Incidence of Undetected Acute Otitis Media in Infants and Young Children
Although it is widely believed that the occurrence of secretory otitis media is closely related to the previous history of acute otitis media, this could not be proved in a questionnaire survey performed during an otological screening for 3-year-old children: The ratio of the ears with positive history of acute otitis media was as low as28% (Toshima et al 1992). In order to clarify whether this is due to the difficulty in diagnosis of acute otitis media in young children or no actual
... o actual correlation between the two conditions , a study was conducted to reveal the incidence of undetected acute otitis media . In a consecutive series of97children under3years of age who visited the pediatric department of Tohoku Rosai Hospital for high fever persisting for more than3days, tympanometry and microscopic examination of the tympanic membrane were performed by otolaryngologists, irrespective of aural symptoms or diagnosis. It was found that 54 out of97children (56%, 77 ears) had acute otitis media. The highest incidence (69%) was found in infants under 1 year old, followed by children in the third year of life (58%) , and the second year of life (41%) . Under two years of age79% of the cases with acute otitis media lacked aural symptoms, therefore their family was not aware of the presence of the disease. These results show that acute otitis media could not be excluded especially under two years of age even though the occurrence of the disease was not reported. This study also suggested that the cooperation between otolaryngologists and pediatricians is mandatory in order to diagnose acute otitis media correctly in infants and young children.