Predictive Value of Adenoid-Nasopharyngeal Ratio in the Diagnosis of Secretory Otitis Media

Abstract

Objectives To explore the associated factors of otitis media with effusion (OME) and analyze the diagnostic value of the adenoid-nasopharyngeal (A/N) ratio to OME. Methods Patients with adenoid hypertrophy (AH) recently in 2 years were collected, including sex, age, duration, with/without rhinosinusitis, and examination results, including Cone Beam Computerized Tomography (CBCT) sinus imaging, tympanometry, pure tone audiometry (PTA), blood test, and allergen detection. According to Liden/Jerger’s classification, the patients were divided into two groups: Type B and type C, which were defined as the tympanometry abnormal group (TAG), and the rest were classified as the tympanometry normal group (TNG). Results A total of 316 children were included in this study. Age and duration were significantly younger and shorter in TAG (6.0(4.0-9.0) vs.5.0(4.0-7.0)); 12.0(4.0-24.0) vs.6.0(2.0-12.0)). Compared to TNG, the allergen test results of fx5 (protein, milk, cod, wheat, peanut, and soybean) in TAG were higher (0.09(0.04-0.25) vs.0.14(0.05-0.45)), but eosinophilia in blood was lower (count: 0.21(0.13-0.35) vs. 0.18(0.12-0.27); ratio: 3.10 (1.90-4.70) vs. 2.50 (1.65-3.80)). A/N ratio and Visual obstruction ratio had a statistical difference (Z = −3.770, P < .01) but the two ratios didn’t have too much disparity (0.82(0.74-0.88) VS 0.80(0.75-0.80)), and they had a positive correlation (r = 0.345, P < .01). A/N ratio of TAG was higher than TNG (0.78(0.70-0.85) vs. 0.86(0.82-0.90)) and had a positive correlation with increasing negative middle ear pressure (r = −3.777, P < .01). A/N ratio was an associated factor of OME (OR:1355.611, P = .006), the cut-off value of A/N ratio was 0.815(sensitivity: 75.3%, specificity: 64.3%, area under the curve (AUC): 0.747) Conclusions A/N ratio indirectly reflected the abnormality of tympanometry in this study. When A/N ratio reaches 0.815, patients are at a higher risk of having OME so it could be a predictor of OME in patients with adenoid hypertrophy.

Otitis media with effusion in preschool children with adenoid hypertrophy: Risk factors and nursing care

“…Through the ear specialist examination, it can be found that the tympanic membrane is sunken, the colour is dark or amber, bubbles or gas–liquid plane can also be seen and the tympanic activity decreases (Restuti et al., 2022). The specific manifestations of infants and young children are slow to respond to the surrounding sound, ear scratching, easy to get angry, easy to wake up from sleep and the inability to accurately turn their heads to the sound source (Li et al., 2022). Even if the child does not complain of hearing loss, parents can still find the child's behaviour changing – carelessness, lack of response to normal conversation and so on.…”

Comparative Study of Montelukast and Mometasone Furoate in the Treatment of Pediatric Obstructive Sleep Apnea Syndrome

“…The degree of adenoid hypertrophy in the patients was evaluated using the Adenoid-Nasopharyngeal ratio (A/N ratio) [9] before and after treatment. The A/N ratio of ≥0.71 was used as the pathological hypertrophy standard and surgical indication.…”

Establishment of novel immortalized middle ear cell lines as models for otitis media

“…OM is a leading cause for childhood antibiotic prescriptions, ambulatory surgery, and hearing loss 7–9 . Risk factors for AOM include those related to host (e.g., age, sex, race/ethnicity, family history of AOM and genetic predisposition, craniofacial anomalies, atopy, immunodeficiency, adenoid hypertrophy, gastroesophageal reflux) and environment (e.g., day‐care attendance, passive smoking, older siblings, use of pacifier, no breastfeeding, pollution, season) 10–14 . Research to improve OM prevention and treatment continues to be a priority given its prevalence, economic and health burdens across societies and the potential for serious difficulties including hearing loss, developmental delay, and even death 1,15,16 .…”

“… 7 , 8 , 9 Risk factors for AOM include those related to host (e.g., age, sex, race/ethnicity, family history of AOM and genetic predisposition, craniofacial anomalies, atopy, immunodeficiency, adenoid hypertrophy, gastroesophageal reflux) and environment (e.g., day‐care attendance, passive smoking, older siblings, use of pacifier, no breastfeeding, pollution, season). 10 , 11 , 12 , 13 , 14 Research to improve OM prevention and treatment continues to be a priority given its prevalence, economic and health burdens across societies and the potential for serious difficulties including hearing loss, developmental delay, and even death. 1 , 15 , 16 Despite the high prevalence, morbidity, and healthcare expenditures, there remains a lack of information regarding the cellular and molecular immunologic and inflammatory events that contribute to the pathogenesis of OM.…”