Evaluation of audiological results after insertion tympanostomy tubes in children

Otitis media is one of the most common childhood infections and the most frequent cause for antibiotic prescriptions. The tympanostomy tubes are the standard treatment of persistent otitis media with effusion in children which improves hearing. When chronic adenoid infection is suspected, adenoidectomy or tonsilloadenoidectomy may be beneficial in treating otitis media in children who have previously undergone tympanostomy-tube insertion. The aim of the study was to evaluated audiology results before and after adenoidectomy and tonsilloadenoidectomy and insertion tympanostomy tubes.Material and methods: Retrospective-prospective study included the group of patients aged between 1-8 year, with otitis media with effusion treated by insertion tympanostomy tubes and adenoidectomy or tonsilloadenoidectomy, during the four-year period (2006-2010) at ENT Clinic, Clinical Center University of Sarajevo. At the examination otomicroscope, pure-tone audiometry and tympanometry were used.Results: Out of the 63 patients we performed both side insertion ventilation tubes with/without adenoidectomy or tonsilloadenoidectomy. Our results presented statistically significant difference between operative or conservative treatment.Conclusions: When chronic adenoid infection is suspected, adenoidectomy or tonsilloadenoidectomy may be beneficial in treating otitis media in children who have previously undergone tympanostomy tube insertion. After this treatment results of audiological and tympanometry tests were increased comparing with results before. Our recommendation is obligatory examination (audiometry and tympanometry) to all chlidren suffering from otitis media with/withaout hypertrophic tonsills and adenoids

Trends in antibiotic treatment of acute sinusitis in the last decade - evidence based study

Background: antibiotics are basic in treatment of acute bacterial sinus infection. Aim: which antibiotic classes are the most common used in clinical trials in treating acute bacterial sinusitis, according to EPOS 2007. guidelines. Data sources: relevant English-language articles identified in the PubMed Central and MEDLINE databases. Study selection: articles about antibiotic treatment of acute sinusitis in adults (19+years), all clinical trials, meta-analysis, practice guidelines and randomized controlled trials published in the last ten years. There were 91 articles, and 53 of them evaluated.Data extraction: articles about complications, no-bacterial and chronic sinusitis, case-reports, surgical treatments.Results: There are totally 15.456 patients in 53 clinical trials. Antibiotic-classes in evaluated trials: penicillin-gruop (49.06%), quinolons (35.86%), macrolids and ketolids (32.07%), cephalosporins (15.09%), carbapenems (3.77%). In relation to total number of treated patients, the most common antibiotics in observed period are from penicillin group (45%). Other antibiotics: quinolons 21.07%, telithoromycin 10.51%, cephalosporins 9.95%, macrolids 9.2%, and carbapenems in 4.24% treated patients. Short-course of antibiotic treatment (less than 7 days) confirmed as safe and effective in 80.7% trials.Conclusion: Although is the amoxicillin and amoxicillin/clavulanate still the most common antibiotic in treatment of acute sinusitis, recent clinical trials are more based on second-line antibiotics, more in single-dose and in short-course treatment

The role of tonsillectomy in pevention helicobacter pylori infection: fact or fiction?

The transmission of the gastric pathogen Helicobacter pylori involves the oral route. The incidence of Helicobater pylori infection varies gobally and depends on the socioeconomic situation of a location. In the territory of Bosnia and Herzegovina, the incidence rate among the populace is 40-50% in persons with normal gastroscopic findings, whereas it is increased in persons with pathohistological findings of the ulcus disease. This study examines the potential preventive role of tonsillectomy with regard to H. Pylori infection in later stages of life. The survey was conducted on a sample of 115 examines (63 male, 52 female), aged between 19 and 65. The survey included examines who underwent esophagogastroscopy at the Clinic for Gastroenterology Clinical Center University of Sarajevo based on indication by a gastroenterology specialist. The survey has shown that of the total of 115 examinees, 28 of them had been tonsillectomised, and 87 had not been tonsillectomised. In the examinees who had not been subjected to tonsillectomy, positive H. Pylori result was found in 65.8%, and 62.8% of those who had beeb tonsillectomised at young age were positive to H. Pylori. The result have shown that H. Pylori infection was equally represented in all age groups, and the rate varies at 52.9-64.8%. Final conclusion was reached that tonsillectomy has no preventive role with regard to H.pylori infection. Conclusion: The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.Der Erstautor gibt keinen Interessenkonflikt an

Evaluation of audiological results after insertion tympanostomy tubes in children

Otitis media is one of the most common childhood infections and the most frequent cause for antibiotic prescriptions. The tympanostomy tubes are the standard treatment of persistent otitis media with effusion in children which improves hearing. When chronic adenoid infection is suspected, adenoidectomy or tonsilloadenoidectomy may be beneficial in treating otitis media in children who have previously undergone tympanostomy-tube insertion. The aim of the study was to evaluated audiology results before and after adenoidectomy and tonsilloadenoidectomy and insertion tympanostomy tubes.Material and methods: Retrospective-prospective study included the group of patients aged between 1-8 year, with otitis media with effusion treated by insertion tympanostomy tubes and adenoidectomy or tonsilloadenoidectomy, during the four-year period (2006-2010) at ENT Clinic, Clinical Center University of Sarajevo. At the examination otomicroscope, pure-tone audiometry and tympanometry were used.Results: Out of the 63 patients we performed both side insertion ventilation tubes with/without adenoidectomy or tonsilloadenoidectomy. Our results presented statistically significant difference between operative or conservative treatment.Conclusions: When chronic adenoid infection is suspected, adenoidectomy or tonsilloadenoidectomy may be beneficial in treating otitis media in children who have previously undergone tympanostomy tube insertion. After this treatment results of audiological and tympanometry tests were increased comparing with results before. Our recommendation is obligatory examination (audiometry and tympanometry) to all chlidren suffering from otitis media with/withaout hypertrophic tonsills and adenoids