Presence Of Otitis Media With Effusion Research Articles

Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy.

Adenoid hypertrophy (AH) and otitis media with effusion (OME) are common pediatric otolaryngological diseases and often occur concurrently. The purpose of this study was to comprehensively analyze the factors that influence the occurrence of OME pediatric patients with AH. Patients younger than 12 years with AH, who were hospitalized for treatment at Beijing Tsinghua Changgung Hospital in Beijing, China, between March 2018 and February 2022 were enrolled. The patients were divided into an AH group and an AH + OME group based on the presence of OME. The authors collected the following clinical data for univariable analysis: sex; age; body mass index (BMI); comorbid nasal congestion/rhinorrhea, recurrent tonsillitis, or allergic rhinitis (AR); adenoid and tonsil grade; tonsillar hypertrophy; food/drug allergy; history of adenoidectomy and congenital diseases; breastfeeding status; preterm birth; exposure to environmental tobacco smoke (ETS); family history of adenotonsillectomy, otitis media, and AR; main data of polysomnography and oropharyngeal conditional pathogen culture data of some patients. Univariate analysis was performed as a basis for logistic regression analysis. A total of 511 children (329 boys and 182 girls) were included, their mean age was 5.37 ± 2.10 years. Of them, 407 (79.6%) were in the AH group and 104 (20.4%) in the AH + OME group. Univariate analysis revealed statistically significant differences in age, BMI, adenoid grade, AR, breastfeeding status, and ETS exposure between the two groups. Multivariate stepwise logistic regression analysis showed that age, adenoid grade, AR, breastfeeding status, and ETS influenced the occurrence of OME in pediatric patients with AH. The risk of OME decreased with increasing age. High adenoid grade, ETS exposure, and comorbid AR were risk factors for OME in pediatric patients with AH, but breastfeeding was a protective factor. The final analytical results of the oropharyngeal conditional pathogen culture data showed that Streptococcus pneumoniae positivity was associated with OME in AH. The pathogenesis of AH with OME is complex. Young age, high adenoid grade, ETS exposure, non-breastfed status, comorbid AR, and the presence of S. pneumoniae in the oropharynx are risk factors for OME in pediatric patients with AH.

Cochlear Implantation in Deaf Children with Coexisting Otitis Media with Effusion: A comparative study.

Cochlear implantation (CI) is a definitive treatment for profound hearing loss in children and adults. Operating on an infected ear is considered a challenge. Hence, CI in the presence of otitis media with effusion (OME) prior to CI surgery has sparked a debate among neurotologists: treat the OME first or go ahead with surgical intervention. This study was conducted to determine whether CI in patients with OME at the time of the surgery has any influence on the surgery procedure, post-operative complications and surgical outcome. A retrospective descriptive analysis of data collected from records of patients who underwent CI surgery in Al Nahdha Hospital, Muscat, Oman, from 2000 to 2018 was conducted. The targeted age group was six months to 14 years old, excluding all adults and patients whose operations were done outside the chosen institution. Out of 369 children, 175 had OME preceding surgery compared to 194 who did not have OME. Intraoperative oedematous hypertrophied middle ear mucosa was observed only in patients with OME (n = 18; P <0.050). Moreover, among the patients with OME, mild intraoperative bleeding occurred in six cases compared to only one case in the non-OME group (P <0.050). Overall, no significant difference was observed in postoperative surgical complications between the two groups (P >0.050). The presence of OME is associated with intraoperative technical difficulties, such as impaired visualisation and bleeding. However, OME is not determinative in performing CI in terms of postoperative complications and outcome. Therefore, there is no need to delay CI until the OME resolves.

Eustachian Tube Dysfunction in Children With Adenoid Hypertrophy: The Role of Adenoidectomy for Improving Ear Ventilation.

To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value (P = .0015). Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation.

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.&#x0D; 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. &#x0D; 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.&#x0D; 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.

