Asymptomatic Middle Ear Dysfunction in Children with Upper Respiratory Infection – Analytical Cross Sectional Study

Abstract

Introduction

Otitis Media with Effusion (OME) is the commonest cause of hearing difficulty and one of the most frequent reasons for elective admission to the hospital for surgery during childhood. The condition starts with dysfunction of middle ear due to poor ventilation through Eustachian tube or extension of the inflammatory process from nasopharynx. In the natural history of the disease, there may be a period of the pre-clinical stage without symptoms or signs of OME. If the disease is identified in this stage, the further sequel of it (like persistent hearing difficulty or retraction pocket formation) may be prevented.

Materials and Methods

A hospital based analytical cross-sectional study was conducted among the children below 12 years of age to assess the middle ear function (by tympanometry) in children having upper respiratory tract infection (but no ear related complaints) and comparing them with the middle ear function in children not having such infection or any recent history of the same. Age and sex matched control group having no such symptoms was constructed. There were 25 children in both study and control group selected from Otorhinolaryngology and Pediatrics outpatient department (OPD). So total numbers of children were 50.

Results 

There was no statistically significant difference in background characteristics (age, sex) of the of study and control groups. There was no statistically significant difference when the tympanic membrane retraction or middle ear pressure is taken into account. But significant difference found in the parameters like middle ear compliance (68% children have low compliance in the study group vs 20% in control, with df= 1, ϰ² = 11.688 and p value was 0.001) and tympanogram curve type (48% in study group have B or C type and 8% have such in control group).

Conclusion

Early diagnosis of the middle ear dysfunction among the children with upper respiratory infection, by clinical examination and suitable audiological investigation in the pre-clinical stage with appropriate intervention can prevent further progression of the disease, causing hearing loss as well as retraction pocket formation.