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Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy

Year 2021, Volume: 13 Issue: 2, 206 - 210, 07.06.2021
https://doi.org/10.18521/ktd.804397

Abstract

Objective: Sleep Disordered Breathing (USB) is one of the most common childhood disorders ranging from simple snoring to obstructive sleep apnea (OSA), and most common cause of it is the adenotonsillar hypertrophy (ATH). Otitis Media with Effusion (OME) is another important problem in children with USB due to ATH. The aim of this study was to evaluate the possible risk factors for the development of EOM in children with USB due to ATH.
Material and Methods: 171 pediatric patients with ATH-related snoring and sleep apnea complaints were included in the study. The patients were divided into two groups. Group 1: patients with ATH + OME and Group 2: patients with ATH alone. A pre-operative standard questionnaire was used to assess USB severity. Twenty-one different parameters were evaluated for both groups.
Results: Age, sex, exposure to tobacco smoke, cow milk exposure before 12 months, breast milk only for at least 6 months, duration of symptoms, USB symptom scores, history of recurrent tonsillitis, adenoid / nasopharynx (AN) ratio, tonsil size, body mass index (BMI), hemoglobin (Hb) level, hematocrit (Hct) ratio, mean platelet volume (MPV), eosinophil ratio, neutrophil-lymphocyte ratio (NLR), thyroid function tests (TSH, fT4), folate and vitamin B12 levels were evaluated. There was no statistically significant difference between these parameters except BMI. BMI values were 16.08 ± 1.96 in Group 1 and 17.11 ± 2.81 in Group 2, respectively (p: 0.006).
Conclusion: Many different parameters were evaluated for EOM, a multifactorial disease. Among the groups, only BMI was different. Further study is required to identify risk factors for the development of EOM in patients with ATH.

