Bilateral Otitis Media With Effusion Research Articles

Topical and oral steroids for otitis media with effusion (OME) in children.

Topical and oral steroids for otitis media with effusion (OME) in children.

Antibiotics for otitis media with effusion (OME) in children.

Antibiotics for otitis media with effusion (OME) in children.

Efficacy of Mometasone Furoate Nasal Spray with Oral Montelukast in the treatment of Otitis Media with Effusion with or without Adenoid Hypertrophy and Atopic diseases

Bacground:Otitis media with effusion [OME] is a common chronic but silent disease of middle ear in children and is the commonest cause of hearing impairment, delayedlanguage development and altered quality of life.Though surgical management is the treatment of choice but now alternative medical treatment with steroid nasal spray is well accepted. Aim of this study: In this prospective, randomized placebo control study we want to observe the efficacy of Mometasone furoate nasal spray in conjunction with oral Leukotriene receptor blocker [Montelukast] in comparison to Mometasone furoate nasal spray only and normal saline spray as placebo for 3 months. Materials and Methods: Total sixty children aged 2-12 years old diagnosed with bilateral OME for at least 3 months with or without enlarged adenoid & atopic diseases, were randomly allocated into three equal groups. The first group A received Mometasonefouroate nasal spray plus Tab Montelukast for 12 weeks and second group B received only mometasonefouroate nasal spray &third group C received normal saline spray for the same duration. Result: Otoscopic clinical exam, Pure Tone audiometry & tympanometry were done at the end of treatment [3 months duration]. In otoscopic examination normal tympanic membrane finding show significant improvement in group A than group B & group C and tympanometric result in group A , show 80% improvement in middle ear status & had larger chi-square value then group B [60% improvement] and group C [10% improvement] and pure tone audiometry result show highest hearing threshold improved in group A and were more significant than group B and control group C. Conclusion: Mometasone furoate nasal spray is a much more effective medical treatment option in resulution of OME when it is combined with oral Leukotriene receptor blocker Montelukastas it helps to normalize the Eustachian tube function and middle ear status by decreasing enlarged adenoid size, atopic disorders and improving hearing power & quality of life. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 836-841

Comparing of anteroinferior and posteroinferior tympanostomy tube insertion: a cohort study.

BackgroundTympanostomy tube insertion (TTI) is one of the primary treatments for Otitis media with effusion (OME) in children, a common condition in children. However, there is still no conclusion on the better choice of tube position, and no relevant research has been found in the literature. This study analyzed the results of the two commonly selected tube insert positions, anteroinferior quadrant (AQ) and posteroinferior quadrant (PQ), in order to determine which is the better choice.MethodsChildren with bilateral OME who received TTI in Beijing Tongren Hospital from May 2020 to January 2021 were selected as subjects. one side on AQ and the other side on PQ randomly. Follow-up visits were arranged at 1 week, 1 month, 6 months and 12 months after surgery. The results of audiology and the tube status of the two positions were recorded and compared statistically.ResultsA total of 90 patients with bilateral OME were selected. There was no difference in preoperative hearing between the 2 groups. The AQ group’s average air conduction threshold was significantly higher than that of the PQ group 1 week after surgery. Although there was no significant difference in tube fall-off rate between the two groups within 6 months, it was significantly higher in AQ group than that in PQ group at 12 months after surgery.ConclusionsCompared to TTI on AQ, TTI on PQ is more stable and better improves hearing, and the operation is also more convenient for surgeons. This study provides reference for a better position of TTI in OME therapy.

Compartive study between anterosuperior and anteroinferior insertion of tympanostomy tubes in treatment of otitis media with effusion

Background: Otitis media with effusion (OME) is the condition in which fluid was presented in the middle ear cavities with absence of signs or symptoms of acute infection. Most episodes of OME resolve within 3 months, without need for surgical intervention. The placement of tympanostomy tubes (TTs) is the treatment for persistent OME. Objective: This study is performed to compare between anterosuperior and anteroinferior insertion of tympanostomy tubes in treatment of otitis media with effusion. Methods: The study included 40 patients with bilateral OME (at least 3 months did not respond to medical treatment) , divided into two groups: Group (I) included 40 patients who had been undergone myringotomy and tympanostomy tubes insertion at antero-superior quadrant of one ear (Right ear). Group (II) included the same 40 patients who had been undergone myringotomy and tympanostomy tubes insertion at antero-inferior quadrant of other ear (left ear). All patients were exposed to complete history taking, ENT examination and audiological investigation (Tympanometry, Pure Tone Audiometry), follow up of cases by clinical and audiological investigations were performed at 1,2 and 6 months.

