Middle Ear Effusion in Children With Cerebral Palsy: a Case-control Study at the Kenyatta National Hospital.

Abstract

Background: Otitis Media with Effusion remains an important cause of preventable hearing loss in children. This condition negatively affects a child’s speech and language development. Children with developmental difficulties are vulnerable to the adverse outcomes of chronic otitis media with effusion, which can worsen the already existing developmental delays. Main Objective: To determine whether children with cerebral palsy are at a higher risk of developing middle ear effusion than those without cerebral palsy at the Kenyatta National Hospital. Study Design and Setting: This was a case-control study on middle ear effusion in children with cerebral palsy versus those without at the Kenyatta National hospital clinics from July 2020 to February 2021. Methodology: One hundred and twenty-four children aged between six months and seven years were recruited into the study comprising sixty-two cases and sixty-two controls. History and physical examination including pneumatic otoscopy was done followed by tympanometric evaluation of the middle ear. Data Analysis and Presentation: Prevalence of middle ear effusion between case and controls was analyzed and presented as percentages with odds ratio and p-values calculated for significance. Pearson chi-square test was used to analyse the relationship between specific risk factors and development of middle ear effusion in children with cerebral palsy. A P value of <0.05 for a 95% confidence interval was considered significant. Results: There were 74 (59.67%) males and 50(40.37%) females with a mean age of 21 months +/- 15.1 months. Middle ear effusion was found in 14(22.6%) of the cases and 7(11.3%) of the controls. The difference was however not statistically significant (p=0.094).Very low birth weight and duration of exclusive breast-feeding for less than six months were significantly associated with middle ear effusion among the cases ( p=0.014 OR 10.16 95% CI 1.051-2.805; p=0.011 OR 3.19 95% CI 1.230-6.320) respectively. Majority of the patients had tympanogram type A 62(50.0%) followed by As 20 (16.7%), with type B being seen in 14(10.0%) of the study population.

Conclusion: Children with cerebral palsy were two times more likely to develop middle ear effusion compared to controls although this was not statistically significant.