scholarly journals Role of adenoid hypertrophy in causation of chronic middle ear effusion

2017 ◽  
Vol 4 (1) ◽  
pp. 203
Author(s):  
Timna C. J. ◽  
Chandrika D.
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Adenoid Hypertrophy ◽  
Age Group ◽  
Type B ◽  
Middle Ear Effusion ◽  
Type C ◽  
Grade 3 ◽  
Ear Effusion

<p>Abstract:</p><p><strong>Background</strong>: Hearing  plays  a  valid  role  in  speech  development  in  children. Otitis media with effusion is one among the commonest causes of hearing loss in children especially below 12 years. It is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection</p><p><strong>Methods</strong>: A prospective study was carried out in Lourdes Hospital, Kochi, over a period of 1 year from January 2013 to December 2013. Thirty patients with chronic middle ear effusion  below the age of 12 years were selected for the study.</p><p><strong>Results</strong>: of the 30 patients  59.5% of patients were in the age group of 5-7 years of age, 16.6 % of patients were in the age group of 9-11 years of age .13.3%  of patients  each were in  the age group of 3-5 years and 7-9 years of age.Among  the 30 patients ,60% were male children and 40% patients were female children.Among the 30 patients , 40% of them had grade 3 adenoid hypertrophy ,33.3% of them had grade 2 adenoid  hypertrophy and  30% of them had grade 4 adenoid hypertrophy and none had grade 1 adenoids. majority of them had grade 3 adenoid hypertrophy by endoscopic assessment.Among  the 30 patients ,66.6 % of them had eustachian tube blockade by the adenoid mass and  33.4% of  them didn’t have eustachian tube blockade.  100% of them  with eustachian tube blockade found to have fluid on doing myringotomy  and  there was  20% of chance of absence of  fluid ,if there is absence of  eustachian tube blockade.</p><p>            Significant association was found between  type B tympanogram and presence of fluid on myringotomy .92.5% of patients with type B tympanogram had fluid on myringotomy . 57.1 % of patients with type C tympanogram  had fluid on doing myringotomy.There were 2 patients with grade 4 adenoid hypertrophy ,without eustachian tube blockade with  bilateral type C tympanogram and  there  was  bilateral dry tap on myringotomy. This reveals that type B tympanogram  and  eustachian tube blockade  better predictor of  otitis media with effusion   than grade of adenoid hypertrophy.</p><p><strong>Conclusion:</strong></p><p>    The present  study  showed that  chronic middle ear effusion was found to be most common  in the age group of  3-5  years of age group and  relatively common in the male children. Tympanogram type B was found to be  strongly associated with fluid on myringotomy .All the children with chronic middle ear effusion in the study group were found to have  ,grade 3 grade 2,and grade 4  adenoid hypertrophy in the  descending order of frequency.Grade 3 adenoid hypertrophy was present in majority of  the children in the study group .Lateral  adenoid hypertrophy ,abutting on the nasopharyngeal orifice of Eustachian tube was present in majority of children. Eustachian tube obstruction was found to be strongly  associated with  fluid on myringotomy and grommet insertion</p><p> </p>

scholarly journals Significance of Adenoidectomy in the Treatment of Otitis Media with Effusion (OME)

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Md Ashraful Islam
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Future Research ◽  
Adenoid Hypertrophy ◽  
Type B ◽  
Middle Ear Effusion ◽  
Ear Effusion ◽  
Grade Iii

