Long-term otologic and auditory sequelae in children with recurrent acute otitis media

Objectives: Recurrent acute otitis media (rAOM) is common in childhood, often complicated by spontaneous tympanic membrane perforation (STMP). However, evidence on long-term otologic and hearing sequelae remains limited. This study aimed to determine the prevalence and characteristics of persistent otomicroscopic, audiometric, and tympanometric abnormalities in children with rAOM.
Methods: This longitudinal cohort study included children with a documented history of rAOM beginning at least five years prior to evaluation at a tertiary pediatric audiology clinic. All participants underwent otomicroscopy, tympanometry, and pure-tone audiometry. Long-term structural and functional ear outcomes were analyzed, and associations with clinical and epidemiological variables were assessed.
Results: A total of 141 children (58.9% boys; mean age 95.5 ± 5.9 months) were evaluated. Of the 282 TM examined, 44.3% were normal. Structural TM changes included localized myringosclerosis (22.3%), extensive retraction (11.7%), and retraction pockets (10.6%). Audiologic evaluation demonstrated mild conductive hearing loss (CHL) in 4.3% of children, low-frequency sensorineural hearing loss (SNHL) in 7.1%, low-frequency CHL in 8.5%, and high-frequency SNHL in 19.9%. A 6000 Hz notch was observed in 24.8% of cases. Tympanometric abnormalities were present in 78.7% of patients. The STMP-rAOM group had higher rates of retraction pockets (20.5% vs 7.9%, p = 0.03) and type Ad tympanograms (28.2% vs 3.2%, p < 0.01).
Conclusion: Children with rAOM frequently manifested persistent otomicroscopic and high-frequency auditory sequelae, emphasizing the importance of prolonged otologic and audiometric follow-up and enhanced hearing surveillance for vulnerable pediatric populations.