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[On the issue of treatment of exudative otitis media in children]
A I Kryukov1, N L Kunelskaya1, A Yu Ivoylov2
1Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152; Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Department of Otolaryngology of Cure Faculty, Moscow, Russia, 117997.
Insights
A new treatment algorithm for childhood exudative otitis media (EOM) improved outcomes. This diagnostic and therapeutic approach achieved high success rates for both catarrhal and secretory EOM stages.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Medical Diagnostics
Background:
- Exudative otitis media (EOM) is a common pediatric condition affecting middle ear fluid accumulation.
- Effective management strategies are crucial for preventing long-term hearing impairment and developmental issues in children.
- Current treatment protocols for EOM require refinement to address varying disease stages.
Purpose of the Study:
- To develop and evaluate a novel therapeutic and diagnostic algorithm for managing exudative otitis media in children.
- To enhance treatment effectiveness by tailoring interventions to the specific stage of EOM (catarrhal or secretory).
- To improve clinical outcomes and reduce the incidence of complications associated with EOM.
Main Methods:
- A cohort of 346 children (aged 3-13 years) with EOM were treated between 2008 and 2017.
- Patients were categorized into two groups: catarrhal stage (150 children) and secretory stage (196 children).
- A specialized diagnostic and treatment algorithm was implemented based on disease staging and individual patient needs.
Main Results:
- The study involved 346 children (682 ears) diagnosed with exudative otitis media.
- Group I (catarrhal stage) and Group II (secretory stage) received tailored conservative and surgical interventions.
- A control group (Group III) with secretory EOM and adenoid hypertrophy underwent adenotomy, with parental refusal of other procedures.
Conclusions:
- The developed EOM treatment algorithm demonstrated significant clinical efficacy.
- Stable positive results were achieved in 94.7% of children with the catarrhal stage and 84.8% with the secretory stage.
- The algorithm is recommended as an integrated approach to improve the quality of care for pediatric EOM.
Aim:
To increase the effectiveness of treatment of children with catarrhal and secretory stages of exudative otitis media (EOM) through the development of a therapeutic and diagnostic algorithm for the management of children with this condition.
Material And Method:
From 2008 to 2017, 346 children (682 ears) aged from 3 to 13 years with exudative otitis media were examined and treated. Two groups of patients were formed: Group 1 (150 children, 298 ears) - with a catarrhal stage of EOM, group 2 (196 children, 384 ears) - with a secretory stage of EOM. Diagnosis and treatment algorithm was created for such patients based on the results of the examination.
Results:
Depending on the treatment, 3 groups of patients were formed: Group I - 150 children with a catarrhal stage of EOM who received conservative and surgical treatment for upper respiratory tract conditions; Group II - 146 children with an a secretory stage of EOM, who underwent conservative and surgical treatment: myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium, a course of conservative treatment for children who did not require surgical treatment; Group III - 50 children with a secretory stage of EOM and grade III adenoids, whose parents, contrary to the doctor's advice, refused the proposed myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium. These children underwent only adenotomy.
Conclusion:
The developed treatment algorithm for children with EOM, depending on the stage of the disease, demonstrated high clinical efficacy and made it possible to achieve stable positive results in 94.7% of cases in patients with the catarrhal stage of ESO and in 84.8% of cases in patients with the secretory stage of ESO, which makes it possible for us to recommend it as an integrated method that improves the quality of treatment for children with EOM.
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