Autoinflation compared to ventilation tubes for treating chronic otitis media with effusion

Background Otitis media with effusion (OME) is the most common cause of acquired hearing loss and surgery in children. Autoinflation has been suggested as an alternative treatment for OME. Objectives The aim of the study was to compare treatment outcome with a new autoinflation device versus ventilation tube (VT) surgery or watchful waiting in children with chronic bilateral OME from the waiting list for surgery. Methods Forty-five children performed autoinflation during four weeks, forty-five were submitted to VT surgery, and twenty-three were enrolled as control group. Tympanometry was performed in the autoinflation and the control groups and audiometry in all groups. Results An equivalent hearing improvement was achieved in the autoinflation and the VT group at one (p=.19), six (p=.23) and twelve (p=.31) months with no significant alteration in the control group. In the autoinflation group 80% of the children avoided surgery and no complications were reported compared to 34% complication rate in the VT group. Conclusion Autoinflation achieved an equivalent improvement in hearing thresholds compared to VT surgery for treating OME. Significance Autoinflation may be a reasonable first-line treatment for children with OME to potentially avoid surgery. Article Summary: The Moniri autoinflation device is well tolerated and an effective alternative to ventilation tubes for treatment of chronic otitis media with effusion in young children. What’s known on this subject: Previous studies have shown that autoinflation may reduce effusion in children with otitis media with effusion; however limited compliance to treatment, lack of adequate hearing evaluation, short follow-up time and also lack of comparative data to ventilation tube surgery have been reported. What this study adds: A new device was developed to allow for the performance of autoinflation in young children. The effect is compared to ventilation tube surgery and equivalent improvement in hearing is achieved in the short and the long-term follow-up.

INFLATE: a protocol for a randomised controlled trial comparing nasal balloon autoinflation to no nasal balloon autoinflation for otitis media with effusion in Aboriginal and Torres Strait Islander children

BackgroundOtitis media with effusion (OME) is common and occurs at disproportionately higher rates among Indigenous children. Left untreated, OME can negatively affect language, development, learning, and health and wellbeing throughout the life-course. Currently, OME care includes observation for 3 months followed by consideration of surgical ventilation tube insertion. The use of a non-invasive, low-cost nasal balloon autoinflation device has been found beneficial in other populations but has not been investigated among Aboriginal and Torres Strait Islander children.Methods/designThis multi-centre, open-label, randomised controlled trial will determine the effectiveness of nasal balloon autoinflation compared to no nasal balloon autoinflation, for the treatment of OME among Aboriginal and Torres Strait Islander children in Australia. Children aged 3–16 years with unilateral or bilateral OME are being recruited from Aboriginal Health Services and the community. The primary outcome is the proportion of children showing tympanometric improvement of OME at 1 month. Improvement is defined as a change from bilateral type B tympanograms to at least one type A or C1 tympanogram, or from unilateral type B tympanogram to type A or C1 tympanogram in the index ear, without deterioration (type A or C1 to type C2, C3, or B tympanogram) in the contralateral ear. A sample size of 340 children (170 in each group) at 1 month will detect an absolute difference of 15% between groups with 80% power at 5% significance. Anticipating a 15% loss to follow-up, 400 children will be randomised. The primary analysis will be by intention to treat. Secondary outcomes include tympanometric changes at 3 and 6 months, hearing at 3 months, ear health-related quality of life (OMQ-14), and cost-effectiveness. A process evaluation including perspectives of parents or carers, health care providers, and researchers on trial implementation will also be undertaken.DiscussionINFLATE will answer the important clinical question of whether nasal balloon autoinflation is an effective and acceptable treatment for Aboriginal and Torres Strait Islander children with OME. INFLATE will help fill the evidence gap for safe, low-cost, accessible OME therapies.Trial registrationAustralia New Zealand Clinical Trials Registry ACTRN12617001652369. Registered on 22 December 2017. The Australia New Zealand Clinical Trials Registry is a primary registry of the WHO ICTRP network and includes all items from the WHO Trial Registration data set. Retrospective registration.

