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The Effect of Amoxicillin-Clavulanate and Actifed Versus Actived Only in treatment of Otitis Media with Effusion

Authors: Ahmed Muhei Rasheed*,FIBMS(Otolaryngology) --- Yusra Hayder Taha**, FICMS(Otolaryngology احمد محي رشيد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2008 Volume: 50 Issue: 3 Pages: 327-331
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Otitis media with effusion(OME)is a common cause of deafness in childrenwith subsequent impairment of speech development and scholastic difficulties.Treatmentremains controversial.Aim: To study the effect of amoxicillin-clavulanate in treatment of OMEPatients and methods: A prospective study of a target sample consisting of sixty childrenunder the age of 12 years presented with chief complaints duration for at least 6 weeks andon examination there were bilateral red and retracted tympanic membranes withoutoversized adenoids and no underlying causes require surgical correction e.g cleft palate.Thepatients were divided into two groups;group A which received Actifed for 4 weeks andgroup B which received Actifed +Amoxicillin-clavulanate for 4 weeks treatmentcourse.After complete history and otolaryngological examination,all the patients were sent tox-ray of postnasal space( to exclude oversized adenoids),audiometry andtympanometry.Assessment was repeated at the end of 2 and 4 weeks of treatment courseincluding audiometry and tympanometry.The response to treatment in group B wascompared to that in group A at the end of 4 weeks treatment course.In this study,we referedto improvement in otoscopic findings and tympanometry results to show the response to 4weeks treatment course.Results: Eight patients(25.81%)in group A have shown response to treatment at the end of 4weeks treatment course,while the response in group B was seen in 15 patients( 51.72%).Conclusion: Amoxicillin-clavulanate has statistically significant effect in treatment of otitismedia with effusion(OME)in short term follow-up and the clearance of middle ear efussionin response to amoxicillin-clavulanate indicates that bacterial infection may play a role in theaetiology of OME.Keywords: Otitis media with effusion,Amoxicillin-clavulanate,Tympanometry.


Article
CLINICAL AND TYMPANOMETRIC ASSESSMENT OF MIDDLE EAREFFUSION VERSUS MYRINGOTOMY FINDING

Authors: Mazin N. Fatoohi --- Hani Musa Bader --- Hamed M. Mohammed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2008 Volume: 50 Issue: 3 Pages: 321-326
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The present study was planned to show the accuracy of clinical examination and
tympanometry in diagnosis of middle ear effusion.
Patients and Methods: The study involved 80 patients (160 ears )suspected to have otitis media
with effusion (OME) from different age groups ; 56 were males and 24 were females .
Clinical assessment for all patients included otoscopy , pneumatic otoscopy and audiological
assessment by using pure tone audiometry and tympanometry then comparing the results to
findings at myringotomy as the gold standard for presence or absence of fluid in the middle ear .
Results : Fluid whether serous or glue was found in 100 ears ( 62.5 %) where as sixty ears were
dry, sensitivity , specificity and accuracy of tympanometry were 90 % , 70 % and 85 %
respectively , and for clinical assessment were 82 % , 52% and 71 % respectively . A combined
clinical and tympanometry sensitivity and specificity were calculated and found to be 96 % and
92 % respectively.
Conclusion : clinical examination as a method for diagnosis of middle ear effusion depend on
experience of the examiner . tympanometry proved to be a reliable diagnostic tool for the
diagnosis of OME , it appeared significantly better at determining non effusion state.

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