Background & Objectives: Adenoid hypertrophy is one of the commonest etiology for otitis media with effusion (OME). OME is a leading cause of diminished hearing in children younger than 12 years. This study compares the efficacy of adenoidectomy on OME in patients with different grades of adenoids and the connection between different position of adenoids and middle ear effusion. Methods: This is a prospective study done on 120 pediatric patients (2 to 12 years) presented with chronic otitis media with effusion and adenoid hypertrophy from 2017 to 2019. Adenoid size was graded and correlated with the type of tympanometry. All the cases were subjected to adenoidectomy with myringotomy and were observed every 3 months. Preoperative and postoperative data were collected and comparison was made to evaluate whether adenoidectomy with myringotomy is sufficient on management of OME. Results: Adenoid tissue grading showed majority of population remained in Grade III (45%) and Grade C (56.67%). There is a highly significant relation between higher adenoid grade and type B tympanometry. This study showed significant association between grade III and grade C adenoid hypertrophy and otitis media with effusion when compared with other grades of adenoid hypertrophy. This suggests that increasing grade of adenoid hypertrophy is important predictor in establishment of otitis media with effusion in patient with adenoid hypertrophy. After adenoidectomy majority of tympanometry curve was shifted from type B to type A. In case of Grade III, type B tympanometry reduced from 45 to 11 (83% to 20%) in right ears; 49 to 7 (90% to 12%) in left ears. Again, in case of Grade C, type B tympanometry reduced from 55 to 6 (80% to 8%) in right ears; 58 to 5 (85% to 7%) in left ears. This change was significant. The greater the size of the adenoid, after adenoidectomy, more improvement noticed in tympanometry curve. Conclusion: This study may not be the actual picture of overall situation due to many limitations. Still it can be concluded that enlarged adenoids has a definite role in causing OME. This research also shows a benefit of adenoidectomy in the removal of middle ear effusion in children with OME. To efficiently assess the efficacy of adenoidectomy for otitis media with effusion in children, future research is needed.

Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

1984 ◽  
Vol 93 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Thomas F. DeMaria ◽  
David J. Lim ◽  
Bruce R. Briggs ◽  
Nobuhiro Okazaki
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Animal Experiment ◽  
Otitis Media With Effusion ◽  
Type B ◽  
Negative Bacterium ◽  
Middle Ear Effusion ◽  
Sterile Saline ◽  
Inflammatory Changes ◽  
Ear Effusion

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

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.

Impedance tympanometry and the home environment in seven-year-old children

1990 ◽  
Vol 104 (1) ◽  
pp. 4-8 ◽  
Author(s):  
David P. Strachan
Keyword(s):  
Home Environment ◽  
Middle Ear ◽  
Important Determinant ◽  
Population Sample ◽  
Age Group ◽  
Type B ◽  
Middle Ear Effusion ◽  
Gas Cooking ◽  
Random Population Sample ◽  
Ear Effusion

AbstractThe distribution of tympanogram types among 872 seven-year-old children from a random population sample was related to 14 features of the home environment reported by parents in a questionnaire. Parental smoking was an important determinant of middle ear underpressure and effusion, and accounted for much of the associations observed with dampness, crowding and rented accommodation. Gas cooking was associated with a higher prevalence of effusion, but a lower prevalence of underpressure; this may deserve further study.After adjustment for seasonal variation, tenure and household smokers, the weekly mean temperature in the bedrooms of 34 children with Type B tympanograms was 18.2°C, compared to 17.9°C for 190 children with Type A tympanograms. The equivalent figures for bedroom relative humidity were 51.8 percent and 52.7 per cent. It is unlikely that heating or ventilation of the home is an important determinant of middle ear effusion and underpressure in this age-group.

Effect of anaesthetic agents on tympanometry and middle-ear effusions

2000 ◽  
Vol 114 (5) ◽  
pp. 336-338 ◽  
Author(s):  
B. M. Fish ◽  
A. R. Banerjee ◽  
C. R. Jennings ◽  
I. Frain ◽  
A. A. Narula
Keyword(s):  
Middle Ear ◽  
General Anaesthetic ◽  
Parental Consent ◽  
Type B ◽  
Middle Ear Effusion ◽  
Anaesthetic Agents ◽  
Middle Ear Fluid ◽  
Type C ◽  
Ear Effusion ◽  
Informed Parental Consent

Following informed parental consent 93 children underwent bilateral grommet insertion. Tympanometry was performed pre-operatively, and immediately prior to myringotomy. A standardized anaesthetic was used. At myringotomy the presence or absence of fluid was recorded, as well as the time since induction of the general anaesthetic.A pre-operative type B tympanogram predicted a middle-ear effusion at myringotomy in 92 per cent of patients. A pre-operative type C2 tympanogram predicted a middle-ear effusion at myringotomy in 39 per cent of patients. Sixty tympanograms (30 per cent) changed following a general anaesthetic. Fourteen type B tympanograms changed to type A and eight of these had effusions. The duration of the general anaesthetic did not influence the probability of a middle-ear effusion being present at myringotomy. A pre-operative type B tympanogram is a good predictor of middle-ear fluid. The duration of the general anaesthetic is not significant in predicting the presence of a middle-ear effusion.