The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study

Background Posterior tympanotomy (PT) is an important step in cochlear implant (CI) surgery, as it is the main access to the round window. Some CI candidates, especially children, may have concomitant otitis media with effusion (OME) which may result in technical issues during PT. There is still a debate whether to wait for OME resolution preoperatively or to proceed to surgery with suspected difficulties. Aims/Objective To evaluate the safety of PT during CI surgery in patients with OME. Material and Methods we included 102 consecutive pediatric candidates in this retrospective study with an age range of 12 months to 6 years. All the patients underwent CI surgery using trans-mastoid, PT to access round window (RW) area. We investigated the effect of the pathology caused by OME on the operative procedure in PT and post-operative consequences. The Results out of 102 patients included in this study, there were 22 patients with OME who had unilateral cochlear implantation with no major operative or post-operative events. Nevertheless, some minor intra operative events and difficulties were encountered. Conclusion and Significance The presence of OME in CI surgery indicates possible surgical challenges such as difficult PT, minor intra-operative risks and with no major post-operative events.

Critical Evaluation of Sinonasal Disease in 64 Adults with Primary Ciliary Dyskinesia.

To date, no study precisely described ear, nose and throat (ENT) disease in adults with primary ciliary dyskinesia (PCD) and its relationship with ciliary function/ultrastructure. A retrospective study of standardized ENT data (exam, audiogram, sinus Computed tomography (CT), and bacteriology) was conducted in 64 adults with confirmed PCD who were followed in two ENT reference centers. Rhinorrhoea and hearing loss were the main symptoms. Symptom scores were higher in older patients. Nasal endoscopy was abnormal in all patients except one, showing nasal polyps in one-third of the patients and stagnant nasal mucus secretions in 87.5% of the patients. Sinus CT opacities were mainly incomplete and showed one-third of the patients with sinus hypoplasia and/or agenesis. Middle meatus mainly grew Haemophilus influenzae, Streptoccocus pneumoniae and Pseudomonas aeruginosa. Otitis media with effusion (OME), which is constant in childhood, was diagnosed in less than one-quarter of the patients. In two-thirds of the patients, audiogram showed hearing loss that was sensorineural in half of the patients. ENT disease severity was not correlated with ciliary function and ultrastructure, but the presence of OME was significantly associated with a forced expiratory volume (FEV1) < 70%. Rhinosinusitis is the most common clinical feature of PCD in adults, while OME is less frequent. The presence of active OME in adults with PCD could be a severity marker of lung function and lead to closer monitoring.

Conservative Management versus Ventilation Tube Insertion in Children with Otitis Media with Effusion Accompanying Cleft Palate

Background: Otitis media with effusion (OME) is a collection of non-purulent fluid in the middle ear space; it is almost universal in children with cleft palate. Cleft palate (CP) is among the most common congenital malformations, with an overall incidence of around 1 in 700 individuals. Surgical closure of the cleft palate may lead to improvement in the audiological status of the patients, but whether early surgical correction can improve the middle ear status in CP children remains open for debate. Aim: A meta-analytical study to evaluate and compare the outcome of ventilation tube insertion versus conservative management in management of otitis media with effusion accompanying cleft palate. Methods: A review process was used to assess eligible studies drawn from included published medical articles about conservative management versus ventilation tube insertion in children with otitis media with effusion accompanying cleft palate through searching the Medline data base (www.pubmed.com) and Cochrane library. Then Data were extracted and analyzed from the included studies. Results: 30 relevant articles were found, by application of inclusion criteria 8 articles were found meeting the inclusion criteria and could undergo Meta-analysis. Our results have shown that OME in children with repaired cleft palate can be managed satisfactorily without routine use of ventilation tube (VT). The presence of OME does not lead to long term complications in all patients. Hearing impairment due to OME can be satisfactorily treated with hearing aid (HA) in a majority of children. VT need to be inserted only if the child is not compliant with using a HA or develops recurrent suppurative otitis media. Patients should be followed-up closely for OME to prevent complications. Conclusion: Routine use of ventilation tube in CP patients should be discouraged; instead Treatment should be based on the need and willingness of the children and their parents. Also with respect to individual bases such when the child is proved to have OME and hearing loss that affect child language and speech development. Insertion of ventilation tubes should be offered as an alternative to hearing aids or conservative management by close otological and audiological follow up.

