THE DIAGNOSIS of non-suppurative, secretory otitis media has been made much more frequently in recent years than it was prior to 1950. This increase has been noticed in children many more times than in adults, as pointed out by Robison and Nicholas. The disease is much more commonly found because of increased vigilance some otologists believe, as does Suehs, since the entity was reviewed and clarified by the brilliant work of Hoople in that year.
However, there are undoubtedly other factors contributing to the greater incidence of this entity, such as the increased use of antibiotics in upper respiratory infections, including otitis media; an increase in the number of so-called virus infections; the greater prevalence of allergic diathesis; increased air travel; and, as Lindsay states, the swing of time pendulum toward extreme conservatism in recommending removal of tonsils and adenoids, a tendency resulting partly from a sense of security afforded by antibiotic therapy.
The condition has received more of the attention it merits lately from that group of practitioners who are first in contact with the patients, namely the pediatrician and general practitioner who attend the acutely ill child. For usually the actual onset of the illness is acute, an otitis media occurring during an acute upper respiratory infection or as an acute otitis media following such an illness. The former need not even reach the stage where it is definitely recognized, its progress being halted by the antibiotic treatment administered.
The attention of the attending physiciain is focused upon the middle ear in the younger child, either by the presence of pain in the affected ear, or by the abnormal appearance of the tympanic membrane, or both.
THE ETIOLOGY OF ACUTE UPPER RESPIRATORY INFECTION (COMMON COLD)
