Otitis media forms in children with upper respiratory infection

Abstract

Introduction: The upper respiratory infection is highly prevalent among young children and often results in otitis media. The incidence and characteristics of otitis media complicating URI has not been studied in Moldova. Objectives: To evaluate the prevalence, the clinical features and particularities of diagnostics of otitis media in children with upper respiratory infection. Methods: We performed a prospective study of 50 children (age range from 6 months to 7 years) with upper respiratory infection. We collected anamnesis data and performed the routine otorhinolaryngologic examination including anterior rhinoscopy, oropharyngoscopy and otoscopy. 100 ears of 50 children were examined by optic and pneumatic otoscopy, using the scheme of detailed description. Electroacoustic examination of middle ear including tympanometry and reflex-audiometry was obtained, analyzed and compared with otoscopy data. Diagnostics was made according to the Algorithm of diagnostics. Repeated tests were performed in 10 days and in a month after the clinical recovery. Results: Otalgia was registered in 7 from 50 examined children and disappeared during first 3 days in all children. Impedance audiometry was the method of reference. The analyses of anamnesis and otoscopy data were on the basis of differential diagnosis between otitis media forms. We detected otitis media in the majority of examined ears (82 %). Otitis media with effusion was diagnosed in 56 % of cases, acute otitis media - in 18 %, recurrent otitis media - in 3 %, adhesive otitis media - in 1 % of ears. The majority cases of otitis media were registered in younger children (first 5 years of life). We analyzed the clinical course of otitis media. Inadequate reaction to sounds and to sleeping disturbances, were the most frequent signs of otitis media. We registered the persistence of otitis media in 80 % of cases in 10 days of clinical recovery and in 40 % in a month. The majority of children with persistent otitis media were younger than 3 years of life. Conclusions: The prevalence of otitis media in children with upper respiratory infection is high. The otalgia is not the sign of reference in otitis media. The complex of anamnesis data analyses, otoscopy and impedance audiometry is necessary for diagnostics and differential diagnostics of otitis media forms. Children of the first 5 years of life with upper respiratory tract infection need an otorhinolaryngologic evaluation and audiologic control in a month after recovery.