The prevalence and impact of otitis media with effusion in children admitted for adeno-tonsillectomy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

• Published in: International journal of pediatric otorhinolaryngology Vol. 110; pp. 76 - 80
• Main Authors: Els, Timothy, Olwoch, Ian Paul
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-07-2018
• Subjects: Acoustic Impedance Tests; Adenoidectomy; Adenoids - pathology; Adenoids - surgery; Audiometry, Pure-Tone; Child; Child, Preschool; Cross-Sectional Studies; Female; Hearing Loss - etiology; Hospitalization; Hospitals; Humans; Hypertrophy - complications; Hypertrophy - epidemiology; Hypertrophy - surgery; Male; Otitis Media with Effusion - complications; Otitis Media with Effusion - epidemiology; Otitis Media with Effusion - surgery; Palatine Tonsil - pathology; Palatine Tonsil - surgery; Prevalence; Quality of Life; South Africa - epidemiology; Surveys and Questionnaires; Tonsillectomy - adverse effects
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2018.04.030

Otitis media with effusion (OME) is a leading cause of acquired hearing loss in children worldwide. However, previous South African studies have consistently reported the local paediatric OME prevalence to be lower than typically published in international literature. Furthermore, no South African studies have investigated OME in children with adenotonsillar hypertrophy. The objective of this study was to determine the prevalence of OME in children admitted for adeno-tonsillectomy at our institution in Pretoria, South Africa. In addition, the study sought to gauge the impact of OME on quality of life using a validated questionnaire (OM-6).
A cross-sectional, observational study was conducted between July 2015 and May 2016 at the Otorhinolaryngology outpatient department at DGMAH. he study included 109 consecutively sampled children, aged 2–12 years (mean 6.1; 49.7% female). Pneumatic otoscopy and tympanometry were performed on all participants. Adenoid hypertrophy was quantified using he adenoid-nasopharyngeal ratio (ANR) on a lateral post-nasal space radiograph (Fujioka's method). The OM-6 questionnaire was completed for each participant. Pure tone audiometry was performed for participants diagnosed with OME.
The prevalence of bilateral OME was 11.9%. For unilateral OME, the prevalence was 22.9% and 16.5%, for the left and right ears, respectively (p > 0.05). The mean hearing loss (SD) was 19.8 dB (9.4). Clinically significant adenoid hypertrophy (ANR ≥ 0.71) was present in 43% of participants. There was no statistically significant (p > 0.05) correlation between the presence OME and adenoid hypertrophy. The mean total OM-6 survey score was 1.67 (SD ± 0.59) in children with OME, and 1.31 (SD ± 0.45) without OME, showing no statistically significant difference (p > 0.05). There was a significant (P < 0.05) correlation between OME and the presence of atopy.
Adeno-tonsillar pathology may play an aetio-pathological role in the development of OME. However, this may be due to the presence of biofilms rather than obstructive adenoid hypertrophy, given the lack of a significant (p > 0.05) correlation between adenoid hypertrophy and OME. Whilst OME was not found to impair quality of life in this population group, the validity of the OM-6 in the South African paediatric population requires further investigation.