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A Study on Improvement in Middle Ear Function Post Adenoidectomy in Patients with Adenoid Hypertrophy
No full textINTRODUCTION:
Adenoid hypertrophy is one of the commonest disorders in paediatric age group. They are very small at birth, progressively enlarge over first four years of life as a result of increased immunological activity, and attain
maximum size between ages of 2 to 7 years.
❖ Large adenoids can partially or totally obstruct nasal respiration causing snoring, hyponasal speech, sleep apnoea, sinusitis and mouth breathing.
❖ Chronically infected adenoids act as reservoir for upper respiratory tract infection.
❖ Chronic adenoiditis can lead to edema and /or obstruction of nasopharyngeal end of eustachian tube causing eustachian tube dysfunction, recurrent acute otitis media, chronic otitis media and otitis media with effusion(OME).
❖ Tympanometry has been advocated since 1970s as a reliable method of assessing middle ear function. It is a graphical representation of impedance or compliance of TM. The mobility or compliance of TM is maximum when air pressure in middle ear is equal to that of EAC.
AIMS AND OBJECTIVES:
1. To study the relationship between size of the adenoids and course of the disease
2. To assess the improvement in middle ear function after adenoidectomy by observing changes in the tympanometry taken before and after the surgery in patients with adenoid hypertrophy and eustachian tube dysfunction.
3. To study the age group most commonly affected
METHODS: This is a prospective observational type of study which included 40 cases between
age group 5 – 15 years and diagnosed to have adenoid hypertrophy with OME. After detailed
history and clinical examination, investigations like x-ray nasopharynx, diagnostic nasal
endoscopy, pure tone audiometry and tympanometry were carried out to confirm the
diagnosis. All patients underwent adenoidectomy under General anaesthesia. Follow up was
done with repeat pure tone audiometry and tympanometry at 1 week, 1 month and 3rd month.
RESULTS: In this study, OME was found more commonly in 5-10 year age group with mean
age of 7.65 years. There was male preponderance of condition. All patients had nasal
obstruction or snoring. Hard of hearing with snoring or nasal obstruction was the common ear
symptom. On otoscopy, dull lustreless, amber coloured TM was the common finding. Most of
the patients had minimal hearing loss and the mean hearing loss on audiometry was 27.9 dB.
Tympanogram showed type B curve in 57.5% of ears. Adenoidectomy was done under GA in
all patients.
Postoperative audiometric assessment showed mean hearing gain at 1st week,1month and 3rd
month being 5.3 ,5.14 and 5.45dB respectively which was statistically significant. At 3
months follow up, 30 ears had A type curve, only 14 ears had B type curve and 36 ears C type
curve which was statistically significant. The improvement in Tympanometry curve types and
hearing gain post operatively were statistically significant irrespective of preoperative grading
of adenoid hypertrophy.
CONCLUSION:
Adenoidectomy is effective in clearing middle ear effusion and causing hearing improvement in children with hypertrophied adenoids and OME
Incidence and Risk Factors of Retinopathy of Prematurity (ROP) among Preterm Babies: Prospective Observational study
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G+A Allelic Variant of PCSK9 Gene rs505151 and Its Association with Coronary Artery Disease
No full textA Comparative study between Mannheim Peritonitis Score and POSSUM Scoring System in Predicting Prognosis of Patients with Perforation Peritonitis
No full textComparative Study Between Half Vacuum Suction and Full Vacuum Suction Drainage in Patients Undergoing Modified Radical Mastectomy in GRH, Madurai
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A Comparative study on Microorganisms Involved in Necrotising Fasciitis and Outcome of Necrotising Fasciitis among Diabetics and Non Diabetics
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