Impact of Isolation on Adenoid Size and Symptoms in Preschool Children Who Previously Qualified for Adenoidectomy: A Case–Control Study

Objectives: To analyze the role of factors that influence adenoid-related symptoms, and the influence of 3 months of isolation in preschool children who were qualified for adenoidectomy. Methods: This was a cohort study of the impact of 3 months of isolation on children aged 3 to 6 years with adenoid-related symptoms and endoscopically confirmed grade II and III adenoid hypertrophy. The children had previously qualified for adenoidectomy. After 3 months, 141 children were asked about their symptoms, 71 of whom were randomly chosen for medical examination, including endoscopic adenoid examination. Additionally, pre- and post-isolation tympanometry results were analyzed. Results: In our study, significant or mild improvements in health were observed in approximately 73% of the children; 92% of the surveyed parents reported that their children exhibited improved nasal patency, 63% of children discontinued snoring, and 30% of children showed a decrease in snoring. Data collected through surveys correlated with endoscopic findings wherein the size of the adenoid decreased by an average of 5.4%, but the amount of mucus covering the adenoid decreased more significantly in 76% of patients, which may be the main problem determining symptoms reported before isolation. In addition, the amount of residual mucus in the nasopharynx significantly affected the middle ear effusion in adenoid hypertrophy. Conclusions and Relevance: This study found that isolation in preschool children stabilizes the bacterial microbiome of the nose and nasopharynx, thereby having a significant effect not only on the number of recurrent infections of the upper respiratory tract but also on the patency of the nose. The only symptom that depended on the size of the pharyngeal tonsil hypertrophy was snoring. There was a weak correlation between prevalence of infections and adenoid size. During the isolation period, the adenoid size reduced by approximately 5.4% only, statistically more significant in the group with grade III adenoid hypertrophy, but the prevalence of infections rapidly decreased. Residual mucous in the nasopharynx found to be in correlation with middle ear effusion.

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The Impact of the Thermal Seasons on Adenoid Size, Its Mucus Coverage and Otitis Media with Effusion: A Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10235603 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5603

Author(s):

Krystyna Masna ◽

Aleksander Zwierz ◽

Krzysztof Domagalski ◽

Paweł Burduk

Keyword(s):

Cohort Study ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Total Sample ◽

Adenoid Hypertrophy ◽

Middle Ear Effusion ◽

Tonsillar Hypertrophy ◽

Seasonal Differences ◽

The Impact ◽

Ear Effusion

Background: The purpose of this study is to analyze seasonal differences in adenoid size and related mucus levels via endoscopy, as well as to estimate changes in middle ear effusion via tympanometry. Methods: In 205 children with adenoid hypertrophy, endoscopic choanal assessment, adenoid hypertrophy assessment using the Bolesławska scale, and mucus coverage assessment using the MASNA scale were performed in two different thermal seasons, summer and winter. The study was conducted in two sequences of examination, summer to winter and winter to summer, constituting two separate groups. Additionally, in order to measure changes in middle ear effusion, tympanometry was performed. Results: Overall, 99 (48.29%) girls and 106 (51.71%) boys, age 2–12 (4.46 ± 1.56) were included in the study. The first group, examined in summer (S/W group), included 100 (48.78%) children, while the group first examined in winter (W/S group) contained 105 (51.22%) children. No significant relationship was observed between the respective degrees of adenoid hypertrophy as measures by the Bolesławska scale between the S/W and W/S groups in winter (p = 0.817) and in summer (p = 0.432). The degrees of mucus coverage of the adenoids using the MASNA scale and tympanograms were also comparable in summer (p = 0.382 and p = 0.757, respectively) and in winter (p = 0.315 and p = 0.252, respectively) between the S/W and W/S groups. In the total sample, analyses of the degrees of adenoid hypertrophy using the Bolesławska three-step scale for seasonality showed that patients analysed in the summer do not differ significantly when compared to patients analysed in the winter (4.39%/57.56%/38.05% vs. 4.88%/54.63%/40.49%, respectively; p = 0.565). In contrast, the amount of mucus on the adenoids increased in winter on the MASNA scale (p = 0.000759). In addition, the results of tympanometry showed deterioration of middle ear function in the winter (p = 0.0000149). Conclusions: The obtained results indicate that the thermal seasons did not influence the size of the pharyngeal tonsils. The increase and change in mucus coverage of the adenoids and deterioration of middle ear tympanometry in winter may be the cause of seasonal clinical deterioration in children, rather than tonsillar hypertrophy. The MASNA scale was found to be useful for comparing endoscopy results.

