scholarly journals A study on the effect of adenoidectomy with tonsillectomy in otitis media with effusion in children

2017 ◽  
Vol 5 (5) ◽  
pp. 1796 ◽  
Author(s):  
Ajayan P. V. ◽  
Divya Raj M. L. ◽  
Anju Mariam Jacob
Keyword(s):  
Otitis Media ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Otitis Media With Effusion ◽  
Learning Ability ◽  
Government Medical College ◽  
Adenoid Hypertrophy ◽  
Tonsillar Hypertrophy ◽  
Chi Square ◽  
Medical College

Background: The aural symptoms attributed to adenoid hypertrophy are Eustachian tube block (ET) and otitis media with effusion (OME). It is thought that adenoid hypertrophy causes a block in air flow through the ET, thus creating a negative pressure in the middle ear leading to effusion which acts as a focus of infection. The role of hypertrophied tonsils in the aetiology of OME is controversial. Adenoid and tonsillar hypertrophy and associated inflammation continue to be a major problem in paediatric age group despite the advances in medicine. Otitis media with effusion is a treatable cause of deafness which may hamper the learning ability of a child. This study was undertaken to study the effect of adenoidectomy with tonsillectomy on established otitis media with effusion in children.Methods: 35 children presenting to the department of ENT, Government Medical College, Thrissur, Kerala, India over one and a half years with features suggestive of secretory otitis media, tonsillar and adenoid hypertrophy who underwent adenoidectomy with tonsillectomy in Government Medical College, Thrissur, Kerala, India were included in the study. A predesigned questionnaire was prepared which included details on clinical symptoms, relevant investigations and preoperative and postoperative evaluation of hearing after 6 weeks and 3 months. Data collected was analyzed using paired t-test and chi square test to determine the improvement in hearing after 6 weeks and 3 months following surgery.Results: Out of the 35 children included in the study, it was seen that 56% of cases, after 6 weeks showed complete resolution of OME which improved to 67% after 3 months. This was assessed by PTA and tympanometry. 33% showed partial improvement with Type C curve in tympanometry and improvement in PTA values.Conclusions: All cases of OME associated with adenoid and tonsillar hypertrophy responded to our treatment with 67% showing complete cure of the condition. It can be assumed that, in the 33% partial responders there may be other factors like allergy, anatomical deformities, immunological which prevented the complete resolution of symptoms in OME. 

scholarly journals Effect of Local versus Systemic Steroids in Treatment of Children with Otitis Media with Effusion

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A G Shafik ◽  
M S Hassabalah ◽  
A M Maarouf ◽  
M K Elghobashy
Keyword(s):  
Allergic Rhinitis ◽  
Otitis Media ◽  
Clinical Symptoms ◽  
Otitis Media With Effusion ◽  
University Hospital ◽  
Adjunctive Treatment ◽  
Oral Steroid ◽  
Adenoid Hypertrophy ◽  
Systemic Steroids ◽  
Significant Difference

Abstract Background otitis media with effusion (OME) or glue ear is the collection of fluid behind the tympanic membrane without inflammatory signs present for 6 weeks. Aim of the Work comparing the effect of intra nasal versus systemic steroids in treatment of children with Otitis media with effusion as regard: Improvement of clinical symptoms and Audiological findings. Subjects and Methods this study is a prospective, case control study on the effects of intranasal versus systemic steroids on children with otitis media with effusion. This thesis study was conducted on 30 patients diagnosed according to clinical and audiological assessment recruited from otorhinolaryngology outpatient clinic Ain Shams university hospital from October 2017 to July 2018. An informed consent was obtained from each patient or control or their legal guardians before enrolment in the study. Results however, statistically there is no significant relation between the occurrence of complete resolution of OME and the route of administration of steroid (either intranasal or systemic), whatever the cause either allergic rhinitis or adenoid hypertrophy. So we can use either intranasal or systemic steroids in management of otitis media with effusion in children with either allergic rhinitis or adenoid hypertrophy or both. Conclusion both topical intranasal and oral steroids are effective adjunctive treatment for OME in children in the short term, without significant difference between the two methods, and thus oral steroid complications could be avoided using local steroid spray.

scholarly journals Analysis of clinical profile of women presenting with pyrexia in pregnancy

2018 ◽  
Vol 7 (4) ◽  
pp. 1406
Author(s):  
Surabhi Porwal ◽  
Amita Sharma
Keyword(s):  
Clinical Symptoms ◽  
Public Health Problem ◽  
Clinical Profile ◽  
Major Public Health Problem ◽  
Abdominal Wall Defects ◽  
Chi Square ◽  
Medical College ◽  
Central Nervous System Defects ◽  
High Risk Situation ◽  
In Pregnancy

