Akcan Fatih Alper, Dündar Yusuf, Akcan Hümeyra Bayram, Uluat Ahmet, Cebeci Derya, Sungur Mehmet Ali, Ünlü İlhan
Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey.
Wayne State University, Department of Otolaryngology -Head &Neck Surgery, Detroit, MI, USA.
Int J Pediatr Otorhinolaryngol. 2018 Feb;105:1-5. doi: 10.1016/j.ijporl.2017.11.030. Epub 2017 Dec 1.
To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion.
This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; < 15 ng/mL was accepted as vitamin D deficiency. The results were compared with the control group in terms of vitamin D levels. Also, subgroup analysis was performed addressing to the complete recovery otitis media with effusion and chronic otitis media with effusion.
One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p < 0.001). Vitamin D deficiency was observed in 33 out of 66 patients (50.0%) in chronic otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006).
This study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion prognosis. There is a significant association between 25(OH)Vitamin D deficiency and follow-up outcomes of otitis media with effusion.
探讨维生素D在分泌性中耳炎预后中的临床作用。
本前瞻性对照研究在土耳其杜兹切大学耳鼻喉科进行。研究组包括2016年9月至2017年2月期间被诊断为分泌性中耳炎的儿童。对照组为接受包皮环切术或腹股沟疝修补术的儿童，经耳鼻喉科检查确认无中耳炎迹象。在未进行任何治疗的3个月随访后，被认定为慢性分泌性中耳炎的未愈病例在全身麻醉下进行鼓膜置管手术。根据3个月末的血清25(OH)维生素D水平对研究组和对照组进行评估；<15 ng/mL被认定为维生素D缺乏。将结果与对照组在维生素D水平方面进行比较。此外，对分泌性中耳炎完全恢复和慢性分泌性中耳炎进行亚组分析。
174例分泌性中耳炎患儿和80例对照患者纳入研究。174例分泌性中耳炎患者中有108例（62%）在3个月随访后完全恢复。174例儿童中有66例患有持续性疾病，在3个月随访后进行了鼓膜置管。分泌性中耳炎组的平均25(OH)维生素D水平为18.98±10.60，对照组为28.07±14.10，研究组与对照组之间的差异具有统计学意义（p<0.001）。慢性分泌性中耳炎组66例患者中有33例（50.0%）存在维生素D缺乏，而分泌性中耳炎完全恢复组108例患者中有35例（32.4%）（p=0.021）。对照组维生素D缺乏率为25%，与慢性分泌性中耳炎组和分泌性中耳炎恢复组存在统计学差异（p=0.006）。
本研究不仅显示了维生素D与分泌性中耳炎发生之间的关系，还证明了维生素D对分泌性中耳炎预后的影响。25(OH)维生素D缺乏与分泌性中耳炎的随访结果之间存在显著关联。
