ACUTE otitis media is an episodic disease in which individual occurrences usually resolve without specific treatment. Sequelae of acute or recurrent infection, however, are often serious and include decreased hearing, chronic mastoiditis, meningitis, cholesteatoma, tympanosclerosis, destruction of the ossicular chain, or facial nerve damage. Specific treatment of the disorder is largely aimed at preventing or reducing sequelae or complications, rather than affecting the acute episode itself. In a recent review of two Finnish prospective studies, Quarnberg and Palva1 state: "Treatment of acute otitis media, which was very straightforward up to the 1950s, has during the era of antibiotics given rise to much controversy. There are advocates of all possible methods, ranging from the use of antibiotics alone and myringotomy alone to both combined. Fortunately, no one proposes no treatment." Now, even that therapeutic nihilism has been broached.
Van Buchem et al2 conducted a double-blind, placebo-controlled, randomized clinical trial,