The relationship between nasal and middle ear pathology.

The results are presented of a prospective clinical-epidemiological study in 2069 healthy children 2 1/2-6 years of age, to determine the epidemiology of SOM and the role of some predisposing factors. Only the study of rhinological parameters is presented in this report. It was demonstrated that there is a very strong correlation between the annual incidence of common colds and of acute otitis media (p less than 0.0001). The correlation between common colds and the tympanometrical findings was not so high but still obvious (p less than 0.05), because of the higher number of negative middle ear pressures with increasing number of common colds. Open mouth breathing (p less than 0.01) and snoring (p less than 0.05) at night showed to be predisposing to SOM and in a lesser extent to negative middle ear pressure. The study of objective rhinoscopical parameters evaluating the condition of the nasal mucosa revealed that edema of the nasal mucosa (p less than 0.01) and the presence of pathological nasal secretions (p less than 0.05) are factors predisposing to SOM and to negative middle ear pressure. Even moderate septal deviations have an unfavourable influence on the eustachian tube function as was shown by the higher incidence of negative middle ear pressures in children with a moderate septal deviation compared to children with a straight septum (p less than 0.05).