RISK FACTORS AND MICROORGANISMS ASSOCIATED WITH OTITIS MEDIA WITH EFFUSION IN CHILDREN.

Background: Otitis media with effusion (OME) is a common childhood otological condition. The middle ear effusion is mucoid or seromucinous in nature, but not purulent. The condition lasts for at least 3 months; this sets it apart from persistent effusion after acute otitis media, which disappears after 2 months in 90% of cases. OME has a high prevalence in children and is responsible for most of the hearing losses in school going age group (5-12 years). Most cases of OME are relatively asymptomatic with nearly 25% discovered incidentally. Despite this apparent absence of symptoms, the potential impact on hearing, speech, language and cognition highlights the need for timely intervention. Aim: To estimate the risk factors associated with OME and to detect different types of microorganisms in the middle ear fluid of children with OME. Materials and Methods: A cross-sectional study was conducted on 458 children presenting with features of OME. A questionnaire was used to determine the risk factors for OME among these children. Otoscopy and tympanometry were used to diagnose and confirm OME. The pure tone average for children with OME was measured. Assessment of risk factors were done in all children. Myringotomy was performed in children with obvious fluid in the middle ear and a sample was sent for culture and sensitivity. Results: OME was highly linked with age less than 9 years in univariate analysis. The mean age of the sample was 8.71 years with the median age being 2.5 years. There are several risk factors related to OME, with nasal allergies (22.9%) and adenoid hypertrophy (22.9%) being the most prevalent. Middle ear fluid was sterile in 74.7% cases whereas 9% of the samples showed Streptococcus pneumoniae & Haemophilus influenzae as the microorganism. Conclusion: Nasal allergies and adenoid hypertrophy were the most common risk factors of OME in children less than 18 years. Otoscopy, tympanometry and pure tone audiometry should be used as screening tools for OME. Middle ear fluid was sterile in majority of cases and hence routine use of antibiotics for treatment of these cases is not recommended. [ABSTRACT FROM AUTHOR]