Adenoid hypertrophy is a significant cause of childhood morbidity. Enlarged adenoid leads to mouth breathing, snoring, sleep apnea, hyponasality, sinusitis, otitis media with effusion (OME), and abnormal facial development.(1) (Assement of middle ear)
Nasopharyngeal obstruction due to adenoid hypertrophy may directly obstruct the pharyngeal ostia of the auditory tube, 2 mechanical obstruction of the Eustachian tube may be an important factor to occuring OME. 3 However, recurrent or chronic infection in the adenoids without obstructive hypertrophy may also manifest as recurrent acute otitis media, persistent OME supporting the theory of adenoids being a reservoir of pathogenic organisms leading to tubal edema and malfunction.4
OME is a highly concurrent disease in young children with adenoid hypertrophy. However, young children are not capable of voicing their symptoms of hearing loss or the parents pay less attention of the child’s hearing change; some of them with adenoid hypertrophy have ME in spite of no complaint of the hearing loss, which may be neglected if no accurate procedures for the assessment of the middle ear function are done.
There is more information available on the influence of enlarged adenoids on tympanometry. In this article, we investigated the effects of adenoidal enlargement on middle ear pressure and tympanogram’s diagnostic efficacies for detecting OME in children, and thereby to recommend the assessments of middle ear functions essential in young patients with adenoid hypertrophy.
Materials and methods
This prospective study was approved by Hospital Research Ethics Board and written informed consent was obtained from the subjects. This study was performed on all the 56 cases of positively diagnose...
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... could exclude MEE. However, 6 ears in which the tympanic pressure was lesser than from -200 daPa correctly predicted the presence of MEE in our study. In addition, type C tracing tympanogram without acoustic stapedius reflex may have MEE as smiliar our results.
Much attention should be paid and be aware of a possible development of hearing loss in adenoid hypertrophy in young children even though without parental suspicion of hearing impairment. It is important to perform the middle ear examination and tympanometer for adenoid hypertrophy before surgery. If the preoperative assessment of the hearing level is not done, without informing the parents it may lead to unnecessary medical controversy. The otoscopy and tympanometry can make a more accurate diagnosis of pediatric OME in the adenoid hypertrophy children with/without parental suspicion of hearing impairment.
Cholesteatoma is a growth of excess skin or a skin cyst (epithelial cyst) that contains desquamated keratin and grows in the middle ear and mastoid (Thio, Ahmed, & Bickerton, 2005). A cholesteatoma can grow and spread, destroying the ossicles, tympanic membrane and other parts of the ear. They appear on the pars flaccida and pars tensa sections of the tympanic membrane. A cholesteatoma can occur when a part of a perforated tympanic membrane is pushed back into the middle ear space, debris and skin cells can build up forming a growth. It can obstruct tympanic membrane movement and movement of the ossicles. As the layers grow, the amount of hearing loss can increase. A cholesteatoma can be congenital (present at birth) or be acquired as a result of another disease. They can also be formed as a result of a surgery, trauma, chronic ear infection, chronic otitis media, or tympanic membrane perforation. It can develop beyond the tympanic membrane and cause intracranial and extracranial complications. Due to this patients can experience permanent hearing loss as a result of an infection of the inner ear as well as other serious health concerns. These include dizziness, facial nerve weakness and infections of the skull (Hall, 2013). Patients may present chronically discharging ear, hearing loss, dizziness, otalgia (ear pain), and perforations (marginal or attic).
Acute OM without perforation involves fluid build up in the ear, as well as a bulging tympanic membrane from a pressure build up inside the ear (Williams, 2003). Acute OM with perforation involves a pussy discharge coming out of the ear, which means that the tympanic membrane has been perforated (Williams, 2003). OME is when no symptoms of an ear infection are present, and there is no perforation of the tympanic membrane, only constant redness and inflammation of the ear (Williams, 2003). CSOM is the most dangerous kind of otitis media as it involves a perforation of the tympanic membrane and continual discharge from the middle ear (longer than 6 weeks) (Coates, Morris, Leach, and Couzos, 2002). If left untreated, this infection can lead to other complications and permanent hearing loss, which can snowball into behavioural and cognition problems in the future (Coates et al.,
In the middle ear the sound is amplified in order to move the fluid in the ear.
Hearing loss can affect a child dramatically in their early development. It is important to be aware and cautious of noticing signs towards possible hearing loss, because language and communication skills deve...
National Institute on Deafness and Other Communication Disorders. (November 2002). Retrieved October 17, 2004, from http://www.nidcd.nih.gov/health/hearing/coch.asp
According to Chapman et al., (2000), the loss of hearing appears to be a chronic issue through...
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Disclosure of pertinent medical facts and alternative course of treatment should not be overlooked by the physician in the decision making process. This is very important information impacting whether that patient will go along with the recommended treatment. The right to informed consent did not become a judicial issue ...
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The target audience for the American Speech-Language-Hearing Association includes audiologist, speech-language pathologists, speech, language, and hearing scientists, students and general public. To attend all this different community, the website has specific information divided by sections, and according to the specific audience; also, the webpage is easy to navigate and has a variety of articles and characteristics mentioned by Hargis, Hernandez, Hughes & Ramaker “accuracy, clarity, completeness, concreteness, organization and visual effectiveness in order to make the communication accessible” (Hargis, Hernandez, Hughes & Ramaker, 1997, p.2).