Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman

Abstract

Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid ( P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.

Respiratory viruses in the healthy middle ear and middle ear with otitis media with effusion

“…It is a multifactorial disorder; eustachian tube (ET) dysfunction, parental smoking, family history, increased number of siblings, and microbial, immunologic, genetic, and environmental factors might have a contribution to its pathogenesis 5 . It can lead to hearing loss, language, and developmental problems 5,6 . OME mainly affects children between the ages of 1 to 6 4,5 .…”

Factors affecting the occurrence of otitis media with effusion in preschool and elementary school children: a comparative cross-sectional study

“…Furthermore, they reported the correlation between grade IV adenoid hypertrophy and middle ear effusion viscosity. 12 Another study by Nwosu et al 13 found that a higher grade of adenoid size was associated with an increased incidence of OME. 13 In addition to adenoid size, the correlation between the adenoids and OME may be caused by microbial reservoirs for ascending infection to the middle ear.…”

“… 11 Several studies have reported on the association between adenoid hypertrophy and OME. 12 13 However, a study by Durgut and Dikici concluded that adenoid size and location were not associated with hearing thresholds and the duration of OME. 14 Several studies found an association between allergic rhinitis and OME in children in subtropical countries 15–17 ; however, there are several differences in the main sensitisers in allergic patients living in tropical urban environments and subtropical areas.…”

Tympanoplasty and adenoidectomy in children: Comparison of simultaneous and sequential approaches

“…Skoloudik et al also noted that the relation between adenoids and torus tubarius is much more important than the volume of lymphoid tissues [ 15 ]. Moreover, Abdel Tawab&Tabook in their recent study reported the highly significant correlation between adenoid size and mucoid nature of middle ear fluid [ 25 ]. However, the role of adenoids in the pathogenesis of OM is more sophisticated due to infectious and inflammatory aspects.…”