Background: Pyrexia in pregnancy is major public health problem in India. Pyrexia in pregnancy is associated with resorption of the embryo, foetal deaths and potentially lethal malformations such as central nervous system defects, abdominal-wall defects, and cardiovascular malformations. This study was carried out to analyse clinical profile of women presenting with pyrexia during pregnancy.Methods: After approval by institutional ethical committee the prospective case control study was conducted in the department of obstetrics and gynecology, NSCB Medical College, Jabalpur (M.P.) from 1st June 2012 to 31st October 2013. Total 100 antenatal women with pyrexia taken as cases and 50 antenatal women without pyrexia taken as control were included and analyzed in this study. In women fulfilling inclusion criteria detailed history was taken and documented in proforma. Required investigations were sent to the department of pathology and virology laboratory of Indian Council of Medical Research, Jabalpur. Results were analyzed statistically by using t test and chi square test.Results: On analysis of clinical symptoms pyrexia, cough, malaise, rash, headache, nausea and vomiting, joint pain, anorexia, breathlessness and burning and frequency of micturition were significantly higher in cases as compare to control. Viral pathogens were responsible for most of the cases of pyrexia in pregnancy.Conclusions: Pyrexia in pregnancy is a high-risk situation, early identification and prompt treatment will reduce maternal and perinatal morbidity and mortality associated with pyrexia in pregnancy.

scholarly journals Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry

2016 ◽  
Vol 24 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Sharath Babu K ◽  
Jayagar Prabakaran ◽  
Shankar Radhakrishnan
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Developed Countries ◽  
Wide Field ◽  
Age Group ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B

Background :  Otitis Media with Effusion(OME) also known as  Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy. Aims and Objectives :  To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion. Materials and Methods:  A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A), adenoidectomy with bilateral grommet insertion (Group B), bilateral grommet insertion (Group C),  bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D). Result : The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.   Conclusion : Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis Media with Effusion who is at risk for speech/language/hearing loss. 

scholarly journals Tympanometric changes following adenoidectomy in children with adenoid hypertrophy

2018 ◽  
Vol 4 (2) ◽  
pp. 391 ◽  
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Maximum Size ◽  
Adenoid Hypertrophy ◽  
Tube Obstruction ◽  
Media Type ◽  
Middle Ear Pressure ◽  
Pressure Changes

<p class="abstract"><strong>Background:</strong> Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect  of  adenoidectomy on Otitis Media with Effusion.</p><p class="abstract"><strong>Methods:</strong> Patients showing &gt;50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied.  </p><p class="abstract"><strong>Results:</strong> Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.</p>

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

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.

scholarly journals Does tonsillar hypertrophy contribute to speech disorders in children?

New Medicine ◽  
2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Iwona Łapińska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Clinical Analysis ◽  
Sleep Apnoea ◽  
Speech Disorders ◽  
Upper Respiratory Tract ◽  
Tonsillar Hypertrophy ◽  
Childhood Diseases ◽  
Appropriate Treatment ◽  
Tonsil Surgery

Introduction. Hypertrophy of the pharyngeal and/or palatine tonsils as well as otitis media with effusion are the most prevalent childhood diseases leading to the referral of children to the ENT specialist. Adenoidectomy is the most commonly performed surgical procedure among paediatric patients. The main indications to adenoidectomy include sleep apnoea, frequent infections of the upper respiratory tract, and otitis media with effusion (OME). OME is defined as the presence of fluid in the middle ear without coexisting symptoms of ear infection. Aim. The aims of the study were to perform a clinical analysis of patients undergoing surgery on tonsils, and to evaluate the effect of tonsillar hypertrophy on speech disorders. Material and methods. The prospective study involved a group of 92 patients subjected to surgical procedures including adenoidectomy, adenotonsillotomy and adenotonsillectomy. Results. The study was carried out in a group of 92 patients aged 4.5-18 years who underwent tonsil surgery in two of Poland’s specialist medical centres. A total of 63 patients treated in the Warsaw centre, and 29 patients receiving treatment in the Elbląg centre, were included. The vast majority of the study group comprised children aged 5 to 9 years. Hearing impairment and the need to turn up the volume of the TV before the procedure were reported by 42 (45.7%) of the respondents. A total of 37 (40.2%) patients reported having to ask about the same thing several times. Among the patients who presented with hearing problems, 28 (30.4%) reported speech disorders, and 4 (4.3%) had slurred speech. Conclusions. Correct and early diagnosis and appropriate treatment of OME in children is necessary. An improvement of hearing in children contributes to an improvement in pronunciation.

Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion

2014 ◽  
Vol 78 (7) ◽  
pp. 1143-1146 ◽  
Author(s):  
Haşmet Yazici ◽  
Fatih Kemal Soy ◽  
Erkan Kulduk ◽  
Sedat Doğan ◽  
Rıza Dündar ◽  
...  
Keyword(s):  
Otitis Media ◽  
Mucociliary Clearance ◽  
Otitis Media With Effusion ◽  
Adenoid Hypertrophy ◽  
Nasal Mucociliary Clearance
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