After almost 40 years of experience with antibiotics, treatment of otitis media (which, in the preantibiotic era, was the most common suppurative head and neck infection) still occupies the single largest time effort of the otorhinolaryngologist.1 However, the type of fluid and the nature of the complications have changed substantially. Instead of doing myringotomies and mastoidectomies to drain purulent fluid, we are doing myringotomies and inserting tubes for removal and prevention of serous and mucoid effusions.
Ironically, some physicians have postulated that the apparent current increase in the prevalence of secretory otitis media is the result of the widespread use of antibiotics. Thus, in controlling one problem it would seem that we have exacerbated another. Few would argue that society is not better off, however, because death from otitis media is now virtually unknown, and necrotizing otitis media is rarely observed. Nonetheless, it would seem that the proportion of
GATES GA. Sulfur Hexafluoride Therapy. Arch Otolaryngol. 1983;109(6):357. doi:10.1001/archotol.1983.00800200003001
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