Vitamin D level in Egyptian children with otitis media with effusion

Background This prospective case-control study was conducted from June 2018 to October 2019 in a tertiary referral hospital to investigate the correlation between otitis media with effusion (OME) and serum vitamin D level in children. The study population included 50 children with adenotonsillar hypertrophy and OME (group A) who underwent adenotonsillectomy with tympanostomy tubes insertion compared to 50 children free from any medical or surgical disease (control group). Serum 25-hydroxy vitamin D was measured using electrochemiluminescence technique for both groups. Results The mean age in group A was 53.4 ± 9.2 months whereas in group B (control group) it was 65.0 ± 13.2 months (P <0.001). In group A, there were 29 (58 %) male children and 21 (42%) female children while in group B, there were 27 (54%) male children and 23 (46%) female children (P = 0.689). The mean vitamin D level in group A was 16.0 ± 6.1 ng/mL with a minimum of 7 ng/mL and a maximum of 32.10 ng/mL. In group B, the mean vitamin D level was 15.7 ± 5.3ng/mL with a minimum of 7.38 ng/mL and a maximum of 27.90 ng/mL. The statistical analysis showed that there was no significant difference in the level of vitamin D level between both groups (P = 0.770). Conclusion In this study, the mean level of serum vitamin D was low in children suffering from OME with adenotonsillar hypertrophy and in children without any medical or surgical disease; however, there was no statistically significant difference in the mean serum level of vitamin D between both groups. Therefore, a further study on a larger sample is needed.

Risk Factors for Subtypes of Children with Speech Sound Disorders Classified by Linguistic Symptoms

Objectives: The purpose of this study is to investigate 22 risk factors for speech sound disorders (SSDs) and to find out whether there are differences in risk factors for each subtype of SSDs of Dodd’s model.Methods: Sixty-two children with SSDs aged 3-9 years participated in the study, and 22 risk factors reported in literature were investigated through parental interviews and a nonverbal intelligibility test. Children with SSDs were divided into children with articulation disorders, phonological delays, and consistent/inconsistent phonological disorders.Results: As a result of the principal component analysis, 22 risk factors were classified into 1) language and gross motor development, 2) gender and early development, 3) otitis media with effusion, 4) socioeconomic status, and 5) family history. Among all risk factors, only general developmental delay around 2 years of age showed a significantly different frequency among subtypes of SSDs.Conclusion: This study directly investigated the risk factors of children with SSDs and classified a number of risk factors into five categories. This study suggests that if children show early general developmental delays, they should be closely monitored and early evaluation and interventions should be planned.

MYRINGOTOMY FOR THE TREATMENT OF OTITIS MEDIA WITH EFFUSION; A COMPARISON IN THE OUTCOME WITH AND WITHOUT GROMMET INSERTION

Objective: To compare the outcome of myringotomy with and without grommet insertion in the patients of otitis media with effusion in terms of improvement of hearing in a one-month follow-up. Study Design: Quasi experimental study. Place and Duration of Study: Pakistan Airforce Hospital Jacobabad and Combined Military Hospital Lahore Pakistan, from Jan to Dec 2020. Methodology: A total of 28 patients aged 4-12 years diagnosed to have conductive hearing loss due to otitis media with effusion not responding to medical treatment were included. Non probability convenience sampling was done. Children aged less than 4 years and above 12 years were not included in the study. They were randomly divided into two groups of 14 patients each using lottery method. Group A underwent myringotomy alone whereas group B underwent myringotomy with grommet insertion. Patients in both groups also underwent adenoidectomy on case-to-case basis. Both groups were compared in terms of improvement in hearing post operatively in a one-month follow-up. Results: There was statistically significant reduction in air bone gap at the end of follow up period as compared to preoperative air bone gap in group B (p=0.007). In group A there was statistically significant reduction in air bone gap at one week (p=0.002) however this improvement was not maintained at 4 weeks (p=0.386). Conclusion: Myringotomy with grommet insertion had significantly more patients with improved hearing as compared to myringotomy alone after one month.

