Tactics of treatment the children with pharyngeal tonsil hypertrophy in combination with otitis media with effusion

Abstract

Actual tactics of treatment for children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy involve medical treatment and observation for 3 months. The next step is to resolve the issue of surgical treatment, however, there are differences in its scope: adenotomy, tympanopuncture/myringotomy, ventilation tubes introduce may be performed. The modern method of adenotomy (endoscopic power assisted adenotomy) has advantages over the classical one due to precision and better possibilities of removal of lymphoid tissue in the peritubar and perichoanal parts of the nasopharynx. The aim of our study was to increase the effectiveness of surgical treatment of children with otitis media with effusion and pharyngeal tonsil hypertrophy. Prospective results of treatment for 47 children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy were studied. In 47 children with otitis media with effusion in combination with pharyngeal tonsil hypertrophy, endoscopic energy adenotomy with tympanopuncture with intratympanic administration of dexamethasone was performed. At the time of adenotomy, all children had been suffering from otitis media with effusion for 3 months or more, and medical treatment had no effect. The examination 1 month after the intervention established, the secretion in the tympanic cavity in 6.4% of children who subsequently require insertion of ventilation tube. In 80.8% of cases, normalization of intratympanic pressure was observed in one month after adenotomy with tympanopuncture. The average values of intratympanic pressure in patients in 2 and 4 weeks after the simultaneously intervention was (76.5±7.8) dPa and (51.3±8.5) dPa, respectively. Power assisted adenotomy with simultaneous tympanopuncture is an effective method of treating children with otitis media with effusion and pharyngeal tonsil hypertrophy and can be recommended for use in clinical practice. Keywords: otitis, otitis with effusion, tonsils hypertrophy, tonsil pharyngeal, adenotomy, inflammatory diseases of the upper respiratory ways.