A Comparative Study of Efficacy of Different Surgical Management Options and Hearing Outcome in Children with Otitis Media with Effusion

Introduction: Otitis Media with Effusion (OME) also known as Secretory Otitis Media or glue ear is one of the commonest causes of preventable deafness among Paediatric population. The most common cause being Eustachian tube dysfunction. There are no constant surgical procedures involved to treat OME. Possible combinations of various surgical modalities include Myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy or tonsillectomy or both. Aims and Objectives: To study the epidemiology, clinicoaudiological profile and radiological characteristics as well as treatment outcome of children less than 12 years old diagnosed with Otitis Media with Effusion (OME) and to assess the effect of four different surgical treatments for glue ear (Myringotomy with grommet insertion, Myringotomy with Grommet plus adenotonsillectomy, Myringotomy with grommet plus adenoidectomy alone, Myringotomy with grommet plus tonsillectomy alone), on improvement in hearing. Materials and Methods: The study was conducted from January 2011 to January 2015 in Sur Ministry of Health Hospital and was performed upon 150 children up to 12 years old who were diagnosed as OME. Complete clinical, radiological and audiological investigations were performed. All the patients received medical treatment and were subjected to surgical management and the results were obtained. The patients were followed up 6 weeks, 3 months and 6 months postoperatively. Postoperative PTA was obtained and hearing outcome was plotted. Results: The prevalence of OME in our study was mostly males between 5-7 years and mostly presented with hearing loss of moderate degree. The commonest otoscopic finding was retracted tympanic membrane. Tympanometry showed B tracing in 78.5% patients. The commonest radiological finding was a grade 3+ adenoid hypertrophy in 42 patients. Most of them received Nasal steroid spray as a form of medical management, surgical modality was started in resistant cases of medical management and a combination of various surgeries performed shows that Myringotomy with grommet insertion and adenoidectomy alone relieved the OME and the Air Bone gap shows that the hearing outcome was better in a gradual follow up period.