Adenotonsiller Hipertrofili Hastalarda Efüzyonlu Otitis Media İçin Risk Faktörlerinin Araştırılması (Efüzyonlu Otitis Media'da Risk Değerlendirmesi)

Amaç: Uykuda Solunum Bozukluğu(USB), basit horlamadan obstrüktif uyku apnesine(OSA) kadar uzanan en yaygın çocukluk çağı bozukluklarından biridir ve bunun da enönemli sebepleri arasında ilk sırada adenotonsiller hipertrofi (ATH) gelmektedir. ATH'yebağlı USB'li çocuklarda karşılaşılan bir diğer önemli sorun ise Efüzyonlu Otitis Media’dır(EOM). Bu çalışmanın amacı, ATH nedeniyle USB olan çocuklarda EOM'nin gelişimindekiolası risk faktörlerini değerlendirmektir.Gereç ve Yöntem: ATH'ye bağlı horlama ve uyku apnesi şikayetleri olan 171 pediatrikhasta çalışmaya dahil edildi. Hastalar iki gruba ayrıldı. Grup 1: tek başına ATH olanlar veGrup 2: ATH + EOM olan hastalar. USB şiddetini değerlendirmek için pre-operatif olarakstandart bir anket kullanıldı. Her iki grup için yirmi bir farklı parametre değerlendirildi. Bulgular: Yaş, cinsiyet, tütün dumanına maruz kalma, 12 aydan önce inek sütü maruziyeti,en az 6 ay sadece anne sütü, semptomların süresi, USB semptom skorları, tekrarlayantonsillit öyküsü, adenoid/nazofarenks (AN) oranı, tonsil büyüklüğü, vücut kitle indeksi(VKİ), hemoglobin (Hb) düzeyi, hematokrit (Hct) oranı, ortalama trombosit hacmi (MPV),eozinofil oranı, nötrofil-lenfosit oranı (NLO), tiroid fonksiyon testleri (TSH, fT4), folat veB12 vitamini düzeyleri değerlendirildi. VKİ dışında bu parametreler arasında istatistikselolarak fark yoktu. VKİ değerleri Grup 1'de 16.08 ± 1.96 ve Grup 2'de sırasıyla 17.11 ± 2.81idi (p: 0.006).Sonuç: Multifaktöriyel bir hastalık olan EOM için pek çok farklı parametre değerlendirildi.Gruplar arasında sadece VKI farklı olarak tespit edildi. ATH hastalarında EOM gelişimiaçısından risk faktörlerini tanımlamak için daha fazla çalışma gereklidir.

Investigation of Risk Factors for Otitis Media With Effusionin Patients with Adenotonsillar Hypertrophy (RiskAssessment in Otitis Media with Effusion)

Objective: Sleep Disordered Breathing (USB) is one of the most common childhooddisorders ranging from simple snoring to obstructive sleep apnea (OSA), and most commoncause of it is the adenotonsillar hypertrophy (ATH). Otitis Media with Effusion (OME) isanother important problem in children with USB due to ATH. The aim of this study was toevaluate the possible risk factors for the development of EOM in children with USB due toATH.Methods: 171 pediatric patients with ATH-related snoring and sleep apnea complaints wereincluded in the study. The patients were divided into two groups. Group 1: patients withATH + OME and Group 2: patients with ATH alone. A pre-operative standard questionnairewas used to assess USB severity. Twenty-one different parameters were evaluated for bothgroups.Results: Age, sex, exposure to tobacco smoke, cow milk exposure before 12 months, breastmilk only for at least 6 months, duration of symptoms, USB symptom scores, history ofrecurrent tonsillitis, adenoid / nasopharynx (AN) ratio, tonsil size, body mass index (BMI),hemoglobin (Hb) level, hematocrit (Hct) ratio, mean platelet volume (MPV), eosinophilratio, neutrophil-lymphocyte ratio (NLR), thyroid function tests (TSH, fT4), folate andvitamin B12 levels were evaluated. There was no statistically significant difference betweenthese parameters except BMI. BMI values were 16.08 ± 1.96 in Group 1 and 17.11 ± 2.81 inGroup 2, respectively (p: 0.006).Conclusions: Many different parameters were evaluated for EOM, a multifactorial disease.Among the groups, only BMI was different. Further study is required to identify risk factorsfor the development of EOM in patients with ATH.

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez