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Comparative study on adhesive otitis media and pars tensa cholesteatoma in children

  • Saeko Yoshida
    Correspondence
    Corresponding author at: Department of Otolaryngology / Deafness and Middle Ear Surgicenter Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan.
    Affiliations
    Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan
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  • Saori Seki
    Affiliations
    Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan
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  • Tomonori Sugiyama
    Affiliations
    Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan
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  • Saori Kikuchi
    Affiliations
    Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan
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  • Naohiro Yoshida
    Affiliations
    Department of Otolaryngology Head and Neck Surgery, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya 330-0834, Japan
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  • Yukiko Iino
    Affiliations
    Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo 115-0053, Japan

    Department of Otolaryngology Head and Neck Surgery, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya 330-0834, Japan
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Published:March 02, 2022DOI:https://doi.org/10.1016/j.anl.2022.02.007

      Abstract

      Objective: Recurrent otitis media and persistent otitis media with effusion in early childhood may cause an atelectatic eardrum and adhesive otitis media, which sometimes progress to pars tensa cholesteatoma. When and how children with adhesive otitis media should be operated on remain controversial. Therefore, this study aimed to analyze the clinical characteristics of children with adhesive otitis media and pars tensa cholesteatoma, and to determine the risk factors of progression to cholesteatoma.
      Methods: Seventeen ears of 15 children with adhesive otitis media (adhesive group) and 14 ears of 13 children with pars tensa cholesteatoma (tensa cholesteatoma group) who underwent tympanoplasty were included in this study. We analyzed the following clinical characteristics of children in both groups: medical and life history, associated diseases, sites of the adhesion, and development and aeration of mastoid air cells as shown by temporal bone computed tomography.
      Results: Most of the children in both groups had a history of recurrent otitis media and/or persistent otitis media with effusion. They showed a male predominance and a frequent association of allergic rhinitis. The number of ears showing undeveloped mastoid air cells in the tensa cholesteatoma group was significantly larger than that in the adhesive otitis media group (P=0.0068). A lack of aeration of the middle ear, including the eustachian tube, was more frequently found in ears with pars tensa cholesteatoma than in ears with adhesive otitis media (P=0.0012). Using multivariate logistic regression, the presence of otorrhea (odds ratio [OR], 14.847; 95% confidence interval [CI], 0.834–264.184), total adhesion (OR, 28.550; 95% CI, 0.962–847.508), and undeveloped mastoid air cells (OR, 19.357; 95% CI, 1.022–366.589) were related to pars tensa cholesteatoma.
      Conclusion: Children with adhesive otitis media should be carefully followed up in the outpatient setting. Ears with poor mastoid development may develop pars tensa cholesteatoma. Additionally, ears with middle ear effusion, total adhesion, and the presence of otorrhea tend to be at risk of pars tensa cholesteatoma. Tympanoplasty or tympanostomy tube insertion should be considered for children with adhesive otitis media who have these risk factors to prevent progression to pars tensa cholesteatoma.

