Peters, Sylvia A. F.; And Others
Examination of the relationship between educational attainment and long-lasting, bilateral otitis media with effusion (OME) in 270 Dutch children (ages 2 to 4) found that, at age 7, early bilateral OME affected spelling ability but not reading ability. Effects of treatment with ventilation tubes were not found. (DB)
Full Text Available Myiasis is a disease that is rarely found in humans. The most often areas are the skin, nose, trachea, mouth, eye, ear and paranasal sinuses. Auriclar myiasis also known as otomyiasis is the presence of larval infestation on the human ear. In general, otomyiasis frequently in children, but can also be found in adult who have mental retardation or cerebral palsy. We reported a case of a boy who has otomyiasis with chronic suppurative otitis media in Sanglah Hospital, Denpasar and has done manage by evacuation of maggots, ear toilet using NaCl 0.9% and concomitant suction, topical and oral antibiotic.
OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... drains from the tube and is swallowed. Otitis media with effusion (OME) and ear infections are connected ...
Das, V K
A cohort of 164 children born within the defined boundaries of greater Manchester during the years 1981 to 1984 inclusive were identified as having bilateral sensorineural hearing loss, giving a prevalence of 1.2/1000 population of 1/817 births. Ninety three children developed an additional conductive hearing loss secondary to otitis media with effusion lasting more than three months and 39 of these (42%) required surgical treatment. Those with congenital infections, adverse perinatal factors...
Homøe, P; Sørensen, H C Florian; Tos, M
OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas...... assessed using median air conduction pure tone average gain, and the 'take rate' (i.e. the percentage of total ears with a closed perforation) was evaluated. RESULTS: All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent of...
Paparella, Michael M; Schachern, Patricia A; Cureoglu, Sebahattin
Otitis media occurs along a continuum. For example, otitis media with effusion characterized by fluid pathology can lead to chronic otitis media plus chronic mastoiditis, characterized by the presence of intractable tissue pathology such as cholesteatoma, cholesterol granuloma or granulation tissue. The literature defines chronic otitis media as having a tympanic membrane perforation and otorrhea. Amongst many other sequelae, which can result from the continuum, an important common one is chronic silent otitis media. This overlooked entity which includes pathology beneath an intact tympanic membrane is commonly seen in our human temporal bone laboratory and in patients. The clinical pathological correlates of this important disease are discussed herein. PMID:12021496
Full Text Available Acute Otitis Media is a common problem of childhood. It is characterized by otalgia, fever, irritability, anorexia and vomiting or diarrhea. Diagnosis is most often made by pneumatic otoscopy. Acute Otitis Media is mostly caused by S.pneumonia or H.influenza there are sensitive to penicillins.
Schoem, Scott R.
This article discusses otitis media in children. It addresses risk factors for otitis media, pathogenesis, diagnosis, bacteria causing otitis media, and treatment for acute otitis media, recurrent acute otitis media, and persistent otitis media with effusion, including antibiotics, steroids, allergy control, autoinflation, mechanical ventilation,…
Mitchell, David P.
Acute otitis media is the most frequent diagnosis made in children visiting a physician's office during the first five years of their life. This paper deals briefly with the epidemiology and diagnosis of this major medical problem and provides some guidelines for management.
Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)
Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin
Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse;
The Otitis Media-6 questionnaire (OM-6) is the most frequently used instrument to measure health related quality of life in children with otitis media. The main objectives of this study are 1) to translate and cross-culturally adapt the OM-6 into Danish, and 2) to assess important psychometric...
Park, Moo Kyun; Lee, Byung Don
Otitis media is defined as inflammation of the middle ear, including the auditory ossicles and the Eustachian tube. Otitis media is a major health problem in many societies. The causes of otitis media includes infection and anatomic/physiologic, host, and environmental factors. In general, otitis media is a childhood disease, and anatomic and physiologic changes have great effects on its development. Thus, in vitro or human experimental studies of otitis media are difficult. Several experimen...
The clinical practice guideline on otitis media with effusion (OME) provides evidence-based recommendations on diagnosing and managing OME in children. This is an update of the 1994 clinical practice guideline "Otitis Media With Effusion in Young Children," which was developed by the Agency for Healthcare Policy and Research (now the Agency for Healthcare Research and Quality). In contrast to the earlier guideline, which was limited to children 1 to 3 years old with no craniofacial or neurologic abnormalities or sensory deficits, the updated guideline applies to children aged 2 months through 12 years with or without developmental disabilities or underlying conditions that predispose to OME and its sequelae. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery selected a subcommittee composed of experts in the fields of primary care, otolaryngology, infectious diseases, epidemiology, hearing, speech and language, and advanced-practice nursing to revise the OME guideline. The subcommittee made a strong recommendation that clinicians use pneumatic otoscopy as the primary diagnostic method and distinguish OME from acute otitis media. The subcommittee made recommendations that clinicians should 1) document the laterality, duration of effusion, and presence and severity of associated symptoms at each assessment of the child with OME, 2) distinguish the child with OME who is at risk for speech, language, or learning problems from other children with OME and more promptly evaluate hearing, speech, language, and need for intervention in children at risk, and 3) manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if known) or diagnosis (if onset is unknown). The subcommittee also made recommendations that 4) hearing testing be conducted when OME persists for 3 months or longer or at any time that language delay, learning problems
Bonney, Asha G.; Goldman, Ran D.
Question Otitis media is a very common condition in pediatrics and can be quite distressing for children and their parents. Is there a role for antihistamines and decongestants in the management of acute otitis media or otitis media with effusion in children?
Post, J Christopher
There is a growing body of evidence, both from animal and human studies, that host genetic factors can influence the risk of developing otitis media (OM). The role of genetics in OM has been elucidated through studies with monozygotic and dizygotic twins, analyses linking genetic polymorphisms to OM susceptibility, and genome scans. Several twin studies have shown a strong genetic component to middle ear effusion risk, with the estimate of the role of heredity for the proportion of time with middle ear effusions being around 0.7. Genetic polymorphisms in plasminogen activator inhibitor-1, interleukin-6, tumor necrosis factor-α, human leukocyte antigen, and mannose-binding lectin have been variously linked with OM and upper respiratory infection susceptibility. Several genome linkage studies have identified chromosomal regions associated with chronic OM, including 3p, 10q, 10q22.3, 17q12 and 19q. A number of candidate genes are associated with these sites. Given the current state of understanding of the role of genetics in OM, a family history of OM should be ascertained for all patients. Children with a strong family history of OM should be considered as candidates for a more aggressive early treatment of OM, particularly if other risk factors are present. These children may be earlier candidates for the placement of tympanostomy tubes and/or adenoidectomy. Existing data do not support routine genetic testing to determine a child's susceptibility to OM; however, given the advances in whole genome sequencing, such testing may someday play a role in the management of the OM patient. PMID:21358196
... is an inflammation and/or infection of the middle ear. Acute otitis media (acute ear infection) occurs ... or viral infection of the fluid of the middle ear, which causes production of fluid or pus. ...
Full Text Available Subacute otitis media is a well-known pathology of ENT practice which is easily diagnosed and subsequently treated in the outpatient clinic. The rate of complications in acute otitis media is lower than in chronic otitis media. We present here the history of a young patient with subacute otitis media who developed both localized labyrinthitis and facial palsy requiring surgical treatment. We conclude that the treatment of subacute otitis media should be carefully monitored because complications may occur. Surgical treatment and pressure release can be efficient for the treatment of a peripheral facial palsy in the course of acute or subacute otitis media.
Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye;
Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....
Gruber, Maayan; Honigman, Tal; Cohen-Kerem, Raanan
Serous otitis media (also known as otitis media with effusion) is one of the most prevalent pediatric diagnoses. However, the recommended clinical approach and significance of this entity are controversial. Pathogenesis is usually based upon a combination of factors as overviewed in the body of the article. The cognitive and behavioral effects amongst children suffering serous otitis media were extensively studied and data points to little if any effects during long term follow-ups in otherwise healthy children. The therapeutic approach can be divided into watchful waiting, systemic drugs, topical drugs, mechanical therapies and surgical therapy (i.e. ventilation tube insertion). The reviewed literature mainly supports the effectiveness of the surgical approach in carefully selected cohorts of patients. PMID:26281082
We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis
Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)
We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis.
Otitis media with effusion (OME, glue ear) usually presents with concerns about the child's behaviour, performance at school, or language development. Children usually only have mild hearing impairment and few other symptoms.Up to 80% of children have been affected by the age of 4 years, but prevalence declines beyond 6 years of age.Non-purulent middle-ear infections can occur in children or adults after upper respiratory tract infection or acute otitis media.Half or more of cases resolve ...
MacAndie, C; O'Reilly, B F
Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss. PMID:10384849
Amalia Nieves Álvarez
La otitis media aguda es una de las infecciones respiratorias superiores más frecuentes en la infancia, fundamentalmente en niños menores de seis años. Su elevada incidencia y recidiva se deben a la interacción entre diferentes factores de riesgo. El signo más específico de presentación es la otalgia, acompañándose de fiebre, malestar y disminución de la audición.Por la frecuencia de niños con otitis media aguda en las consultas externas y de urgencia del hospital, nos planteamos conocer su c...
Wessman, Marcus; Bjarnsholt, Thomas; Eickhardt-Sørensen, Steffen Robert; Johansen, Helle Krogh; Homøe, Preben
The objectives of this study were to examine middle ear biopsies from Greenlandic patients with chronic otitis media (COM) for the presence of mucosal biofilms and the bacteria within the biofilms. Thirty-five middle ear biopsies were obtained from 32 Greenlandic COM patients admitted to ear surg...
Acute suppurative otitis media (ASOM) is an abrupt infection of the middle ear of short duration. The disease is one of the most common diseases world-wide. Treatment of ASOM consists of medical management, that is antibiotic based on empirical or bacterial culture for 10-14 days and surgical management, if failure of antibiotic treatment or mastoiditis stage of coalescent occurs.
Venekamp, Roderick P.; Sanders, Sharon L.; Glasziou, Paul P.; Del Mar, Chris B.; Rovers, Maroeska M.
BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 1997 a
Giebink, G S
Streptococcus pneumoniae infection and disease have been modeled in several animal species including infant and adult mice, infant and adult rats, infant Rhesus monkeys, and adolescent and adult chinchillas. Most are models of sepsis arising from intravenous or intraperitoneal inoculation of bacteria, and a few were designed to study disease arising from intranasal infection. Chinchillas provide the only animal model of middle ear pneumococcal infection in which the disease can be produced by very small inocula injected into the middle ear (ME) or intranasally, and in which the disease remains localized to the ME in most cases. This model, developed at the University of Minnesota in 1975, has been used to study pneumococcal pathogenesis at a mucosal site, immunogenicity and efficacy of pneumococcal capsular polysaccharide (PS) vaccine antigens, and the kinetics and efficacy of antimicrobial drugs. Pathogenesis experiments in the chinchilla model have revealed variation in ME virulence among different pneumococcal serotypes, enhancement of ME infection during concurrent intranasal influenza A virus infections, and natural resolution of pneumococcal otitis media (OM) without intervention. Research has explored the relative contribution of pneumococcal and host products to ME inflammation. Pneumococcal cell wall components and pneumolysin have been studied in the model. Host inflammatory responses studied in the chinchilla ME include polymorphonuclear leukocyte oxidative products, hydrolytic enzymes, cytokine and eicosanoid metabolites, and ME epithelial cell adhesion and mucous glycoprotein production. Both clinical (tympanic membrane appearance) and histopathology (ME, Eustachian tube, inner ear) endpoints can be quantified. Immunologic and inflammatory studies have been facilitated by the production of affinity-purified antichinchilla immunoglobulin G (IgG), IgM, and secretory IgA polyclonal antibody reagents, and the identification of cross-reactivity between
Amalia Nieves Álvarez
Full Text Available La otitis media aguda es una de las infecciones respiratorias superiores más frecuentes en la infancia, fundamentalmente en niños menores de seis años. Su elevada incidencia y recidiva se deben a la interacción entre diferentes factores de riesgo. El signo más específico de presentación es la otalgia, acompañándose de fiebre, malestar y disminución de la audición.Por la frecuencia de niños con otitis media aguda en las consultas externas y de urgencia del hospital, nos planteamos conocer su comportamiento en el grupo estudiado. Se realizó un estudio descriptivo longitudinal retrospectivo a los pacientes que acudieron a consulta de Otorrinolaringología con otitis media aguda del Hospital Pediátrico Universitario Centro Habana, ubicado en La Habana, en el período comprendido entre enero de 2006 hasta diciembre de 2009. Se caracterizaron los pacientes en cuanto a edad, sexo, factores predisponentes, manifestaciones clínicas, etapa clínica de la otitis, recurrencia y tratamiento. Resultados: El sexo masculino y los menores de cinco años fueron los más afectados. Los factores de riesgo predominantes fueron el tabaquismo pasivo, asistencia a círculos infantiles y lactancia materna insuficiente. Las manifestaciones clínicas más frecuentes fueron los síntomas catarrales, otalgia y fiebre. La otitis media con trasudado fue la etapa clínica más observada. El grupo de edades que mayor recurrencia presentó fue el de uno a cuatro años y la terapia antimicrobiana con amoxicilina fue la más utilizada.
