Evaluation of middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion.

OBJECTIVE: Our aim was to analyze the changes in middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion. METHODS: This prospective, descriptive study was performed on 64 patients (with normal tympanic membranes and tympanograms) undergoing adenoidectomy or adenotonsillectomy. All patients were operated by single experienced team using curettage technique. First tympanometry was done on the day before surgery. Tympanometry was repeated on the first-, third-, and seventh-day after the operation. Patients are separated into two groups according to age as patients younger than 6 years (Group A) and patients older than 6 years (Group B). All data were separately evaluated for each ear using Jerger Classification. RESULTS: Of the 64 patients included in the study, 35 were male and 29 were female, and the average age was 91.01 ± 37.4 (35-178) months. Pathological decreases in the middle ear pressures of at least one ear were determined in 48 (75%) patients on the first postoperative day and in 10 (15.6%) patients on the third postoperative day. Middle ear pressures returned to preoperative values by the seventh postoperative day except in two patients. There were statistically significant differences (p<0.0001) among preoperative and first, third, and seventh postoperative day mean middle ear pressure. There were no statistically significant differences between Groups A and B in terms of tympanometry values of both ears obtained preoperatively and on the first, third, and seventh postoperative day. CONCLUSION: In our study, temporary eustachian dysfunction and aural fullness occur in the early period after adenoidectomy and/or adenotonsillectomy. This situation may be due to post-surgery clots and edema in nasopharynx. We consider that tubal orifice can be exposed to surgical trauma as adenoidectomy surgeries are done by curettage technique. There is a need for comparative studies using microdebrider or laser adenoidectomy accompanied by an endoscope.

[Nasal foreign bodies: an analysis of 130 patients]. / Burunda yabanci cisim: 130 hastanin degerlendirilmesi.

OBJECTIVES: This study aims to investigate clinical manifestations and treatment protocols in patients with a diagnosis of nasal foreign bodies. PATIENTS AND METHODS: We retrospectively evaluated 130 patients (72 males, 58 females; mean age 3.65±2.31 years; range 15 month to 72 years) who were diagnosed with nasal foreign bodies and received treatment between November 2008 and July 2013. Age and sex of the patients, type of foreign body, side of presentation, signs and symptoms, management practices, and outcomes were recorded. RESULTS: Most of the patients were children between the ages of 2 and 5 (n=113, 86.9%). The most common foreign bodies were small plastic toys (43.8%), nut, walnut, corn, bean and the other seed grains (29.2%). Foreign bodies were detected in the right nasal passage in 74 patients (56.9%), left nasal passage in 54 patients (41.6%) and both nostrils in two patients (1.5%). Of the patients, 92.3% were admitted to our clinic within 24 hours. CONCLUSION: Nasal foreign bodies are frequent encountered in the emergency setting of ear, nose, and throat diseases. Although they are not life-threatening conditions, they require urgent intervention, as they may lead to several complications in the long-term. Parents and caregivers of children should keep objects which can be put into the nose away and be instructed that they should consult a physician in case of nasal foreign bodies.