MIDDLE EAR DISORDERS AMONG CLEFT LIP AND PALATE IN CHILDREN: A CONJOINT EXPOSITION

Objective: To analyze the frequency of middle ear disorders among the cleft lip and palate and association with hearing Loss. Study Design: Cross Sectional analytical study. Place and Duration of Study: Audiology Department of Cleft Hospital, Gujrat and ENT department of National Institute of Rehabilitation Medicine, Islamabad, from Oct 2018 to Mar 2019. Methodology: We recruited a sample of 100 cleft lip and palate children of both genders, aged 3 month to 12 years, using nonprobability sampling. Screening was performed with otoscopy, tympanometry and hearing assessment. Results: Out of sample population, 62% were males and 38% females with a mean age of 2.27 ± 2.73 years. The middle ear disorders were found to be 70%. Among these otitis media with effusion was the most common 43 (61.43%), followed by Acute otitis media 8 (11.43%) and Eustachian tube dysfunction 6 (8.57%). Tympanosclerosis and dry tympanic membrane perforation were the least common. Statistically significant association of hearing loss was found with the middle ear disorders (p<0.001). Conclusion: Middle ear disorders especially otitis media with effusion are common in cleft lip/ palate children.

Acute Stress Induces Cerumen Secretion: Case series of Four Medical Students during Exams

Background and Objectives: Cerumen is a common physiological condition; it only becomes a problem if it causes a hearing impairment or other ear-related symptoms. There is increasing evidence for a relationship between stress and hearing problems. The study aims to understand the association between acute stress and increasing cerumen secretion among medical students during exams. Materials and Methods: The study is a retrospective, single-center, and consecutive case series conducted in Benha University Hospitals in Egypt We defined four cases of medical students who complained of earwax accumulation during their final exams from the 15th to the 13th of July 2021. Results: Four medical students participated in the study. Younger Females and males’ percentages were equal, and the mean age was 19.625 years old. Headache, ear discomfort, and ear pruritus are most common, followed by tinnitus, ear debris, and otitis media with effusion, while hearing loss, fever, and ear pain are slightly rare. The bilateral accumulation of earwax is typical than unilateral accumulation. Remowax was used in almost of cases and then ear wash. Males had high perceived stress, while females had moderate stress. Conclusions: This retrospective case series showed an association between acute stress and excessive cerumen secretion among small medical students during their final exams.

Acute Stress Induces Cerumen Secretion: Case series of Four Medical Students during Exams

Background and Objectives: Cerumen is a common physiological condition; it only becomes a problem if it causes a hearing impairment or other ear-related symptoms. There is increasing evidence for a relationship between stress and hearing problems. The study aims to understand the association between acute stress and increasing cerumen secretion among medical students during exams. Materials and Methods: The study is a retrospective, single-center, and consecutive case series conducted in Benha University Hospitals in Egypt We defined four cases of medical students who complained of earwax accumulation during their final exams from the 15th to the 13th of July 2021. Results: Four medical students participated in the study. Younger Females and males’ percentages were equal, and the mean age was 19.625 years old. Headache, ear discomfort, and ear pruritus are most common, followed by tinnitus, ear debris, and otitis media with effusion, while hearing loss, fever, and ear pain are slightly rare. The bilateral accumulation of earwax is typical than unilateral accumulation. Remowax was used in almost of cases and then ear wash. Males had high perceived stress, while females had moderate stress. Conclusions: This retrospective case series showed an association between acute stress and excessive cerumen secretion among small medical students during their final exams.

The validity of topical drug therapy for otitis media with effusion

Otitis media with effusion is difficult to diagnose, since the course of the disease is mostly asymptomatic, while the initial stage of the disease is very similar to Eustachiitis or the pre-perforative stage of acute otitis media. At this stage, dysfunction of the auditory tube and negative pressure in the tympanic cavity creates the conditions for the production of transudate, which clinically, in addition to hearing loss, is accompanied by soreness, a feeling of congestion, pressure, fluid transfusion in the ear. When conducting local medical procedures, they are primarily guided by the condition of the mucous membrane of the eustachian tube, nasopharynx and nasal cavity, but changes in the eardrum are no less important. Thus, the use of topical analgesics with an anti-inflammatory effect becomes no less relevant in the treatment.A literature review was carried out with an analysis of scientific research data on the use of a topical combination drug that has a local anesthetic and anti-inflammatory effect in the treatment of diseases of the external and middle ear.Analysis of the literature showed that the use of lidocaine-phenazone-containing drops promotes rapid regression of the inflammation in the external auditory canal and the tympanic membrane, as well as relieving of pain. It can be used both in children (including newborns) and in adults who are suffering from otitis media but with intact tympanic membrane, including otitis media with effusion.Combined topical drugs containing lidocaine-phenazone demonstrate efficacy and safety in the treatment of catarrhal and otitis media with effusion in all age groups.

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

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.