Postirradiation otitis media with effusion in nasopharyngeal carcinoma patients treated by intensity‐modulated radiotherapy

Postirradiation otitis media with effusion (OME) is a common adverse otologic effect in nasopharyngeal carcinoma (NPC) patients treated by radiotherapy. The purpose of this study was to determine the long-term incidence of postirradiation OME in NPC patients following intensity-modulated radiotherapy (IMRT) and to evaluate the potential factors associated with the development of this otologic complication. Retrospective observational study. A retrospective review of NPC patients treated by IMRT between January 2002 and June 2008 was conducted. Otologic complications were regularly evaluated during follow-up. Presence of OME was detected by findings of otoscopic exam, pure-tone audiometry, impedance audiometry, and tympanocentesis. Incidence of postirradiation OME and relevant factors were analyzed. A total of 105 patients (210 ears) were enrolled in the study. There were 34 patients (32.4%) with unilateral or bilateral postirradiation OME 3 years or more following radiotherapy. There was no correlation between the complication and the stage of primary tumor. The presence of pretreatment OME, however, was significantly associated with the development of postirradiation OME. Although there was no significant relationship between the radiation dose and post-treatment OME, the link with radiation toxicity was demonstrated by the finding that 28% of postirradiation OME developed in the ears contralateral to the side of primary nasopharyngeal tumor. Postirradiation OME remains a common late toxicity in NPC patients treated by modern radiotherapy. Pretreatment injuries by the tumor and radiation-induced damages to the eustachian tube both play a major role in the development of the otologic complication.

Effect of Media Restriction upon Children with Otitis Media with Effusion

The purpose of this study is to investigate the effect of viewing television and playing video games upon children with chronic otitis media with effusion (OME). Forty-nine patients (31 males and 18 females) from 1-11 years old (mean: 4.5 y.o.) were assessed for OME outcomes under media restriction. The presence of OME was evaluated with otoscopic findings. Media restriction achievement and sleep habits were examined through the use of retrospective survey questionnaires. The group of patients in whom media restriction was well-enforced (n = 43) showed a significant amelioration of OME compared with the poorly restricted group (n = 6) [p < 0.05]. A positive correlation was found between the degree of media restriction achievement and the score of sleep habits improvement [p < 0.05], and the group in whom sleep habits improved well (n = 29) showed better OME outcomes than the unchanged group (n = 20) [p < 0.05]. These findings suggest that viewing television and playing video games are both associated with subsequent deterioration of OME through sleep disturbance.

Factors associated with the presence of drug-resistant bacteria and recurrent acute otitis media in children – a study in a private clinic

Conclusions. The proportion of drug-resistant bacteria was lower than previous reports. In children with acute otitis media (AOM), lower age, presence of multiple bacteria, and otitis media with effusion (OME) represented significant factors for recurrent AOM and the presence of drug-resistant bacteria. Objective. Recently, the proportion of drug-resistant bacteria has been increasing in children with AOM. We studied the proportion of drug-resistant bacteria and background factors for detection of drug-resistant bacteria and recurrent AOM in a private clinic. Subjects and methods. Subjects comprised 170 patients <12 years old with AOM. Middle ear fluid was collected and pathogenic bacteria were identified. The following factors were considered: age, sex, use of antibiotics in the past 1 month, past history of recurrent AOM, presence of OME, and multiple bacteria of the three main strains (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis). Results. A total of 169 strains were detected in 77% of children with AOM. Drug-resistant bacteria comprised 44 of the 169 strains (26%). Lower age (p=0.001) and presence of multiple bacteria (p<0.001) represented significant factors for the presence of drug-resistant bacteria. OME was a significant factor for recurrent AOM (p<0.001).