Effectiveness of mometasone furoate nasal spray on tympanometric results and hearing loss in children with otitis media with effusion

BackgroundOtitis media with effusion (OME) is one of the commonest causes of hearing loss in children. Oral and nasal topical steroids alone or combined with antibiotics lead to its quicker resolution. The aim of this study was the assessment of the efficacy of mometasone furoate nasal spray in conjunction with oral antibiotics for management of OME in children. One hundred sixty-eight children aged (4–12 years old) diagnosed with bilateral OME for at least 3 months were randomly allocated into two equal groups: the 1st group received mometasone furoate aqueous nasal spray plus oral amoxicillin–clavulanate for 4 weeks, and the 2nd group received amoxicillin–clavulanate alone for the same period.ResultsThe tympanometric results after 1 month of medical treatment was much better in the 1st group compared to the 2nd group with 60% of patients of the 1st group having type A tympanogram versus 16% of patients of the 2nd group having this type (p = 0.0001). However, the average air-bone gap was not statistically different between the two groups.ConclusionMometasone furoate nasal spray is effective in OME as adjunctive treatment when combined with antibiotics as it helps to normalize the Eustachian tube function and middle ear status.

Executive Summary of Clinical Practice Guideline on Tympanostomy Tubes in Children (Update).

Executive Summary of Clinical Practice Guideline on Tympanostomy Tubes in Children (Update).

Prevalence of Asymptomatic Otitis Media with Effusion in Children with Adenoid Hypertrophy and its Relation to Adenoid Size: A Cross-sectional Study

Introduction: Otitis Media with Effusion (OME) occurs as a sequela of adenoid hypertrophy. But most often hearing loss due to OME goes unnoticed in children. This causes poor cognitive development, inattention and thus poor scholastic performance. Aim: To estimate the frequency of asymptomatic OME in children with adenoid hypertrophy and to find the association between adenoid size and occurrence of OME and hearing loss. Materials and Methods: The present study was a prospective cross-sectional study conducted in a tertiary care centre in South India from November 2019 to November 2021. Children of 5-12 years of age, with symptoms suggestive of adenoid hypertrophy and with no complaints of hearing loss, were selected. A detailed ear, nose, throat examination, Pure Tone Audiometry (PTA) and tympanometry were done in all patients. Adenoid size was graded by nasal endoscopy using Mc Murray and Clements scale and also based on radiographs (comparing the distance between maximum convexity of adenoid and line drawn along basiocciput (A) and posterior part of hard palate and sphenobasioccipital synchondrosis (N)) using A/N ratio. All patients subsequently underwent adenoidectomy. Myringotomy was done along with adenoidectomy in cases with bilateral OME. All OME patients were followed-up with tympanometry, one month and three months postoperatively. The frequency of OME was presented as percentage. The association between adenoid size and asymptomatic OME as well as hearing loss was done using Fisher's exact test. Results: A total of 150 children between 5-12 years with adenoid hypertrophy were analysed. The mean age was 9 years. On analysing the association between adenoid size (both radiographically and endoscopically) and OME, 30 (20%) had bilateral effusion and 18 (12%) had unilateral effusion and prevalence of asymptomatic OME was calculated as 32%. Most of the patients had Grade 2 adenoids radiographically, and Grade 3 adenoids as per nasal endoscopy. Majority of patients had Type B Tympanogram. There was significant association between OME and adenoid size. Association between adenoid size with hearing loss showed significant association between the two with p=0.001 on right ear and p<0.001 on left ear (radiographically), and p=0.0027 on right ear and p=0.043 on left ear (as per nasal endoscopy). About 93% of children with bilateral Type B tympanogram and all children with unilateral Type B and bilateral Type C returned to normal on three months follow-up. Conclusion: There was association between adenoid size, and occurrence of OME and hearing loss. About 32% of the study population were detected to have asymptomatic OME.

