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[Different treatment methods and efficacy analysis of otitis media with effusion in children with different hearing
1Department of Otorhinolaryngology Head and Neck Surgery，Children Hospital Affiliated to Zhejiang University of Medicine，Hangzhou，310051，China.
Insights
Tailored treatment for otitis media with effusion (OME) in children, considering hearing loss and effusion type, yields similar effective outcomes. Allergic rhinitis significantly impacts OME treatment success.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Medical Treatment Efficacy
Background:
- Otitis media with effusion (OME) is a common pediatric condition affecting hearing.
- Treatment strategies for OME vary, necessitating analysis of their effectiveness based on clinical factors.
- Understanding factors influencing treatment outcomes is crucial for optimizing pediatric care.
Purpose of the Study:
- To analyze and compare the treatment methods and outcomes for pediatric otitis media with effusion (OME) based on varying degrees of hearing loss.
- To identify factors influencing the therapeutic effects of OME treatment in children.
Main Methods:
- Retrospective analysis of clinical data from 318 children (556 ears) with OME.
- Treatment groups were defined by hearing loss degree, disease duration, and effusion characteristics: drug treatment, myringotomy, and tympanostomy tube insertion.
- Comparison of curative effects and recurrence rates across treatment groups; multivariate logistic regression identified influencing factors.
Main Results:
- Effective rates for drug treatment, myringotomy, and tympanostomy tube insertion groups were 95.6%, 89.6%, and 90.9%, respectively, with no statistically significant difference in recurrence.
- Tympanic membrane perforation occurred in a small number of cases (4 ears total).
- Allergic rhinitis was identified as a significant factor influencing OME therapeutic effect (OR=0.073, P=0.003).
Conclusions:
- Treatment of pediatric OME should integrate disease duration, hearing loss degree, and effusion characteristics for optimal outcomes.
- Diverse treatment modalities demonstrated comparable efficacy, low recurrence, minimal damage, and satisfactory safety.
- Allergic rhinitis negatively impacts the therapeutic effectiveness of OME treatment in children.
Abstract:
Objective:To explore and analyze the treatment methods and effects of otitis media with effusion in children with different hearing loss. Methods:Clinical data of 318 children （556 ears） with otitis media with effusion（OME）admitted to Department of Otorhinolaryngology Head and Neck Surgery, Children Hospital Affiliated to Zhejiang University of Medicine from January 2020 to December 2021 were collected. Different treatment methods were selected according to the degree of hearing loss, combined with course of disease and the characteristics of effusion in tympanic cavity. They were divided into drug treatment group: critical hearing loss and mild hearing loss, and the course of disease was less than 3 months; myringotomy group: mild hearing loss and course of disease ≥3 months or moderate and severe hearing loss and course of disease<3 months, tympanic effusion was rarefied liquid; tympanostomy tube insertion group: mild hearing loss and course of disease ≥3 months, or moderate and severe hearing loss group and course of disease<3 months, tympanic effusion is sticky or jelly liquid, and moderate and severe hearing loss group and course of disease ≥3 months. 95% of children with adenoid hypertrophy or tonsillar hypertrophy and adenoid hypertrophy were diagnosed as obstructive sleep apnea hypopnea syndrome（OSA） and underwent endoscopic adenoidectomy or tonsillectomy and adenoidectomy. The curative effect and recurrence of different treatment groups were compared. Results:The drug treatment group and myringotomy group were followed up in 1, 3 and 6 monthes after operation. The tympanostomy tube insertion was followed up every three months after operation, with an average of one year. The patients were followed up in 1, 3 and 6 monthes after taking the tube off. The effective rates of drug treatment group, myringotomy group and tympanostomy tube insertion group were 95.6%, 89.6% and 90.9% respectively. The three groups recurred in 6, 4 and 5 ears respectively, and the difference was not statistically significant. Tympanic membrane perforation was left in 4 ears, 3 ears in tympanic tube group and 1 ear in myringotomy group. Multivariate Logistic regression analysis showed that allergic rhinitis（OR=0.073, 95%CI: 0.013-0.401, P=0.003） was the factor influencing the therapeutic effect of OME. Conclusion:the treatment of OME in children should not only be combined with course of disease, but also combined with different hearing loss and the characteristics of effusion in tympanic cavity. Different treatment methods can get the same effect, with low recurrence rate, small damage and satisfactory safety. Allergic rhinitis affects the therapeutic effect of OME.
