Acute otitis media in children: Correlation with palatine tonsil size, adenoidectomy and adenotonsillectomy

Dalibor Vranješ, Slobodan Spremo, Dmitar Travar, Aleksandara Aleksić, Biljana Banjac


Objective – The objective of the survey was to assess the role and importance of the hypertrophy of palatine tonsils and previously performed adenoidectomy and adenotonsillectomy for the incidence of the acute otitis media in children.

Materials and methods – The prospective and controlled study was carried out among 160 patients of both genders, aged between 6 months and 7 years, with an acute otitis media, during a 12-month period. The control group consisted of 40 examinees who had not been diagnosed with this disease. Clinical assessment of the palatine tonsil size was performed according to the degree of obstruction of the isthmus faucium: hypertrophy - grade I (both palatine tonsils obstruct up to ½ of the isthmus faucium), and hypertrophy - grade II (both palatine tonsils obstruct more than ½ of the isthmus faucium). Patients were stratified by age into three groups: 3 - 11 months, 1 - 2.5 years and 2.6 - 7 years. The association between antibiotic therapy and new cases of adenotonsillar infections was evaluated. Follow-up audiological examinations were conducted. The study was carried out on the basis of a questionnaire survey.

Results – Adenoidectomy was performed in 8.3% of examinees with acute otitis media, adenotonsillectomy in 7.5%, while 84.2% of examinees were not treated with any of the above mentioned surgical procedures. No statistically significant differences were found compared to the control group (p=0,213). The palatine tonsils were eutrophic in 26.8% of the examinees with the acute otitis media, 55.4% had hypertrophy - grade I, and 17.9% hypertrophy - grade II. The differences between the observed groups were statistically significant (p=0.019).

Conclusion – The hypertrophy of palatine tonsils was statistically significantly more prevalent in examinees with acute otitis media compared with the control group. This kind of level of significance was not recorded regarding previously performed adenoidectomy and adenotonsillectomy.


Otitis media; Hypertrophy; Palatine tonsils; Adenoidectomy; Adenotonsillectomy

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