María Pía Nitsche
Full Text Available La otitis media aguda es una de las enfermedades infecciosas más comunes diagnosticadas en niños. Con respecto a su tratamiento, el uso de antibióticos sigue siendo controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos seis revisiones sistemáticas que en conjunto incluyen 18 estudios clínicos aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que los antibióticos disminuyen el dolor a las 48-72 horas y reducen el riesgo de perforación timpánica en niños con otitis media aguda, sin embargo no disminuyen el riesgo de recurrencia tardía y aumentan el riesgo de efectos adversos (rash, vómitos y diarrea.
To determine whether otitis media affects First Nations children more severely than other children, I studied the data on otitis media occurrence among these children; on risk factors, particularly bottle feeding; and on prevention and treatment. First Nations children do seem to have more severe otitis media than other children. Health promotion might help ameliorate the situation. Supporting breastfeeding in the community is strongly recommended.
Nomiya, Shigenobu; Kariya, Shin; Nomiya, Rie; MORITA, NORIMASA; Nishizaki, Kazunori; Paparella, Michael M.; Cureoglu, Sebahattin
The information on incidence of the facial nerve canal dehiscence in chronic otitis media is important for surgeons. The purpose of this study is to disclose the histopathologic findings of facial nerve canal dehiscence in human temporal bones with chronic otitis media. We divided the human temporal bones into two groups (age 4 years, and under 4 years of age). We evaluated the incidence and the area of the facial nerve canal dehiscence in chronic otitis media under light microscopy. Age-matc...
Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko
Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM. PMID:26546407
Dimitris G. Balatsouras
Full Text Available Introduction. Otitis media with effusion is a common pediatric disease whose diagnosis is based on pneumatic otoscopy, pure-tone audiometry, and tympanometry. The aim of this study was to evaluate transiently evoked otoacoustic emissions in the diagnosis of otitis media with effusion as compared to tympanometry. Patients and Methods. 38 children with bilateral otitis media with effusion were studied. 40 normal children of similar age and sex were used as controls. All subjects underwent pneumatic otoscopy, standard pure-tone audiometry, tympanometry, and transiently evoked otoacoustic emissions. Results. In the group of children with bilateral otitis media, transiently evoked otoacoustic emissions were absent in 51 ears (67%. In the remaining 25 ears (33% the mean emission amplitude was reduced, as compared to the mean value of the control group. Conclusions. Transiently evoked otoacoustic emissions should be included in the diagnostic workup of otitis media with effusion because it is a fast, reliable, and objective test. Transiently evoked otoacoustic emissions should always be used in conjunction with tympanometry, because a more meaningful interpretation of transiently evoked otoacoustic emissions measures is possible.
Maxwell, K S; Fitzgerald, J E; Burleson, J A; Leonard, G; Carpenter, R; Kreutzer, D L
Based on recent studies in the authors' laboratory on the correlation of cytokines and inflammation in otitis media (OM), the authors hypothesized that in chronic otitis media with effusion (COME) interleukin-8 (IL-8) is responsible for 1. the accumulation of leukocytes in the middle ear cleft and 2. in situ leukocyte activation with subsequent tissue damage. Additionally, the authors hypothesized that IL-8 expression is at least in part under the control of interleukin-1 (IL-1) and tumor necrosis factor (TNF). To begin to test this hypothesis, middle ear effusions (MEE) obtained from children ages 2 to 90 months (mean age, 29 months) undergoing tympanostomy tube placement for the presence of these inflammatory cytokines were analyzed. For these studies, IL-8, interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha), and tumor necrosis factor-beta (TNF-beta) were measured in MEE by radioimmunoassay (RIA) or enzyme-linked immunoassay (ELISA). IL-8, IL-1 beta, TNF-alpha, and TNF-beta were present in 92%, 67%, 77%, and 0% of effusions, respectively. The mean (+/- SEM) values for IL-8, IL-1 beta, and TNF-alpha were 4805 (+/- 913) pg/mg, 4076 (+/- 1510) pg/mg, and 163 (+/- 90) pg/mg. Further analysis indicated that levels of IL-8 correlated with IL-1 beta (R2 = .500, P = .000) and TNF-alpha (R2 = .387, P = .023). Thus the authors' studies clearly demonstrate that IL-8 is consistently present in the MEE of children with COME and is strongly correlated with levels of IL-1 beta and TNF-alpha, both known inducers of IL-8 production. These results support the authors' hypothesis that IL-1 beta, TNF-alpha, and IL-8 are intimately involved in the inflammatory cascade in the middle ear and suggest regulation of these cytokines as possible sites of future therapeutic intervention in otitis media with effusion (OME). PMID:8052085
LIU Li-min; DONG Min-ming
Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child with OME is not at risk for speech/language/or learning problems. Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate. Complementary or alternative medicine is not recommended as a treatment for OME. This paper provides a systematic review of management of OME, which we hope will be helpful for clinicians.
Schuerman, Lode; Borys, Dorota; Hoet, Bernard; Forsgren, Arne; Prymula, Roman
Acute otitis media (AOM), one of the most common childhood diseases, is associated with a substantial medical, social and economic burden. Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are the two main causes of bacterial OM. The 7-valent pneumococcal CRM(197)-conjugate vaccine (7vCRM, Prevnar/Prevenar, Wyeth) demonstrated efficacy against AOM caused by vaccine pneumococcal serotypes. Protection against overall AOM was also observed with an 11-valent pneumococcal protein D-conjugate vaccine (11Pn-PD) in the Pneumococcal Otitis Efficacy Trial (POET). Following POET, an optimized 10-valent pneumococcal non-typeable H. influenzae protein D-conjugate vaccine (PHiD-CV; Synflorix, GlaxoSmithKline Biologicals) was developed. This vaccine includes serotypes 1, 5, and 7F, in addition to those already included in 7vCRM, and was recently licensed in Europe for active immunization against invasive disease and AOM caused by S. pneumoniae in infants and children from 6 weeks up to 2 years of age. The use of protein D as carrier protein permits avoidance of possible interferences known to occur with some conjugate vaccines, and has the added potential benefit of providing protection against NTHi. This review seeks to highlight the recent advances in the field of OM vaccination, with a focus on data regarding the recently licensed PHiD-CV. PMID:19666154
Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook [Masan Samsung Hospital, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Jung, Keon Sik [Pohang Sunrin Hospital, Pohang (Korea, Republic of)
To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.
To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media
Full Text Available Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1% but it was not noticeably associated with outcome (P= 0.41. The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, P=0.04. Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases.
Plejdrup Hansen, Malene; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente;
Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged...
Ergün, Ihsan; Keven, Kenan; Sengül, Sule; Kutlay, Sim; Sertcelik, Ayse; Ertürk, Sehsuvar; Erbay, Bülent
Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and a very uncommon form of extrapulmonary tuberculosis. Although there have been several case reports in the nonimmunosuppressive population of tuberculous otitis media, it has never been reported in an immunosuppressed allograft recipient. We present a case of diagnosed tuberculous otitis media after recurrent chronic otitis media treated several times with empiric antibiotic treatment. After the patient developed postauricular fistula and underwent surgical removal of granulation tissue, the diagnosis was made on the basis of histopathology and growth in culture of Ziehl-Neelsen. Clinical response promptly followed institution of antituberculous treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide. PMID:15168420
Alzbutiene, G.; Hermansson, A.; Caye-Thomasen, P.;
OBJECTIVE: The present experimental study explored pathomorphological changes and calcium depositions in the tympanic membrane during experimental acute otitis media caused by nontypeable Haemophilus influenzae in myringotomized and nonmyringotomized ears. MATERIAL AND METHODS: A rat model of exp...
Heidemann, C. H.; Lous, J.; Berg, J.;
Introduction: Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatmen....... Conclusion: Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline....
Bluestone, Charles D.; Swarts, J. Douglas
The pathogenesis of otitis media is multifactorial, but the role of evolution on its development has not been addressed. We posit that the high prevalence of middle-ear disease is most likely restricted to humans, in contrast to other wild species, because the associated hearing loss would have reduced the fitness of affected individuals as a result of predation. We present here the possible consequences of two human adaptations that may have resulted in ubiquitous otitis media: the interacti...
Juhn, S K; Garvis, W J; Lees, C J; Le, C T; Kim, C S
Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukin-1 beta and tumor necrosis factor alpha) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation. PMID:8179269
Eosinophilic otitis media (EOM) is intractable otitis media characterized by the presence of a highly viscous yellow effusion containing eosinophils. It occurs mainly in patients with bronchial asthma and is resistant to conventional treatments for otitis media. Here we discuss the clinical features, pathogenesis, and management of EOM. EOM predominantly affects women and presents most often in patients in their 50s. The clinical features of the middle ear in EOM are roughly divided into the otitis media with effusion type and chronic otitis media type. The latter is further divided into two subtypes: simple perforation and granulation tissue formation. EOM is often complicated by rhinosinusitis (eosinophilic sinusitis). High-tone loss is more frequently found and more severe in EOM patients than in chronic otitis media control patients, and EOM patients sometimes become deaf suddenly. Systemic or topical steroid administration is the most effective treatment for patients with EOM. The instillation of triamcinolone acetonide, a suspension of steroids, into the middle ear is very effective for controlling eosinophilic inflammation. It is very important to explain to patients with EOM that the disease may last for a long period and that progressive and sudden hearing loss may occur. PMID:18940145
Bahia, Paulo Roberto Valle; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia
The findings of computed tomography (CT) of 89 patients clinically suspected of having otitis media were studied in this work. Such results were compared to clinical diagnosis, otoscopy, surgical findings and previous data. Among the results of our analysis, we studied seven patients with acute otitis media and 83 patients with chronic otitis media. The patients with acute otitis media have undergone CT examinations to evaluate possible spread to central nervous system. The diagnosis of cholesteatoma, its extension and complications were the main indication. for chronic otitis media study. The main findings of the cholesteatomatous otitis were the occupation of the epitympanun, the bony wall destruction and the ossicular chain erosion. The CT demonstrated a great sensibility to diagnose the cholesteatoma. (author) 25 refs., 10 figs.
Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.
Full Text Available Studies relating chronic otitis media and language disorders in children have not reported consistent findings. We carried out the first selective study aimed at discerning the role of chronic right otitis media in children less than 3 years of age in language development. A total of 35 children were studied using a full linguistic protocol, auditory brainstem responses, and middle latency responses. Twelve children had a history of chronic exclusive right otitis media. Seventeen age-matched children were selected as controls. Also, three children having a history of chronic left otitis media were compared with three age-matched controls. Linguistic tests showed significant differences between patients and controls in phonetic, phonological, and syntax scores but not semantics. Correlation studies between linguistic scores and auditory evoked responses in the whole cohort showed a significant coefficient in phonetic and phonological domains. These results emphasize the causative effect of right ear chronic otitis media and indicate that it mainly impairs phonetic and phonological coding of sounds, which may have implications for prophylactic treatment of at-risk children.
Pajor, Anna; Danilewicz, Marian; Jankowski, Andrzej; Durko, Tomasz
In the pathogenesis of chronic otitis media (COM), much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs) may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of mast cells in chronic otitis media in relationship to different clinical courses of COM, bacterial infections and types of disease. The MCs expression was measured immunohistochemically in paraffin-embedded granulation tissue specimens taken during surgery, by staining with a monoclonal antibody against tryptase. The density of tryptase-positive mast cells was lower in tissue samples from the group with a good clinical course than in those from the group with poor healing and recurrence (p = 0.006). There were no differences between the groups of patients with granulomatous and cholesteatomatous chronic otitis media (p = 0.66) or between the groups of patients with and without bacterial infection (p = 0.30), although the density of mast cells was lower for those with Pseudomonas aeruginosa/Proteus sp./ /Staphylococcus MRSA infection. In conclusion, the expression of mast cells in chronic otitis media granulation tissue was found to differ depending on the clinical course of the disease, but not on bacterial infection or type of COM. This may suggest that mast cells contribute to the maintenance of the inflammatory process, but not to antibacterial defense in chronic otitis media. PMID:22038229
Full Text Available : INTRODUCTION: Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. The incidence of tuberculosis in the middle ear is very low and accounts for only 0.04% of all cases of chronic Suppurative otitis media. Its diagnosis is often delayed because it can easily be confused with other acute or chronic middle ear conditions, still the treatment of tuberculous otitis media is medical treatment with anti -tuberculous drugs and mastoid exploration if the temporal bone is involved and also to clear the disease from the middle ear cavity to avoid further complications. CASE PRESENTATION: A 21 year male patient presented with ear discharge, deafness and headache, diagnosed as primary tuberculous otitis media, treated with mastoidectomy and anti-tuberculous treatment. DISCUSSION: Primary tuberculous otitis media is very rare condition in adults, it is commonly seen in children which is also secondary to pulmonary tuberculosis / extra pulmonary tuberculosis the treatment of choice is anti tuberculous treatment for 06 months, surgery indicated to clear the disease from middle ear, temporal bone and to avoid further complications. CONCLUSION: Even though primary tuberculosis in middle ear and mastoid is very rare, the diagnosis is possible only with histological findings. In our case there was no signs of pulmonary / extra pulmonary tuberculosis, treated with mastoidectomy followed by anti - tuberculous treatment.
