Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors

Background: Adult-onset otitis media with effusion (AO-OME) is relatively difficult to characterize, because of its associated co-morbidities. Objectives: To quantify the burden, assess co-existing diseases, and management of patients with AO-OME. Design of the Study: A descriptive observational prospective study. Setting: Clinical department in a tertiary hospital. Materials and Methods: Adult patients with conductive hearing impairment without ear discharge (excluding other pathologies) nor external ear pathology were eligible. The patients also had tympanometry with type B tracings (tympanograms). Interventions: Clinico-demographic characteristics, history of otologic symptoms, affected ear, and hearing impairment were obtained. Pure-tone audiometry (PTA), tympanometry, and radiological investigations were performed. Other existing diseases (co-morbidities) were noted. The main outcome measure was audiologically confirmed AO-OME. Results: Prevalence of AO-OME was (110/3452) 3.2%. Young adults (age group 18–30 years) constituted 33.7% (28/83), mean age was 37.3 ± 11.5 years, and 46/83 (55.4%) were males and 37/83 (44.6%) were females. The common otologic symptoms were feeling of fullness in the ear in 27.7% (23/83), hearing loss in 24.1% (20/83), and bilateral ear involvement in 32.5% (27/83). PTA revealed 8.2% (9/110) had normal hearing, whereas 62.7% (69/110) ears had conductive hearing loss. Patients had radiological investigations, namely plain X rays in 67.5% (56/83) and computerized tomography scan of sinuses in 10.8% (9/83). Three (3/83) patients (3.6%) each had nasoendoscopy, and nasal and nasopharyngeal examination under anaesthesia and biopsy. The major associated diseases (co-morbidities) were allergy in 38.6% (32/83), infective rhinosinusitis in 24.1% (20/83), and upper respiratory tract infection in 14.5% (12/83). Conclusion: Prevalence of AO-OME was 3.2%. AO-OME co-existed commonly with allergy and other inflammatory diseases of the upper respiratory tract. The management was conservative medical management.

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“…Elderly patients aged over 60 years were also excluded because of the possibility of having subclinical middle ear malfunctions. [ 16 ]…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Co-Morbidities of Adult-Onset Otitis Media With Effusion

Sogebi

Oyewole

2022

Journal of West African College of Surgeons

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“…Middle ear function can also be evaluated by impedance audiometry or tympanometry which renders specific graphs for ear pathologies [8]. Applying this tool in ET dysfunction is not yet well recognized systematically.…”

Section: Tympanometrymentioning

confidence: 99%

“…Applying this tool in ET dysfunction is not yet well recognized systematically. A type C tympanogram reflects an ET dysfunction, which is a frequent pattern of subclinical middle ear malfunctions [8,16]. Although a negative middle ear tube pressure on tympanometry, especially when the peak is below − 100 daPa, can indicate an ET dysfunction, the diagnosis remains presumably clinical.…”

Section: Tympanometrymentioning

confidence: 99%

“…As such, it is not widely used in studies on ETD. For Sobegi et al, a C tympanogram reflects an ET dysfunction, which is a frequent pattern of subclinical middle ear malfunctions [8]. Although a negative middle ear tube pressure on tympanometry can indicate an ET dysfunction, the diagnosis remains a clinical one in the vast majority of cases.…”

Section: Introductionmentioning

confidence: 99%

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Is there a relationship between Eustachian tube dysfunction and nasal septal deviation in a sample of the Lebanese population?

et al. 2020

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Background The Eustachian tube (ET) is considered an organ by itself due to its specific functions. An ET Dysfunction (ETD) is discussed when this tube is unable to ventilate the middle ear properly. Clinically, the patient reports usually some aural fullness, “popping”, “under water” sensation as if the ear is clogged. This condition is common affecting at least 5% of the adult population. It can impair quality of life and become disabling. On the other side, the prevalence of nasal septal deviation (NSD) is believed to be around 22.83% in the adult population. Nasal septal deviation is thought to cause a decline in the middle ear ventilation according to certain authors. The primary outcome is to define the predictive value of the side of Eustachian Tube Dysfunction (ETD) symptoms vis-à-vis the side of nasal septal deviation (NSD) in patients having the two conditions concomitantly. Methods A cross-sectional study was conducted between July 2018 and September 2019. Overall, 60 consecutive subjects (total of 120 ears), randomly seen at the Otorhinolaryngology Outpatient Clinics at the Eye and Ear International Hospital, Lebanon, all year-round were enrolled and tested without any geographic preferences. The Eustachian Tube Dysfunction Questionnaire (ETDQ) -7 questionnaire was used to evaluate ETD. Results A significantly higher ETD score was found in males compared to females, in those with left septal deviation compared to right and in those who have symptoms on the left compared to right side. Frequent exposure to higher changes in altitude (commute from home to workplace) was also significantly associated with higher ETD scores (r = 0.265), whereas higher Left Tympanometric peak pressure (TPP in daPa) on tympanometry was significantly associated with lower ETD score (r = − 0.467). Furthermore, 25 patients who had symptoms on the left side had also a septal deviation to the left side (86.2%), whereas 29 (93.5%) patients who had the symptoms on the right side had septal deviation to the right side (p < 0.001). Conclusion Our data highlighted the importance of altitude and geographic distribution of patients especially in a population exposed to barotrauma on a daily basis like the Lebanese population. Tympanometry, on the other hand, failed to correlate with patient reported symptoms and thus needs further evaluation. The reported ETD symptoms of the patient correlates to the side of NSD.

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“…The rest of the papers are on erythrocyte ATPase activity, 31 neurocalcin-delta, 32 corneal macular retinal nerve fiber, 33 and middle ear malfunction in the elderly. 34 In addition, we have papers on bowel injury following gynaecological laparoscopic surgery, 35 and erroneous opinion on cause of death. 36 …”

Section: Growth and Developmentmentioning

confidence: 99%

Editorial: HIV and NCDs: inevitable interaction in resource limited settings.

Tumwine¹

2018

Afr H. Sci.

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Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors

Cited by 7 publications

References 26 publications

Prevalence and Co-Morbidities of Adult-Onset Otitis Media With Effusion

Prevalence and Co-Morbidities of Adult-Onset Otitis Media With Effusion

Is there a relationship between Eustachian tube dysfunction and nasal septal deviation in a sample of the Lebanese population?

Editorial: HIV and NCDs: inevitable interaction in resource limited settings.

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