Browsing by Author "Bitar, Mohamad A"

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Accuracy of Video Otoscopy in Predicting the Presence of Middle Ear Effusion in Children Compared to Tympanometry: A Diagnostic Study
(2024-11) Othman, Deema; Alashkar, Masa; Bitar, Mohamad A
Importance: Middle ear effusion (MEE) is the primary cause of conductive hearing impairment among children, predominantly occurring up to the age of two years. The gold standard for detecting MEE is tympanometry (Grayson-Stadler, Eden Prairie, Minnesota). This study explores a less costly alternative, the video otoscope (Inventis S.R.L, Padova, Italy). Objective: The primary objective is to compare video otoscopy with tympanometry in terms of its ability to diagnose MEE. The secondary objective is to explore the prevalence of MEE in special populations. Methods: We conducted a retrospective diagnostic study that included patients aged 0-18 years who visited the pediatric otolaryngology clinic for suspected MEE over a two-year period. Clinical presentation, otoscopy findings, and tympanometry results were reviewed. The data were analyzed using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York). The significance of the results was assessed using the chi-squared test. Results: We included 337 patients with a mean age of 5.1 years (standard deviation = 2.68); 967 tympanometry tests were available for comparison with the corresponding ears. Validity tests showed that the sensitivity of video otoscopy was 79.5%, the specificity was 56.9%, the positive predictive value was 89.6%, and the negative predictive value was 37.4%. The overall accuracy was 75.5%. These results were statistically significant. Conclusion: Video otoscopy was capable of diagnosing MEE in children 89.6% of the time. However, tympanometry is still needed in specific conditions, such as narrow ear canals, dull tympanic membranes, and clear tympanic membranes in patients with decreased hearing, a history of ear infections, or speech delay.
A retrospective observational cohort study evaluating the postoperative outcomes of intracapsular coblation tonsillectomy in children
(2022-12) Bitar, Mohamad A
Abstract: Coblation intracapsular tonsillectomy (ICT) is becoming popular due to its decreased postoperative complications. However, a concern exists about the need for revision surgery. We conducted a retrospective observational cohort study, with a null hypothesis that Coblation ICT is not associated with recurrence of the preoperative symptoms, obstructive tonsillar regrowth, or the need for revision tonsillar surgery. We reviewed 345 patients (median age of 4.5 years; IQR 3.2-6.3), operated by the senior author between Feb 2017 and Sep 2020, for a median follow-up of 395.0 days (IQR 221.5-654.5). Most patients had snoring (94.2%), mouth breathing (92.8%), restless sleep (62.6%), and sleep disorder breathing (52.8%); 12.5% had recurrent tonsillitis. The mean initial total symptoms score (TSS) was 5.2 (SD 1.4, range 1-8); 87.5% had three or more symptoms; 86.7% underwent ICT; TSS decreased postoperatively to a mean of 0.2, SD 0.8, range 0-7. The mean hospital stay was 0.96 day (SD 0.36, range 0-3). Secondary bleeding occurred in 0.7% of ICT patients. No patient required admission or intervention. There was no documented tonsillar regrowth resulting in upper airway obstruction. No one needed tonsillar revision surgery. Intracapsular tonsillectomy was shown to be an effective procedure with long-lasting results.