Rosenfeld, Richard M; Shin, Jennifer J; Schwartz, Seth R; Coggins, Robyn; Gagnon, Lisa; Hackell, Jesse M; Hoelting, David; Hunter, Lisa L; Kummer, Ann W; Payne, Spencer C; Poe, Dennis S; Veling, Maria; Vila, Peter M; Walsh, Sandra A; Corrigan, Maureen D
The American Academy of Otolaryngology-Head and Neck Surgery Foundation has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated "Clinical Practice Guideline: Otitis Media with Effusion." To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 18 recommendations developed emphasize diagnostic accuracy, identification of children who are most susceptible to developmental sequelae from otitis media with effusion, and education of clinicians and patients regarding the favorable natural history of most otitis media with effusion and the lack of efficacy for medical therapy (eg, steroids, antihistamines, decongestants). An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. PMID:26833645
Himi, T; Suzuki, T; Kodama, H; Takezawa, H; Kataura, A
Levels of cytokines, interleukin (IL)-1 alpha, IL-1 beta, tumor necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were investigated in samples of the middle ear effusions (MEEs) from 144 ears with otitis media with effusion (OME) by enzyme-linked immunosorbent assay, followed by cytologic analysis. Middle ear effusions of the acute purulent type contained a significantly higher concentration of cytokines compared with normal control sera (p chronic stage of MEE showed higher levels of TNF than IL-1 and GM-CSF. Meanwhile, IL-1 beta showed significantly higher concentrations in acute purulent types than in serous and mucoid types (p otitis media but also with chronic otitis media. This study showed that cytokines, especially IL-1 beta, contribute to infiltration into the middle ear by inflammatory cells. This implies that the persistent presence of cytokines in MEE could be a factor in prolonged OME. PMID:1416648
Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)
Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.
Rosenfeld, Richard M; Culpepper, Larry; Doyle, Karen J; Grundfast, Kenneth M; Hoberman, Alejandro; Kenna, Margaret A; Lieberthal, Allan S; Mahoney, Martin; Wahl, Richard A; Woods, Charles R; Yawn, Barbara
The clinical practice guideline on otitis media with effusion (OME) provides evidence-based recommendations on diagnosing and managing OME in children. This is an update of the 1994 clinical practice guideline "Otitis Media With Effusion in Young Children," which was developed by the Agency for Healthcare Policy and Research (now the Agency for Healthcare Research and Quality). In contrast to the earlier guideline, which was limited to children aged 1 to 3 years with no craniofacial or neurologic abnormalities or sensory deficits, the updated guideline applies to children aged 2 months through 12 years with or without developmental disabilities or underlying conditions that predispose to OME and its sequelae. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery selected a subcommittee composed of experts in the fields of primary care, otolaryngology, infectious diseases, epidemiology, hearing, speech and language, and advanced practice nursing to revise the OME guideline. The subcommittee made a strong recommendation that clinicians use pneumatic otoscopy as the primary diagnostic method and distinguish OME from acute otitis media (AOM). The subcommittee made recommendations that clinicians should (1) document the laterality, duration of effusion, and presence and severity of associated symptoms at each assessment of the child with OME; (2) distinguish the child with OME who is at risk for speech, language, or learning problems from other children with OME and more promptly evaluate hearing, speech, language, and need for intervention in children at risk; and (3) manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if known), or from the date of diagnosis (if onset is unknown). The subcommittee also made recommendations that (4) hearing testing be conducted when OME persists for 3 months or longer, or at any time that
Fletcher, Mark A.; Bernard Fritzell
Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POE...
Mahesh V .
Full Text Available Chronic Suppurative Otitis Media (CSOM is a condition of the middle ear that is characterized by persistent or recurrent discharge through a chronic perforation of the tympanic membrane from the middle ear cleft. Untreated cases of Chronic Suppurative Oti tis Media can result in a broad range of complications like mastoiditis, labyrinthitis, facial nerve paralysis and serious intracranial complications. In this study an attempt is made to know the aerobic bacteriology of Chronic Suppurative Otitis Media, wi th antimicrobial susceptibility testing of the bacterial isolates. The present prospective study was carried out on 50 patients presenting with Chronic Suppurative Otitis Media between January 2014 to December 2014 in the department of E.N.T, Basaveshwara Medical College Hospital and Research Centre, Chitradurga. The most common bacteria in Chronic Suppurative Otitis Media in this study was Pseudomonas aeruginosa (62% followed by Staphylococcus aureus (22%. Gentamicin was the most sensitive (100% antibio tic against Pseudomonas aeruginosa followed by Amikacin (96.77%. Ceftriaxone and Gentamicin were the most sensitive (100% antibiotic against Staphylococcus aureus followed by Amikacin (90.9%
Qvist, M; Grøntved, A M
OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may be us...
Short, K.R.; Diavatopoulos, D.A.; Thornton, R.; Pedersen, J.; Strugnell, R.A.; Wise, A.K.; Reading, P.C.; Wijburg, O.L.
Otitis media (OM) is one of the most common childhood diseases. OM can arise when a viral infection enables bacteria to disseminate from the nasopharynx to the middle ear. Here, we provide the first infant murine model for disease. Mice coinfected with Streptococcus pneumoniae and influenza virus ha
Tonnaer, E.L.G.M.; Sanders, E.A.M.; Curfs, J.H.A.J.
This study describes the development of a physiological rat model for otitis media. The model is based on the assumption that bacteria, intranasally introduced into the nasopharynx, will be transferred into the middle ear cavity during swallowing provided that the ambient air pressure is higher than
Arguedas, A.; Kvaerner, K.; Liese, J.; Schilder, A. G. M.; Pelton, S. I.
Objective: To assess the perceived disease burden and management of otitis media (OM) among an international cohort of experienced physicians. Methods: A cross-sectional survey conducted in France, Germany, Spain, Poland, Argentina, Mexico, South Korea, Thailand and Saudi Arabia. Face-to-face interv
Venekamp, R.P.; Sanders, S.; Glasziou, P.P.; Mar, C.B. Del; Rovers, M.M.
BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. OBJECTIVES: To assess the effects of antibiotics for children with AOM. SEARCH METHODS: We search
Full Text Available In the pathogenesis of chronic otitis media (COM, much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of mast cells in chronic otitis media in relationship to different clinical courses of COM, bacterial infections and types of disease. The MCs expression was measured immunohistochemically in paraffin-embedded granulation tissue specimens taken during surgery, by staining with a monoclonal antibody against tryptase. The density of tryptase-positive mast cells was lower in tissue samples from the group with a good clinical course than in those from the group with poor healing and recurrence (p = 0.006. There were no differences between the groups of patients with granulomatous and cholesteatomatous chronic otitis media (p = 0.66 or between the groups of patients with and without bacterial infection (p = 0.30, although the density of mast cells was lower for those with Pseudomonas aeruginosa/Proteus sp./ /Staphyloccocus MRSA infection. In conclusion, the expression of mast cells in chronic otitis media granulation tissue was found to differ depending on the clinical course of the disease, but not on bacterial infection or type of COM. This may suggest that mast cells contribute to the maintenance of the inflammatory process, but not to antibacterial defense in chronic otitis media. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 479–485
Berry, S; Gandotra, S C; Saxena, N C
Thirty Patients of Unsafe chronic suppurative otitis media were subjected to pre-operative CT scanning followed by surgical exploration of the middle ear and mastoid, and their scans were compared with the peroperative data. High resolution CT scanning has been advocated for evaluation of unsafe chronic suppurative otitis media as it is capable of delineating detail required to detect Labyrinthine fistulae, Facial canal erosion, Sinus and Dural plate erosion and Ossicular integrity. Our results showed CT scan to be highly sensitive for soft tissue density mass in the middle ear and mastoid. Dural plate exposure, Sinus plate erosion, Facial canal and Stapes integrity, moderately sensitive for Malleus and Incus integrity and least sensitive for Lateral canal fistulae. Both Axial and Coronal scans were done as many important structures are best seen in only one of these planes. The principal merit of CT scan of the Tomporal bone lies in its inherent ability to depict pathology which is not clinically evident. PMID:23119400
Full Text Available Background/Aim. Otitis media with effusion (OME is characterized by the prolonged presence of fluid (longer than 12 weeks of different viscosity in the middle ear, without perforation of the eardrum or signs of acute inflammation. The conservative treatment does not always provide satisfactory recovery, so surgical treatment may be unavoidable. The aim of the study was to determine the incidence, type and frequency of complications caused by ventilation tube insertion as a part of treatment for OME in children, and specifically, to evaluate the evolution of these changes over the extended period of time. Methods. During a 5-year period (1986-1991, 84 children with chronic bilateral OME, aged from 6 months to 12 years, were enrolled in the study and treated with ventilation tube insertion. All the patients were periodically checked every 6 months over a 3-8 year period following the intervention (otomicroscopic examination, audiometry, tympanometry, and reexamined in 2013 (22-27 years after the primary surgical intervention. Results. The complications observed in this study (51% were atrophic scarring of the tympanic membrane, myringo- and tympanosclerosis, retraction of the eardrum, persistent perforations, granulation tissue formations, development of chronic otitis and sensorineural hearing loss. Conclusion. The incidence of complications after ventilation tube insertion was 51% in this study. Atrophic scars and myringosclerosis were the most prominent complications. Despite high complications rate ventilation tube insertion still remains the treatment of choice in children with otitis media with effusion.
mohsen Rajati Haghi; Mohamad Mahdi Ghasemi; Mehdi Bakhshaee; Atefeh Taghati; Atefeh Shahabipour
Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM). Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA) findings of COM patients with the ossicular condition determined during surgery. M...
Varshney, Saurabh; Nangia, Ashutosh; Bist, S. S.; R. K. Singh; Gupta, N.; Bhagat, S.
This study was conducted to find out the status of the ossicles in cases of chronic suppurative otitis media (CSOM). One hundred and fifty cases of CSOM, who underwent surgery, were included and their intra-operative ossicular chain findings noted. Ossicular erosion was found to be much more common in unsafe CSOM than in safe CSOM. Malleus was found to be the most resistant ossicle to erosion whereas incus was found to be the most susceptible.
Varshney, Saurabh; Nangia, Ashutosh; Bist, S S; Singh, R K; Gupta, N; Bhagat, S
This study was conducted to find out the status of the ossicles in cases of chronic suppurative otitis media (CSOM). One hundred and fifty cases of CSOM, who underwent surgery, were included and their intra-operative ossicular chain findings noted. Ossicular erosion was found to be much more common in unsafe CSOM than in safe CSOM. Malleus was found to be the most resistant ossicle to erosion whereas incus was found to be the most susceptible. PMID:22319706
Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna
Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a liter...
Faramarzi, Abolhassan; Motasaddi-Zarandy, Masoud; Khorsandi, Mohammad-Taghi
In this study, we reviewed the surgical findings in a series of revision tympanomastoidectomy to determine the most common causes of failure in chronic otitis media surgery. The intraoperative findings at revision mastoidectomy with tympanoplasty of 116 patients were analyzed. The most common sites of pathologic tissue at revision surgery (with cholesteatoma and/ or granulation tissue) were unexenterated cells of the sinodural angle. The most common mechanical cause of retention of debris in canal wall down procedures was facial ridge. PMID:18298298
We describe two cases of tuberculous otitis media studied with high-resolution computed tomography (CT). Findings included extensive soft tissue densities with fluid levels in the tympanic cavity, the antrum, the mastoid and petrous air cells. Multifocal bony erosions and reactive bone sclerosis were seen as well. CT proved valuable for planning therapy by accurately displaying the involvement of the various structures of the middle and inner ear. However, the specific nature of the disease could only be presumed. (orig.)
Jagadeesan, Padmaja; Madeswaran, K; Thiruppathy, S P; Kalairajan, D; Inbasekaran, V
Petrous apicitis is a rare intracranial complication of otitis media. A 4-year-old female child was presented with persistent ear discharge, retro-orbital pain and lateral rectus palsy (triad of Gradenigo's syndrome). A right temporal burr-hole was placed and tapping was done under antibiotic coverage. Turbid cerebrospinal fluid could be drained. Follow-up could not be done as the patient refused treatment and was discharged against medical advice. PMID:12797641
Full Text Available Tuberculosis is a serious infectious disease affecting various organs and tissues even if the lung is the most commonly involved site.A case of tuberculous otitis media in a patient who had no history of tuberculosis is herewith presented with the aim of increasing the awareness of this disease whose diagnosis is often delayed because either of the rarity of this pathologic condition or of its usually indolent course.
