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

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.

Keywords

• Adenotonsilar hyperthropy
• Sleep Disorder
• Otitis media with effusion
• Pediatric

Adenotonsiller Hipertrofili Hastalarda Efüzyonlu Otitis Media Gelişiminde Etkili Risk Faktörlerinin Araştırılması

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.

Keywords

• Adenotonsiller hipertrofi
• Uyku bozukluğu
• Efüzyonlu otitis media
• Pediatrik

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