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Antibacterial Therapy and Middle Ear Effusions

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894760850s246 ◽

1976 ◽

Vol 85 (2_suppl) ◽

pp. 250-253 ◽

Cited By ~ 1

Author(s):

Paul A. Shurin

Keyword(s):

Drug Therapy ◽

Effective Treatment ◽

Otitis Media ◽

Middle Ear ◽

Middle Ear Effusion ◽

Prolonged Administration ◽

Antimicrobial Drugs ◽

Acute Attacks ◽

Ear Effusion

Antimicrobial drugs chosen for their activity against the causative pathogens of otitis media provide effective treatment for acute attacks. Prolonged administration of some of these agents has recently been shown to be of value in the prevention of symptomatic otitis. The role of drug therapy in the management of chronic or recurrent middle ear effusion is unknown at present.

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The Role of Eustachian Tube Dysfunction in Immune-Mediated Middle Ear Effusion and Inflammation

Auris Nasus Larynx ◽

10.1016/s0385-8146(85)80149-8 ◽

1985 ◽

Vol 12 ◽

pp. S203-S205 ◽

Cited By ~ 1

Author(s):

Allen F. Ryan ◽

Jeffrey P. Harris ◽

Antonino Catanzaro ◽

Stephen I. Wasserman

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Eustachian Tube Dysfunction ◽

Middle Ear Effusion ◽

Immune Mediated ◽

Tube Dysfunction ◽

Ear Effusion

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Role of Tonsillectomy and Adenoidectomy in the Management of Children with Middle Ear Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800890s513 ◽

1980 ◽

Vol 89 (5_suppl) ◽

pp. 43-46 ◽

Cited By ~ 2

Author(s):

James B. Snow

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Clinical Effectiveness ◽

First Year ◽

Middle Ear Effusion ◽

Beneficial Effects ◽

Per Se ◽

Second Year ◽

Ear Effusion

Evidence for the clinical effectiveness of adenoidectomy or tonsillectomy and adenoidectomy in the management of children with persistent middle ear effusions is incomplete and what evidence there is in the literature is not convincing. In the first year after tonsillectomy and adenoidectomy there is less otitis media. The beneficial effects of tonsillectomy and adenoidectomy on the incidence of otitis media declines in the second year after the operation. The prevailing opinion is that adenoidectomy is not indicated in the vast majority of children in whom a middle ear effusion has persisted for six weeks or more in spite of antibiotic therapy. Factors favoring an adenoidectomy would be persistent nasal obstruction, persistent purulent rhinorrhea and persistent adenoiditis. The role of tonsillectomy is even less clear, but the decision regarding tonsillectomy is made by most clinicians on the basis of the amount of intercurrent or chronic tonsillitis rather than on the basis of the middle ear effusion per se.

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Comparison of the proteins of middle ear effusion with human mast cell proteins

The Journal of Laryngology & Otology ◽

10.1017/s0022215100132293 ◽

1995 ◽

Vol 109 (12) ◽

pp. 1146-1150

Author(s):

Yoseph Rakover ◽

Amir Shneyour ◽

Gabriel Rosen ◽

Yaacov Lensky

Keyword(s):

Mast Cells ◽

Middle Ear ◽

Human Mast Cell ◽

Middle Ear Effusion ◽

Secretory Otitis Media ◽

Human Mast Cells ◽

Gradient Gel Electrophoresis ◽

Protein Components ◽

Ear Effusion

AbstractIn order to clarify the role of mast cells in the aetiology of secretory otitis media (SOM), we compared the protein components of middle ear effusion (MEE) with human mast cells using acrylamide gradient gel electrophoresis and electrofocusing methods. This first direct comparison between the proteins of MEE and human mast cells has been made possible by a method developed in our laboratory for cultivation of human mast cells in tissue culture.On electrophoresis, we found that out of 12 bands of MEE proteins that were different from the serum, seven (58 per cent) had a similar electrophoretic migration rate (Rx) to mast cells. On electrofocusing, three of the four bands of MEE had a similar Rx to the mast cells. We have shown that proteins of mast cells and MEE had similar Rxs. Therefore, our study supports previous studies which suggests that mast cells play an important role in the aetiology of SOM.

