Study Of The Relationship Between Adenoidal Hypertrophy And Secretory Otitis Media

Objective:Adenoid hypertrophy is the most important cause of pediatric secretory otitis media, but the specific mechanism is uncertain. Children are too young to accurately express symptoms and cooperate with physical examination, leading to a higher rate of missing diagnosis than original thought. Childhood is a critical period of the development of language, psychological and so on, but hearing loss will be affect its development. So children with adenoid hypertrophy should be given related ear examination which are widely used, but the treatment is still lack of normative standards. The purpose of the study was to explore the relationship between adenoid hypertrophy and the occurrence and prognosis of secretory otitis media in children and to guide the clinical doctors on the early diagnosis and treatment of secretory otitis media.Methods:To obtain a collection of appropriate medical histories, nasopharyngeal lateral slice endoscopy, acoustic immittance and pure tone hearing threshold tests were performed routinely on289hospitalized children whose adenoid bodies were resected prior to surgery. Those who had ear symptoms or presented with a B type or C (>-150dapa) type curve in acoustic immittance testing were suspected to have a middle ear effusion, and underwent further exmaination through a temporal bone CT or a tympanic cavity puncture examination during the operation. Through the use of statistical software we analyzed the relationship between secretory otitis media, the degree of adenoid hypertrophy and the condition of Eustachian tubeResults:Among289children with adenoid hypertrophy,44children (15.2%) were complicated with secretory otitis media confirmed by tympanic cavity puncture in which43ears (51.8%) were type B,10ears(12%) were type C (<-200dapa),30ears(36.2%) were C (>-200dapa). The results demonstrated that the occurrence of secretory otitis media was positively associated with the degree of adenoid hypertrophy and compression of the Eustachian tube.Conclusion:Acoustic immittance cannot be used as the gold standard of the diagnosis of secretory otitis media. Temporal bone CT is necessary for patients who have ear symptoms or present with a C type curve in acoustic immittance or have a suspected middle ear effusion in order to ensure diagnosis. For children with adenoid hypertrophy, endoscopic adenoidectomy can promote the healing of secretory otitis media. For the patients in different periods of secretory otitis media should be given "personalized" treatment on the basis of the results of temporal bone CT examination.