ABSTRACT: The significant incidence of atopy associated with otitis media with effusion (OME) has suggested a role of allergy in the pathogenesis of OME. Past studies implicated allergy in the pathogenesis of otitis media [OM]. Otitis media is a common condition, especially in children. Most episodes of OM were associated with an upper res piratory viral infection and are short- lived and self-limiting with or without medical tre atment. However, chronic OM with ...
E Kaitlynn Allen; Ani Manichaikul; Wei-Min Chen; Rich, Stephen S.; Daly, Kathleen A.; Michèle M Sale
The first Genome Wide Association Study (GWAS) of otitis media (OM) found evidence of association in the Western Australian Pregnancy Cohort (Raine) study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM). Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS...
BELLUSSI, L.; M. Mandalà; Passàli, FM; Passàli, GC; Lauriello, M; Passali, D
Purpose of this study was to correlate results from a survey on otitis media and the State-Trait Anxiety Inventory test. This survey investigated prevalence of otitis media (OM) in our territory, influence on development of language and personality and social costs. State-Trait Anxiety Inventory is a suitable test to differentiate state anxiety caused by a specific event [in this case, otitis media with effusion (OME)] from a trait anxiety (anxious personality) in parents and caregivers. The ...
André Souza de Albuquerque Maranhão
Full Text Available ABSTRACT INTRODUCTION: Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. OBJECTIVE: To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. METHODS: Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. RESULTS: We identified 14 patients, eight (57% of whom were females and six (43% males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%, acute suppurative otitis media in six (43%, and chronic otitis media without cholesteatoma was diagnosed in two patients (14%. Besides labyrinthitis, 24 concomitant complications were identified: six cases (25% of labyrinthine fistula, five cases (21% of meningitis, five cases (21% of facial paralysis, five cases (21% of mastoiditis, two cases (8% of cerebellar abscess, and one case (4% of temporal abscess. There was one death. Eight (57% individuals became deaf, while six (43% acquired mixed hearing loss. CONCLUSION: Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant.
Bento, Ricardo Ferreira
Full Text Available Introduction: Cholesteatomas are cystic destructive lesions that affect any pneumatized area of the temporal bone. They can cause intracranial and extracranial complications. Objective: To register the patients with complicated cholesteatomatous chronic otitis media, who were interned in the otorhinolaryngology nursing of the Clinical Hospital of São Paulo, between the years of 2001 and 2008. Method: Retrospective study involving 34 patients with complicated cholesteatomatous chronic otitis media, who had been otorhinolaryngology nursing in the Clinical Hospital of the Medicine College of the University of São Paulo, from 2001 through 2008. Results: The age of the patients ranged from 7 to 83 years, with predominance of the masculine sex (76%. The extracranial complications were more frequent than the intracranial complications, and some patients presented both types of complication. All the patients received endovenous antibiotic, and only one patient was not submitted to surgical procedure. No patient died, and in the six-month follow-up no incapacitating severe neurological sequels occurred. Conclusion: The precocious and aggressive treatment of the complicated cholesteatomatous chronic otitis media diminishes the disease morbimortality.
Full Text Available Diseases of the outer and middle ear (Otitis externa and Otitis media are a frequent clinical problem which is mostly approached in the wrong way. We believe that the approach to a diseased ear in dogs or cats by practicing veterinarians in our country is most often incorrect. Namely, the conventional approach to inflammation of the outer ear is narrowed down to cleaning the ear, usually with cotton wool and hydrogen peroxide, and then by applying ear drops for veterinary or human use over the next few days. A somewhat more conscientious approach implies treatment using antibiotics, topical and/or systemic, but based on an antibiogram. If the presence of a foreign body is suspected, the veterinarian will use an otoscope, and this is where the entire diagnostic approach in our conditions usually ends. Such procedures most often fail to resolve the problem, so that the disease recurs after a certain time or becomes chronic recurrent Otitis externa, which is one of the biggest problems in dog dermatology. Experience shows that veterinarians here are generally not familiar with the pathogenesis of outer and middle ear infection, and that this is the reason why they approach diagnostics and therapy in the wrong way. The most important thing is to have in mind that bacteria and fungi linked with a pathological process in the ear canal are merely opportunistic microorganisms, and never primary pathogens, themselves responsible for Otitis externa. Antibiotic or antimycotic treatment does not cure the basic disease which led to the inflammation, but only its consequences. A large number of factors involved in the inflammation of the outer or middle ear are traditionally divided into primary, predisposing, secondary, and underlying. The basis for the successful treatment of Otitis externa and Otitis media is the recognition, elimination or control of the primary factors (atopy, nutritive allergy, keratinization disorders, parasitic infestations. The
Hermanus C. Myburgh
Interpretation: The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~64% to 80% using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.
Amrhein, P; Hospach, A; Sittel, C; Koitschev, A
Acute otitis media is one of the most common infections in childhood and the options of therapy have been examined in numerous studies. Nevertheless, there are controversial opinions regarding the question whether antibiotic therapy makes sense. This is proved through the many different ways that the primary treatment of the middle ear infection is handled throughout the international community. This work gives an overview of the current knowledge and based on these results gives practical recommendations to assist with the diagnosis and treatment of the individual patients. PMID:23247747
Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations
Sharma, Karan; Manjari, Mridu; Salaria, Neha
Chronic mucosal diseases of middle ear cleft or chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. The present prospective study was conducted to evaluate the clinical, intraoperative and histopathological changes in middle ear cleft. 100 patients diagnosed with CSOM who underwent surgery were taken. The mucosa and granulation tissue was removed along with ossicles wherever indicated and sent for histopathological examination. On clinical examination, 72 cases were found to be of tubotympanic type and 28 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases 8 were found to be of unsafe type which was also proven histologically. Stratified squamous epithelium was revealed in most of the cases accompanied by changes in the submucosa. Ossicular chain was involved in 40 cases with incus being the commonest bone to be eroded. PMID:24427703
Ayala, Oscar D.; Wakeman, Catherine A.; Skaar, Eric P.; Mahadevan-Jansen, Anita
Otitis media (OM) is the leading cause of acute physician visits and prescription of antibiotics for children. Current standard techniques to diagnose acute otitis media (AOM) are limited by their ability to probe only changes in symptoms of the bacterial infection that cause AOM. Furthermore, they are not able to detect the presence of or identify bacteria causing AOM, which is important for diagnosis and proper antibiotic treatment. Our goal is to detect the presence of and identify the pathogens involved in causing AOM based on their biochemical profile using Raman spectroscopy (RS). An inVia confocal Raman microscope (Renishaw) at 785 nm was used to detect bacteria causing AOM in vitro. The three main bacteria that cause AOM, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae were cultured in chocolate agar and Mueller-Hinton agar to determine which agar type would minimize Raman signal from the growth agar. Preliminary results identified specific Raman spectral features characteristic of S. pneumoniae. RS has the potential to accurately diagnose AOM, which will help in identifying the antibiotic that will be most beneficial for the patient and ultimately decrease the course of infection.
Corwin, Michael J.; Vezina, Richard M.; Pelton, Steven I.; Feldman, Henry A.; Coyne-Beasley, Tamera; Mitchell, Allen A.
BACKGROUND: Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption. METHODS: We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age. RESULTS: A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI –0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI –1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57). CONCLUSIONS: Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children. PMID:24394686
Adams, Daniel J; Susi, Apryl; Erdie-Lalena, Christine R; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M
Acute otitis media (AOM) symptoms can be masked by communication deficits, common to children with autism spectrum disorders (ASD). We sought to evaluate the association between ASD and otitis media. Using ICD-9-CM diagnostic codes, we performed a retrospective case-cohort study comparing AOM, and otitis-related diagnoses among children with and without ASD. Children with ASD had a significantly increased rate of AOM, otitis media with effusion, otorrhea, and PE tube placement. Children with ASD were more than twice as likely to develop mastoiditis, and to undergo mastoidectomy and tympanoplasty. Children with ASD are more likely to have middle ear infections and otitis-related complications, highlighting the importance of routine middle ear examinations and close attention to hearing impairment in this population. PMID:26739355
Lin, Jizhen; Caye-Thomasen, Per; Tono, Tetsuya; Zhang, Quan-An; Nakamura, Yoshihisa; Feng, Ling; Huang, Jianmin; Ye, Shengnan; Hu, Xiaohua; Kerschner, Joseph E
process of OM with mucoid effusion, especially disorders of mucin production resulting from middle ear bacterial infection and Eustachian tube dysfunction. In this review, we will focus on several aspects of this disorder by analyzing the cellular and molecular events such as mucin production and mucous......Otitis media (OM) with mucoid effusion, characterized by mucous cell metaplasia/hyperplasia in the middle ear cleft and thick fluid accumulation in the middle ear cavity, is a subtype of OM which frequently leads to chronic OM in young children. Multiple factors are involved in the developmental...... cell differentiation in the middle ear mucosa with OM. In addition, infectious agents, mucin production triggers, and relevant signaling pathways will be discussed....
Cayé-Thomasen, Per; Schmidt, Peter Thelin; Hermansson, Ann; Holst, Jens Juul; Thomsen, Jens
OBJECTIVE: The neuropeptide substance P (SP) is an inducer of neurogenic inflammation and bone resorption in the middle ear. Resorption of the bone tissue structures surrounding the middle ear cavity is a distinct feature of the initial stage of acute otitis media (AOM), which may be due to nerve...... fiber release of SP. MATERIAL AND METHODS: To investigate possible release of SP in the middle ear mucosa during AOM, we used a well-established rat model of AOM caused by Streptococcus pneumoniae. Following tissue extraction on Days 1, 3 and 6 post-inoculation, the mucosal concentration of SP was...... measured using a radioimmunoassay. RESULTS: Compared to sham-inoculated control ears, the concentration of SP was significantly reduced on Day 1 and even further reduced on Day 3, whereas partial replenishment was found on Day 6. CONCLUSION: SP seems to be depleted in the rat middle ear mucosa in the...
Seventy six patients with chronic otitis media were examined by CT. Using 3 dried skulls, the epitympanum was impacted with a piece of paraffin containing of 2 % iodine, and studied with CT-scan (Toshiba 60A-30) to clarify whether or not the paraffin could produce a soft tissue density on CT which was similar to that of cholesteatoma in the middle ear. The results showed that computed tomography was excellent in demonstrating a soft tissue mass in the middle ear with inflammatory disease. When the middle ear infection with granulation tissue or cholesteatoma existed, the resulting soft tissue mass was indistinguishable. CT scanning was useful for accurate determination of location of bone destruction in the middle ear as well as of the ossicles. (author)
Kim, Dong-Kee; Park, Shi-Nae; Park, Kyung-Ho; Yeo, Sang Won
We describe a very rare case of tuberculous otitis media (TOM) with direct intracranial extension. The patient was a 55-year-old man who presented to our ENT clinic for evaluation of severe headaches and right-sided otorrhea. A biopsy of granulation tissue obtained from the right external auditory canal demonstrated chronic inflammation that was suggestive of mycobacterial infection. Magnetic resonance imaging of the brain indicated intracranial extension of TOM through a destroyed tegmen mastoideum. After 2 months of antituberculous medication, the headaches and otorrhea were controlled, and the swelling in the external ear canal subsided greatly. Rarely does TOM spread intracranially. In most such cases, intracranial extension of tuberculosis occurs as the result of hematogenous or lymphogenous spread. In rare cases, direct spread through destroyed bone can occur, as it did in our patient. PMID:24526478
Full Text Available Introduction: Chronic suppurative otitis media (CSOM is defined as infection of the middle ear that lasts for >3 months and is accompanied by tympanic membrane perforation. The incidence is higher in developing countries, especially among the low socioeconomic strata of the society. Many authors have focused their attention on the bacterial flora of CSOM, but very little is known about the mycological aspects of these, the importance of which has been increasing in the recent years. Objective: The present study was aimed to speculate the etiological fungal flora responsible for the cases of CSOM among patients who attended the Ear, Nose, and Throat Department of our hospital a tertiary care center in Uttarakhand. Materials and Methods: The total of 107 patients (both males and females who were clinically diagnosed with CSOM and were on any antibiotics (oral, topical or systemic for >14 days and still persisted with symptoms were included in this study. Results: Among the 107 cases of CSOM studied, fungi were isolated in 83 (77.57%. Majority of the patients were in second and third decades of life (62.62%. Of the 83 fungal culture positive cases, the predominantly isolated fungi were Aspergillus species (47%, Candida species (41%, and Penicillium species (9.6%. Among the Aspergillus, the predominant species were Aspergillus flavus (17 isolates and Aspergillus niger (12 isolates. Candida albicans (19 isolates and Candida tropicalis (9 isolates were the commonly isolated species of Candida. Conclusion: A definite search for fungal etiology is desirable in all cases of CSOM. Prolonged use of topical antibiotics or antibiotics-steroids ear drops may cause suppression of bacterial flora and the subsequent emergence of fungal flora. This probably increases the incidence of fungal superinfection. Otologists should suspect mycotic otitis media in patients with continuous otorrhea and who do not respond to the antibacterial treatment.
