Natural History of Otitis Media

eardrum as their diagnostic criterion, Brownlee et al found that 84% of all subjects seen were noted to have had at least one bout of otitis media by the time they were five years old, and that multiple episodes were the rule rather than the exception. The incidence of otitis media in the 651 patients reported by Brownlee et al is shown in Figure 1. Fifty percent of all patients had three or more bouts of otitis and half of those went on to record six or more episodes. All of the patients were treated with antibiotics but only three myringotomies were performed throughout the 2,876 episodes of disease. The investigators did not encourage tonsillectomy and adenoidectomy but noted that of the 60 patients that were subjected to that operative procedure, no significant difference in the subsequent incidence of otitis media was seen. No patient in the series had tympanostomy tubes inserted and there was an incidence of 13% temporary hearing loss observed from random audiograms. For purposes of com-