Update on first African clinical trial on earpopper for the treatment of otitis media with effusion [FCT/UATH/HREC/PR/330

Background:Otitis media with effusion (OME) is a middle ear condition characterized by the accumulation of serous fluid. It is common, though not exclusive; among children with its attendant developmental consequence if missed or untreated in early life. OME could be managed surgically, pharmacologically, or physiologically. EarPopper is a medical device developed for physiologic management of OME, Eustachian tube dysfunction, and related problems. We aim to ascertain the suitability/efficiency of EarPopper® device for the treatment of OME in our setting.Methodology:This is a prospective interventional study of volunteers diagnosed with OME from four (4) medical centers in Abuja. Pneumatic otoscopy, video-otoscopy, tympanometry, and pure-tone audiometry were done to confirm the diagnosis. Serial EarPopper sessions were performed twice weekly for 2–12 weeks, and outcome was assessed using patients’ reports. The reports include the EarPopper scoring system (ESS) and audiometric parameters (before and after therapy).Results:Forty-five patients (17 males and 28 females) aged between 3–56 years were enrolled. Thirty-five were diagnosed with bilateral OME and 10 unilateral. All patients had Type-B tympanometry tracing with mild-to-moderate conductive hearing losses and ESS of between 2.45% and 84%. Out of the 45 participants, 32 (71.1%) completed the treatment, whereas 13 (28.9%) were lost to follow-up. Duration of EarPopper treatment ranged from 2 to 12 weeks. The outcome revealed improvement in 26/32 (81.3%) with significant reduction in ESS (1% to 9.8%). Six patients 6/32 (18.9%) had persistence symptoms. These 18.9% had the propensity to progress to chronic OME.Conclusion:This study highly suggests good prospect in using EarPopper for the management of OME among Africans.

Impact of advancement of otitis media with effusion on vestibular organ condition in children

Abstract Introduction Otitis media with effusion (OME) is one of the most common otorhinolaryngological (ENT) disorders in childhood. This study aimed to investigate the vestibular organ condition in children with OME and whether the presence of vestibular disturbances depends on the advancement of OME. Materials and Methods Subjects were 53 children between 4 and 14 years old with bilateral OME and treated with middle ear drainage. The study group was divided into two subgroups according to the advancement of the disease. The participants were submitted to an evaluation consisting of anamnesis, ENT evaluation, static posturography, and electronystagmography (ENG). Examination was performed before surgery and one month after drainage. Results The posturography revealed the presence of disturbances before and after ME drainage. After drainage, the assessed parameters improved; they still, however, remained elevated. Disturbances in posturography, both before and after drainage, were expressed more fully in the subgroup with stage II compared to the stage I subgroup, especially before drainage. The analysis of the ENG confirmed that the stage of clinical advancement affects the severity of vestibular disorders in children with OME. Greater vestibular disorders in the form of the presence of spontaneous nystagmus and position were more frequent in the subgroup with stage II. Conclusions ME effusion affects the vestibular organ in children with OME. The degree of vestibular disturbances depends on the clinical advancement of the disease. The assessment of the vestibular organ condition is beneficial and should be included in the OME diagnostic and for qualification for surgical treatment.

The Efficacy of Nasal Steroids in Treatment of Otitis Media with Effusion: A Comparative Study

Introduction: Otitis media with effusion (OME) is defined as effusion in the middle ear without signs and symptoms of an acute infection. Objectives:To evaluate the efficacy of nasal steroids in OME in children by compared with oral steroids and with nasal saline spray. Patients and Methods: This study included 60 children with bilateral OME. The children were divided into three equal groups; group A, 20 children received mometasone furoate nasal spray. In group B, 20 children received oral prednisolone. In group C, 20 child received hypertonic sea water nasal spray. Clinical follow-up was done once per week for 4 weeks, at the end of treatment, and then monthly for 3 months. Otoscopic examination, audiological evaluation was done before treatment for each group and repeated at 3,6 months after treatment. Results: A highly significant difference between systemic or topical nasal steroid and hypertonic sea-water nasal spray was detected regarding symptoms improvement, clinical examination, adenoids hypertrophy and hearing condition. The difference between systemic and topical steroid was statistically insignificant. Conclusion: Nasal steroid spray is an effective treatment for OME, with a result similar to systemic steroid but without the hazard of corticosteroids.