scholarly journals Impact of adenotonsillectomy on hearing profile of children with chronic middle ear effusion

2018 ◽  
Vol 5 (4) ◽  
pp. 1377
Author(s):  
Febin James ◽  
Josmy George ◽  
Regina M.
Keyword(s):  
Hearing Loss ◽  
Standard Deviation ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Age Group ◽  
Middle Ear Effusion ◽  
Adenotonsillar Hypertrophy ◽  
Ear Effusion

Background: Chronic middle ear effusion (CME) also known as otitis media with effusion (OME)/glue ear/secretory otitis media is the commonest cause of hearing loss in children, characterized by presence of sterile serous fluid within the middle ear, causing temporary and reversible hearing loss. The aim of present investigation was to determine the effect of adenotonsillectomy on hearing profile of children with persistent OME.Methods: This prospective study was conducted in the Department of ENT, Aarupadai Veedu Medical College, Pondicherry during the period of June 2014 to February 2016. 50 children, between the age group of 3-12 years, with features suggestive of OME, and adenotonsillar hypertrophy that underwent adenotonsillectomy during the study period was included in this study. Demographic details and clinical features were collected from the participants. Hearing evaluation was performed by pure tone audiometry (PTA) and tympanometry preoperatively at time of diagnosis and postoperatively at 6 weeks and 3 months after adenotonsillectomy. Data collected was plotted into master chart and analysed using paired t-test and chi square test to determine the improvement in hearing after 6 weeks and 3 months following surgery.Results: 46 children aged between 3 and 12 years with a mean age of 5.3 and standard deviation of 2.2 years. OME was most prevalent in age group was 5-7 years (34.78%) followed by 7-9 years (30.43%). There were 26 (56.52%) males and 20 (43.47%) females. Pre-operatively most of the subjects were having moderate conductive hearing loss (between 26dB to 40dB) with a mean hearing loss of 34.2dB and a standard deviation of 12.2dB. At 6 weeks postoperatively, hearing loss of children were within 16-25dB with a mean loss of 21.6dB and a standard deviation of 6.4dB. At 3 months postoperatively, 30 children were having only minimal hearing loss and 8 were having mild hearing loss.Conclusions: CME is a common cause of childhood hearing loss having a long-term sequel affecting the language development of the child. Adenoidectomy can improve the middle ear function and the hearing profile of child and can be considered as a practical management option in children with chronic adenotonsillar hypertrophy with established otitis media with effusion.

Impedance screening for otitis media with effusion in Nigerian children

1988 ◽  
Vol 102 (11) ◽  
pp. 986-988 ◽  
Author(s):  
F. O. Ogisi
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Type B ◽  
Middle Ear Effusion ◽  
Acoustic Reflex ◽  
Nigerian Children ◽  
Contributory Factors ◽  
Type C ◽  
Low Prevalence ◽  
Ear Effusion

AbstractTympanometry and acoustic reflex tests performed on 431 school children aged five to six years showed that eight per cent of the ears screened had type B or type C tympanograms suggestive of otitis media with effusion (1.2 per cent type B, and 6.8 per cent type C). Preliminary otoscopy revealed tympanic membrane appearances consistant with middle ear effusion in a correspondingly low proportion of ears (7.6 per cent), whilst acoustic reflex screening at 105 dB for three frequencies (0.5, 1 and 2 kHz) showed absent reflexes at one or more frequencies in 8.1 per cent of the ears. The findings indicate a relatively low prevalence of otitis media with effusion in children in Nigeria. Possible contributory factors are discussed.

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

1985 ◽  
Vol 12 ◽  
pp. S203-S205 ◽  
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

To Tube or Not to Tube: That Continues to Be the Question

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 332-332
Author(s):  
DAVID W. TEELE ◽  
BERNARD ROSNER ◽  
JEROME O. KLEIN
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Middle Ear Effusion ◽  
Speech And Language ◽  
Clinically Significant ◽  
Ear Effusion

In Reply.— We appreciate Chamberlin's thoughtful comments about the associations between otitis media with effusion and development of speech and language and his concern about results that are statistically significant but may not be "clinically significant." We share his view that measurements of the sequelae of disease should include those that are meaningful to the child. We reported results of tests of speech and language that indicated that children who had spent many days with middle ear effusion during the first years of life scored significantly lower than did children who had not spent such time.

Sign in / Sign up

Export Citation Format

Share Document