Otitis media with effusion in Chinese preschool and school children in Hong Kong: Is the disease different from that in the West

Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle ear space (without perforation of the tympanic membrane). It is one of the most extensively studied topics in the West but data is lacking in this part of the world. Diagnosis with tympanometry remains a sensitive and specific tool in clinical medicine and has been widely accepted. The pathophysiology of OME is not well understood but its association with upper respiratory tract infections and Eustachian tube dysfunction are fully established. The roles of allergy, immunity and anatomical variations in the aetiology of OME remain to be clarified.;From 1995 to 1998, over 8000 children at age 2 to 7 underwent a stratified screening survey and case-control comparison study for risk factors in Hong Kong. The prevalence of OME in disease age-groups 2--3, 4--5 and 6--7 were identified with reference to the methods of screening and definition of tympanometric findings, ranging from 5.2% to 21.6% clinically and 7.3% to 30.7% tympanometrically with highest prevalence in the younger age-group. The natural history in terms of spontaneous resolution was also calculated.;To answer the research question of whether the disease is different from that in the West. This part of analysis is performed across the disease in countries where the epidemiological surveys have been performed in a metropolitan population. Twenty-seven comparisons were made and only two showed differences from our study. In the five areas that are dealt with in this section, our data corresponds with that found in the literature both in side-by-side comparisons and statistical analyses. The prevalences of OME in age 2--3, 4--5 and 6--7 in Hong Kong are not different from those reported in the literature. The hearing status and natural course of the disease reported in the literature are also similar to what we found in our epidemiological survey.;The general discussion on OME with reference to our findings is presented at last. The diagnostic approaches and epidemiology relevant to the local problem in Hong Kong is further expanded upon.;Based on the findings as described in this thesis, the conclusion that otitis media with effusion is not a disease different from that in the West is made.