Abstract

OBJECTIVES--To describe the progress of the epidemic of surgery for glue ear since 1983 and trends in the use of different operative procedures. DESIGN--Analysis of routine hospital data. SETTING--Thirteen health districts in the Oxford and East Anglian regions. MAIN MEASURES--Annual rates of surgery in children under 10 years of age. RESULTS--The rate of surgery for glue ear reached a peak in 1986 since when it has declined by 12.6%. The rate peaked in all 13 districts but at different times over a six year period (1984-1989/90). Following the peak, district rates plateaued in eight districts and declined in five. These changes have been accompanied by: an increase in the proportion of operations confined to the tympanic membrane since 1983 (from 40% to 60%); an increase in the use of grommets after myringotomy (from 50% to 94% since 1980); and an increased use of day surgery for ear-only operations (from about 10% in the late 1970s to 50% in 1987/88). CONCLUSIONS--The previously reported epidemic of surgery for glue ear is waning. This seems to be a result of changes in the clinical judgment of general practitioners and surgeons as to its use and possibly of a reduced demand from parents.