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The Role of Coagulase-Negative Staphylococci in Chronic Otitis Media With Effusion

Otolaryngology ◽

10.1177/019459988209000628 ◽

1982 ◽

Vol 90 (6) ◽

pp. 837-843 ◽

Cited By ~ 10

Author(s):

Joel M. Bernstein ◽

Diane Dryja ◽

Erwin Neter

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Antibiotic Sensitivity ◽

Middle Ear Effusion ◽

Coagulase Negative Staphylococci ◽

Heterogenous Group ◽

Ear Effusion

Twenty-eight middle ear effusions from 27 patients with chronic otitis media with effusion were studied for the presence of bacteria. The most common isolates were coagulase-negative staphylococci. However, biochemical and antibiotic sensitivity patterns demonstrated that these organisms represented a heterogenous group. At least three subtypes of coagulase-negative staphylococci were identified from the middle ear effusions, and in only one instance was the isolate from the ear canal identical with that of the middle ear effusion. The data presented suggest that coagulase-negative staphylococci from the middle ear effusions may not be contaminants; however, it cannot be determined from this study whether these organisms play a role as pathogens or as the result of indolent colonization.

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Middle Ear Effusion—Allergy Relationships

Ear Nose & Throat Journal ◽

10.1177/014556139507401106 ◽

1995 ◽

Vol 74 (11) ◽

pp. 752-758 ◽

Cited By ~ 8

Author(s):

Kenneth F. Mattucci ◽

Barak J. Greenfield

Keyword(s):

Surgical Therapy ◽

Middle Ear ◽

Common Factor ◽

Middle Ear Effusion ◽

Number Of Children ◽

Tube Dysfunction ◽

Allergy Treatment ◽

The Common ◽

Ear Effusion

Middle ear effusion (MEE), in its various forms, is one of the most common disorders of childhood. There are several possible etiologies, depending on the makeup of the effusion. However, the common factor in many middle ear effusions is eustachian tube dysfunction, and the role of allergy, although only one of many possible causes, is significant. A relatively large number of children with MEE are found to have atopic disorders. Nonetheless, allergy treatment alone must not preclude the use of conventional medical and surgical therapy. Optimal results will be obtained if recurrent or persistent MEE is managed in a coordinated manner by the otologist, pediatrician and allergist.

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Pediatrician's View of Middle Ear Effusions: More Questions than Answers

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894760850s206 ◽

1976 ◽

Vol 85 (2_suppl) ◽

pp. 20-24 ◽

Cited By ~ 20

Author(s):

Jack L. Paradise

Keyword(s):

Middle Ear ◽

Chronic Conditions ◽

Well Being ◽

Supporting Evidence ◽

Middle Ear Effusion ◽

Pediatric Practice ◽

Infancy And Childhood ◽

Controlled Treatment ◽

The Impact ◽

Ear Effusion

Although middle ear effusion is the most common of the chronic conditions encountered in pediatric practice, it frequently goes unrecognized, and relatively little is known about its epidemiology or its natural history. More importantly, the impact of middle ear effusion on the overall well-being of infants and children, and on their cognitive and language development, remains essentially unexplored. In part because of these gaps in our knowledge, and also because prospective, controlled treatment trials have not been reported, uncertainty and controversy exist concerning: 1) the necessity, in many instances, of treating middle ear effusion; 2) the choice of various treatment methods; and 3) the timing of those treatments that are undertaken. Finally, the widespread use of adenoidectomy to prevent middle ear inflammation is seriously lacking in supporting evidence. A few reported studies bear on some of these questions, but both their scope and the information they provide are limited. In order to resolve important prognostic and treatment issues concerning middle ear effusion during infancy and childhood, carefully designed epidemiologic and clinical studies of types not hitherto reported are urgently needed.

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