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Inflammatory middle ear diseases in patients with cystic fibrosis
Insights
Cystic fibrosis (CF) patients show similar rates of middle ear disease as the general population. This study found no increased incidence of inflammatory middle ear conditions in CF individuals.
Area of Science:
- Otolaryngology
- Pediatrics
- Genetics
Background:
- Cystic fibrosis (CF) is a genetic disorder affecting multiple organs.
- Middle ear diseases are common, but their incidence in CF patients is debated.
- Previous studies suggest a higher prevalence of middle ear pathology in CF.
Purpose of the Study:
- To investigate the prevalence of inflammatory middle ear diseases in patients with cystic fibrosis.
- To compare the incidence of otitis media in CF patients with non-CF populations.
- To identify potential correlations between middle ear conditions and other CF-related symptoms.
Main Methods:
- Audiometry and tympanometry were performed on 111 pediatric and young adult CF patients.
- Patient history of acute otitis media and presence of nasal polyps were recorded.
- Middle ear pressure and impedance were analyzed to detect abnormalities.
Main Results:
- 35% of CF patients had a history of acute otitis media, similar to non-CF patients.
- Only 6% of CF patients were diagnosed with secretory otitis media.
- No significant correlation was found between nasal polyps and tubal dysfunction or secretory otitis.
- Hearing impairment was infrequent, affecting only 4 out of 88 evaluable patients.
Conclusions:
- The incidence of inflammatory middle ear diseases in cystic fibrosis patients is comparable to the general population.
- Findings contradict some previous studies suggesting a higher prevalence of middle ear pathology in CF.
- CF patients do not appear to have a significantly elevated risk for common middle ear inflammatory conditions.
Abstract:
111 patients with cystic fibrosis (CF), aged 7 months to 29 years, were examined to detect inflammatory middle ear diseases. 35% had a history of one or more attacks of acute otitis media, an incidence at the same level as in non-CF patients. None had chronic suppurative otitis. Only 4 out of the 88 patients able to cooperate in audiometry had a hearing impairment. In 2, the hearing loss was perceptive, in 3 very mild, and in the fourth case, moderately severe. The middle ear pressure was measured in 108 patients, in 86 of whom it proved normal. In 15 patients the middle ear pressure was lower than--100 mmH2O, indicating tubal occlusion, and in 7 patients the impedance minimum was lacking, indicating an accumulation of mucus. These 7 patients (6%) had secretory otitis media. Nasal polyps were or had been present in 32%. There was no correlation between nasal polyps and tubal occlusion or secretory otitis. The incidence of inflammatory middle ear diseases in CF patients was in the same range as in non-CF patients, a finding at variance with some previous investigations showing middle ear pathology in 25--48%.