The role of adenoidal obstruction in the pathogenesis of otitis media with effusion in Nigerian children.
BACKGROUND
Although adenoidectomy is generally applied in the treatment of otitis media with effusion (OME), there is still much debate about the role of adenoid in the pathogenesis of OME. The purpose of this study is to determine the incidence of OME in children with obstructive adenoid disease in comparison with normal control, and the degree of nasopharyngeal obstruction by adenoid as it relates to the development of OME in Nigerian children.


METHODS
Controlled, prospective clinical study was carried out. Diagnosis of OME was made with finding of type B tympanogram on tympanometry evaluation. The incidence of OME among adenoidal patients was compared with its incidence in normal control. The degree of nasopharyngeal obstruction among the adenoidal subjects was evaluated with an adenoidal-nasopharyngeal ratio parameter obtained from soft tissue radiograph of nasopharynx, and was related to the results of tympanometric evaluation of the adenoidal subjects.


RESULTS
The incidence of OME was significantly higher in the adenoidal children than the normal control (p < 0.001). The risk of OME was more than 7 times as more among adenoidal group than among the non-adenoidal control. Gross nasopharyngeal obstruction was significantly associated with type B tympanogram (p = 0.002). The diagnosis of OME correlated significantly with the degree of nasopharyngeal obstruction (r = 0.32; p = 0.002).


CONCLUSIONS
Our study found adenoid obstruction as a significant risk factor for OME in children. The risk of OME increases with the increasing degree of nasopharyngeal obstruction.
Department of Otolarlaryngology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. tochiorji@yahoo.com
F T
FT
Orji
N E
NE
Okolugbo
B C
BC
Ezeanolue
D000158:Acoustic Impedance Tests / Q000379:methods*; D000234:Adenoids / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009305:Nasopharynx / Q000000981:diagnostic imaging*; D009549:Nigeria / Q000453:epidemiology; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000453:epidemiology; D038781:Otoscopy; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012574:Schools; D013334:Students