34 Otitis media with effusion in extremely premature children

Abstract

<h3></h3> Extremely preterm children (born under 28 weeks) have a high risk for hearing loss, one of the reasons for which is otitis media with effusion (OME). The higher prevalence of OME in preterm born children relative to term ones is explained by the morphofunctional immaturity, organs’ pathologies, adverse side effects of the treatment received in the NICU. The aim of study was to assess the prevalence of OME, its duration in extremely preterm children and to analyze the risk factors of OME in this population. 109 extremely preterm born children from 6 months to 15 years old were observed prospectively. The mean gestation age was 26.7±1.3 weeks; the mean birth weight was 971±197 g. All children underwent ENT assessment with otomicroscopy and audiological evaluation at least twice during the first year of their life and at least once a year for children older than 12 months. The diagnosis of chronic OME was established with disease duration of more than 8 weeks; the diagnosis of recurrent OME was confirmed in case of the presence at least two recurrences of the disease within 18 months. 64 children (58.7%) were identified with OME, 70.3% of them with bilateral effusion. OME was revealed in 47 children (43.1%) during their first year of life, the disease was more common in the second half-year. Chronic OME was established in 54.7% of all children. In addition to well-known risk factors for OME a high association of OME with perinatal infections and bronchopulmonary dysplasia (BPD) was noted in extremely preterm children. In the first year of life OME was associated with perinatal infections in 63.8% of children, and BPD in 68.1%. Incidence of recurrent OME was significantly higher in children with BPD (p&lt;0.05). In the study OME was shown to be a common, recurring disorder in extremely preterm children. It can lead to hearing problems causing speech, language, cognitive, and academic delay. One of the causes of OME was infections in the perinatal period. Children with BPD had a higher risk of OME and an increased risk of chronic/recurrent OME. The high incidence of OME in extremely premature children, especially given OME’s asympotomatic presentation, requires long-term ENT and audiological monitoring at least until the age of 3 years.