A clinical study to determine the effects of adenoidectomy in cases of secretory otitis media in school going children

Abstract

<p><strong>Background: </strong>Secretory otitis media (SOM) is common otological symptom in children. If left untreated it leads to hearing and speech impairment. Surgical management is effective in serious cases. The present study was done with the objective<strong> </strong>to assess the effect of adenoidectomy by pure tone and impedance audiometry in cases of SOM with hypertrophied adenoids.</p><p><strong>Methods: </strong>This study comprised 50 cases, who were aged 5-12 years and diagnosed as SOM with adenoid hypertrophy. It was carried out for a period one and half years from December 2015 to July 2017 at Mamata Medical College and Research Hospital, Khammam, Telangana. After detailed history and clinical examination, investigations such as pure tone audiogram, impedance audiometry, X-ray nasopharynx and diagnostic nasal endoscopy were carried out to confirm the diagnosis. All patients were posted for adenoidectomy and when indication was present tonsillectomy was also done. They were followed up at 1st, 3rd and 6th month for pure tone audiometry and impedance was done at 6th month of surgery.</p><p><strong>Results: </strong>In this study, maximum number (60%) of cases belonged to 5-7 years age group, with slight male preponderance (56%). On pure tone audiometry 68% had 16-25 dB and 32% had 26-40 dB hearing loss and average being 24.95 dB. On impedance only 14% had peak preoperatively. Postoperatively, no peak/peak conversion was seen in 33% of cases and mean A-B gap improvement at 1st, 3rd and 6th month was 13 dB, 13.2 dB and 12.7 dB respectively (p value is 0.0001,<5%) when compared to preoperative findings.</p><p><strong>Conclusion: </strong>Adenoidectomy is effective in the management of middle ear infection in children having hypertrophied adenoids.</p>

Bacteriological study of nasopharyngeal carriage of the child with nasopharyngitis

“…The impact of nasopharyngeal infections on the middle ear was widely argued in the literature; Sajitha et al, Sridhar. 22,23…”

Tonsillar Hypertrophy in Childhood

“…Unlike the palatine tonsil, the other elements of Waldeyer's ring are not readily visible but possess anatomical relationships to the ear and paranasal sinuses, which can lead to pathology [33]. It has been hypothesized that facial growth abnormalities may occur with obstructive tonsillar hypertrophy or with the forward displacement of the tongue that develops as a result.…”