A STUDY OF HEARING IMPROVEMENT AFTER ADENOIDECTOMY VS. ADENOIDECTOMY WITH GROMMET INSERTION IN THE CASE OF OTITIS MEDIA WITH EFFUSION
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Keywords
Otitis Media with Effusion, Adenoidectomy, Grommet Insertion
Abstract
Background: Otitis Media with Effusion (OME), also known as Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Otitis media with effusion is one of the most common chronic otological conditions and the most common cause of conductive hearing loss in the pediatric population. Ventilation tube insertion with or without adenoidectomy is considered a standard surgical procedure.
Aims and Objectives: The hearing improvement after adenoidectomy vs. adenoidectomy with grommet insertion in the case of otitis media with effusion.
Materials and Methods This study was conducted in the Department of ENT in different private clinics in Balasore and Cuttack, Odisha. It consists of 60 patients, and their ages range from 2 to 12 years.
Result: In our study, the predominant age group was between 2–5 years (31.67%) and 8–11 years (31.67%). The mean age was 6.96. Higher incidence in male (71.67%) than female (28.33%) children. Preoperatively, 63% of ears had a dull tympanic membrane, and 37% of ears had an amber-colored tympanic membrane. All the patients had a B-type tympanogram curve. Postoperatively, at the end of 6 months of follow-up, patients who underwent adenoidectomy with grommet insertion had 94% normal tympanic membrane, 92% had a type A tymanogram curve, a mean PTA of 8.47 with a P value of <0.001, and 84% had an AB gap < 10 dB. While patients who underwent adenoidectomy alone had a 72% normal tympanic membrane, 64% had a type A tympanogram curve with a mean PTA of 15.40 dB with a P value of <0.001 and an AB gap of <10 dB in 60% of children. In Group A, 11 patients had persistant retracted tympanic membrane at the end of 6 months of followup, and hence these patients were taken up for myringotomy with grommet insertion, and they all improved symptomatically.
Conclusion: It is evident that secretory otitis media is a treatable cause of conductive hearing loss, and it is due to Eustachian tubal dysfunction secondary to adenoid hypertrophy and recurrent upper respiratory tract infection.
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Dr. Nilamadhaba Prusty
Associate Professor, Department of ENT, FM MCH, Balasore
Dr. Dillip Kumar Pradhan
Assistant Professor, Department of Medicine, PRM MCH, Baripada
Dr. Biswaranjan Prusty
Assistant Professor, Department of Medicine, DD MCH, Keonjhar
Dr. Siddharth Panditray
Consultant, ENT & Head and Neck Surgery, AHPGIC, Cuttack