Prognosis

Children

OME related to acute otitis media (AOM) has a high rate of spontaneous resolution, with 90% resolving by 3 months.[70] OME that is not preceded by AOM has a resolution rate of 28% to 52% within 3-4 months of diagnosis.[71][72] Furthermore, 30% to 40% of children in whom OME spontaneously clears will have repeated episodes of OME.[73][74][72][71] Risk factors for persistent OME include OME onset during the summer or fall seasons, prior tympanostomy tube placement, no previous adenoidectomy, and hearing loss over 30 dB HL in the better-hearing ear.[106][107]

Tympanostomy tube placement with or without adenoidectomy is the gold standard for treatment of chronic OME in children who have hearing loss, speech delay, or are at risk for speech and other developmental sequelae.[53] Around 14% of children with either OME or AOM require a second set of tubes within 5 years of initial tube placement due to recurrence of OME or AOM.[108] Risk factors for requiring a second set of tympanostomy tubes are younger aged children (<18 months), those with a family history of tympanostomy tube placement for recurrent AOM, or those who had middle ear effusions intraoperatively at the time of the first set of tubes.[109]

Adults

In adults who do not have an underlying illness as the cause of OME, the rate of spontaneous resolution within one month is around 30%.[75] Patients with a history of a preceding upper respiratory tract infection are more likely to experience spontaneous resolution of OME.[75] In practice, tympanostomy tube placement is considered for adult patients with chronic OME. In adults who undergo tympanostomy tube placement for chronic OME, the recurrence rate after tympanostomy tube extrusion is as high as 61%.[110]

Use of this content is subject to our disclaimer