Otitis media with effusion: The role of Helicobacter Pylori in its pathogenesis

BackgroundOtitis Media with Effusion (OME) is the most common disease of the middle ear. Different factors play a role in its pathogenesis, such as viral and bacterial infections, allergy, morphological and functional changes of nasal passage, Eustachian Tube (ET), and cleft palate. This study aims to investigate the Helicobacter Pylori presence in middle ear effusions from patients with OME through RT-PCR and compare our results with results from other published articles. MethodsThe study was carried out from October 2007 to February 2009, in the Department of Otorhinolaryngology of SS. Annunziata Hospital, Chieti, Italy. 132 consecutive patients with OME were included in the study. Fluid in the middle ear was assessed for the presence of Helicobacter Pylori through RT-PCR. Results132 consecutive patients with OME were included in the study. The patients were between ages 8 and 78 (median 50); 62 were males (47%), 70 were females (53%), and 53 patients had bilateral OME (40%). 185 samples were collected from 132 patients. Of the 185 samples taken from the ear, 21 (11.35%) were not adequate for the correct execution of the DNA extraction procedure. The remaining 167 samples, subjected to RT-PCR, did not show in any case an increase in fluorescence linked to the FAM fluorophore, thus demonstrating the complete absence of Helicobacter Pylori. ConclusionBased on the results obtained, we can affirm that although a third of the cases of OME is correlated to the presence of reflux, Helicobacter Pylori does not seem to play any role in the pathophysiology of OME as it cannot be found in endo-tympanic exudate.

Mersin'de ilkokul çocuklarında efüzyonlu otitis media prevalansı ve risk faktörleri

Aim: To investigate the prevalence of otitis media with effusion (OME) and related risk factors among primary school children in Mersin.
 Material and Method: The study was conducted at eight primary government schools in the distinct socioeconomic district between October 2018 and December 2018. Using the combined physical examination and otoscopic evaluations, a total of 960 children included the study. 
 Findings: Of the children who were screened, 53.2% were girls and the mean age was 7.57 ± 0.45 years (min: 5 - max: 11 years). In this study, OME prevalence was 2,6% (20 of 761 children) and all children had bilateral OME. There was no statistically significant difference between the presence of OME and the number of people at home, incoming level, month of birth, birth weight, duration of breastfeeding, age average, class, gender, smoking in the house, presence of hearing loss in the family, history of otitis in the family, use of pacifier, use of baby bottle, presence of allergy, previous history of otitis, the presence of open mouth, snoring and tonsil grades.
 Conclusion: Although the low prevalence of OME in our study, considering that OME and its possible preventive severe complications, screening for OME should be a part of preventive health services, particularly for primary school children.

Asymptomatic Otitis Media With Effusion in Children With Adenoid Enlargement

ObjectivesTo estimate the burden, and clinical factors associated with development of Otitis media with effusion (OME) in children with enlarged adenoids. MethodsConsecutive eligible patients with adenoid (sometimes with tonsillar) enlargement managed operatively in a period of five years. Patients had no complaints suggestive of hearing impairment. Age, sex, clinical diagnosis, and weight of patients were recorded. Otoscopic, audiometric, and radiological examinations findings were recorded. Tympanometry patterns were classified according to Jerger's classification; type B and C tympanograms represented OME. Some patients had Pure Tone Audiometry (PTA). Plain nasopharyngeal X-ray assessed the adenoid: nasopharyngeal (AN) ratio with >0.5 regarded as obstructive adenoid. Results216 ears of 108 children were assessed. 49.1% of children were in age range 1-3 years, mean 3.6 ± 2.6 years. 62.0% were males, weight ranged from 7.8 to 31.0 kg, mean was 14.3 ± 5.2 kg. 63.9% had associated tonsillar enlargement. Mean AN ratio was 0.69 ± 0.07.Tympanometric findings showed prevalence of OME in all ears was 63/216 = 29.2%, consisting of 30.5% with unilateral (Right ear 19.4%, Left ear 11.1%), and 13.9% with bilateral OME. Acoustic reflexes were absent in both ears in 32 (29.6%) of the patients. There was normal hearing in 16/38 ears (42.1%), while others had different types of hearing loss. Two factors namely increased age and weight were significantly associated with OME in patients with Adenoid enlargement. Conclusions29.2% of children with adenoid enlargement had a co-morbidity of asymptomatic OME. The factors associated with OME were increased age and weight of the patients.

