The Prevalence of Tympanic Membrane and Related Middle Ear Pathology in Children

Objective: To record with video-otoscopy the appearance of the tympanic membranes of a cross section of children aged 9 to 10 years. Study Design: Cross-sectional study nested within an established longitudinal study of childhood development, the Avon Longitudinal Study of Parents and Children. Setting: South West England, U.K. Participants: Approximately 6908 of 7261 children with ages ranging from 105 to 140 months born between April 1, 1991, and December 31, 1992, were examined by trained technicians with video-otoscopy. Main Outcome Measures: Two photographs were taken of each child's tympanic membranes to show the features of the pars tensa and the pars flaccida. Results: In just less than three quarters of the children, both ears were normal. Retraction of the pars flaccida was present in 9.6% of children, and that of the pars tensa was present in 7.9%. Most of these changes were mild with few severe retractions. There were 15 cases of overt or suspected cholesteatoma. Conclusion: The tympanic membrane changes reflect most of the middle ear disease seen in 9- to 10-year-old children. The prevalence is low, and few children have serious disease at this stage.