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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2014, Number 2

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Rev Invest Clin 2014; 66 (2)

The middle ear pressure does not change after adenotonsillectomy in children younger than 10 years old

Montaño-Velázquez BB, Villanueva-Padrón LA, Conde-Vázquez E, Álvarez-Romero E, Romero-Asato JG, Jáuregui-Renaud K

Language: Spanish
References: 17
Page: 152-156
PDF size: 140.45 Kb.


ABSTRACT

Objective. In children aged less than 10 years, to assess whether adenotonsillectomy has some permanent or transitory effect on middle ear pressure. Material and methods. 20 children aged 4 to 9 years old (13 girls and 7 boys) participated in the study. The day before surgery and on days 1, 7, 14 and 21 after adenotonsillectomy both tympanometry and pure tone audiometry were performed. During surgery, medication consisted in dexamethasone, atropine, propofol and sevoflurane. Results. Before surgery, the middle ear pressure was within the range of 0 ± 99 daPa. On day 1 of the followup study, the average right and left middle ear pressure decreased less than -99 daPa in 6 patients aged 4 to 9 years old (2 girls and 4 boys), with a body mass index from 11.9 to 16.6. At day 7 of follow-up, the middle ear pressure increased and none of the patients showed a pressure less than -99 daPa. Before surgery and during the 21 days of follow-up, hearing thresholds were always ≤ 20 dB nHL. No significant difference was observed between children with or without an average middle ear pressure lower than -99 daPa on their age, weight, height, body mass index or duration of the surgery. Conclusions. After adenotonsillectomy, children aged 4 to 9 years old who received dexamethasone, atropine and sevoflurane might develop negative middle ear pressure with no hearing loss, which may resolve in 1 week. After adenotonsillectomy, in patients with otalgia or risk factors for middle ear disease, closer evaluation of middle ear pressure may be advisable.


REFERENCES

  1. van Staaij BK, van den Akker EH, van der Heijden GJ, et al. Adenotonsillectomy for upper respiratory infections: evidence based? Arch Dis Child 2005; 90: 19-25.

  2. Van Den Akker EH, Hoes AW, Burton MJ, et al. Large international differences in (adeno)tonsillectomy rates. Clin Otolaryngol Allied Sci 2004; 29: 161-4.

  3. Bonding P, Tos M. Middle ear pressure during brief pathological conditions of the nose and throat. Acta Otolaryngol 1981; 92: 63-9.

  4. Hone SW, Moodley S, Donnelly MJ, et al. The effect of tonsillectomy on Eustachian tube function. Clin Otolaryngol Allied Sci 1997; 22: 511-4.

  5. Bluestone CD. Studies in otitis media: Children’s Hospital of Pittsburgh-University of Pittsburgh progress report-2004. Laryngoscope 2004; 114(11, Pt. 3 Suppl. 105): 1-26.

  6. Motta G, Casolino D, Cassiano B, et al. Adeno-tonsillar surgery in Italy. Acta Otorhinolaryngol Ital 2008; 28: 1-6.

  7. Kornblut A, Kornblut AD. Tonsillectomy and adenoidectomy. In: Paparella MM, Shumrick DA (eds.). Otolaryngology: Head and Neck. Vol. III. Philadelphia: WB Saunders Co; 1980: 2282-301.

  8. Tay HL. Post-operative morbidity in electrodissection tonsillectomy. J Layngol Otol 1995; 109: 209-11.

  9. Bluestone CD, Cantekin EI, Beery QC. Certain effects of adenoidectomy of Eustachian tube ventilatory function. Laryngoscope 1975; 85: 113-27.

  10. Maw AR. Chronic otitis media with effussion (glue ear) and adenotonsillectomy: prospective randomised controlled study. Br Med J 1983; 287: 1586-8.

  11. Flisberg K. Ventilatory studies on the Eustachian tube. A clinical investigation of cases with perforated ear drums. Acta Otolaryngol 1996; Suppl. 219: 1-82.

  12. Ozturk O, Demiraran Y, Ilce Z, et al. Effects of sevoflurane and TIVA with propofol on middle ear pressure. Int J Pediatr Otorhinolaryngol 2006; 70: 1231-4.

  13. Tjernström O, Andréasson L, Groth P, et al. Effect of atropine on the Eustachian tube function. ORL J Otorhinolaryngol Relat Spec 1985; 47: 95-100.

  14. Goldman AC, Govindaraj S, Rosenfeld RM. A meta-analysis of dexamethasone use with tonsillectomy. Otolaryngol Head Neck Surg 2000; 123: 682-6.

  15. Steward DL, Welge JA, Myer CM. Steroids for improving recovery following tonsillectomy in children. Cochrane Database Syst Rev 2003; 1: CD003997.

  16. Al-Shehri AM. Steroid therapy for post-tonsillectomy symptoms in adults: a randomized, placebo-controlled study. Ann Saudi Med 2004; 24: 365-7.

  17. Tan CT, Escoubet B, Van den Abbeele T, et al. Modulation of middle ear epithelial function by steroids: clinical relevance. Acta Otolaryngol 1997; 117: 284-8.




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