References

  • Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008; 15:242-252.
  • Schlaud M, Urschitz MS, Urschitz-Duprat PM, Poets CF. The German study on sleep-disordered breathing in primary school children: epidemiological approach, representativeness of study sample, and preliminary screening results. Pediatr Perinat Epidemiol 2004; 18:431-440.
  • Tos M. Epidemiology and natural history of secretory otitis. Am J Otol 1984; 5:459-462.
  • Teele DW, Klein JO, Rosner B, et al. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989;160:83-94.
  • Ryding M, White P, Kalm O. Eustachian tube function and tympanic membrane findings after chronic secretory otitis media. Int J Pediatr Otorhinolaryngol 68 (2004) 197–204.
  • Tong MC, Yue V, Ku PK, Lo PS, van Hasselt CA. Screening for otitis media with effusion to measure its prevalence in Chinese children in Hong Kong. Ear Nose Throat J 79 (2000) 626–629.
  • Wang Z, Chen P, Xu Z, Wei Y, Hu Y, Zhang B et al. The prevalence of otitis media with effusion of kindergarten children in Wuhan city. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 23 (2009) 1036–1037, 1043.
  • Daly KA, Giebink GS. Clinical epidemiology of otitis media, Pediatr. Infect. Dis. J.19 (Suppl. 5) (2000) 31–36.
  • Parikh SR, Coronel M, Lee JJ, Brown SM. Validation of a new grading system for endoscopic examination of adenoid hypertrophy. Otolaryngol Head Neck Surg 2006;135(5):684–687.
  • Brodsky L. Modern assessment of tonsils and adenoids, Pediatr. Clin. North Am. 36 (6) (1989) 1551–1569.
  • Sharifkashani S, Dabirmoghaddam P, Kheirkhah M, Hosseinzadehnik R. A new clinical scoring system for adenoid hypertrophy in children. Iran J Otorhinolaryngol. 2015; 27: 55-61.
  • Bitar MA, Rahi A, Khalifeh M, Madana LMS. A suggested clinical score to predict the severity of adenoid obstruction in children. Eur Arch Otorhinolaryngol 2006; 263:924–928.
  • Martines F, Bentivegna D, Maira E, Sciacca V, Martines E. Risk factors for otitis media with effusion: case–control study in Sicilian school children, Int. J. Pediatr. Otorhinolaryngol. 75 (2011) 754–759.
  • Okur E, Yildirim I, Kilic MA, Guzelsoy S. Prevalence of otitis media with effusion among primary school children in Kahramanmaras, in Turkey, Int. J. Pediatr. Otorhinolaryngol. 68 (5) (2004) 557–562.
  • Zielhuis GA, Rach GH, Den Bosch V, Den Broek V. The prevalence of otitis media with effusion: a criticalreview of the literature, Clin. Otolaryngol. 15 (1990) 283–288.
  • Apostolopoulos K, Xenelis J, Tzagaroulakis A, Kandiloros D, Yiotakis J, Papafragou K. The point prevalence of otitis media with effusion among school children in Greece, Int. J. Pediatr. Otorhinolaryngol. 44 (3) (1998) 207–214.
  • Saim A, Saim L, Saim S, Ruszymah BH, Sani A. Prevalence of otitis media with effusion amongst pre-school children in Malaysia, Int. J. Pediatr. Otorhinolaryngol. 41 (1997) 21–28.
  • Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries, Evid. Rep. Technol. Assess. (Full Rep) 153 (2007) 1–186.
  • Bailie R, Stevens M, McDonald E, Brewster D, Guthridge S. Exploring crosssectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities, BMC Public Health 10 (2010) 147.
  • Zielhuis GA, Heuvelmans-Heinen EW, Rach GH, Van den Broek P. Environmental risk factors for otitis media with effusion in preschool children, Scand. J. Prim. Health Care 7 (1989) 33–38.
  • Kraemer MJ, Richardson ME, Weiss NS, Furukawa CT, Shapiro GG, Pierson WE, et al. Risk factors for persistent middle ear effusions, JAMA 249 (1983) 1022–1045.
  • Iversen M, Birch LM, Lundqvist GR, Elbrond O. Middle ear effusion in children and the indoor environment: an epidemiological study, Arch. Environ. Health 40 (1985) 74–79.
  • Eliçora SŞ, Öztürk M, Sevinç R, Derin S, Dinç AE, Erdem D. Risk factors for otitis media effusion in children who have adenoid hypertrophia.Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):374-7.
  • Kum RO, Ozcan M, Baklaci D, et al. Investigation of neutrophil-tolymphocyte ratio and mean platelet volume in sudden hearing loss. Braz J Otorhinolaryngol 2015;81:636–641.
  • Atan D, Apaydin E, O¨ zcan KM, et al. New diagnostic indicators in chronic otitis media with effusion: neutrophil to lymphocyte ratio and thrombocyte lymphocyte ratio. ENT Updates 2016;6:12–15.
  • Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease, Br. J. Haematol. 117 (2002) 399–404.
  • Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G. Alterations of platelet function, number and indexes during acute pancreatitis, Pancreatology 4 (2004) 22–27.
  • Somuk BT, Soyalıç H, Koc S, Gürbüzler L, Doğru S, Eyibilen A. Mean platelet volume as an inflammatory marker of chronic otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):1958-60.
  • Braun T, Dreher A, Dirr F, Reichel O, Patscheider M. Pediatric OSAS and otitis media with effusion. HNO. 2012 Mar;60(3):216-9.
  • Kaya S, Selimoğlu E, Cureoğlu S, Selimoğlu MA. Relationship between chronic otitis media with effusion and overweight or obesity in children. J Laryngol Otol. 2017 Oct;131(10):866-870.
  • Kim JB, Park DC, Cha CI, Yeo SG. Relationship between pediatric obesity and otitis media with effusion. Arch Otolaryngol Head Neck Surg. 2007 Apr;133(4):379-82.
  • Kim SH, Park DC, Byun JY, Park MS, Cha CI, Yeo SG.The relationship between overweight and otitis media with effusion in children. Int J Obes (Lond). 2011 Feb;35(2):279-82.

Adenotonsiller Hipertrofili Hastalarda Efüzyonlu Otitis Media Gelişiminde Etkili Risk Faktörlerinin Araştırılması

Year 2021, Volume: 13 Issue: 2, 206 - 210, 07.06.2021
https://doi.org/10.18521/ktd.804397

Abstract

Amaç: Uykuda Solunum Bozukluğu (USB), basit horlamadan obstrüktif uyku apnesine (OSA) kadar uzanan en yaygın çocukluk çağı bozukluklarından biridir ve bunun da en önemli sebepleri arasında ilk sırada adenotonsiller hipertrofi (ATH) gelmektedir. ATH'ye bağlı USB'li çocuklarda karşılaşılan bir diğer önemli sorun ise Efüzyonlu Otitis Media’dır (EOM). Bu çalışmanın amacı, ATH nedeniyle USB olan çocuklarda EOM'nin gelişimindeki olası risk faktörlerini değerlendirmektir.
Gereç ve Yöntemler: ATH'ye bağlı horlama ve uyku apnesi şikayetleri olan 171 pediatrik hasta çalışmaya dahil edildi. Hastalar iki gruba ayrıldı. Grup 1: tek başına ATH olanlar ve Grup 2: ATH + EOM olan hastalar. USB şiddetini değerlendirmek için pre-operatif olarak standart bir anket kullanıldı. Her iki grup için yirmi bir farklı parametre değerlendirildi.
Bulgular: Yaş, cinsiyet, tütün dumanına maruz kalma, 12 aydan önce inek sütü maruziyeti, en az 6 ay sadece anne sütü, semptomların süresi, USB semptom skorları, tekrarlayan tonsillit öyküsü, adenoid/nazofarenks (AN) oranı, tonsil büyüklüğü, vücut kitle indeksi (VKİ), hemoglobin (Hb) düzeyi, hematokrit (Hct) oranı, ortalama trombosit hacmi (MPV), eozinofil oranı, nötrofil-lenfosit oranı (NLO), tiroid fonksiyon testleri (TSH, fT4), folat ve B12 vitamini düzeyleri değerlendirildi. VKİ dışında bu parametreler arasında istatistiksel olarak fark yoktu. VKİ değerleri Grup 1'de 16.08 ± 1.96 ve Grup 2'de sırasıyla 17.11 ± 2.81 idi (p: 0.006).
Sonuç: Multifaktöriyel bir hastalık olan EOM için pek çok farklı parametre değerlendirildi. Gruplar arasında sadece VKI farklı olarak tespit edildi. ATH hastalarında EOM gelişimi açısından risk faktörlerini tanımlamak için daha fazla çalışma gereklidir.