Broides, Arnon; Bereza, Olga; Lavi-Givon, Noga; Fruchtman, Yariv; Gazala, Eli; Leibovitz, Eugene
AIM: To determine parental knowledge about acute otitis media (AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting (WW) approach in primary care settings in southern Israel.
Renukananda, G.S.; U P, Santosh; George, Nitha Mary
Objectives: To study the microbial flora and determine the efficacy of topical ciprofloxacin ear drops in comparison with combination of topical and oral ciprofloxacin as first line management in patients diagnosed with chronic suppurative otitis media.
Faramarzi, A H; Heydari, S T; Rusta, M
Background The incidence of fistulas found during the surgery for chronic otitis media with cholesteatoma has been reported in a wide range in different geographical areas. This study aims to find the prevalence of labyrinthine fistula in the south of Iran. Methods A prospective cross sectional study of 787 (504 ears belong to 462 patients) consecutive tympanoplasty with or without mastoidectomy for chronic otitis media was performed. Data on preoperative clinical and preoperative and postope...
Conclusion: Otitis media linked with high levels of multiple antibiotic resistant bacteria is a major health concern in all age groups of the study population. An appropriate knowledge of the etiology and antibacterial susceptibility of microorganisms would contribute to a rational antibiotic use and the success of treatment for chronic supportive otitis media. [Int J Res Med Sci 2014; 2(4.000: 1521-1525
Shailendra Ratre; Yadram Yadav; Sushma Choudhary; Vijay Parihar; Yatin Kher; Ketan Hedaoo
Pneumocephalus is a rare complication of chronic otitis media. Despite its rarity intra-cranial air carries a potential risk of increased intra-cranial pressure or meningitis, which requires immediate therapy. A 10-year-old child presented to us with complaints of fever, headache, vomiting, and decreased hearing from left ear. He had history of left ear discharge since 2 years. Clinical examination revealed neck rigidity and left chronic otitis media. Contrast enhanced computed axial tomograp...
Full Text Available ABSTRACT: The significant incidence of atopy associated with otitis media with effusion (OME has suggested a role of allergy in the pathogenesis of OME. Past studies implicated allergy in the pathogenesis of otitis media [OM]. Otitis media is a common condition, especially in children. Most episodes of OM were associated with an upper res piratory viral infection and are short- lived and self-limiting with or without medical tre atment. However, chronic OM with effusion (OME has significant sequelae, is refractory to mo st medical treatments, and frequently requires surgical intervention. A large body of epid emiologic and mechanistic evidence supports a role for allergic rhinitis [AR] as a risk for OM. To establish the association of allergic rhinitis with otitis media with effusion 100 childr en of age group 5 to14 were taken, 50 children were suffering from otitis media[test group] & 50 we re healthy[control group]. These children were evaluated clinically & a battery of laboratory tests was performed in all children to establish the prevalence of allergic rhinitis in the m. Out of 50 children with otitis media 12 were suffering from allergic rhinitis & out of 50 health y children 3 were suffering from allergic rhinitis. Chi-square test was performed and the 'P0. 05' value was found to be 0.0127[uncorrected] and was highly significant. The se findings indicate that prevalence of allergic rhinitis is more in persons suffering from OME as compared to healthy individuals
Full Text Available OBJECTIVES: To identify the common bacteria found in the nasopharynx of patients of serous otitis media, to study the prevalence of adenoiditis in patient of serous otitis media and to study the bacteria isolated from operated adenoid tissue of patients of serous otitis media. METHOD AND MATERIA LS : Study was carried out on clinically diagnosed 40 cases of serous otitis media. Patients were operated under general anaesthesia. At the commencement of the surgery, a sterile swab was taken with an applicator from the surface of the adenoid. Prior to surgery, the adenoid tissue was palpated and confirmed. Adenoidectomy was done by curettage method using adenoid curette and the specimen was immediately transported in normal saline to the microbiology lab in a sterile bottle along with the surface swab. RESULT: 95% culture shows bacterial growth , males are more common in serous otitis media and most bacteria isolated from nasopharyngeal swab and adenoid are Gram positive bacteria includes Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus species, Streptococcus viridians, Streptococcus pyogenes and Gram negative bacteria includes Moraxella catarrhalis, Klebsiella pneumonia. CONCLUSION: T he nasopharyngeal and adenoid bacterial flora is polymicrobial in nature and there is no difference in the pathogens isolated from nasopharynx swab or adenoid culture in patients of serous otitis media.
Daigler, G.E.; Markello, S.J.; Cummings, K.M. (State Univ. of New York, Buffalo (USA))
This case-control study investigated the possible association between home environmental air pollutants and their effect on otitis media and asthma in children. Patients with physician-diagnosed otitis (n = 125, 74% response), with asthma (n = 137, 80% response), and controls (n = 237, 72% response) from a private pediatric practice seen between October 1986 and May 1987 were studied. A questionnaire inquired about housing characteristics (i.e., age, insulation, heating system) and sources of indoor air pollution such as cigarette smoking, use of woodburning stoves, household pets, etc. Analysis of the responses confirmed previous findings of significant relationships between maternal smoking (P = .021), and the presence of pets (P = .034) and the occurrence of asthma. A newly reported relationship between exposure to woodburning stoves and the occurrence of otitis (P less than .05) was reported. This implicates yet another risk factor (wood burning) in the etiology of otitis media.
Orji, Foster Tochukwu; Dike, Benjamin O; Oji, Onuoha
The major burden of chronic suppurative otitis media (CSOM) is the embarrassing ear discharge which may last for few months to many years or even a lifetime with increasing risks of complications. We conducted this study to determine the risk factors for protracted non-healing ear discharge among CSOM patients. We carried out a retrospective analysis of non-cholesteatomatous CSOM patients treated in a tertiary hospital in a developing country. Comparison was made between 128 patients with ear discharge persisting beyond 24 months and 58 patients whose otorrhoea resolved within 6 months in terms of socio-demographic and other potential risk factors. Major risk factors identified by logistic regression analysis were rural residence, multidrug-resistant bacteria, and bilateral CSOM (P = 10 miles away from hospital, and >7 persons in a family (P = 0.012, 0.041, 0.013, 0.010, and 0.043, respectively). Age, sex, nasal allergy, and self-medication were not significant risk factors for non-healing ear discharge. Protracted non-healing ear discharge still remains a prominent feature of CSOM in our experience. Rural residence, multidrug resistance, bilateral CSOM, and long distance to health facilities are prime risk factors. Measures to address these risk factors to bring about a decline in the number of non-healing ear discharge among CSOM patients, especially in our rural communities, are urgently needed. PMID:25178414
mohsen Rajati Haghi
Full Text Available Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM. Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA findings of COM patients with the ossicular condition determined during surgery. Materials and Methods: 97 Patients with COM who underwent ear surgery for the first time were included in the study. A checklist of preoperative clinical findings, audiometric parameters and intraoperative findings was filled out for all patients. Results: Mean amount of Air-Bone Gap (ABG, Bone Conduction threshold (BC and Air Conduction threshold (AC of 97 Patients were 35.17, 13.13 and 48.30 respectively. In ears with or without cholesteatoma, granulation tissue, or otorrhea, mean of AC, BC, and ABG were not significantly different. In ossicular erosion and discontinuity (OD, mean of AC and BC thresholds increased significantly but ABG didn’t change significantly. Conclusion: According to the results of this study, in preoperative assessment of COM patients to predict ossicular condition we recommend considering AC, BC and ABG levels together instead of using ABG alone as is routine in our daily practice.
Gül, Aylin; Akdağ, Mehmet; Kiniş, Vefa; Yilmaz, Beyhan; Şengül, Engin; Teke, Memik; Meriç, Faruk
Our aim in this study was to evaluate the efficiency of preoperative temporal bone computed tomography (CT) in detecting pathologic conditions in patients with chronic suppurative otitis media (CSOM). The intraoperative findings and temporal bone CT results of 350 patients who were diagnosed with CSOM between September 1, 2010, and June 1, 2013, were compared. Comparison parameters were as follows: the presence of cholesteatoma, erosion of the outer ear bone canal, erosion of the middle ear chain, erosion of the dural plate, erosion of the lateral semicircular canal, erosion of the sigmoid sinus wall, and dehiscence of the facial canal. The contribution of CT was limited in showing the outer ear canal destruction, dural plate destruction, facial canal destruction, lateral semicircular canal destruction, and destruction of the sigmoid sinus wall. However, CT was more sensitive in detecting cholesteatoma and erosion of the ossicular chain. These results indicate that preoperative CT of patients with CSOM serves as an important guide for otolaryngologists, although there are limitations in the evaluation of the CT results. PMID:25377960
To assess the degree of reliability of computed tomography (CT) and the agreement between the imaging studies and intraoperative findings in chronic otitis media (COM) with cholesteatoma. We studied 51 patients diagnosed clinically as having inflammatory disease of the middle ear. All the patients under-went high-resolution Ct of temporal bone in axial and coronal planes. The imaging studies were retrospectively correlated with the intraoperative findings and the sensitivity of CT in the detection of erosive cholesteatoma was determined. Open radical mastoidectomy is the surgical technique most frequently used to treat cholesteatoma in our center. The greatest radio-surgical correlation was achieved in the detection of masses presenting soft tissue attenuation in air-filled cavities in middle ear (100%) and in bone erosion (87.5%). The 20 patients (39%) who were diagnosed as having COM with cholesteatoma underwent surgical treatment in our center. CT is the technique of choice in the study of COM with cholesteatoma, providing basic and necessary information for the image-based diagnosis of this disease, the detection of masses presenting soft tissue attenuation and bone erosion. We also point out the role of CT as an intraoperative guide and discuss its low sensitivity for the detection of small areas of dura mater exposure, ossicular luxation and facial canal dehiscence. (Author) 8 refs
Sugimoto, Hisashi; Ito, Makoto; Hatano, Miyako; Nakanishi, Yosuke; Maruyama, Yumiko; Yoshizaki, Tomokazu
Although it appears very uncommon in adult COM, Mycobacterium abscessus should be considered as a possible cause of a chronically draining ear. Multi-antibiotic chemotherapy including high-dose clarithromycin can effectively treat adult COM cased by M. abscessus. The first case report of adult chronic otitis media (COM) caused by M. abscessus is described here. A 61-year-old woman presented persistent otorrhea for 2 months, despite treatment with standard antimicrobial drugs. Physical examination revealed a small perforation of the tympanic membrane and edematous middle ear mucosa. Mycobacterial cultures and PCR yielded non-tuberculous mycobacteria (NTM); M. abscessus. Intravenous panipenem/betamipron and amikacin and oral clarithromycin were administered for 36 days. Computed tomography of the temporal bone showed improved aeration in the tympanic cavity, but soft tissue shadow remained unchanged in the mastoid 31 days after starting medication. She therefore underwent tympano-mastoidectomy at 36 days. At surgery, inflammation remained in the middle ear, and edematous pale mucosal tissue was noted around the stapes and ossicular chain. Histopathologic examination showed inflammation and granulation tissue, but no caseating necrosis or acid-fast bacilli. After surgery the symptoms resolved and remained well without evidence of infection recurrence 12 months after the operation. PMID:20206453
Seven, Huseyin; Coskun, Berna Uslu; Calis, Asli B; Sayin, Ibrahim; Turgut, Suat
Intracranial abscesses are serious complications of chronic suppurative otitis media (COM). This study included 32 patients presenting with intracranial abscesses from 780 patients hospitalized for treatment of COM. The 32 patients had 59 intracranial complications. Perisinus abscess (13 of 32) was the most common intracranial abscess, followed by temporal lobe abscess (8 of 32), epidural abscess (7 of 32), cerebellar abscess (6 of 32) and subdural empyema (2 of 32). Headache (93%), fever (87%) and altered mental status (62%) were the most common presenting symptoms and signs, along with symptoms of COM. All patients were treated with intravenous antibiotics and canal wall down mastoidectomy. Cholesteatoma with granulation tissue and bony defects at the sinus plate and/or dural plate were seen in most of the patients. Gram negative bacilli and anaerobes were the most common organisms cultured from the abscesses. Three patients had neurological sequels. One patient died. The early diagnosis of these complications requires a high index of suspicion and imaging studies. A multidisciplinary and coordinated approach is important for the management of these patients. PMID:15959795
Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna
Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802
Kari J. Kværner
Full Text Available SAMMENDRAGMed utgangspunkt i data fra et populasjonsbasert utvalg av 7 992 norske tvillinger ble sammenhengenmellom gjentatte ørebetennelser og forhold under svangerskapet studert. Som parametre på intrauterinevekstforhold ble informasjon om fødselsvekt og gestasjonsalder fra Medisinsk Fødselsregister benyttet.Informasjon om rapporterte øreinfeksjoner ble basert på spørreskjemaer som ble besvart av tvillingene ialderen 18–25 år. Først studerte vi individuelle effekter av fødselsvekt og gestasjonsalder på forekomsten avotitis media (OM. Rapportert fødselsvekt hos individer med OM var signifikant lavere enn hos kontrollene,med en gjennomsnittsforskjell på 86 gram. Hos de som rapporterte OM var gjennomsnittlig gestasjonsalder3 dager kortere enn i kontrollmaterialet. Deretter beregnet vi effekten av fødselsvekt ved bruk av co-twinkontroll metoden. Blant monozygote (MZ tvillingpar gjenspeiler fødselsvektforskjeller innenfor tvillingparetintra-uterine miljøforskjeller. Blant dizygote (DZ par kan vektforskjellen være både genetiske ogmiljøbetinget. Ved sammenligning av fødselsvektforskjeller innenfor tvillingparene er tvillingen som ikkehar gjentatte øreinfeksjoner en matchet kontroll blant OM diskordante par. Resultatene antyder at lavfødselsvekt er en risikofaktor for otitis media. Gjennomsnittlig vektforskjell blant par diskordante for OMvar 48 gram, og den av tvillingen som ikke rapporterte OM hadde signifikant høyere fødselsvekt.Kværner KJ, Tambs K, Harris J, Magnus P. Do pregnancy-related factors influence the development ofotitis media? Nor J Epidemiol 1997; 7 (1: 55-58. ENGLISH SUMMARYThe association between intrauterine growth, as measured by weight and gestational age, and the occurrenceof recurrent ear infections was studied using data from a population based sample of 7992 Norwegian twins.Perinatal measures were collected from the Medical Birth Registry, and reports of recurrent ear infectionswere based on
Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen;
BACKGROUND: Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated...... media was significantly improved after 13 months. The improvement of HRQOL was significantly lower for children with sleep problems compared with children without sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work during the preceding 3......: HRQOL in children with otitis media was significantly improved after 13 months. The improvement in HRQOL was significantly lower for children with sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work due to the child's otitis media. There...
