Prevalence of middle ear effusion among children with adenoid hypertrophy at a national referral hospital in Tanzania

Introduction: Middle ear effusion (MEE) is a common childhood disorder that causes hearing impairment due to the presence of fluid in the middle ear which reduces the middle ear's ability to conduct sound. Temporary or persistent hearing loss as a result of MEE causes speech, language and learning delays in children. There are few studies on MEE in Tanzania despite the huge burden of hearing loss among children with adenoid hypertrophy which is a known risk factor for MEE. Method: A cross-sectional study was conducted among 420 children aged nine years and below having adenoid hypertrophy with or without MEE. The diagnosis of adenoid hypertrophy was confirmed with a lateral view x-ray of the nasopharynx and tympanometry for cases with MEE. The primary objective of the study was to assess the prevalence of MEE among children with adenoid hypertrophy. Results: The prevalence of MEE among children with adenoid hypertrophy was 61.7%, with 218 (51.9%) males and 202 (48.1%) females. The most affected age group was 2-4 years with an incidence 193 (46%) and in this age group, males (53.9%) were more affected than females (46.1%). Generally, males, 134 (51.7%) were more affected by MEE than females, 125 (48.3%) of all 259 children with MEE. In terms of age group predominance by MEE, children aged 3-4 years, 107(41.3%) were more affected than all other age groups. Additionally, 4 (1.5%) children with MEE presented with hearing loss. Conclusion: There is a high prevalence of MEE among children with adenoid hypertrophy but no significant association with hearing loss.

L'otite sereuse chez l'adulte : demarche diagnostique et therapeutique

L'otite seromuqueuse (OSM) de l'adulte est une situation regulierement rencontree en consultation ORL. Le but de notre travail est de dicter a travers notre serie et une revue de la litterature une demarche diagnostique et therapeutique en presence d'une otite seromuqueuse de l'adulte. Patients et Methodes : Nous avons mene une etude retrospective sur une periode de 10 ans allant de 2002 a 2011. Ont ete inclus les patients de plus de 18 ans chez qui a ete porte le diagnostic d'otite seromuqueuse avec un suivi minimum de un an. Resultats : Notre population etait constituee de 53 patients. 60 des patients avaient des antecedents de traitement par radiotherapie du massif facial. Vingt patients etaient suivis pour rhinite chronique. Tous les patients ont eu un examen ORL complet et un scanner des rocher dans tous les cas. 62 des patients ont eu un traitement medical. 92 de nos patients ont ete operes; 17 patients ont eu une regression complete et persistante dans le temps. Discussion : le diagnostique etiologique d'une otite seromuqueuse chronique de l'adulte passe par un examen ORL complet; suivi d'un scanner injecte des rocher. Le traitement n'est pas clairement codifie

The Role of Adenoidal Obstruction in the Pathogenesis of Otitis Media with Effusion in Nigerian Children

Background: Although adenoidectomy is generally applied in the treatment of otitis media with effusion (OME); there is still much debate about the role of adenoid in the pathogenesis of OME. The purpose of this study is to determine the incidence of OME in children with obstructive adenoid disease in comparison with normal control; and the degree of nasopharyngeal obstruction by adenoid as it relates to the development ofOMEin Nigerian children. Method: Controlled; prospective clinical study was carried out. Diagnosis of OME was made with finding of type B tympanogram on tympanometry evaluation. The incidence of OME among adenoidal patients was compared with its incidence in normal control. The degree of nasopharyngeal obstruction among the adenoidal subjects was evaluated with an adenoidal-nasopharyngeal ratio parameter obtained from soft tissue radiograph of nasopharynx; and was related to the results of tympanometric evaluation of the adenoidal subjects. Results: The incidence of OME was significantly higher in the adenoidal children than the normal control (p 0.001). The risk ofOMEwas more than 7 times as more among adenoidal group than among the non-adenoidal control. Gross nasopharyngeal obstruction was significantly associated with type B tympanogram (p

L'otite seromuqueuse de l'enfant

L'OSM est la cause la plus frequente de surdite acquise de l'enfance. Environ 90des enfants presentent au moins un episode d'OSM avant l'age de 6 ans avec une frequence maximale a l'age de 2 ans. Le developpement de l'OSM peut etre explique par la defaillance d'autres barrieres protectrices (systeme mucociliaire; systeme immunitaire; trompe auditive) qui n'assurent plus de resistance aux bacteries. Le meilleur moyen diagnostic actuel de l'OSM est l'otoscopie pneumatique qui a une sensibilite de 94et une specificite de 80. La tympanometrie sert surtout a documenter l'OSM et a suivre l'evolution. Le traitement de l'OSM ne peut etre envisage que si un benefice persistant et cliniquement significatif est assure par rapport a l'evolution spontanee. Aucun traitement medical n'a fait la preuve de son efficacite. Le traitement deconges- tionnant nasal et les antihistaminiques n'ont montre aucune superiorite par rapport au placebo. Ailleurs; l'indication chirurgicale (ATT) depend de la perte auditive; des symptomes associes; des facteurs de risque au developpement; et de la prevision anticipee du temps de resolution de l'epanchement. Malgre son diagnostic relativement aise; la strategie therapeutique etant controversee. Le traitement n'est justifie que lorsque l'OSM est chronique. L'ATT demeure l'unique traitement efficace. La prevention des causes de l'inflammation est primordiale mais s'avere difficile. Nous nous proposons de resumer les avancees actuelles en epidemiologie; pathogenie; diagnostic et dans la prise en charge de l'OSM

Otoscopy Compared with Tympanometry: An Evaluation of the Accuracy of Simple Otoscopy

Background: Although otoscopy has been shown to compare favourably with results of tympanometry; the actual diagnostic value of otoscopy for otitis media with effusion (OME) has not been evaluated in Nigeria. The study was aimed at evaluating the sensitivity; specificity and predictive value of otoscopy in the diagnosis of OME as compared with tympanometry. Method: It was a prospective hospital-based; descriptive cross-sectional study in which the results of simple otoscopy were compared with results of the tympanometry of 82 ears of children aged between 6 months and 12 years; who presented to the Otolaryngology clinics of the UNTH Enugu with symptoms of obstructive adenoid enlargement. Results: Simple otoscopy produced 84.4agreement with tympanometry in detecting OME. The agreement was better in older children than the younger ones (P

Otoscopy Compared With Tympanometry: An Evalluation of the Accuracy of Simple Otoscopy

Background:Although otoscopy has been shown to compare favourably with results of tympanometry; the actual diagnostic value of otoscopy for otitis media with effusion (OME) has not been evaluated in Nigeria. The study was aimed at evaluating the sensitivity; specificity and predictive value of otoscopy in the diagnosis of OME as compared with tympanometry. Method: It was a prospective hospital-based; descriptive cross-sectional study in which the results of simple otoscopy were compared with results of the tympanometry of 82 ears of children aged between 6 months and 12 years; who presented to the Otolaryngology clinics of the UNTH Enugu with symptoms of obstructive adenoid enlargement. Results: Simple otoscopy produced 84.4agreement with tympanometry in detecting OME. The agreement was better in older children than the younger ones (P