Keywords
otitis with effusion
tonsils hypertrophy
tonsil pharyngeal
adenotomy
inflammatory diseases of the upper respiratory ways
How to Cite
Abstract
Actual tactics of treatment for children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy involve medical treatment and observation for 3 months. The next step is to resolve the issue of surgical treatment, however, there are differences in its scope: adenotomy, tympanopuncture/myringotomy, ventilation tubes introduce may be performed. The modern method of adenotomy (endoscopic power assisted adenotomy) has advantages over the classical one due to precision and better possibilities of removal of lymphoid tissue in the peritubar and perichoanal parts of the nasopharynx. The aim of our study was to increase the effectiveness of surgical treatment of children with otitis media with effusion and pharyngeal tonsil hypertrophy. Prospective results of treatment for 47 children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy were studied. In 47 children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy, endoscopic energy adenotomy with tympanopuncture with intratympanic administration of dexamethasone was performed. At the time of adenotomy, all children had been suffering from otitis media with effusion for 3 months or more, and medical treatment had no effect. The examination 1 month after the intervention established, the secretion in the tympanic cavity in 6.4% of children who subsequently require insertion of ventilation tube. In 80.8% of cases, normalization of intratympanic pressure was observed in one month after adenotomy with tympanopuncture. The average values of intratympanic pressure in patients in 2 and 4 weeks after the simultaneously intervention was (76.5±7.8) dPa and (51.3±8.5) dPa, respectively. Power assisted adenotomy with simultaneous tympanopuncture is an effective method of treating children with otitis media with effusion and pharyngeal tonsil hypertrophy and can be recommended for use in clinical practice.
Keywords: otitis, otitis with effusion, tonsils hypertrophy, tonsil pharyngeal, adenotomy, inflammatory diseases of the upper respiratory ways.
References
Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media – prevention and treatment. Infect Drug Resist. 2014;10(7):15-24. DOI: 10.2147/IDR.S39637. PMID: 24453496.
Rasheed AM, Abbas AM, Hilal SA, Homadi NJ. Adenoidectomy and Endoscopic Myringotomy with and without ventilation tube insertion for Treatment of Otitis Media with Effusion in 6–12 years old Children. International Tinnitus Journal. 2023;27(1):27-33. DOI: 10.5935/0946-5448.20230005. PMID: 38050881.
Vanneste P, Page C. Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment. A review. Journal of Otology. 2019;14(2):33-9. DOI: 10.1016/j.joto.2019.01.005. PMID: 31223299.
Hydri AS, Udaipurwala IH, Aslam I. Adenoidectomy Before Or After Myringotomy In A Single Stage Procedure: Does The Sequence Matter? Journal of Bahria University Medical and Dental College 2019;9(2),94-7. DOI: 10.51985/JBUMDC2018119.
Martines F, Bentivegna D, Di Piazza F, Martinciglio G, Sciaccaet V, Martines E. The point prevalence of otitis media with effusion among primary school children in Western Sicily. Eur Arch Otorhinolaryngol. 2010;267:709-4. DOI: 10.1007/s00405-009-1131-4. PMID: 19859723.
Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngol Head Neck Surg. 2016;154(1):S1-41. DOI: 10.1177/0194599815623467. PMID: 26832942.
Durgut O, Dikici O. The effect of adenoid hypertrophy on hearing thresholds in children with otitis media with effusion. International Journal of Pediatric Otorhinolaryngology. 2019;124:116-9. DOI: 10.1016/j.ijporl.2019.05.046. PMID: 31176025.
Capaccio P, Torretta S, Marciante GA, Marchisio P, Forti S, Pignataro L. Endoscopic Adenoidectomy in Children With Otitis Media With Effusion and Mild Hearing Loss. Clin Exp Otorhinolaryngol. 2016;9(1):33-8. DOI: 10.21053/ceo.2016.9.1.33. PMID: 26976024.
