Otosurgery of incipient adhesive otitis media in children

In 20 children, 21 ears with incipient adhesive otitis media were treated by mobilizing the thin, adherent tympanic membrane, strengthening it with a fascial graft, inserting Silastic on the promontory, and establishing middle-ear drainage. The evaluation criteria were adhesive, atrophic and retractive changes in the tympanic membrane. The median follow-up period was 19 months. At follow-up, the material showed a statistically significant improvement in hearing, with a median hearing-loss of 17 db. post-operatively against 30 db. pre-operatively. There was a pronounced improvement in the adhesive and atrophic, as well as in the retractive, changes in the tympanic membrane. The present method of otosurgery is taken to be justified by the threat that incipient adhesive otitis media will develop into total middle-ear atelectasis with maximum hearing-loss and a risk of cholesteatoma. A further justification is afforded by the favourable therapeutic results.