The effect of middle ear effusion on the inner ear condition in children.

Otitis media with effusion (OME) is the most common cause of hearing impairment among children in developed nations. Middle ear (ME) fluid accumulation leads to progressive hearing impairment, usually of the conductive type. In some cases, mixed hearing loss associated with OME has been noted. It was reported that effusion in the ME has a negative impact on the vestibular system of the inner ear. The aim of this random-sample cohort study was to evaluate postural stability and the influence of ME drainage on vestibulospinal reflexes in children with OME, and to determine whether disturbances in the vestibular organ correlate with a sensorineural component in OME-related hearing loss. The study group consisted of 53 children with bilateral OME who were treated with bilateral ME drainage. The study group was divided into subgroups according to hearing loss. The control group consisted of 29 healthy children. Vestibular function and hearing evaluation were performed before and 4 weeks after drainage. A comparison of the stabilograms of the study group and the control group revealed elevated parameters in most of the tests. In the subgroup with mixed hearing loss, either before or after ME drainage, elevated stabilogram parameters were found in all tests. Posturography revealed vestibular system disturbances before and after ME drainage in the subgroup with mixed hearing loss, especially before ME drainage. The stabilogram parameters in the subgroup with conductive hearing loss after ME drainage were better in most tests in comparison to those before the procedure. The presence of effusion in the ME has a negative effect on the inner ear. We highlight the importance of monitoring the condition of the vestibular system in all children with OME, especially in cases with mixed hearing loss and more advanced clinical stages of the disease.

Oral steroids for hearing loss associated with otitis media with effusion in children aged 2–8 years: the OSTRICH RCT

Children with hearing loss associated with otitis media with effusion (OME) are commonly managed through surgical intervention, hearing aids or watchful waiting. A safe, inexpensive, effective medical treatment would enhance treatment options. Small, poorly conducted trials have found a short-term benefit from oral steroids. To determine the clinical effectiveness and cost-effectiveness of a 7-day course of oral steroids in improving hearing at 5 weeks in children with persistent OME symptoms and current bilateral OME and hearing loss demonstrated by audiometry. Double-blind, individually randomised, placebo-controlled trial. Ear, nose and throat outpatient or paediatric audiology and audiovestibular medicine clinics in Wales and England. Children aged 2-8 years, with symptoms of hearing loss attributable to OME for at least 3 months, a diagnosis of bilateral OME made on the day of recruitment and audiometry-confirmed hearing loss. A 7-day course of oral soluble prednisolone, as a single daily dose of 20 mg for children aged 2-5 years or 30 mg for 6- to 8-year-olds, or matched placebo. Acceptable hearing at 5 weeks from randomisation. Secondary outcomes comprised acceptable hearing at 6 and 12 months, tympanometry, otoscopic findings, health-care consultations related to OME and other resource use, proportion of children who had ventilation tube (grommet) surgery at 6 and 12 months, adverse effects, symptoms, functional health status, health-related quality of life, short- and longer-term cost-effectiveness. A total of 389 children were randomised. Satisfactory hearing at 5 weeks was achieved by 39.9% and 32.8% in the oral steroid and placebo groups, respectively (absolute difference of 7.1%, 95% confidence interval -2.8% to 16.8%; number needed to treat = 14). This difference was not statistically significant. The secondary outcomes were consistent with the picture of a small or no benefit, and we found no subgroups that achieved a meaningful benefit from oral steroids. The economic analysis showed that treatment with oral steroids was more expensive and accrued fewer quality-adjusted life-years than treatment as usual. However, the differences were small and not statistically significant, and the sensitivity analyses demonstrated large variation in the results. OME in children with documented hearing loss and attributable symptoms for at least 3 months has a high rate of spontaneous resolution. Discussions about watchful waiting and other interventions will be enhanced by this evidence. The findings of this study suggest that any benefit from a short course of oral steroids for OME is likely to be small and of questionable clinical significance, and that the treatment is unlikely to be cost-effective and, therefore, their use cannot be recommended. Studies exploring optimal approaches to sharing natural history data and enhancing shared decision-making are needed for this condition. Current Controlled Trials ISRCTN49798431 and EudraCT 2012-005123-32. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 61. See the NIHR Journals Library website for further project information.

