Details
Category: Volume 08 Issue 03 March 2020
Hits: 1125

Title: Tympanometric Findings among Children with Enlarged Adenoids in a Tertiary Health Care Establishment

Authors: Navin Agrawal, Saket Bansal, Chhavi Agrawal, Anand Sharma, Saurabh Vijay

 DOI: https://dx.doi.org/10.18535/jmscr/v8i3.40

Abstract

   

Aim: To critically appraise the tympanometric findings among children with adenoid hypertrophy in a Tertiary Health Care Centre.

Materials and Methods: A prospective case-control study was carried out among newly diagnosed cases of adenoid enlargement in a Tertiary Health Care Centre between June 2018 and November 2018. Tympanometry was done on every study subject and each ear was studied as a single entity. Types B and C tympanograms were taken as indicators of OME. Data was collected and analysed using SPSS version 20.

Results: 59 ears were studied of the thirty patients having adenoid hypertrophy within the study period. 13 (22.03%) ears had type C tympanogram, while 16 (27.12%) ears had type B. The total incidence of OME was 49.15%; there were 5 (16.67%) unilateral OME, while bilateral OME was 12 (40%). The study showed that adenoid hypertrophy was statistically significant with the OME.

Conclusion: This study showed that enlarged adenoids is a significant risk factor for OME in children. There were more cases of bilateral OME than unilateral OME. This establishes the need for prompt hearing evaluation and management.

Keywords: Tympanometry, Adenoids, Otitis media with effusion, hearing evaluation.

References

  1. D. Bluestone, “Obstructive adenoids in relation to otitis media,” Annals of Otology, Rhinology and Laryngology, vol. 84,no. 19, pp. 44–48, 1975.
  2. I. Pelton, “New concepts in the pathophysiology and management of middle ear disease in childhood,” Drugs, vol. 52, supplement 2, pp. 62–67, 1996.
  3. E. Roberts, M. R. Burchinal, S. C. Jackson et al., “Otitis media in early childhood in relation to preschool language and school readiness skills among African American children,” Pediatrics, vol. 106, no. 4, pp. 725–735, 2000.
  4. Xia, Z.Wang, L. Cui, C. Wei, Y. Liu, and F.Huang, “The observational and analysis of the function and morphology of the ET in OME and chronic rhinosinusitis in children,” Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, vol. 28, no. 13, pp. 929–931, 2014.
  5. T. Orji, N. E. Okolugbo, and B. C. Ezeanolue, “The role of adenoidal obstruction in the pathogenesis of otitis media with effusion in Nigerian children,” Nigerian Journal of Medicine, vol.19, no. 1, pp. 62–68, 2010.
  6. A. Mwaniki, Prevalence of otitis media with effusion in children with obstructive adenoid tissue compared with normal control at the Kenyatta National Hospital. A dissertation in partial fulfillment of the requirement for the degree of masters of medicine at the university of Nairobi, Kenya [M.S. thesis], University Of Nairobi, Nairobi, Kenya, 2015.
  7. Li, L. L. Hunter, R. H.Margolis et al., “Prospective study of tympanic membrane retraction, hearing loss, and multifrequency tympanometry,” Otolaryngology Head and Neck Surgery, vol. 121, no. 5, pp. 514–522, 1999.
  8. Jaw TS, Sheu RS, Liu GC, Lin WC. Development of adenoids: a study by measurement with MRI images. Kaohsiung Journal of Medical Sciences. 1999; 15 :12-8.
  9. Goeringer GC, Vidić B. The embryogenesis and anatomy of Waldeyer's ring. Otolaryngol. Clin. North Am. 1987 May;20(2):207-17.
  10. Vogler RC, li FJ, Pilgram TK. Age-specific size of the normal adenoid pad on magnetic resonance imaging. Clinical Otolaryngology andAllied Sciences. 2000; 25: 392-5
  11. W. D. Jeans, D. C. J. Fernando, A. R.Maw, and B. C. Leighton,“A longitudinal study of the growth of the nasopharynx and its contents in normal children,” British Journal of Radiology, vol.54, no. 638, pp. 117–121, 1981
  12. Tomonaga, Y. Kurono, T. Chaen, and G. Mogi, “Adenoids and otitis media with effusion: nasopharyngeal flora,” American Journal of Otolaryngology—Head and Neck Medicine and Surgery, vol. 10, no. 3, pp. 204–207, 1989.
  13. A. Gates, “Adenoidectomy for otitis media with effusion,” Annals of Otology, Rhinology & Laryngology, vol. 163, pp. 54–58, 1994.
  14. L. Dhingra, “Eustachian tube and its disorders,” in Disease of the Ear Nose andThroat, pp.59–60, Gopsons, New Delhi, India, 4th edition, 2009.
  15. D. Bluestone, E. I. Cantekin, Q. C. Beery, and J. L. Paradise,“Eustachian tube ventilatory function in relation to cleft palate,” Annals of Otology, Rhinology and Laryngology, vol. 84,no. 3, part 1, pp. 333–338, 1975.
  16. Di Francesco, B. Paulucci , C. Nery, and R. F. Bento, “Craniofacial morphology and otitis media with effusion in children,” International Journal of Pediatric Otorhinolaryngology, vol. 72, no. 8, pp. 1151–1158, 2008.
  17. K. Margaret and D. L. Adriane, “Epidemiology of otitis media with effusion,” in Head and Neck Surgery-Otolaryngology, J. B. Byron, T. J. Jonas, D. N. Shawn et al., Eds., vol. 1, pp. 1297–1306, Williams andWilkins, New York, NY, USA, 4th edition, 2006.
  18. A. Silva, C. Kirkland, A. Simpson, I. A. Stewart, and S. M. Williams, “Some developmental and behavioral problems associated with bilateral otitis media with effusion,” Journal of Learning Disabilities, vol. 15, no. 7, pp. 417–421, 1982.
  19. S. Gravel and I. F. Wallace, “Effects of otitis media with effusion on hearing in the first 3 years of life,” Journal of Speech, Language, and Hearing Research, vol. 43, no. 3, pp. 631–644,2000.
  20. Lertsburapa, J.W. Schroeder, and C. Sullivan, “Assessment of adenoid size: a comparison of lateral radiographic measurements, radiologist assessment, and nasal endoscopy,” International Journal of Pediatric Otorhinolaryngology, vol. 74, no. 11, pp. 1281–1285, 2010.

Corresponding Author

Saket Bansal

Department of ENT, IMCHRC, Indore (M.P.), India