Contemporary diagnostics and treatment in children with otitis media

Abstract

Introduction: Otitis media (OM) causes hearing impairment, and impact on a child’s speech, learning, social, physical, emotional and educational development. Untreated OM can result in chronic discharge from ear with intracranial life threatening complications. Acute (AOM ), recurrent OM (ROM) and OM with effusion (OME) needs differential diagnostics and intensive treatment including surgical one. Early detection of persistent and chronic otitis media and associated hearing loss facilitate to avoid cronicization and psiho-social consequences. Purpose: to evaluate the contemporary trends in diagnostics and treatment of OM in childhood. Materials and methods: Total 156 children with AOM, ROM, OME were included in the Project. The middle ear status was assessed by screening-otoscopy, otomicroscopy, screening impedance audiometry, complete impedance audiometry, and conventional audiometry. Results of examination were compared with the surgery data. All children received treatment according to therapeutic algorithm. The effectiveness of this management of OM was elaluated by analysis of hearing, quality of life and general health dynamics. Results: The audiological tests were sensitive to 97-99% of OM cases, screening otoscopy - to 57 %. Chronic and recurrent forms of OM were diagnosed by impedance audiometry and otomicroscopy in dynamics. Surgical treatment - myringotomy was applied in 4% of children with AOM, myringotomy with tympanostomy tube insertion in 88% of children with ROM and 33% of children with OME. Effectiveness of this management was confirmed by stable hearing improvement in 91% of cases, quality of life and general health positive dynamic in 94% of children with OM. Conclusion: The differential diagnostics of OM in childhood is based on the complex of screening tools and complete otological examination. The management of OM in childhood includes balance of medical and surgical approaches.