The prevalence of otitis media in 2–3 year old Cameroonian children estimated by tympanometry

BackgroundAcute otitis media is a common illness in children under-five years of age and associated with major health care resources in high-income countries. However, there is paucity of data on its epidemiology and clinical presentation in low-income countries. We estimated the prevalence of otitis media and assessed risk factors among children in Cameroon. MethodsA community-based cross-sectional prevalence study of otitis media (OM) was performed on randomly selected children aged 2–3 years in Yaoundé, Cameroon from March to June 2013. OM was assessed by clinical inspection for chronic suppurative otitis media (CSOM) and tympanometry for otitis media with effusion (OME). CSOM was defined as draining of the middle ear with duration of more than two weeks and OME was defined as a flat ‘type B’ tympanogram. ResultsOut of 529 children enrolled in the study, 433 (56% males) subjects with available tympanograms were evaluated. Altogether, 9.7% (42/433) of children met the case definition of CSOM, OME or its complications. This consisted of 3 (0.7%) children identified with unilateral CSOM; 7 (1.6%) children with bilateral OME; 31 (7.2%) with unilateral OME and 1 (0.2%) subject with unilateral dry tympanic membrane perforation.Logistic regression analyses showed statistically significant association between OM and parental reporting of “current symptoms of upper respiratory tract infections”, Prevalence Odds Ratio (POR) = 3.71; 95% CI = 1.69–8.14). ConclusionAs many as two out of a hundred children between the ages of 2–3 years were affected by significant middle ear disease i.e. CSOM or bilateral OME. These data could be useful as a baseline for estimating the impact of pneumococcal conjugate vaccines (PCV13) introduced in July 2011 for infants in Cameroon.

The prevalence and impact of otitis media with effusion in children admitted for adeno-tonsillectomy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

IntroductionOtitis media with effusion (OME) is a leading cause of acquired hearing loss in children worldwide. However, previous South African studies have consistently reported the local paediatric OME prevalence to be lower than typically published in international literature. Furthermore, no South African studies have investigated OME in children with adenotonsillar hypertrophy. The objective of this study was to determine the prevalence of OME in children admitted for adeno-tonsillectomy at our institution in Pretoria, South Africa. In addition, the study sought to gauge the impact of OME on quality of life using a validated questionnaire (OM-6). MethodsA cross-sectional, observational study was conducted between July 2015 and May 2016 at the Otorhinolaryngology outpatient department at DGMAH. he study included 109 consecutively sampled children, aged 2–12 years (mean 6.1; 49.7% female). Pneumatic otoscopy and tympanometry were performed on all participants. Adenoid hypertrophy was quantified using he adenoid-nasopharyngeal ratio (ANR) on a lateral post-nasal space radiograph (Fujioka's method). The OM-6 questionnaire was completed for each participant. Pure tone audiometry was performed for participants diagnosed with OME. ResultsThe prevalence of bilateral OME was 11.9%. For unilateral OME, the prevalence was 22.9% and 16.5%, for the left and right ears, respectively (p > 0.05). The mean hearing loss (SD) was 19.8 dB (9.4). Clinically significant adenoid hypertrophy (ANR ≥ 0.71) was present in 43% of participants. There was no statistically significant (p > 0.05) correlation between the presence OME and adenoid hypertrophy. The mean total OM-6 survey score was 1.67 (SD ± 0.59) in children with OME, and 1.31 (SD ± 0.45) without OME, showing no statistically significant difference (p > 0.05). There was a significant (P < 0.05) correlation between OME and the presence of atopy. ConclusionAdeno-tonsillar pathology may play an aetio-pathological role in the development of OME. However, this may be due to the presence of biofilms rather than obstructive adenoid hypertrophy, given the lack of a significant (p > 0.05) correlation between adenoid hypertrophy and OME. Whilst OME was not found to impair quality of life in this population group, the validity of the OM-6 in the South African paediatric population requires further investigation.