Supporting Institution

Çalışmamız herhangi bir kurumdan destek almamıştır.

References

  • Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008; 15:242-252.
  • Schlaud M, Urschitz MS, Urschitz-Duprat PM, Poets CF. The German study on sleep-disordered breathing in primary school children: epidemiological approach, representativeness of study sample, and preliminary screening results. Pediatr Perinat Epidemiol 2004; 18:431-440.
  • Tos M. Epidemiology and natural history of secretory otitis. Am J Otol 1984; 5:459-462.
  • Teele DW, Klein JO, Rosner B, et al. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989;160:83-94.
  • Ryding M, White P, Kalm O. Eustachian tube function and tympanic membrane findings after chronic secretory otitis media. Int J Pediatr Otorhinolaryngol 68 (2004) 197–204.
  • Tong MC, Yue V, Ku PK, Lo PS, van Hasselt CA. Screening for otitis media with effusion to measure its prevalence in Chinese children in Hong Kong. Ear Nose Throat J 79 (2000) 626–629.
  • Wang Z, Chen P, Xu Z, Wei Y, Hu Y, Zhang B et al. The prevalence of otitis media with effusion of kindergarten children in Wuhan city. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 23 (2009) 1036–1037, 1043.
  • Daly KA, Giebink GS. Clinical epidemiology of otitis media, Pediatr. Infect. Dis. J.19 (Suppl. 5) (2000) 31–36.
  • Parikh SR, Coronel M, Lee JJ, Brown SM. Validation of a new grading system for endoscopic examination of adenoid hypertrophy. Otolaryngol Head Neck Surg 2006;135(5):684–687.
  • Brodsky L. Modern assessment of tonsils and adenoids, Pediatr. Clin. North Am. 36 (6) (1989) 1551–1569.
  • Sharifkashani S, Dabirmoghaddam P, Kheirkhah M, Hosseinzadehnik R. A new clinical scoring system for adenoid hypertrophy in children. Iran J Otorhinolaryngol. 2015; 27: 55-61.
  • Bitar MA, Rahi A, Khalifeh M, Madana LMS. A suggested clinical score to predict the severity of adenoid obstruction in children. Eur Arch Otorhinolaryngol 2006; 263:924–928.
  • Martines F, Bentivegna D, Maira E, Sciacca V, Martines E. Risk factors for otitis media with effusion: case–control study in Sicilian school children, Int. J. Pediatr. Otorhinolaryngol. 75 (2011) 754–759.
  • Okur E, Yildirim I, Kilic MA, Guzelsoy S. Prevalence of otitis media with effusion among primary school children in Kahramanmaras, in Turkey, Int. J. Pediatr. Otorhinolaryngol. 68 (5) (2004) 557–562.
  • Zielhuis GA, Rach GH, Den Bosch V, Den Broek V. The prevalence of otitis media with effusion: a criticalreview of the literature, Clin. Otolaryngol. 15 (1990) 283–288.
  • Apostolopoulos K, Xenelis J, Tzagaroulakis A, Kandiloros D, Yiotakis J, Papafragou K. The point prevalence of otitis media with effusion among school children in Greece, Int. J. Pediatr. Otorhinolaryngol. 44 (3) (1998) 207–214.
  • Saim A, Saim L, Saim S, Ruszymah BH, Sani A. Prevalence of otitis media with effusion amongst pre-school children in Malaysia, Int. J. Pediatr. Otorhinolaryngol. 41 (1997) 21–28.
  • Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries, Evid. Rep. Technol. Assess. (Full Rep) 153 (2007) 1–186.
  • Bailie R, Stevens M, McDonald E, Brewster D, Guthridge S. Exploring crosssectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities, BMC Public Health 10 (2010) 147.
  • Zielhuis GA, Heuvelmans-Heinen EW, Rach GH, Van den Broek P. Environmental risk factors for otitis media with effusion in preschool children, Scand. J. Prim. Health Care 7 (1989) 33–38.
  • Kraemer MJ, Richardson ME, Weiss NS, Furukawa CT, Shapiro GG, Pierson WE, et al. Risk factors for persistent middle ear effusions, JAMA 249 (1983) 1022–1045.
  • Iversen M, Birch LM, Lundqvist GR, Elbrond O. Middle ear effusion in children and the indoor environment: an epidemiological study, Arch. Environ. Health 40 (1985) 74–79.
  • Eliçora SŞ, Öztürk M, Sevinç R, Derin S, Dinç AE, Erdem D. Risk factors for otitis media effusion in children who have adenoid hypertrophia.Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):374-7.
  • Kum RO, Ozcan M, Baklaci D, et al. Investigation of neutrophil-tolymphocyte ratio and mean platelet volume in sudden hearing loss. Braz J Otorhinolaryngol 2015;81:636–641.
  • Atan D, Apaydin E, O¨ zcan KM, et al. New diagnostic indicators in chronic otitis media with effusion: neutrophil to lymphocyte ratio and thrombocyte lymphocyte ratio. ENT Updates 2016;6:12–15.
  • Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease, Br. J. Haematol. 117 (2002) 399–404.
  • Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G. Alterations of platelet function, number and indexes during acute pancreatitis, Pancreatology 4 (2004) 22–27.
  • Somuk BT, Soyalıç H, Koc S, Gürbüzler L, Doğru S, Eyibilen A. Mean platelet volume as an inflammatory marker of chronic otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):1958-60.
  • Braun T, Dreher A, Dirr F, Reichel O, Patscheider M. Pediatric OSAS and otitis media with effusion. HNO. 2012 Mar;60(3):216-9.
  • Kaya S, Selimoğlu E, Cureoğlu S, Selimoğlu MA. Relationship between chronic otitis media with effusion and overweight or obesity in children. J Laryngol Otol. 2017 Oct;131(10):866-870.
  • Kim JB, Park DC, Cha CI, Yeo SG. Relationship between pediatric obesity and otitis media with effusion. Arch Otolaryngol Head Neck Surg. 2007 Apr;133(4):379-82.
  • Kim SH, Park DC, Byun JY, Park MS, Cha CI, Yeo SG.The relationship between overweight and otitis media with effusion in children. Int J Obes (Lond). 2011 Feb;35(2):279-82.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Fatih Alper Akcan 0000-0003-2476-768X