      Keywords

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      References

        • Sade J
        • Berco E.
        Ateletasis and secretory otitis media.
        Ann Otol Rhinol Laryngol. 1976; 85 (Suppl 25 Pt2): 66-72
        • Borgstein J
        • Gerritsma TV
        • Wieringa MH
        • Bruce IA.
        The Erasmus atelectasis classification: proposal of a new classification for atelectasis of the middle ear.
        Laryngoscope. 2007; 117: 1255-1259
        • Tono T
        • Sakagami M
        • Kojima H
        • Yamamoto Y
        • Masuda K
        • Komori M
        • et al.
        Staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society.
        Auris Nasus Larynx. 2017; 44: 135-140
        • Sade J.
        Atelectatic tympanic membrane: Histologic study.
        Ann Otol Rhinol Laryngol. 1993; 102: 712-716
        • Granstrom G
        • Holmquist J
        • Jarlstedt J
        • Renvall U.
        Collagenase activity in middle ear effusion.
        Acta Otolaryngol. 1985; 100: 405-413
        • Yellon RF
        • Doyle WJ
        • Whiteside TL
        • Diven WF
        • March AR
        • Fireman P.
        Cytokines, immunoglobulins, and bacterial pathogens in middle ear effusions.
        Arch Otolaryngol Head Neck Surg. 1995; 121: 865-869
        • Li Y
        • Hunter L
        • Rh Margolis
        • Levine SC
        • Lindgren B
        • Daly K
        • et al.
        Prospective study of tympanic membrane retraction, hearing loss and multifrequency tympanometry.
        Otolaryngol Head Neck Surg. 1999; 121: 514-522
        • Tos M
        • Stangerup S
        • Larsen P.
        Dynamics of eardrum changes following secretory otitis.
        Arch Otolaryngol Head Neck Surg. 1987; 113: 380-385
        • Spilsbury K
        • Miller I
        • Semmens JB
        • Lannigan FJ.
        Factors associated with developing cholesteatoma: a study of 45,980 children with middle ear disease.
        Laryngoscope. 2010; 120: 625-630
        • Day KA
        • Rich SS
        • Levine S
        • Margolis RH
        • Le CT
        • Lindgren B
        • et al.
        The family study of otitis media.
        Genet Epidemiol. 1996; 13: 451-468
        • Kong K
        • Coates HLC.
        Natural history, definitions, risk factors and burden of otitis media.
        MJA. 2009; 191: S39-S43
        • Magnuson B.
        Atelectatic ear.
        Int J Pediatr Otolarygol. 1981; 3: 25-35
        • Yaginuma Y
        • Kobayashi T
        • Takasaka T.
        The habit of sniffing in nasal diseases as a cause of secretory otitis media.
        Am J Otol. 1996; 17: 108-110
        • Falk B.
        Sniff-induced negative middle ear pressure; study of a consecutive series of children with otitis media with effusion.
        Am J Otolaryngol. 1982; 3: 155-162
        • Kreiner-Møller E
        • Chawes BL
        • Caye-Thomasen P
        • Bønnelykke K
        • Bisgaard H.
        Allergic rhinitis is associated with otitis media with effusion: a birth cohort study.
        Clin Exp Allergy. 2012; 42: 1615-1620
        • Zhang Y
        • Xu M
        • Shang J
        • Zeng L
        • Wang Y
        • Zheng QY.
        Risk factors for chronic and recurrent otitis media- a meta-analysis.
        POLS one. 2014; (9 e86397): 1-9
        • Chantzi FM
        • Kafetzis DA
        • Bairamis T
        • Auvamidou C
        • Paleologou N
        • Grimani I
        • et al.
        IgE sensitization, respiratory allergy symptoms, and heritability independently increase the risk of otitis media with effusion.
        Allergy. 2006; 61: 332-336
        • Hurst DS
        • Denne CM.
        The role of allergy to eustachian tube dysfunction and subsequent need for insertion of pressure equalization tubes.
        Ear Nose Throat J. 2020; 99 (39S–47S)
        • Busgaard H.
        The Copenhagen prospective study on asthma in childhood (COPSAC). Design rationale, and baseline data from a longitudinal birth cohort study.
        Ann Allergy Asthma Immunol. 2004; 93: 381-389
        • Falade AG
        • Ige OM
        • Yusuf BO
        • Onadeko MO
        • Onadeko BO.
        Trends in the prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema.
        J Natl Med Assoc. 2009; 101: 414-418
        • Fasunla AJ
        • Ijitola JO
        • Nwaorgu OG.
        Tympanometric patterns of children with allergic rhinitis treated at a tertiary health institution.
        Oto Open. 2017; 14 (1)2473974X17742648
        • Danner CJ.
        Middle ear atelectasis: What causes it and how is it corrected.
        Otolaryngol Clin N Am. 2006; 39: 1211-1219
        • Ars B.
        Tympanic membrane retraction. Retraction pocket.
        Acta Otorhinolaryngol Bel. 1995; 49: 163-171
        • Doyle WJ
        • Seroky JT
        • Alper CM.
        Gas exchange across the middle ear mucosa in monkeys. Estimation of exchange rate.
        Arch Otolaryngol Head Neck Surg. 1995; 121: 887-892
        • Spinner A
        • Munjuluru A
        • Wootten CT.
        Prevalence of cholesteatoma in children with Down syndrome receiving treatment at pediatric health care facilities.
        JAMA Otolaryngol Head Neck Surg. 2020; 146: 864-865