Erişkin dönem başlangıçlı efüzyonlu otitis media: Etyolojik çalışma

Amaç: Eriflkin dönemde bafllayan efüzyonlu otitis mediada EOM etyolojik nedenler ve nazal endoskopinindeğeri arafltırıldı.Hastalar ve Yöntemler: Çalıflmaya, eriflkin dönemdeEOM görülen 50 hasta alındı. Hastalara rutin KBB muayenesi dıflında, pnömotik otoskopi ve otomikroskobi yapıldı. Saf-ses odyometri ve timpanogram testleri uygulandı. Nazal kavite ve nazofarenks 4 mm rijid 0° ve30° endoskop kullanılarak incelendi. Hastaların tümüne deri testi uygulandı ve kanlarında spesifik IgE düzeylerine bakıldı. Endikasyonu olduğunda burun veparanazal sinüsler, nazofarenks ve kafa tabanı bilgisayarlı tomografi ile incelendi.Bulgular: Hastaların 14’ünün sağ kulağında, 12’sininsol kulağında ve 24’ünün iki kulağında EOM saptandı.Üç hastada alerji, dört hastada belirgin septal deviasyon vardı. Yirmi hastada orta meada mukopürülanakıntı, iki hastada ise lateral nazal duvarda polipoiddoku belirlendi. On üç hastada östaki ağzında mukoidve pürülan akıntı, 10 hastada ödem, befl hastada isenazofarenkste kitle saptandı. Biyopsi sonuçları birhastada yassı epitel hücreli karsinom, diğerlerinde iselenfoid hiperplazi fleklinde idi.Sonuç: Nazal endoskopinin, eriflkin EOM’de sık görülen nedenleri ortaya koymada oldukça etkili bir yöntem olduğu sonucuna varıldı

Adult onset otitis media with effusion: an etiologic study

Objectives: We investigated the etiologic causes and the value of nasal endoscopy in adult onset otitis media with effusion OME .Patients and Methods: The study included 50 patients with adult-onset OME 28 males, 22 females; mean age 46 years; range 18 to 41 years . Pneumatic oto- scopy, otomicroscopy, pure-tone audiometry and tym- panometry were performed in ali patients. The nasal cavity and the nasopharynx were examined by nasal endoscopy. Skin prick tests were performed and serum specific IgE levels were determined in ali patients.Computed tomography seans of the nasal cavity, paranasal sinuses, nasopharynx, and the skull base were obtained when indicated.Results: Adult-onset OME was bilateral in 24 patients.Allergy was deteeted in three patients. Four patients had marked septal deviation. Mucopurulent diseharge in the middle meatus was observed in 20 patients and polypoid tissue in the lateral nasal wall in two patients. Mucoid and purulent diseharge and edema were observed at the ori- fice of the eustachian tube in 13 patients and 10 patients, respeetively. Biopsies obtained from nasopharyngeal masses revealed squamous celi carcinoma in one patient and lymphoid hyperplasia in four patients.Conclusion: We concluded that nasal endoscopy was a reliable method in the investigation of etiologic factors in adult-onset OME.

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