Abdullah Belada 0000-0001-8990-8215

Publication Date June 7, 2021
Acceptance Date May 6, 2021
Published in Issue Year 2021 Volume: 13 Issue: 2

Cite

APA Akcan, F. A., & Belada, A. (2021). Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy. Konuralp Medical Journal, 13(2), 206-210. https://doi.org/10.18521/ktd.804397
AMA Akcan FA, Belada A. Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy. Konuralp Medical Journal. June 2021;13(2):206-210. doi:10.18521/ktd.804397
Chicago Akcan, Fatih Alper, and Abdullah Belada. “Investigation of Risk Factors for Otitis Media With Effusion in Patients With Adenotonsillar Hypertrophy”. Konuralp Medical Journal 13, no. 2 (June 2021): 206-10. https://doi.org/10.18521/ktd.804397.
EndNote Akcan FA, Belada A (June 1, 2021) Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy. Konuralp Medical Journal 13 2 206–210.
IEEE F. A. Akcan and A. Belada, “Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy”, Konuralp Medical Journal, vol. 13, no. 2, pp. 206–210, 2021, doi: 10.18521/ktd.804397.
ISNAD Akcan, Fatih Alper - Belada, Abdullah. “Investigation of Risk Factors for Otitis Media With Effusion in Patients With Adenotonsillar Hypertrophy”. Konuralp Medical Journal 13/2 (June 2021), 206-210. https://doi.org/10.18521/ktd.804397.
JAMA Akcan FA, Belada A. Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy. Konuralp Medical Journal. 2021;13:206–210.
MLA Akcan, Fatih Alper and Abdullah Belada. “Investigation of Risk Factors for Otitis Media With Effusion in Patients With Adenotonsillar Hypertrophy”. Konuralp Medical Journal, vol. 13, no. 2, 2021, pp. 206-10, doi:10.18521/ktd.804397.
Vancouver Akcan FA, Belada A. Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy. Konuralp Medical Journal. 2021;13(2):206-10.