Risk factors of otitis media with effusion

Conclusion

A highly prevalent disease is otitis media with effusion. There is a strong relation between adenoid hypertrophy and secretory otitis media. Adenoid hypertrophy is a very common etiological factor. This must be taken into consideration in management of persistent otitis media with effusion. Also linked to otitis media with effusion is recurrent upper respiratory infection, so protection of the children against it helps in prevention of secretory otitis media.

Introduction

Non-suppurative otitis media is very common in children. There is acute otitis media that occurs after upper respiratory tract infection. It is presented by acute inflammatory symptoms like elevation of body temperature and ear pain. Unlikely, otitis media with effusion is a type of chronic non-suppurative otitis media doesn’t show fever or otalgia. Otitis media with effusion means presence of   fluid in the middle ear cavity. Non-suppurative otitis media is very common in children. There is acute otitis media that occurs after upper respiratory tract infection. It is presented by acute inflammatory symptoms like elevation of body temperature and ear pain. Unlikely, otitis media with effusion is a type of chronic non-suppurative otitis media doesn’t show fever or otalgia. Otitis media with effusion means presence of   fluid in the middle ear cavity.

Aim of the study

This study aims to know the commonest causes and risk factors for secretory otitis media to help us in its prevention and to provide better treatment for it according to etiological factors.

Patients and Methods

This is a prospective study that was done at the department of Otoorhinolaryngology, Minya University hospital between December 2021 and October 2022. Ethically permission was sought from a local faculty of medicine research ethics committee (FMREC) No:205/2021. All patients gave their agreement in accordance with the committee's protocol for data retrieval for research purposes after assurances of confidentiality were made to ensure that the study would not jeopardise the patients' safety.

143 patients who had otitis media with effusion presented to our clinic confirmed by tympanogram were included in this study.

Inclusion criteria:

Age of patient 4-16 years.

Patients accepting the research procedure

Patients with bilateral otitis media with effusion

Exclusion criteria:

Patients refusing the research procedure.

Age of patient <4 years and >16 years.

Patients confirmed to have unilateral otitis media with effusion.

History of the patients was taken. Their parents were asked about nasal obstruction, snooring, mouth breathing, recurrent upper respiratory tract infection, allergic manifestations (snee-zing, itching and runny nose) and passive smoking. all the patients underwent otoscopic examination. Anterior rhinoscopy and oral cavity examination was done. The children had tympanometry to confirm clinical diagnosis. Imaging in the form of x-ray nasopharynx lateral view was done.

SPSS (Statistical Package for Social Sciences) Windows 10.0 was used to statistically analyse the results. The study's data were evaluated utilising descriptive statistical techniques. Results were evaluated using a P0.05 significance level.

Results and analysis

The study was done on 143 patients. The age ranged from4 years to16 years with mean7.92 years in males and 7.73 years in females There were 71 males and 72 females.

There were 21 patients who had chronic tonsillitis and this was not statistically significant (p>0.05). among otitis media with effusion children, 102 cases had adenoid hypertrophy diagnosed clinically and confirmed by X-ray. This relation was statistically significant (P<0.05). there was no statistically significant relation between otitis media with effusion and passive smoking or allergic children. The number of cases of passive smoking and allergic children was 26 cases and 23 cases respectively. There were 97children who gave complete history of recurrent upper respiratory infection and this relation was statistically significant.

Discussion

Among children, secretory otitis media is a prevalent illness. The definition of it is when there is fluid in the middle ear cavity. without exhibiting any acute manifestations as elevation of body temperature or earache. Age of the patient is a very important risk factor for otitis media. In our study age ranges from 4 years   To16 years with mean7.8 it is more common in children. The incidence decreases as the child gets older. In a study done by Caylan ^[1], age of otitis media children ranged from 5 to 10 years. While the study done by Okur ^[2] children aged from 6-16 years.

According to our study, there was a strong relation between the presence of adenoid hypertrophy (hypertrophy of adenoid tissue) and otitis media with effusion. It is a very important etiological factor 102 children of otitis media had hypertrophied adenoid (71.3%%). Ozlem celebi ^[3] agreed with our study. 53.7% of otitis media cases in their study showed adenoid hypertrophy.

There is still research on the relationship between allergy and otitis media pathogenesis. In our study, there was no significant relation between allergic children and affection by otitis media with effusion. There were only 23 allergic children (16.1%(

Martines^[4] tested children with OME for allergies using a skin prick test; 62.9% of the results were positive, whereas 37% were negative.

Upper respiratory tract infection may be complicated by otitis media. Bentivegna^[5]. said that 29% to 50% of all upper respiratory tract infections develop into otitis media. This agrees with our study, 97 children with otitis media and effusion were discovered to have a history of recurrent upper respiratory tract infections.

Our study agreed with Ozlem celebi^[3]. that there is no significant relation between otitis media with effusion and chronic tonsillitis. 21 children with chronic tonsillitis and otitis media with effusion were found in our study.

Otitis media with effusion is more common and is made more likely by passive smoking. But in our study there was no significant relation between passive smoking and otitis media with effusion. Only 26 children (18.18%) had history of exposure to cigarette smoking. That disagree with the study done by Ilicali ^[6] revealed there was a causal link between passive smoking and otitis media with effusion.