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[Diagnosis and therapy of seromucous otitis. Experience with 2766 operations on children].

We compared tympanometric patterns with the type of ear effusion on 1693 ears of children with chronic seromucous otitis. There was no exact agreement between the tympanograms and the viscosity of the middle ear effusion. We inserted ventilating tubes in 943 of 2766 ears with SOM. A tube was only used if there was mucus in the middle ear. In cases of thin fluid we used myringotomy alone. A test to find the best tube is discussed. For a child with SOM the insertion of a ventilation tube is so helpful and complications so rare that in our opinion there is no better way of treatment. The complications are probably related more to the underlying disease than to the ventilation tube.

Acoustic Impedance Tests↗

Otitis media.

Dysfunction of the eustachian tube is the underlying problem in all types of otitis media. Systemic antibiotics and careful follow-up are the treatment of choice for acute suppurative otitis media, whereas topical antibiotics with saline irrigation are used in patients with a chronic condition. Myringotomy and tube insertion may be required in patients with secretory otitis media that does not undergo spontaneous resolution.

Acute Disease↗

Mastoid obliteration with primary ossicular reconstruction.

Soft tissue mastoid obliteration was used as a means to control a persistent draining mastoid cavity that would not respond to aggressive office management using meticulous cleansing, local antibiotics, and packing. Thirty-three draining cavities which could not be controlled medically, had soft tissue mastoid obliteration performed using a Palva flap. Of the 33 cases obliterated, 31 were successful in obtaining a dry cavity but two still required cleansing every four to six months. Primary reconstruction of the hearing mechanism was performed in 21 of the 33 cases, the others having severe pre-operative cochlear damage. Of those cases reconstructed, 13 were reconstructed using a TORP and eight were reconstructed using a hemi-incus interposition.

Ear Ossicles↗