Prevalence of tympanometric alterations in children with chronic sinusitis.
OBJECTIVE
Due to its anatomical and functional connections, middle ear disorders frequently occur in sinusitis. Its prevalence, however, is likely to be underestimated. We evaluated the prevalence of middle ear dysfunction, as assessed by tympanometry, in children with chronic sinusitis in a large group of patients with chronic respiratory symptoms, and its possible relationship with respiratory allergy.


METHODS
From a population of 1,810 children with respiratory symptoms referred to our Pediatric Allergy center, subjects with chronic sinusitis diagnosed by clinical criteria were selected. Children underwent testing of middle ear function by tympanometry and of allergy by skin tests with environmental allergens. Patients were divided into three groups according to age.


RESULTS
Two hundred and eighty-eight children (15.9%) had clinical diagnosis of chronic sinusitis according to the established criteria. Twenty-four patients were in group 1, 220 in group 2, and 44 in group 3. Altered middle ear pressure was found in 76.4% of patients, with a significantly higher rate of altered tympanograms in younger children (p<0.001). A positive skin prick test was found in 29.9% of children, with a significantly higher rate of positivity in older children (p=0.01).


CONCLUSIONS
The decrease with age in the rate of tympanometric alterations is likely to be associated to the anatomic development of the upper airways, while the presence of atopy does not seem to play a role in their occurrence.
Leo
Gualtiero
G
Pediatric Allergy and Respiratory Pathophysiology Unit, Istituti Clinici di Perfezionamento, Via Castelvetro 32, 20154 Milan, Italy. g.leo@icp.mi.it
Piacentini
Elena
E
Incorvaia
Cristoforo
C
Consonni
Dario
D
Cazzavillan
Alessandro
A
D000158:Acoustic Impedance Tests / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004427:Ear Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology*; D014432:Tympanic Membrane / Q000503:physiopathology*