Medical Management V/S Surgical Management of Otitis Media with Effusion in Children A prospective study.

Ramesh Babu Kalyanasundaram; Amirthagani Arumugam

Volume : VI, Issue : V, May - 2017

Medical Management V/S Surgical Management of Otitis Media with Effusion in Children A prospective study.

Ramesh Babu Kalyanasundaram, Amirthagani Arumugam

Abstract :

1 AIM OF THE STUDY: To document clinical profile (presenting manifestation, he� assessment) of persistent OME with he� impairment in children. To compare the improvement in he� after non surgical versus adenoidectomy with bilateral tympanostomy done in a single sitting. METHODS and MATERIALS : This prospective study was carried out in the department of otorhinolarynology, Tanjore Medical College . The study period was from January 2010 to May 2011. 60 children diagnosed with OME and persistent he� impairment in the age group of 5 – 12 years were studied prospectively. History, otoscopy, tympanometry, acoustic reflexometry and pure tone audiometry findings were recorded before treatment and followed up at 2nd month and 6th month after randomly alloting the children into 2 Groups – A and B each consisting of sample size of 30 and giving a Non surgical management to Group A and surgical management to Group B. RESULTS:The mean age at presentation was 8.06 (�2.25) years. 85% of patients had bilateral he� impairment and 72 % of patients had symptoms of adenoid hypertrophy at presentation. Abnormal findings were noted in 90%, 90%, 94% of ear examination on pneumatic otoscopy, tympanometry, non pneumatic otoscopy and acoustic reflexometry respectively. CONCLUSIONS: Bilateral he� impairment, symptoms of adenoid hypertrophy, significant he� impairment (≥ 20dB), abnormal findings on otoscopy and tympanometry were present in more than 60% of children presenting with OME and he� impairment. In our study, Medical management ( Group A ): 35% of children in Group A showed improvement for a short duration with recurrence associated with he� impairment. In our study surgical modality of management in the form of adenoidectomy with bilateral tympanostomy done in a single sitting was found to improve he� significantly better than Medical management , without major complications.