but at different times over a six year period (1984-1989/90). Following the peak, district rates plateaued in eight districts and declined in five. These changes have been accompanied by: an increase in the proportion of operations confined to the tympanic membrane since 1983 (from 40% to 60%); an increase in the use of grommets after myringotomy (from 50% to 94% since 1980); and an increased use of day surgery for ear-only operations (from about 10% in the late 1970s to 50% in 1987/88).

CONCLUSIONS

The previously reported epidemic of surgery for glue ear is waning. This seems to be a result of changes in the clinical judgment of general practitioners and surgeons as to its use and possibly of a reduced demand from parents.