Ferlito S, Cocuzza S, Grillo C, La Mantia I, Gulino A, Galletti B, et al. Complication and sequelae following tympanostomy tube placement in children with effusion otitis media: single center experience and review of literature. Acta Medica Mediterranea, 2020;36:1905. DOI: 10.19193/0393-6384_2020_3_298.
Blanc F, Ayache D, Calmels MN, Deguinec O, Francois M, Leboulanger N, et al. Management of otitis media with effusion in children. Société franc¸ aise d’ORL et de chirurgie cervico-faciale clinical practice guidelines [French society of ENT and head and neck surgery clinical practice guidelines]. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2018;135(4):269-73. DOI: 10.1016/j.anorl.2018.04.008. PMID: 29759911.
Dar WQ, Qazi SM, Nisar J. Comparative evaluation of adenoidectomy and myringotomy with or without ventilation tube placement in the treatment of otitis media with effusion. Global Journal for Research Analysis. 2018;7(9):41-4. Available at: https://www.researchgate.net/publication/344482681
Kosakovsky AL, Yurochko FB (eds). Pediatric Otology. Lviv: Ms; 2017. 288 p. [In Ukrainian].
Kosakovsky AL, Gavrylenko YuV. A modern approach to the treatment of acute and chronic adenoiditis in children. Ukrainian Medical Journal. 2014;2(100):71-6. Available at: https://is.gd/EINzfO [in Ukrainian].
Kulikova OO, Lozova YuV, Chumakova AV. Modern methods of diagnosis and treatment of secretory otitis media in children. Study guide for independent work of trainees and intern doctors. Kyiv: FOP Kolyada OP; 2018. 28 p. Available at: https://is.gd/QZFuqA [in Ukrainian].
Chen W, Yin G, Chen Y, Wang L, Wang Y, Zhao C, et al. Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy. Front Pediatr. 2023;11:1098067. DOI: 10.3389/fped.2023.1098067. PMID: 36911018.
Kishchuk VV, Rautskis PA. Morpho-functional changes of the mucous glands of the pharyngeal tonsil in its pathology. Reports of Morphology. 2015;1(21):34-7. Available at: http://nbuv.gov.ua/UJRN/Vismorf_2015_21_1_10 [in Ukrainian].
Timen GE, Kuzyk IV, Kobzaruk LI, Pysanko VN. Treatment tactics for children with otitis media with effusion. Journal of Ear, Nose, and Throat Diseases. 2000;5:19-25. [In Ukrainian].
Kuzyk IV. Treatment tactics for children suffering from otitis media with effusion. [Cand Med Sc diss abstr, spec. 14.01.19 – Otorhinolaryngology]. Kyiv: State Enterprise "Otolaryngology Institute named after prof. O.S. Kolomiychenko NAMS of Ukraine"; 2002. 22 p.
Sarin V, Anand V, Bhardwaj B. Audiological Outcome of Classical Adenoidectomy versus Endoscopically-Assisted Adenoidectomy using a Microdebrider. Iran J Otorhinolaryngol. 2016;28(84):31-7. PMID: 26878001.
Tao J, Luo R, Chen Y, Hou C, Qin H. [Myringotomy or tympanostomy tube insertion, comparison of surgical treatment of adenoid hypertrophy and otitis media with effusion in children]. Lin Chuang er bi yan hou tou Jing wai ke za zhi [China] Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery. 2020;34(3):207-10. DOI: 10.13201/j.issn.2096-7993.2020.03.005. PMID: 32791583.
Hao J, Chen M, Liu B, Yang Y, Liu W, Ma N, et al. Compare two surgical interventions for otitis media with effusion in young children. Eur Arch Otorhinolaryngol. 2019;276(8):2125-31. DOI: 10.1007/s00405-019-05421-9. Erratum in: Eur Arch Otorhinolaryngol. 18 Jun 2019. PMID: 31127413.
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