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Ellen M. Mandel, MD; Howard E. Rockette, PhD; Charles D. Bluestone, MD; Jack L. Paradise, MD; Robert J. Nozza, PhD

Arch Otolaryngol Head Neck Surg. 1989;115(10):1217-1224.

Abstract
• We studied 109 children with otitis media with effusion of 2 months' duration or longer that was unresponsive to medical management. Eighty-six subjects who had neither "significant" hearing loss nor defined symptoms were randomly assigned to receive myringotomy, myringotomy with tympanostomy tube insertion, or no surgery, and 23 subjects with significant hearing loss, defined symptoms, or both were randomly assigned to receive either myringotomy or myringotomy with tube insertion. Myringotomy with tube insertion provided more disease-free time and better hearing than either myringotomy alone or no surgery; however, some subjects who underwent myringotomy with tube insertion developed otorrhea or persistent perforation of the tympanic membrane. Myringotomy offered no advantage over no surgery regarding percent of time with middle-ear effusion, number of acute otitis media episodes, and number of subsequent surgical procedures. These results may not properly be extrapolated to less severely affected children.

(Arch Otolaryngol Head Neck Surg. 1989;115:1217-1224)

Author Affiliations
From the Departments of Pediatrics (Drs Mandel and Paradise), Otolaryngology (Drs Bluestone and Nozza), and Graduate School of Public Health, the Department of Biostatistics (Dr Rockette), University of Pittsburgh (Pa).

Footnotes
Accepted for publication March 28, 1989.

Read in part before the Third International Symposium on Recent Advances in Otitis Media With Effusion, Fort Lauderdale, Fla, May 20, 1983.

Reprint requests to Children's Hospital of Pittsburgh, Department of Pediatric Otolaryngology, One Children's Place, 3705 Fifth Ave at DeSoto street, Pittsburgh, PA 15213 (Dr Mandel).

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