Cakabay Taliye, Üstün Bezgin Selin, Tarakcioglu Mahmut Cem, Kocyigit Murat, Serin Keskinege Bilge, Giran Örtekin Safiye, Ozdemir Mustafa
Kanuni Sultan Suleyman Training and Research Hospital Otolaryngolgy Clinic, Istanbul, Turkey.
Kanuni Sultan Suleyman Training and Research Hospital Otolaryngolgy Clinic, Istanbul, Turkey.
Auris Nasus Larynx. 2019 Oct;46(5):803-807. doi: 10.1016/j.anl.2019.02.009. Epub 2019 Mar 18.
In this study, we aimed to evaluate the diagnoses of the infants who were admitted to our outpatient clinic with the complaint of pulling on the ear and to identify the related factors which may contribute to the diagnosis.
This prospective study included a total of 102 infants who were admitted to our hospital with the complaint of tugging and pulling on, touching, and rubbing the ears on the shoulder or pillow and shaking the head between July 2016 and July 2017. The complaints were evaluated throughout the day, and the application seasons, the person referred the patient to the ear, nose, and throat (ENT) specialist, the child development specialist and child psychiatrist, allergy and atopy histories, and the relationship between the results and diagnoses were evaluated.
46.1% of the patients had normal examination findings, while the second most common finding was cerumen in 37.2%, and the third one was otitis media with effusion (OME) in 16.7%. In infants who were directly referred by the family, normal and serological diagnosis were found to be statistically significantly higher than that of OME diagnosis, whereas in the infants referred by the family physicians and pediatrist, the OME was found to be statistically significantly higher than normal and cerumen levels. The presence of additional complaints in the OME group was found to be higher than normal and cerumen group. In those with complaints during the day, the most common finding was OME, while it was cerumen in those with complaints a few times in a day and normal examination finding in those tugging on their ears only, when they were falling asleep, indicating statistical significance. Of 47 infants with normal physical examination findings, 37 were assessed by the child psychiatrist, and depression was found in six of one of the parents during the family interviews.
In this study, the majority of the infants referred to the ENT outpatient clinic had normal examination findings, while the rate of OME diagnosis was high. Considering the negative consequences of EOM in infants, the diagnosis of the EOM becomes extremely important. If there are no otologic pathologies in the majority of infants who were admitted with ear pulling and tugging, the possibility of different factors in etiology gives rise to thought. Therefore, further studies are required to prove this condition.
在本研究中，我们旨在评估因耳部牵拉主诉前来我院门诊就诊的婴儿的诊断情况，并确定可能有助于诊断的相关因素。
这项前瞻性研究共纳入了102例于2016年7月至2017年7月期间因在肩部或枕头处牵拉、触摸和揉搓耳朵以及摇头等主诉前来我院就诊的婴儿。对这些主诉进行了全天评估，并对就诊季节、将患者转诊至耳鼻喉科（ENT）专科医生、儿童发育专科医生和儿童精神科医生的人员、过敏和特应性病史以及结果与诊断之间的关系进行了评估。
46.1%的患者检查结果正常，第二常见的发现是耵聍，占37.2%，第三是中耳积液（OME），占16.7%。在由家庭直接转诊的婴儿中，正常和血清学诊断在统计学上显著高于OME诊断，而在由家庭医生和儿科医生转诊的婴儿中，OME在统计学上显著高于正常和耵聍水平。OME组中额外主诉的出现率高于正常和耵聍组。在白天有主诉的婴儿中，最常见的发现是OME，而在一天中有几次主诉的婴儿中最常见的是耵聍，仅在入睡时牵拉耳朵的婴儿检查结果正常，差异具有统计学意义。在47例体格检查结果正常的婴儿中，37例由儿童精神科医生进行了评估，在家庭访谈期间发现其中一位家长中有6例存在抑郁情况。
在本研究中，转诊至耳鼻喉科门诊的大多数婴儿检查结果正常，而OME诊断率较高。考虑到婴儿中耳积液的负面后果，中耳积液的诊断变得极其重要。如果大多数因耳部牵拉前来就诊的婴儿没有耳部病理学病变，病因中不同因素的可能性就值得思考。因此，需要进一步研究来证实这种情况。
