[Clinical analysis of abnormal acoustic admittance in preschool children with nasal and nasopharyngeal disorders].

Objective: To investigate the risk factors of related disorders, which could lead to potential otitis media by observing the abnormal configuration of drum and abnormal acoustic immittance without symptoms in preschool children.

Methods: Eighty-one cases (162 ears) received flexible pharyngorhinoscopy, skin prick test, CT examination of sinus, and were diagnosed as allergic rhinitis, chronic sinusitis, adenoid hypertrophy. They had no complaints of ear related symptoms, but were observed to have abnormality in ear drum by physical examined. Acoustic immittance measurement were performed, so as to estimate whether they were accompany with potential otitis media. The changes of examination and tests were analyzed before and after the treatment.

Results: There were 15 cases (29 ears) with abnormal acoustic admittance among 81 cases (162 ears) who had no ear related symptoms but had different degree abnormality in ear drum. The morbidity rate of these 15 patients was 13.6% (6/44 ears) in allergic rhinitis patients, 18.2% (12/66 ears) in chronic sinusitis patients, and 21.2% (11/52 ears) in adenoid hypertrophy patients, respectively. The differences among the three diseases had statistical significance (χ² = 63.02,P < 0.05). Among 29 ears, 28 ears whose type of tympanic pressure curve were transferred from type C to type A two weeks after treatment. One ear whose type of tympanic pressure curve transferred from type B to type C four weeks after treatment. All cases had been followed up with no recurrent cases.

Conclusions: Some preschool children with nasal and nasopharyngeal disorders had abnormal configuration of drum and abnormal acoustic immittance, and had potential risk for otitis media. Among the disorders, adenoid hypertrophy impact more on middle ear function. The early intervention of related diseases could prevent the developing trend of otitis media.