Yang, Bin; Tian, Cong; Zhang, Zhi-guang; Han, Feng-chan; Azem, Rami; Yu, Heping; Zheng, Ye; Jin, Ge; Arnold, James E; Zheng, Qing Y
Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2b(nee)) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2b(nee) mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2b(nee) mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2b(nee)) mirrors craniofacial dysmorphology and otitis media in humans. PMID:21818352
Ahmed Nasar, Mohammed Abd Allah, Mohammed Attia, Hasan Abd Al Naby
Full Text Available Background: Active opening of the eustachian tube is accomplished by contraction of the paratubal muscles. Disturbance of any of the ET functions may contribute to the development of otitis media (OM with effusion and other middle ear diseases. Sonotubometry seems to be the most "physiologic" method for assessment of ET function and has the advantage that it can be performed on ears with an intact tympanic membrane and without the use of a pressure chamber. The aim of this study was to compare the Eustachian tube function using sonotubometry in patients with combined airway disease associated with Eosinophilic otitis media with that having combined airway disease without otitis media. Patients and methods: This study was applied on 45 patients divided into 3 groups each of 15. 1st group is the control group, 2nd group patients with combined airway disease without Eosinophilic otitis media, 3rd group patients with combined airway disease associated with Eosinophilic otitis media. Results: Our results explains that the tubal opening durations were significantly longer in patients of EOM group than in patients with combined airway disease without EOM group and also the normal control group.Conclusion: Sonotubometry can be performed in patients with or without an intact tympanic membrane and under physiological conditions. Sonotubometry is also inexpensive, painless, and easy to perform in both adults and children. Therefore, it has great potential value as a diagnostic tool for individuals with suspected ET disease
Bracken Michael B
Full Text Available Abstract Background Otitis media is one of the most common infections of early childhood. Surfactant protein A functions as part of the innate immune response, which plays an important role in preventing infections early in life. This prospective study utilized a candidate gene approach to evaluate the association between polymorphisms in loci encoding SP-A and risk of otitis media during the first year of life among a cohort of infants at risk for developing asthma. Methods Between September 1996 and December 1998, women were invited to participate if they had at least one other child with physician-diagnosed asthma. Each mother was given a standardized questionnaire within 4 months of her infant's birth. Infant respiratory symptoms were collected during quarterly telephone interviews at 6, 9 and 12 months of age. Genotyping was done on 355 infants for whom whole blood and complete otitis media data were available. Results Polymorphisms at codons 19, 62, and 133 in SP-A1, and 223 in SP-A2 were associated with race/ethnicity. In logistic regression models incorporating estimates of uncertainty in haplotype assignment, the 6A4/1A5haplotype was protective for otitis media among white infants in our study population (OR 0.23; 95% CI 0.07,0.73. Conclusion These results indicate that polymorphisms within SP-A loci may be associated with otitis media in white infants. Larger confirmatory studies in all ethnic groups are warranted.
Worden Katherine A
Full Text Available Abstract Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42. OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10. Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465
Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn;
The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute an...... vaccine in infants. The panel report also recommends short and long term goals for current and future OM research....
Pajor, Anna; Jankowski, Andrzej; Danilewicz, Marian; Durko, Tomasz
In chronic otitis media molecular pathogenetic mechanisms are still unknown, however, angiogenesis may play a role. The aim of the study was to determine the intensity of angiogenesis in granulation tissue in chronic otitis media of different clinical course. Twenty six granulation tissue specimens (twenty two--from chronic otitis media, four--from prolongated otitis externa) taken during surgery were analyzed. The angiogenesis (microvessel density) was measured in paraffin-embedded tissue by an immunohistochemical method, by staining for endothelial cells with a monoclonal antibody against CD 34. The presence of CD 34 was found in all specimens. The expression was more intense in tissue samples from the group with good clinical course (good healing and without recurrence) than those in the group with poor healing and recurrence (mean number of dots for mm2 589,2 vs 533,3, respectively) and from the group without bacterial infection by Pseudomonas aeruginosa than those with this infection (mean number of dots for mm2 645,5 vs 440,8, respectively), but differences were not significant. In conclusion it is suggested that angiogenesis may contribute to different clinical course of chronic otitis media. PMID:17152811
Full Text Available Background/Objective: We assessed the validity of computed tomography (CT in the diagnosis of complicated chronic otitis media (COM. "nPatients and Methods: The findings obtained from a pre-operative high resolution CT of temporal bone including coronal and axial views of 20 patients with complicated COM were compared to their intraoperative findings."nResults: In our study, CT was helpful in determining the anatomy of the mastoid and could accurately predict the mastoid air cell aeration, size and status of ossicles, presence of lateral semicirculal canal (SCC fistula and post-auricular fistula (All sensitivities equal to 100%. But it overdiagnosed the erosion of tegmen (positive predictive value of 50%. CT was unable to distinguish between cholesteatoma and fluid (abscess or effusion and granulation tissue or polyps and was also unable to correctly reveal the facial nerve dehiscence and had a low sensitivity for showing erosion of facial canal (50% and sigmoid sinus (60%."nConclusion: Because most complications resulting from cholesteatoma are caused by bony erosions, CT is helpful in determining the complications of COM. CT can accurately predict the extent of disease and is helpful in detection of some complications such as fistula of Lateral Semicircular Canal (LSC, erosions of dural plate and ossicular erosions. However, it is unable to distinguish between cholesteatoma, mucosal disease and fluid, and little it did contribute to detecting the facial nerve course and dehiscence. It cannot also be used for the diagnosis of the sigmoid sinus problems which could be related to no contrast administration in our study.
Górecka-Tuteja, Anna; Jastrzębska, Izabela; Składzień, Jacek; Fyderek, Krzysztof
Background/Aims To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. Methods Children aged 7–10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3–5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. Results Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. Conclusions LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease. PMID:27193974
Yorgancılar, E; Yildirim, M; Gun, R; Bakir, S; Tekin, R; Gocmez, C; Meric, F; Topcu, I
The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach. PMID:22249835
Sameer Raisuddin Qureshi
Full Text Available Objective: Chronic suppurative otitis media (CSOM can lead to dreadful and fatal complications. Objective of my study is an assessment of factors leading to the development of CSOM complications in different age groups and which age group is more prone to the development of complications. And to find out most frequent complication occurring in the target population. Introduction: CSOM is a long standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation. It affects both sexes and all age groups. Pathways of spread of infection: Direct bone erosion, venous thrombophlebitis, preformed pathways. Classification of complications: Intracranial - Mastoiditis, facial paralysis, labrynthitis, petrositis. Extracranial - Meningitis, extradural abscess, subdural abscess, brain abscess, lateral sinus thrombophlebitis, otitic hydrocephalus. Development of complications depends upon; organism′s virulence, poor resistance of the patient, systemic disease, resistance to antibiotics, poor socioeconomic status, lack of awareness about healthcare, lack of availability of trained specialist. Materials and Methods: A descriptive cross-sectional study was carried out from 2008 to 2013 in ENT Head and Neck Surgery Department, Jinnah Postgraduate Medical Centre, Karachi. Record of 65 patients was selected through nonprobability convenient sampling; sample was divided into two groups according to age Group A 10-18 years and Group B 18-45 years. Data were analyzed on SPSS software; Chi-square test was used and P < 0.05 was considered significant with confidence interval taken as 95%. Results: Population means age was found to be 18.28. Population sex dominant was male 63.1%. Mean duration of complaints is 1.69. There are strong associations between duration of complaints and family income (P = 0.05, and also between age of patient and diagnosed complication (P = 0.00. Conclusions: Most of the patients were of
Amad Meimaneh Jahromi
Full Text Available ntroduction: Chronic otitis media (COM is regarded as one of the disabling diseases which have a great influence on the quality of life. Because of the surgical approach of cholesteatoma, timely diagnosis is very important in management of patients with COM. The purpose of this study was to assess the frequency of cholesteatoma in patients with COM, demographic factors and disease related factors. Materials and Methods: In this retrospective study, medical records of 100 patients with COM who had surgery since 2005 to 2009 in Imam Reza Hospital were selected. Patients’ age, gender, duration of COM, clinical manifestations, location of perforation of tympanic membrane and presence or absence of cholesteatoma were analyzed by SPSS statistical software and some tables and graphs were planned. Results: patients included 70 males and 30 females with an average age of 23.08 ± 11.35. Mean of COM duration was 8.04 ± 7.14 years. The most common manifestations of the disease were otorrhea (92% and hearing loss (80%. The most frequent type of tympanic perforation was total perforation. Frequency of cholesteatoma was 42% and it was more common in males than females (42.9% and 40%. Presence of choleasteatoma was related to gender, age, location of tympanic perforation, presence of otorrhea and hearing loss. Conclusion: Prevalence of cholesteatoma in patients with COM in Mashhad is more than other cites of Iran and also other countries, but it is less than prevalence of non cholesteatomatos COM. It is very important to pay more attention to patients with COM who are evaluated about presence of cholesteatoma, specially those with otorrhea, hearing loss, total perforation of tympanic membrane or male gender.
M Khajeh Karameddini
Full Text Available In a period of 12 months 241 children (2-12 years old with Otitis Media were examined. 98 bacteria were isolated from Otitis Media discharge and tested for sensitivity against 13 generic antibiotics. The disk-agar diffusion and macrodilution both methods were used for these tests. Staphylococcus aureus had the highest and streptococcus pneumonia the lowest rate of occurrence. Otitis Media cases caused by merely a single bacterium were 12 fold more than those caused by two bacteria and 4 fold more than those caused by more than two bacteria. The antibacterial efficacy of carbenicillin, gentamicin, kanamycin and amikacin was higher than that of other antibiotics in disk-agar diffusion method. The MIC rates of cefoperazone against four most frequently encountered bacteria were higher than that of Mezlocillin.
Full Text Available Pneumocephalus is a rare complication of chronic otitis media. Despite its rarity intra-cranial air carries a potential risk of increased intra-cranial pressure or meningitis, which requires immediate therapy. A 10-year-old child presented to us with complaints of fever, headache, vomiting, and decreased hearing from left ear. He had history of left ear discharge since 2 years. Clinical examination revealed neck rigidity and left chronic otitis media. Contrast enhanced computed axial tomography scan of head [Figure 1] and [Figure 2] showed pneumocephalus in left cerebellopontine angle, opacification of left middle ear and nonpneumatisation of left mastoid. Child was immediately put on empirical intravenous antibiotics and decongestants. He showed clinical improvement in 3 days. Pneumocephalus secondary to chronic otitis media is extremely rare; we are reporting one such case in a child with review of literature.
Uhari, M.; Kontiokari, T; Koskela, M.; Niemelä, M. (Mika)
OBJECTIVE: To examine whether xylitol, which reduces the growth of Streptococcus pneumoniae, might have clinical importance in the prevention of acute otitis media. DESIGN: A double blind randomised trial with xylitol administered in chewing gum. SETTING: Eleven day care nurseries in the city of Oulu. Most of the children had had problems with recurrent acute otitis media. SUBJECTS: 306 day care children: 149 children in the sucrose group (76 boys; mean (SD) age 4.9 (1.5) years) and 157 in th...