Epidemiology and Treatment of Otitis Media with Effusion in Children in the First Year of Primary School

In this multicentre study we evaluated the prevalence and risk factors of otitis media with effusion (OME) in Italian school-children and the effectiveness of medical treatment of chronic OME with a new cephalosporin, ceftibuten. During two winter periods, 3413 children, aged 5 to 7 years, were examined for the presence of OME by means of pneumotoscopy and a portable, hand-held tympanometer. The prevalence of asymptomatic OME was 14.2%, with no difference as regards sex, age, month of examination or geographic area. Younger children had significantly more bilateral than unilateral effusion. A recent episode of acute otitis media and previous tonsillectomy or adenoidectomy were associated with an increased risk of OME in multivariate logistic regression models. The presence of OME was unrelated to such factors as birthweight, prematurity, sibling or parental history of allergy, duration of daycare attendance, family history of ear infections. After 12 weeks, 26.6% of children with OME still had middle-ear fluid: 52 were randomized to ceftibuten (9 mg/kg q.d. for 14 days) and 59 to no treatment (nasal saline drops allowed). Children treated with ceftibuten had a significantly better resolution of middle-ear effusion after 4 and 8 weeks. As mass screening programmes for OME in the year of school entry are questioned, a focus only on children with known risk factors seems advisable. Ceftibuten can be useful in reducing the duration of middle-ear effusion.

Is there a relationship between proximity to industry and the occurrence of otitis media with effusion in school entrant children?

In a study of the relationship between the prevalence of persistent otitis media with effusion (OME) in school entrant children in Redcar and Cleveland and the distance of the homes of these children from known industrial emission points, 1156 school entrant children were screened for the presence of persistent OME. The social disadvantage scores and map references were determined from the postcode area of each of the study entrants and map references were also obtained of known industrial emission points in the locality. Analyses were conducted on the association between the presence of OME and distance from emission sources and between the presence of OME and disadvantage score. A significantly greater proportion of study entrants with OME lived within 1000 metres of an industrial emission point than further away. However, there was no trend established between the proportion of study entrants with OME and increasing distance from an emissions source, nor was there any significant relationship established between the social disadvantage score of the areas of residence of the study entrants and the presence of OME. Further research is required to establish the effect of confounding variables on this relationship.

Otitis media, hearing sensitivity, and maternal responsiveness in relation to language during infancy

The relation of otitis media with effusion (OME) and associated hearing loss to language and cognitive skills at 1 year of age was studied to determine whether OME-related hearing loss had a direct association with language and cognitive outcomes at 1 year of age or an indirect association with these outcomes, as mediated by the child-rearing environment. Subjects were 61 black infants attending community-based child care programs. The presence of OME was assessed biweekly from 6 to 12 months of age by otoscopy and tympanometry. Hearing was assessed with visual reinforcement audiometry when children were well and when ill with OME. Language and cognitive skills and the child-rearing environment at home and in child care were examined. The results indicated a modest correlation between hearing loss associated with OME and receptive language. However, the direct association between OME-related hearing loss and all the language and cognitive measures was negligible. Hearing loss had an indirect association with receptive and expressive language, cognitive development, and overall communication as mediated by child-rearing factors. That is, children with more frequent hearing loss tended to have less responsive mothers and home environments, and this association was linked to lower performance on the infant assessments. (J P EDIATR 1995;126:481-9)

The otological profile of a cohort of Dutch 7.5-8-year-olds.

The otological characteristics of a birth cohort of 7.5-8-year-old Dutch children are reported. Questionnaire information was available for 1004 children, while otomicroscopic, tympanometric and pure-tone audiometric data were available for 946 children. Twenty-nine per cent of the children had been treated surgically for various ENT diseases. Fifty-five per cent of the children had normal tympanic membranes, 19% mild abnormalities, and 26% moderate to severe abnormalities. At this age the prevalence of bilateral otitis media with effusion (OME), as shown by a type B tympanogram was 2.5%, while that of unilateral OME was 7%. A pure-tone average hearing level of > or = 15 dB in the better-hearing ear was found in 4% of the children. The presence of OME was associated with a mean hearing loss of 20 dB. This study shows that structural and functional middle-ear abnormalities are highly prevalent in Dutch school children.