الفهرس 
Acknowledgements
Otitis mediaOnly 14 pages are availabe for public view
 |  | from | 140 |  |  |
| | | from | 140 | | |
Abstract
Otitis media with effusion (OME) is characterized by the presence of fluid within the middle ear cavity, in the absence of the symptoms and signs that would indicate an acute infection or tympanic membrane perforation. OME is an extremely common condition in children, especially between the ages of 2 years and 11 years. OME may cause a variable conductive hearing loss with potential implications for children’s psycho-kinetic, speech development, and school performance.
The aim of this study is to compare the results of treating otitis media with effusion with myringotomy and aspiration of middle ear content with and without inserting Grommet tubes.
This study was carried out on 100 patients of bilateral otitis media with effusion. All 100 patients subjected to myringotomy only for Rt ear (group A) and myringotomy with ventilation tube insertion for Lt ear (group B).
The presenting symptom was hearing impairment in all cases, earache was present in about half of patients, nasal symptoms like nasal obstruction, snoring and nasal discharge were present in around 20%-30% of cases and this reflects the association between adenoid enlargement and OME in this age group.
The association between positive indoor parental smoking and OME was present in 27% of our cases.
The nature of midlle ear fluid in our study was glue in about 2/3 of cases and the rest was somewhat serous effusion. Glue was significantly more in those patients with adenoid hypertrophy.
Follow up of our patients at one week after surgery revealed subjective hearing improvement in all patients.
At 3 months after sugery there was no statistically significant difference in hearing in both ears. As regards otoscopic examination; healing of the tympanic membrane was significantly faster in group A and also signs of recurrence of OME was higher in group A. Revising the tympanometric findings in both groups at 3 months there was a statistically significant difference in favor of group B.
At 6 months after surgery ears in group B with the help of longer aeration provided by the Grommet tube were more able to sustain the good hearing they achieved at the 3rd month more than group A in which more than half of patients noticed DROP of hearing compared with that degree at 3rd month.
There were some complications reported at the 6th month -apart from recurrence of OME which was higher in group A- such as more perforation of tympanic membrane, more otorrhea and more tympanosclerosis that were statistically significant in group B.
We recommend that surgical insertion of Grommet tube should be considered in a child with OME who is at risk for speech/language/hearing loss/ or learning problems to prevent these problems from occurring.