Rosa-Olivares, Jose; Porro, Amanda; Rodriguez-Varela, Marielys; Riefkohl, Gloria; Niroomand-Rad, Iran
.On the basis of research evidence, a recommended strategy for improving the care of middle ear infections is to identify the subset of patients least likely to benefit from antibiotic therapy. They include children ages 6 months to 23 months with unilateral disease without severe signs and symptoms (moderate or severe otalgia, otalgia lasting more than 48 hours,or temperature of 39°C [102.2°F]), and those older than 2 years ofage with unilateral or bilateral disease who have mild signs andsymptoms.(9) On the basis of research evidence, the initial treatment of otitis media with effusion is watchful observation. There is little harm in observing a child who is not at risk for speech, language, or learning difficulties compared to medical or surgical intervention.(4) On the basis of research evidence, administration of the annual influenza vaccine and the conjugated pneumococcal vaccination has been shown to have a small but statistically significant impact on the frequency of middle ear disease. (7)(8) On the basis of expert opinion, optimal outcomes depend oncommunication between clinicians and parents. At a minimum , primary care clinicians should state their reasons for their own clinical judgment about appropriate management and for referral to otolaryngology if necessary. PMID:26527627
Marchisio, P; Santagati, M; Scillato, M; Baggi, E; Fattizzo, M; Rosazza, C; Stefani, S; Esposito, S; Principi, N
This paper reports the results of the first study in which Streptococcus salivarius 24SMB, a safe α-haemolytic strain capable of producing bacteriocin-like substances with significant activity against acute otitis media (AOM) pathogens, was intranasally administered in an attempt to reduce the risk of new episodes of AOM in otitis-prone children. In this prospective, randomized, double-blind, placebo-controlled study, 100 children aged 1-5 years with histories of recurrent AOM were randomized 1:1 to receive an intranasal S. salivarius 24SMB or placebo twice daily for 5 days each month for 3 consecutive months. Fifty treated children and 47 who received placebo who were compliant with study protocol were followed monthly for 6 months. The number of children who did not experience any AOM was higher among the children treated with the S. salivarius 24SMB preparation than among those in the placebo group (30.0 vs 14.9%; p = 0.076). Moreover, the number of children who received antibiotics during the study period was lower among the children treated with S. salivarius 24 SMB than among those who received placebo (70 vs 83.0%; p = 0.13). Compared with the children who were not colonized by S. salivarius 24SMB after treatment, the number of colonized children who experienced any AOM was significantly lower (42.8 vs 13.6%; p = 0.03). Similar results were observed when the children treated with antibiotics for AOM were analysed (67.8 vs 95.5%; p = 0.029). This study revealed the ability of intranasally administered S. salivarius 24SMB to reduce the risk of AOM in otitis-prone children. PMID:26385346
Jensen, Ramon Gordon; Koch, Anders; Homøe, Preben
BACKGROUND:: Children in the developing parts of the world have a high prevalence of chronic suppurative otitis media (CSOM). It is estimated that 65 to 330 million people worldwide have CSOM, yet very little is known about the natural course of the disease. The Inuit population of the Arctic reg...
Koch, Anders; Homøe, Preben; Pipper, Christian Bressen;
Inuits of the Arctic experience very high rates of chronic suppurative otitis media (CSOM), yet world-wide, very little is known about the epidemiology of CSOM. The study aims were to determine incidence, median age at debut, risk factors, and associated population attributable risks for CSOM in ...
Denning, Jennifer; Mayberry, Wanda
Thirty-five preschoolers, assigned to otitis media (OM) or no OM groups, were administered the Southern California Postrotary Nystagmus Test and the Miller Assessment for Preschoolers (MAP). Children with a history of OM had significantly decreased scores on the Stepping and Vertical Writing MAP tests, indicating vestibulospinal dysfunction. (SK)
Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse;
investigate possible predictors for clinical success. STUDY DESIGN: Longitudinal observational study. SETTING: Secondary care units. METHODS: Four hundred ninety-one families were enrolled in the study. The Otitis Media-6 questionnaire was applied in the assessment of child quality of life. Caregivers...
Background: Otitis media (OM) or middle ear infection is a common childhood illness and is most frequent during the crucial first 3 years of life when speech and language categories are being established, which could potentially have a long-term effect on language and literacy skill development. Aims: The purpose of the current study was to…
Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter;
BACKGROUND: Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements. OBJECTIVES: We investigated the prevalence of chronic suppurative...... otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds. METHODS: In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low...
Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.
Tapiainen, T. (Terhi)
Abstract The purpose was to evaluate the microbiological mechanism of action of xylitol and to assess its use in clinical practice for preventing acute otitis media (AOM). To test whether the effect of xylitol on S. pneumoniae is inhibited by fructose, a total of 20 strains of S. pneumoniae were exposed to xylitol in the presence of fructose and other carbon sources. Addition of 5% xylitol to the media resulted in marked growth inhibition, an effect which was totally el...
Full Text Available Background/Aim. Bacterial flora is a very important factor in pathogenesis of chronic suppurative otitis media (CSOM and significantly influences the type and intensity of osteolytic process. There are few histomorphometric investigations of middle ear mucosa in chronic otitis. The aim of this study was to identify aerobic bacteria responsible for chronic suppurative otitis media as well as their association with histomorphometric changes of middle ear mucosa. Methods. A prospective study that comprised 153 patients treated in the Clinc for Ear, Thorat and Nose Diseases, Niš, was conducted. Bacteriologic analysis of diseased ear secretion was carried out in all patients. Intraoperatively removed granulation tissue was used for histomorphometry. The analysed parameters were: the number of inflammatory cells, as well as vascularization and vasodilatation. Results. The most frequently isolated aerobic bacteria from chronic suppurative otitis media were Staphylococcus aureus (29.02%, Pseudomonas aeruginosa (29.02% and Proteus spp. (21.76%. There was no correlation between the type of pathologic process and the type of bacteria.The number of inflammatory cells in the granulation tissue in pure cultures of Staphylococcus aureus was 1,597.33 ± 549.45 and in Pseudomonas auriginosa cultures was 2,639 ± 648. Conclusion. This study showed that there is a statistically significant correlation between the number of inflammatory cells in the granulation tissue and the type of aerobic bacteria we isolated. The intensity of the infection in chronic suppurative otitis media depends on the type of the isolated bacteria, which emphasizes the importance of adequate preoperative antimicrobial therapy.
Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn;
The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute an...... vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.......The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute and...... chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate...
Vishal Sharma* and Gagandeep Kaur
Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity that presents as ear discharge. If untreated it can lead to various intracranial and extra cranial complications. This prospective study was carried out to find out various agents causing chronic suppurative otitis media and do determine the antibiogram. A total of 170 patients presenting with ear discharge were included in this study. Specimen processing, organism isolation, identification...
Nielsen, Nina Odgaard; Soborg, Bolette; Børresen, Malene;
To evaluate the cytokine response pattern in Inuit in Greenland in relation to age, gender, body mass index (BMI), Mycobacterium tuberculosis infection (MTI), and otitis media (OM) to assess whether Inuit may have signs of impaired immune responsiveness to infection.......To evaluate the cytokine response pattern in Inuit in Greenland in relation to age, gender, body mass index (BMI), Mycobacterium tuberculosis infection (MTI), and otitis media (OM) to assess whether Inuit may have signs of impaired immune responsiveness to infection....
Background Since chronic inflammation is the histopathologic landmark of otitis media with effusion, clinical observations led us to believe that the use of a Nasal Corticoteroid Ciclesonide may be more effective than an oral antibiotic in the treatment of serous otitis media in atopic children. Methods We studied forty pediatric patients (age 6–11 years) in a randomized open labeled 2-week trial to compare the efficacy of the nasal corticosteroid Ciclesonide 50 mcg/nostril 2 sprays per nostr...
Mahmood Shishegar; Abolhasan Faramarzi; Tayyebe Kazemi; Akbar Bayat; Mohammad Motamedifar
Background: Otitis media with effusion is one of the leading causes of hearing loss in children. Effective treatment of effusion in the middle ear requires appropriate empirical treatment and characterization of responsible pathogens. Objective of the present study was to detect pathogens in clinical samples from patients with otitis media with effusion in our area and to determine the sensitivity profile of isolated organisms to commonly used antibiotics. Methods: Sixty three samples of midd...
Full Text Available Total 100 patients of age group 6-65 years old of chronic suppurative otitis media (squamous type-33 and mucosal type-67 visiting ENT OPD with main complain related to ear were selected randomly and thorough ENT examination was done followed by nasal endoscopy and required radiological investigation. 64 patients were found having one or other nasal pathology that might be the culprit for ear disease of the total nasal pathologies maximum cases were of DNS alone or with Allergic rhinitis followed by nasal sinusitis and nasal polyps. The study concludes that nasal diseases are the precipitating factors for chronic suppurative otitis media so every case of CSOM should have through examination of nose and PNS to rule out sinonasal pathology.
Khan, M Nadeem; Ren, Dabin; Kaur, Ravinder; Basha, Saleem; Zagursky, Robert; Pichichero, Michael E
Nontypeable Haemophilus influenzae (NTHi) is a predominant organism of the upper respiratory nasopharyngeal microbiota. Its disease spectrum includes otitis media, sinusitis, non-bacteremic pneumonia and invasive infections. Protein-based vaccines to prevent NTHi infections are needed to alleviate these infections in children and vulnerable populations such as the elderly and those with chronic obstructive pulmonary disease (COPD). One NTHi protein is included in a pneumococcal conjugate vaccine and has been shown to provide efficacy. Our lab has been interested in understanding the immunogenicity of NTHi vaccine candidates P6, protein D and OMP26 for preventing acute otitis media in young children. We expect that continued investigation and progress in the development of an efficacious protein based vaccine against NTHi infections is achievable in the near future. PMID:26894630
Jeffrey P. Pearson
Full Text Available Inflammation in the middle ear mucosa, which can be provoked by different primary factors such as bacterial and viral infection, local allergic reactions and reflux, is the crucial event in the pathogenesis of otitis media with effusion (OME. Unresolved acute inflammatory responses or defective immunoregulation of middle inflammation can promote chronic inflammatory processes and stimulate the chronic condition of OME. Cytokines are the central molecular regulators of middle ear inflammation and can switch the acute phase of inflammation in the chronic stage and induce molecular-pathological processes leading to the histopathological changes accompanying OME. In this review we present cytokines identified in otitis media, immunoregulatory [interleukin (IL-2, IL-10, transforming growth factor-ÃŽÂ²] and allergy associated (IL-4, IL-5, granulocyte-macrophage colony-stimulating factor, as crucial molecular regulators, responsible for chronic inflammation in the middle ear and the chronic condition of OME.
Smirnova, Marina G; Birchall, John P; Pearson, Jeffrey P
Inflammation in the middle ear mucosa, which can be provoked by different primary factors such as bacterial and viral infection, local allergic reactions and reflux, is the crucial event in the pathogenesis of otitis media with effusion (OME). Unresolved acute inflammatory responses or defective immunoregulation of middle inflammation can promote chronic inflammatory processes and stimulate the chronic condition of OME. Cytokines are the central molecular regulators of middle ear inflammation and can switch the acute phase of inflammation in the chronic stage and induce molecular-pathological processes leading to the histopathological changes accompanying OME. In this review we present cytokines identified in otitis media, immunoregulatory [interleukin (IL)-2, IL-10, transforming growth factor-beta]) and allergy associated (IL-4, IL-5, granulocyte-macrophage colony-stimulating factor), as crucial molecular regulators, responsible for chronic inflammation in the middle ear and the chronic condition of OME. PMID:15203548
Johnson, M D; Contrino, A; Contrino, J; Maxwell, K; Leonard, G; Kreutzer, D
Recent studies have suggested that cytokines likely play a central role in the formation and maintenance of otitis media with effusion (OME). Currently, there is no immunologically defined animal model for the study of cytokines as they contribute to the formation of OME. In the present study, a murine model of OME, using eustachian tube blockage via an external surgical approach, was developed. The murine model temporal bone histology appears to mimic the histology found in chronic otitis media with effusion in humans. Additionally, using this murine model, interleukin-1 alpha (IL-1 alpha) expression was detected in the middle ear using standard immunohistochemical techniques. IL-1 alpha seemed localized to the epithelial lining of the middle ear as well as 5% to 10% of inflammatory cells. This model should provide the necessary tool to further study the immunologic aspects of OME. PMID:8072363
Homøe, Preben; Bjarnsholt, Thomas; Wessman, Marcus;
Biofilm may explain the recurrences and recalcitrant episodes of otorrhea in chronic suppurative otitis media (CSOM). This study investigates bacterial biofilm in Greenlanders with CSOM and chronic otitis media with effusion (COME). The study is partly blinded, prospective and retrospective. Six...... were analyzed with microscopy and peptide nucleic acid fluorescence in situ hybridization (PNA-FISH). Biofilm was confirmed in 83% of CSOM smears but in none of the COME smears. Mucosal biofilm was confirmed in 80% of the biopsies from adults with CSOM. This study provides direct morphological evidence...... of biofilm in samples from human CSOM. This may help to explain the microbiological mechanisms of the disease and alter the treatment strategy in the future....
