Management of middle ear disease in pediatric primary ciliary dyskinesia

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-03-04 DOI:10.1016/j.ijporl.2025.112297

Ethan G. Muhonen , Austin Zhu , Sera Sempson , Samantha Bothwell , Scott D. Sagel , Kenny H. Chan

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引用次数: 0

Abstract

Introduction

Primary ciliary dyskinesia (PCD) adversely affects the middle ear from early childhood resulting in otitis media with effusion (OME) and conductive hearing loss (CHL). Chronic otorrhea and tympanic membrane (TM) perforation are serious postoperative complications from tympanostomy tube (TT) placement. Management of OME and CHL has been debated for decades. This study reports on a proposed management schema for the middle ear in individuals with PCD.

Methods

A pediatric PCD cohort was retrospectively reviewed at Children's Hospital Colorado (CHCO) using electronic health record systems. Paired middle-ear/audiologic data for all subjects at their most recent CHCO visits were organized in a 4-age-group grid to compare clinical/audiologic outcomes between no-TT and TT subgroups.

Results

68 PCD subjects with middle-ear and audiologic data were tabulated. No-TT and TT subgroup comparisons showed no difference in clinical (normal TM and OME prevalence) and hearing [CHL percentage and pure-tone average (PTA)] outcomes across 4 age-groups except for higher percentage of normal TM (10 to <15 years category; p = 0.006) and fewer hearing loss ears (≥15 years category; p = 0.008), both favoring the no-TT subgroup. There were 9/13 (subjects/ears) in the TT subgroup with TM perforations, and a total of 130 sets of TT and other medical/surgical procedures were performed in this sub-cohort.

Conclusion

Children with PCD have a high prevalence of otologic complications. A schema is proposed to restrict the indications for TT placement and guide active management of CHL with the goal of preventing adverse sequalae of OME and achieving best clinical outcomes.

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小儿原发性纤毛运动障碍中耳疾病的处理

原发性纤毛运动障碍（PCD）从儿童早期就对中耳产生不利影响，导致渗出性中耳炎（OME）和传导性听力损失（CHL）。慢性耳漏和鼓膜穿孔是鼓膜造瘘管置入术后的严重并发症。OME和CHL的治疗已经争论了几十年。本研究报告了PCD患者中耳的建议管理方案。方法采用电子病历系统对科罗拉多州儿童医院（CHCO）的一组儿童PCD患者进行回顾性分析。所有受试者最近一次CHCO就诊时的配对中耳/听力学数据被组织成4个年龄组网格，以比较无TT和TT亚组之间的临床/听力学结果。结果将68例PCD患者的中耳及听力学资料制成表格。无TT和TT亚组比较显示，4个年龄组的临床（正常TM和OME患病率）和听力[CHL百分比和纯音平均（PTA）]结果没有差异，除了正常TM的百分比较高（10至15岁）；P = 0.006)和更少的听力损失耳(≥15岁类别；p = 0.008)，均支持无tt亚组。TT亚组中有9/13（受试者/耳朵）有TM穿孔，在该亚组中共进行了130组TT和其他医疗/外科手术。结论PCD患儿耳科并发症发生率高。我们提出了一个方案来限制TT放置的适应症，指导CHL的积极管理，以防止OME的不良后遗症，达到最佳的临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.