Alternative treatment for otitis media with effusion: eustachian tube rehabilitation.

In this study, we evaluated the effectiveness of eustachian tube rehabilitation (ETR) as treatment for otitis media with effusion (OME). Thirty-five children with persistent OME were enrolled. Patients were divided into three groups: group I (isolated OME); group II (OME and atypical swallowing); group II (OME, habitual mouth breathing and atypical swallowing). All children underwent ETR. Otomicroscopy and tympanograms were performed before treatment, and at one and three months following ETR. Considering the overall patient population after ETR (one and three months later), the prevalence of type A tympanogram increased significantly compared to before therapy (p < 0.005), while the prevalence of type B tympanogram decreased significantly (p < 0.005). We found significant differences between pre- and both post-therapy control in groups I and II. However, children in group II experienced significant improvement of middle ear conditions only three months after the end of therapy (p < 0.005). On the basis of the physiopathologic knowledge of OME and the underlying principles of ETR, we conclude that ETR can be considered a useful therapy in management of OME.

Hearing in children with otitis media with effusion--clinical retrospective study.

Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion. Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz-4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1-3 yr, 4-6 yr, 7-9 yr, 10-12 yr, 13-15 yr. At age 1-3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4-6 and 7-9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4-6 and 7-9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined.

Impact of middle ear effusion on balance performance in children.

UNLABELLED: Middle ear effusion (MEE) is a common childhood disease characterized by accumulation of fluid in the middle ear. MEE treatment focuses on the resultant conductive hearing loss. Recently, researchers have investigated the potential effects of MEE on balance. PURPOSE: The purpose of this study was to compare balance of children with MEE to that of healthy children and to examine whether a relation exists between balance skills and the degree of muscle strength. METHODS: Twenty children with MEE and twenty healthy children aged 4.5 - 7.5 years underwent balance and strength sub-tests of Bruininks - Oseretsky Test of Motor Performance (BOTMP) and electronystagmography recordings (ENG). Parents completed a questionnaire designed to elicit their perceptions of their child's balance abilities in daily living activities. RESULTS: MEE children performed significantly worse than did the control group on BOTMP balance sub-test. BOTMP strength subtest indicated that children with MEE had poorer muscle strength than the control group, although the difference was not significant. ENG results showed no pathologic recordings in both study group and control group. Finally, a significant correlation was found between parents' responses on the questionnaire and their child's performance on BOTMP balance subtest. CONCLUSIONS: MEE may negatively impact children's balance, while muscle strength is less affected. Furthermore, the BOTMP appears to be a sensitive assessment of balance disturbances in children with MEE.

Randomised controlled trial of the effect of ventilation tubes (grommets) on quality of life at age 1-2 years.

AIMS: To study the effect of treatment with ventilation tubes on quality of life in children aged 1-2 years with persistent otitis media with effusion (OME), as compared to watchful waiting. METHODS: Multicentre randomised controlled trial (n = 187) with two treatment arms: ventilation tubes and watchful waiting. Children were detected by auditory screening at the age of 9-12 months, and were subsequently diagnosed as having persistent (4-6 months) bilateral OME. Quality of life (TAIQOL and Erickson scales) was measured at 0, 6, and 12 months follow up. RESULTS: There was improvement in quality of life, but the ventilation tube group did not improve significantly more than the watchful waiting group. Although an attempt has been made to identify possible subgroups that benefit more, we were not able to find such subgroups, which might be a result of lack of power in this study. CONCLUSION: Ventilation tubes do not have a substantial incremental effect on the quality of life of infants aged 1-2 years with uncomplicated persistent bilateral OME.

[Incidence and treatment of otitis with effusion in patients with cleft palate]. / Incidencia y tratamiento de la otitis seromucosa en pacientes con fisura palatina.

We evaluated 40 children with cleft palate repaired, between 1990 and 1995. Treatment was myringotomy and insertion of a tympanostomy tube, followed by monitoring. In this retrospective study of 40 children aged 8 to 48 months, the prevalence of otitis media with effusion was 84.8%. The condition was persistent in 17.6% of children up to 3 years of age after treatment. Audiological thresholds were evaluated with BERA one or more times. Hearing acuity improved after so, therefore we propose it as the best strategy for ensuring adequate hearing for language development while minimizing morbidity (incidence of complications = 14.7%).

[Influence of secretory otitis media on mastoid pneumatization. Multiple regression analysis]. / Influencia de la otitis media secretoria en la neumatización mastoidea. Análisis mediante regresión múltiple.

The influence of secretory otitis media (SOM) on mastoid pneumatization was studied in 122 ears of 61 children under 15 who were seen at our clinic two times. Age, tympanometry, mastoid size, and time between visits were analyzed. Multiple regression analysis yielded and equation relating age and SOM with mastoid size at first examination. Another regression equation explained the contribution of SOM resolution or persistence and age on mastoid size at the time of the second examination. This equation explained 76.14% of the variability in mastoid size and showed that normal ears had better mastoid growth than children with SOM. Even thought inflammation resolved with medical or surgical treatment, mastoid pneumatization was more developed in normal subjects.

[Hearing capacity and speech production in 417 children with facial cleft abnormalities]. / Hörvermögen und Sprachleistungen bei 417 Kindern mit Spaltfehlbildungen.

Children with cleft palates often suffer from chronic conductive hearing losses, delayed language acquisition and speech disorders. This study presents results of speech and language outcomes in relation to hearing function and types of palatal malformations found. 417 children with cleft palates were examined during followup evaluations that extended over several years. Disorders were studied as they affected the ears, nose and throat, audiometry and speech and language pathology. Children with isolated cleft lips were excluded. Among the total group, 8% had normal speech and language development while 92% had speech or language disorders. 80% of these latter children had hearing problems that predominantly consisted of fluctuating conductive hearing losses caused by otitis media with effusion. 5% had sensorineural hearing losses. Fifty-eight children (14%) with rhinolalia aperta were not improved by speech therapy and required velopharyngoplasties, using a cranial-based pharyngeal flap. Language skills did not depend on the type of cleft palate presents but on the frequency and amount of hearing loss found. Otomicroscopy and audiometric follow-ups with insertions of ventilation tubes were considered to be most important for language development in those children with repeated middle ear infections. Speech or language therapy was necessary in 49% of the children.