Jan. 12, 1999 CHAPEL HILL - An ear condition common among infants and toddlers known as otitis media with effusion decreases steadily as children approach their school years, according to a new University of North Carolina at Chapel Hill study.
The study, conducted at UNC-CH's Frank Porter Graham Child Development Center, is good news for parents worried about early ear problems, which mostly disappear by kindergarten.
Every two to four weeks from infancy through age 5, researchers tested 86 black children attending nine child-care centers in North Carolina's Triangle area to learn whether they had otitis media with effusion and how long it lasted. The most commonly reported diagnosis for children under age 2, the condition involves inflammation, fluid buildup in the middle ear and, sometimes, infections.
"Between ages 6 months and 12 months, we found some of these children had fluid in their ears as much as three-quarters of the time," said Dr. Susan A. Zeisel, study coordinator and adjunct associate professor of nursing. "By age 2, they had it 30 percent of the time, and by age 3, they had it as little as 10 percent."
A report on the findings appears in the January issue of Pediatrics, a professional journal.
Besides Zeisel, authors are Dr. Joanne E. Roberts, research professor of speech and hearing; Dr. Eloise C. Neebe, applications analyst; Rhodus Riggins Jr., research associate; and Dr. Frederick W. Henderson, professor of pediatrics at the UNC-CH School of Medicine.
"Only eight of 60 children who had experienced more than four consecutive months of otitis media with effusion in both ears before age 2 continued to show persistent effusion after age 2," Zeisel said. "These findings are good news in that they confirm what many doctors believed -- that most children will outgrow otitis media even if we do nothing."
Children with fluid in their middle ears may or may not feel pain, Zeisel said. Some experience temporary hearing loss while others do not. A small percentage require tubes surgically placed in their ears for drainage.
Interest in otitis media with effusion is high because it appears to be increasing, possibly because of the growing number of children in child-care, she said. Some researchers believe the condition can slow children's speech and language development and impede academic success, while others say no one has documented lasting effects.
"The bottom line is that we just don't know the answer to this very important question," Zeisel said. "A lot of researchers are working on it."
While the new study contained no major surprises, it is important for several reasons, Henderson said. The examinations closely documented what happened to the children's middle ears over an extended period and now offer scientists an accurate natural history of the condition.
Most previous comparable work relied on less precise doctors' records and parents' memories, which are even less accurate. Forty-six of the 86 subjects were girls.
Throughout the study, subjects received whatever treatment their doctors felt appropriate at the time.
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