The outcome of acute otitis media. (A report to the Medical Research Council).

Although acute otitis media is now a much less serious condition than it was in the pre-antibiotic period, it is still very frequent, probably affecting at least a quarter of all children in the United Kingdom (Fry, 1961; Lowe, Bamforth, and Pracy, 1963; Medical Research Council, 1957; Miller, Court, Walton, and Knox, 1960; Neil, Harrison, Morbey, Robinson, Tate, and Tate, 1966). The final outcome has been in some doubt. Nowadays serious complications are rare and mastoidectomy is seldom necessary, but hearing does not always return to normal. Thus, in the Medical Research Council Report (1957), 6 5% were 'deaf' (as tested by crude methods) at the end of6 months; Neil and his colleagues (1966) noted that 20% had a hearing loss of more than 20 decibels in one or more frequencies after 6 months and in 6-5% this deafness was present still after 3-4 years; Lowe et al. (1963) reported that in 25% of their children there was a 'significant deafness' of 30 decibels or more 6 months after the attack; Olmsted, Alvarez, Moroney and Eversden (1964) reported deafness (15 decibel loss) in 12% of a group of children in Philadelphia 6 months after an attack of acute otitis media; and Reed, Struve, and Maynard (1967), in a cohort study of Eskimo children, reported deafness (loss of 25 decibels or more) in 31 % after 34 years. Although the criteria of 'deafness' are not directly comparable, it is evident that in all studies there is an appreciable proportion of children with some hearing defects after attacks of acute otitis media. It is well known that deafness can impede the educational progress of children (Ling, 1956). Faced with these differences in published reports we considered it important to determine the state of hearing in children (many now young adults) some years after suffering attacks of acute otitis media, and to try to correlate this with possible causal factors.