Changes in the clinical presentation of chronic otitis media from the 1970s to the 1990s.

Clinical features of 1123 patients with chronic otitis media referred to a Finnish university hospital for surgical treatment over a 20-year period were analyzed. The number of patients declined by 48 per cent from the period 1976-1985 to 1986-1995. The decline was evident in all age groups but the proportion of children increased significantly from 14 per cent in 1976-1985 to 20 per cent in 1986-1995. A male predominance was noted with the exception of patients with sequelae of otitis in whom the sex distribution was equal. In cholesteatomatous ears, no significant change occurred in the type or size of cholesteatomas or in the incidence of ossicular destruction. Likewise, no significant change was noted in the size of perforations or in the incidence of ossicular destruction in patients with dry eardrum perforations. However, hearing levels of patients treated 1976-1985 were significantly worse than those of patients 1986-1995. Severe complications caused by the disease were rare during both periods.