Outcome of different treatment modalities in preschool children with otitis media with effusion

The problem of otitis media with effusion [OME] in infants and young children is worldwide. Although medical treatment is tried first, many children do not respond to it. In this study, seventy preschool children with OME received medical treatment for 3 months; 52 of them do not respond and treated surgically. A group of the children with obstructive symptoms were treated by adenoidectomy alone while the remaining were treated by adenoidectomy and bilateral myringotomy with insertion of grommet tube in the left ear only. Those without obstructive symptoms were treated by bilateral myringotomy with insertion of grommet tube in the left ear only. Follow up for six months including clinical and tympanometric assessment was done. The results revealed that medical treatment was successful in 25.7% of patients. Removal of adenoids, when indicated, improves the outcome of treatment. The use of grommet tube is more beneficial than myringotomy alone

Evaluation of office balance tests

Balance tests may give valuable information that sometimes can be of help. Of these tests we evaluated five to study their sensitivity, specificity and correlation with electronystagmographic [ENG] results. These tests are; head shaking test [HST], Unterberger [UT] or Fukuda stepping test [FST], Dix-Hallpike test [DHT], Romberg's test [RT] and Tandem gait test [TGT]. We found that HST has low sensitivity and high specificity while UT has high sensitivity and low specificity. Dix-Hallpike test is both sensitive and specific for diagnosing benign paroxysmal positional vertigo [BPPV]. Romberg's and TGT tests are positive only in acute vestibular loss and neurological dysfunction. Correlation with ENG results was done and described. We concluded that HST is a good bed-side test in screening for unilateral vestibular hypofunction yet, it is better done using ENG tracing. Dix-Hallpike test is the most sensitive test in diagnosing BPPV without the need for ENG. Unterberger test had 86% sensitivity and 18% specificity. It is a good screening test and it correlates positively with ENG results. Romberg's test and TGT were good screening tests for acute vestibular loss and neurological dysfunction but don 't correlate with the ENG results