Clustering upper airway physicals, otitis media with effusion and auditory functions in children
Mustafa Aslıer1, Nesibe Gül Yüksel Aslıer1, İlker Ercan2
1Department of Otorhinolaryngology, Sancaktepe Education and Research Hospital, Istanbul, Turkey.
Insights
Adenoid hypertrophy and adenoid location near the Eustachian tube opening are linked to otitis media with effusion and hearing loss in children. Tonsillar hypertrophy and nasal septal deviation were not significant factors.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Pediatric Sleep Medicine
Background:
- Adenoid hypertrophy (AH) is a known cause of otitis media with effusion (OME), a leading cause of hearing loss in children.
- Other upper airway factors like adenoid location, tonsillar hypertrophy (TH), and nasal septal deviation (NSD) may also contribute to OME.
- Understanding these associations is crucial for diagnosing and managing childhood hearing impairment.
Purpose of the Study:
- To investigate the relationship between upper airway physical characteristics and OME in children.
- To evaluate the impact of these physical factors on auditory functions.
- To identify key predisposing factors for OME and associated hearing deficits.
Main Methods:
- A prospective clinical study involving 43 children (86 ears, aged 3-11 years).
- Otolaryngologic examinations, pure tone audiometry (PTA), traditional tympanometry (TT), and wideband tympanometry (WBT) were performed.
- Cluster analysis was used to group participants based on age, sex, adenoid choana percentage (ACP), adenoid around torus tubarius (AATT), TH, NSD, OME, and audiological parameters.
Main Results:
- Cluster analysis identified two distinct groups of ears.
- Significant differences were found between clusters in the presence of AH, AATT, OME, ACP, TT peak pressure, WBT resonance frequencies, WBT APARs, and PTA thresholds.
- Lower WBT APARs and higher PTA thresholds correlated with higher ACP and increased presence of AATT and OME in one cluster.
Conclusions:
- Adenoid hypertrophy (AH) and adenoid location around the torus tubarius (AATT) are associated with otitis media with effusion (OME) and impaired hearing.
- These findings highlight the importance of adenoid evaluation in children with OME and hearing loss.
- Tonsillar hypertrophy (TH) and nasal septal deviation (NSD) were found to be insignificant factors in the development of these clusters.
Objective:
Adenoid hypertrophy (AH) has been identified as a cause of otitis media with effusion (OME), which is the most common cause of childhood hearing loss. Indeed, there may be other upper airway-related predisposing factors such as, location of the adenoid, accompanying tonsillar hypertrophy (TH) and nasal septal deviation (NSD) for the development of OME. In this study, we aimed to evaluate the associations between the upper airway physicals and OME with auditory functions.
Methods:
Eighty-six ears of 43 children, aged 3-11 years were included in this prospective clinical study. Findings of otolaryngologic examinations were noted. Data of pure tone audiometry (PTA), traditional tympanometry (TT) and wideband tympanometry (WBT) parameters were collected. Cluster analysis was performed to the following variables: age, sex; the adenoid choana percentage (ACP), the presences of adenoid around torus tubarius (AATT), TH, NSD and OME; peak pressure (PP) values on TT, resonance frequencies (RF) on WBT, ambient pressure absorbance ratios (APAR) and PTA hearing thresholds.
Results:
Two groups of ears revealed by clustering; cluster-1 (n = 46) and cluster-2 (n = 40), at the similarity level of 0.662. The presences of AH, AATT, OME and the medians of ACP, PP, RF, WBT APARs at all frequencies except 5656 Hz and 8000 Hz, all PTA thresholds were significantly different between two clusters (p < 0.05). The lower WBT APARs and higher PTA thresholds were associated with higher levels of ACP and higher frequencies of the presence of AATT and OME in cluster-1.
Conclusion:
There are associations between AH, AATT and OME together with decline in hearing and SEA. Whereas, TH and NSD are not related to the formation of clusters and they are insignificant factors.
Related Concept Videos
01:28Physical Assessment of the Respiratory Tract IV: Auscultation
Breath Sounds
Breath sounds are categorized into vesicular, bronchovesicular, and bronchial.
01:31Respiratory System Abnormal Finding II: Palpation and Auscultation
Palpation Findings
During a respiratory assessment, palpation can reveal several vital abnormalities:
01:29Physical Assessment of the Respiratory Tract III: Percussion
Percussion in Respiratory Assessment
Percussion evaluates underlying tissue composition with audible and tactile vibrations,...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...