PREVENTION OF OTITIS MEDIA AND ADENOID DISEASES IN CHILDREN: AN INTEGRATED OTORHINOLARYNGOLOGICAL APPROACH

Abstract

Background: Adenoid hypertrophy (AH) and Otitis Media (OM) are inextricably linked pathologies in pediatric otorhinolaryngology, often referred to as the "Adenoid-Otitis Syndrome." In the Andijan region, chronic adenoiditis serves as a primary reservoir for infection and a mechanical obstruction to the Eustachian tube, driving recurrent ear infections. This study aims to evaluate the efficacy of a comprehensive preventive strategy targeting nasopharyngeal health to reduce the incidence of otitis media in children. Methods: A prospective randomized controlled study involving 400 children aged 3–9 years with Grade II-III adenoid hypertrophy and a history of recurrent OM was conducted. Participants were divided into two groups: Group A (n=200) received a preventive regimen (nasal saline irrigation, topical intranasal corticosteroids, and breathing exercises), while Group B (n=200) received standard symptomatic treatment during acute episodes. Clinical outcomes, including adenoid size regression, tympanometry results, and frequency of OM episodes, were monitored for 12 months. Results: Group A demonstrated a significant reduction in the frequency of Acute Otitis Media episodes (1.2 ± 0.5 vs. 3.8 ± 1.1 per year in Group B, p<0.001). Tympanometric normalization (Type A) was achieved in 75% of Group A compared to 40% in Group B. Furthermore, 45% of children in the preventive group avoided the need for adenotomy due to symptomatic improvement. Conclusion: Proactive management of adenoid vegetation through conservative preventive measures significantly lowers the burden of otitis media. Treating the nasopharynx is the key to protecting the middle ear in the pediatric population.