TMSS Medical College Journal

Background: Adenoid hypertrophy a major problem in paediatric age group despite the advances in medicine. Otitis media with effusion is a treatable cause of deafness which may hamper the learning ability of a child. This study was | undertaken to study the effect of adenoidectomy on established otitis media with effusion in children. Objective: To find | out the effect of adenoid hypertrophy on develop of OME. Materials and Methods: This was a prospective observational study was conducted on 100 children between the age group 4-12 years, in Department of ENT, Shaheed Ziaur Rahman | Medical College Hospital, Bogura for a period of March’ 2018 to February’ 2019 . These children presented in with | features suggestive of OME and adenoid hypertrophy such as difficulty in hearing, snoring, mouth breathing. Results: | Forty cases were moderate adenoid among them 33(82.5%) cases had normal tympanometry and 7(17.5%) had abnormal | tympanometry. The difference was not statistically significant (p>0.05) between two groups. Of 138 ears had type A | tympanometry among them 83(60.1%) ears in age <6 years and 55(39.9%) in age 7-12 years. The difference was not | statistically significant (p>0.05) between two groups. Conclusion: Adenoidectomy improves the outcome of OME by improving Eustachian tube function and by removing the focus of infection. It can be regarded as a useful management | option in children with adenotonsillar hypertrophy and established otitis media with effusion. The disease process can be | identified in its early stages by simple investigations like tympanometry at the earliest. Early diagnosis will help minimize the sequelae of OME.

Otitis media with effusion (OME) refers to the accumulation of mucoid or serous fluid, within the middle ear cleft, without features of acute infection.’ Adenoid is composed of lymph epithelial tissue and it is part of Waldyer’s ring. The adenoids produce immunoglobulins through their B-cells which can be induced through antigen which leads to development of immunity during childhood.>* Adenoid tissue is not radiographically visible until the age of one year. Adenoid enlargement can directly obstruct the pharyngeal orifice of Eustachian tube which can lead to otitis media with effusion (OME)®’. The effect of both obstruction and infection from tonsil and adenoid are seen to cause major ill effect nose and paranasal sinus, eustachian tube and middle ear cleft®. It has been postulated that the enlargement of adenoids or repeated infections of adenoids result in Otitis media with effusion (OME)®. Synonyms of OME include glue ear, serous otitis media, secretory otitis media and chronic nonpurulent otitis media.9 This study is a prospective study with the specific objective to evaluate the effect of adenoidectomy with tonsillectomy in treatment of established bilateral secretory otitis media in children.