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  • Title: Pars tensa and pars flaccida retractions in persistent otitis media with effusion.
    Journal: Otol Neurotol; 2001 May; 22(3):291-8. PubMed ID: 11347629.
    Abstract:
    OBJECTIVE: In children with otitis media with effusion (OME), to investigate the incidence of, and any association, between retractions of the pars tensa and pars flaccida; to assess the effect of pars tensa and pars flaccida retractions on the hearing; to investigate risk factors for retractions; and to document the natural history of such retractions over a 12-week 'watchful aiting" period. STUDY DESIGN: Prospective, observational study. SETTING: Sixteen departments of otolaryngology in hospitals in the U.K. PATIENTS: A cohort of 1,267 children aged 3.25 to 6.75 years with confirmed OME. None had previously received surgical intervention. INTERVENTIONS: Follow-up over a "watchful waiting" period of 12 weeks. MAIN OUTCOME MEASURES: Otoscopy and pure-tone audiometry. RESULTS: Retraction of the pars tensa to the incus or promontory occurred in 8% of the better-hearing ears and 10% of the poorer-hearing ears. Pars flaccida retraction to the malleus or farther occurred in 4.5% of the better-hearing ears and 5.5% of the poorer-hearing ears. Retractions were not associated with a longer history of hearing problems. Pars tensa or pars flaccida retraction in association with OME did not materially affect the hearing. Pars tensa retractions, followed up over a 12-week period, resolved in 69% of the better-hearing ears and 65% of the poorer-hearing ears. In 14% and 10% of ears, respectively, the OME had also resolved. CONCLUSIONS: There is minimal evidence to support the concept that pars tensa or pars flaccida retractions are a strong or relevant marker for the severity or evolution of OME in children. Prospective studies over a longer period of follow-up are required to confirm this.
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