Endoscopic Grading of Adenoid in Otitis Media with Effusion

Abstract

INTRODUCTION:
 Adenoid is thought to be one of the causes of otitis media with effusion, though it is controversial. Grading the adenoid by rigid nasal endoscope in patients with otitis media with effusion may justify adenoidectomy in otitis media with effusion in the future.
 METHODS:
 A prospective study was carried out at GMS Memorial Academy of ENT and head neck studies from 15th December 2005-April 2007. Study group comprised of 32 children with otitis media with effusion and control group of 28 children with clinically normal ear and nose. Rigid nasal endoscope was used for grading of adenoid in study and control group. The severity of otitis media with effusion was assessed by preoperative air-bone gap and thickness of the fluid aspirated from middle ear during ventilation tube insertion.
 RESULTS:
 In the study group 13 out of 32 had grade 4 adenoid hypertrophy. This grade 4 adenoid hypertrophy was found to be statistically significant in children with otitis media with effusion (P < 0.0002). In control group 15 out of 28 had grade 1 adenoid hypertrophy which was significant in the same group (P < 0.002). Air-bone gap and thickness of fluid did not correlate with the increasing grade of adenoid hypertrophy.
 CONCLUSIONS:
 Grade 4 adenoid hypertrophy was statistically found to be significant with otitis media with effusion but severity of hypertrophy were not reflected by hearing loss and thickness of fluid.
 Keywords: adenoid hypertrophy, myringotomy , otitis media with effusion, ventilaiton tube insertion.

Relationship between chronic otitis media with effusion and overweight or obesity in children

“…Adenoid hypertrophy has been reported in children with OME and is thought to play a role in OME development 20 . A recent study showed that grade 4 adenoid hypertrophy was significantly more common in children with OME than in those without 21 . However, the presence of adenoid hypertrophy occluding more than 50 per cent of the airway passage was not associated with OME in children (affected, 40 per cent; those with lower grade adenoid hypertrophy, 60 per cent).…”

Changes in Auditory Steady - State Response and Tympanometry Post Adenotonsillectomy in Otitis Media with Effusion

“…The normal middle ear pressure is -100 mm of H 2 O to + 50 mm of H 2 O and the normal middle ear compliance is 0.39 ml to 1.30 ml. Enlarged adenoid causes tubal obstruction at its nasopharyngeal opening and causes reduction of middle ear pressure and compliance towards negative side due to absorption of gas which leads to otitis media with effusion [3]. Local symptoms and signs include hearing loss, feeling ing [7].…”

Tympanometric Findings among Children with Adenoid Hypertrophy in Port Harcourt, Nigeria

“…In general, it attains maximum size between the ages of 3 and 7 years and then regresses [ 5 ]. However, there is significant growth of the soft tissue of the nasopharynx between the age of 3 and the age of 5 years, which leads to the narrowing of the nasopharyngeal airway [ 6 ]. Subsequently, the growth of the nasopharynx increases while the soft tissues remain relatively unchanged and thus the airway increases [ 7 ].…”