Abstract
OBJECTIVE
Adenoid hypertrophy and chronic adenoiditis are associated with an increased incidence of chronic otitis media. This study intends to determine the relationship between chronic otitis media and stimulated ciliary beat frequency (CBF) in children undergoing adenoidectomy.
METHOD
25 children undergoing adenoidectomy at a tertiary care pediatric hospital were enrolled in this study. Patients were stratified according to their indication for surgery, including: adenotonsillar hypertrophy with obstructive sleep apnea (ATH), chronic otitis media with effusion (COME), or recurrent episodes of acute otitis media (RAOM). Adenoids were harvested using curette. Tissue was sectioned into 1mm strips and allowed to equilibrate in DMEM/F12 with 2% fetal bovine serum for 24 hours. Cilia-bearing tissue was then stimulated using isoproterenol (10-4 M). CBF was recorded hourly for four hours using the Simmons-Ammons Video Analysis (SAVA) program.
RESULTS
At two hours, children with RAOM had significant elevation in ciliostimulation compared to children with ATH and COME (p = 0.0253 and p = 0.0355 respectively). At three hours, children with COME demonstrated a blunted ciliostimulation compared to ATH and RAOM (p = 0.0188 and p = 0.0111 respectively). Results at one and four hours were not significantly different among all groups.
CONCLUSION
There is a significant increase in ciliostimulation at two hours in children with RAOM. This may be related to adenoid tissue hypersensitivity in patients with frequent infections. At three hours, children with COME demonstrated a blunted ciliary stimulation. This ciliary dysfunction may imply a physiological explanation in addition to mechanical obstruction in children with COME.