Avick Kumar Das
Full Text Available Background: Eustachian tube function (ETF has been the center of focus as a prognostic factor because of its presumed primary role in the pathogenesis of otitis media and clearance of the middle ear cavity. There is a general agreement that adequate ETF is necessary for middle ear surgery. In this study, the incidence of ET dysfunction and its patency has been evaluated in inactive mucosal variety of chronic otitis media, in relation to the types of central perforation. Materials and Methods: A cross-sectional study was done with 54 patients presenting with inactive mucosal type of chronic otitis media. All the recruited patients were first examined clinically and under microscope and then their audiological (impedance audiometry and radiological assessment of mastoid was done. Alongside otoendoscopy, nasal endoscopy, dye test were done. In all these cases, other routine investigations were also performed. Results: Impedance audiometry offers an easy means of assessing ETF. The automatic Toynbee test can be a practical, objective and suitable method to assess ventilatory function of ET. The saccharin test is a simple, cost-effective and is valuable diagnostic tool to assess the mucociliary function of the ET. Mucociliary and ventilatory function may vary in the same patient. Saccharin test and methylene blue tests are comparable. Patients having poor saccharin test, methylene blue test, and ventilatory test are more prone to develop central perforation posterior to the handle of the malleus. The most frequent abnormal finding at nasal endoscopy was edema about the tubal orifice. Conclusion: A clinically useful test for ETF is still lacking. Impedance audiometry offers an easy means of assessing ETF. Ventilatory function of ET which is the single most important contributory factor in the pathogenesis of chronic otitis media should be evaluated with the objective method before tympanoplasty.
Phaniendra, V.; Pratinidhi, Santosh K.; I V Renuka
Facial palsy is a common manifestation of intratemporal facial nerve schwannoma. Review of English literature describes intratemporal facial nerve schwannoma presenting as vertigo, tinnitus (without facial palsy) which were diagnosed on CT scan or MRI of temporal bone. We are presenting two cases of asymptomatic facial nerve schwannoma without facial palsy presenting only as Chronic Suppurative Otitis Media (CSOM), which were diagnosed incidentally during surgery.
Prata, Anelise Abrahao Salge; Antunes, Marcos Luiz; Abreu, Carlos Eduardo Cesario de; Frazatto, Ricardo; Lima, Bruno Thieme
Introduction: The chronic otitis media (COM) is a prevalent disease and the most frequent cause of indication to mastoidectomy. Many studies have evaluated the use of tomography (CT) of temporal bones for preoperative evaluation of COM and its indication in the preoperative approach is still controversial nowadays. Objective: To evaluate the sensitivity of the clinical and radiological findings of COM according to the intraoperative surgical results and histopathological findings. Method: Tra...
Yildirim-Baylan, Muzeyyen; Ozmen, Cihan Akgul; GUN, Ramazan; Yorgancilar, Ediz; AKKUŞ, Zeki; Topcu, Ismail
This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, t...
Acute otitis media (AOM) is a common disease in childhood and is one of the most common causes for outpatient antibiotic treatment. The major aetiological agents of AOM have varied over the decades. Now the three most common pathogens are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The resistance patterns of these organisms have also varied from the beginning of the antibiotic era to the situation we have today with an increasing incidence of penicillin-resista...
Gan, V N; Kusmiesz, H; Shelton, S; Nelson, J.D.
One hundred five infants and children with acute otitis media were randomized to therapy with loracarbef, an experimental carbacephem antibiotic, or amoxicillin-clavulanate (Augmentin), an approved drug for this disease. Ninety-two were evaluable (46 in each group). Middle ear fluid samples obtained for culture before therapy grew Haemophilus spp. in 30% of cases, pneumococci in 29% of cases, and Moraxella catarrhalis in 15% of cases. beta-Lactamase-producing bacteria were found in 37% of pat...
Xu, Qingfu; Pichichero, Michael E.; Casey, Janet R.; Zeng, Mingtao
After our recent discovery of a Streptococcus pneumoniae 19A “superbug” (Legacy strain) that is resistant to all Food and Drug Administration–approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) ...
Chaput de Saintonge, D M; Hathaway, N R
Diagnostic and prescribing practices in otitis media vary, and audit is difficult because doctors may not see comparable cases. Seven general practitioners took part in a pilot study to discover if simulated patients evoked the same diagnostic and treatment responses as reveal patients. Forty-eight patients entered the study over three weeks and provided data for two simulations; one included the doctor's description of the ear and the other a photograph instead. Each doctor was shown the two...
Adhami, Maya; Tohme, Souheil
This is a report of three cases of complications of acute otitis media. The first case describes coalescent mastoiditis seen in a ten-month-old infant, the second case is petrositis, sigmoid sinus thrombosis and otitic hydrocephalus seen in a five-year-old child and the third case is an extradural abscess encountered in a three-year-old child. The assessment, diagnosis and treatment of each case are illustrated and discussed. PMID:21409946
Omer Coskun; Duran Tok
AIM: Study; we aimed the isolation of bacteria and establishment of their susceptibility to antibiotics in patients diagnosed as Chronic Supurative Otitis Media. METHOD: Sixty-three patients were included in the study. The samples of suppurative material were cultured. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) and species was identified. RESULTS: S.aureus was isolated in 36,5 % of the 63 patients enrolled in the study....
McWilliams, Colin J.; Goldman, Ran D.
Question As concern about antimicrobial resistance grows, I am aware of the need to reduce unnecessary antibiotic treatment; however, in my practice I see many children with acute otitis media (AOM) and this is the most common reason I prescribe antibiotics. Most of these children are young and otherwise healthy, and I am uncertain about when to prescribe antibiotics and when to endorse “watchful waiting.” Which children will benefit from antibiotic treatment?
PEREIRA, Agnes de Fátima Faustino; Silva, Thiago Cruvinel da; CALDANA, Magali de Lourdes; Machado, Maria Aparecida Andrade Moreira; Marilia Afonso Rabelo BUZALAF
Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM). Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles s...
Faramarzi, Mohammad; Dehbozorgi, Mohammad Mehdi; Heydari, Seyed Taghi
Introduction: In developing countries, chronic otitis media (COM) and cholesteatoma are relatively prevalent. Within the field of otology, COM surgery remains one of the most common surgical treatments. Most recent studies evaluating the potential prognostic factors in COM surgery have addressed graft success rate and types of middle ear and mastoid pathology. There has been much controversy about this issue until the present time. This study evaluated the effect of cholesteatoma on the GSR i...
Zumach, Anne; Gerrits, Ellen; Chenault, Michelene; Anteunis, Lucien
Purpose: The aim of the present study was to examine the long-term consequences of early-life otitis media (OM) and the associated hearing loss (HL) on language skills of school-aged children. Method: In a prospective study, the middle-ear status of 65 Dutch healthy-born children was documented every 3 months during their first 2 years of life;…
Son, Mi Ju; Kim, Yun Hee; Kim, Young-Eun; Lee, Hye Won; Lee, Myeong Soo
Introduction The aim of this systematic review is to analyse the trial data on the efficacy of herbal medicines for acute otitis media. Methods and analysis The following 11 databases will be searched from their inception: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Allied and Complementary Medicine Database (AMED), the Cochrane Central Register of Controlled Trials (CENTRAL), China Network Knowledge Infrastructure (CNKI) and five Korean databases (...
Allen, E Kaitlynn; Manichaikul, Ani; Chen, Wei-Min; Rich, Stephen S; Daly, Kathleen A; Sale, Michèle M
The first Genome Wide Association Study (GWAS) of otitis media (OM) found evidence of association in the Western Australian Pregnancy Cohort (Raine) study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM). Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS of COME/ROM had P-values ranging from P = 0.06-0.80. After removal of SNPs previously genotyped in our GWAS of COME/ROM (N = 21) and those that failed Fluidigm assay design (N = 1), 26 SNPs were successfully genotyped in 716 individuals from our COME/ROM family population. None of the SNP associations replicated in our family-based population (unadjusted P = 0.03-0.93). Replication in an independent sample would confirm that these represent novel OM loci, and that further investigation is warranted. PMID:25089819
E Kaitlynn Allen
Full Text Available The first Genome Wide Association Study (GWAS of otitis media (OM found evidence of association in the Western Australian Pregnancy Cohort (Raine study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM. Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS of COME/ROM had P-values ranging from P = 0.06-0.80. After removal of SNPs previously genotyped in our GWAS of COME/ROM (N = 21 and those that failed Fluidigm assay design (N = 1, 26 SNPs were successfully genotyped in 716 individuals from our COME/ROM family population. None of the SNP associations replicated in our family-based population (unadjusted P = 0.03-0.93. Replication in an independent sample would confirm that these represent novel OM loci, and that further investigation is warranted.
Kanzaki, Sho; Inoue, Yasuhiro; Watabe, Takahisa; Ogawa, Kaoru
We describe the case history of a 70-year-old female patient presenting with bilateral hearing disturbance, facial paralysis, and vertigo. Radiological tests of temporal bone revealed soft tissue in the mastoid and tympanic cavities, and T1 weighted MRI revealed prominent Gd enhancement of the middle skull basal meninges. Middle ear inflammation appeared to induce pachymeningitis and to exacerbate associated symptoms, leading to a decline in the patient's overall condition. Bilateral mastoidectomies were effective in improving her general condition. Her hearing improved only on the right side because ossiculoplasty was performed only on that side. Her facial movement progressively improved and pachymeningitis diminished over time. We speculate that removal of the infectious granulation within the middle ears and mastoids ameliorated the acute inflammation. The etiology remains unknown in this case. PMID:15121225
Shie, Chuen-Kai; Chang, Hao-Ting; Fan, Fu-Cheng; Chen, Chung-Jung; Fang, Te-Yung; Wang, Pa-Chun
We propose a novel hybrid otitis media (OM) computer aided detection (CAD) system, designed to aid in the self-diagnosis of various forms of OM. OM is a prevalent disease in both children and adults. Our system is able to differentiate normal ear from acute otitis media (AOM), otitis media with effusion (OME) and the multi-categories of chronic otitis media including perforation, retraction, cholesteatoma, etc. We propose a modified double active contour segmentation method designed for use with otoscope images, and enabled to handle user acquired data. To describe the visual symptoms (e.g., red, bulging, effusion, perforation, retraction, etc.) of otitis media accurately, we extract color, geometric and texture features by grid color moment, Gabor filter, local binary pattern and histogram of oriented gradients. A powerful classification structure based on Adaboost is used to select the most useful features and build a strong classifier. Our system achieves classification accuracy as high as 88.06% and is suitable for real use. In addition, some interesting observations about OM otoscope images are also discussed. PMID:25571030
Murrah, Kyle A; Pang, Bing; Richardson, Stephen; Perez, Antonia; Reimche, Jennifer; King, Lauren; Wren, John; Swords, W Edward
Streptococcus pneumoniae strains lacking capsular polysaccharide have been increasingly reported in carriage and disease contexts. Since most cases of otitis media involve more than one bacterial species, we aimed to determine the capacity of a nonencapsulated S. pneumoniae clinical isolate to induce disease in the context of a single-species infection and as a polymicrobial infection with nontypeable Haemophilus influenzae. Using the chinchilla model of otitis media, we found that nonencapsulated S. pneumoniae colonizes the nasopharynx following intranasal inoculation, but does not readily ascend into the middle ear. However, when we inoculated nonencapsulated S. pneumoniae directly into the middle ear, the bacteria persisted for two weeks post-inoculation and induced symptoms consistent with chronic otitis media. During coinfection with nontypeable H. influenzae, both species persisted for one week and induced polymicrobial otitis media. We also observed that nontypeable H. influenzae conferred passive protection from killing by amoxicillin upon S. pneumoniae from within polymicrobial biofilms in vitro. Therefore, based on these results, we conclude that nonencapsulated pneumococci are a potential causative agent of chronic/recurrent otitis media, and can also cause mutualistic infection with other opportunists, which could complicate treatment outcomes. PMID:26014114
Gilberto Eduardo Marrugo Pardo
Full Text Available Antecedentes: las consecuencias de la otitis media con efusión crónica en la audición, en el desarrollo cognitivo, lingüístico y de habilidades comunicativas son las principales razones a considerar para la búsqueda, diagnóstico y tratamiento adecuado de esta patología en los niños. Objetivo: comparar el rendimiento operativo de la neumatoscopia e impedanciometria como métodos diagnósticos de la efusión del oído medio. Material y métodos: estudio de pruebas diagnósticas, recolección prospectiva de pacientes llevados a miringocentesis y tubos de ventilación en la Fundación Hospital de la Misericordia de enero de 2002 a diciembre de 2003. Neumatoscopia en la consulta preoperatoria e impedanciometria cercana al procedimiento quirúrgico. Resultados. Sesenta pacientes, edad promedio 39.6 meses, 55.5% hombres, 18.3% con antecedente de labio y paladar hendido. La sensibilidad de la neumatoscopia fue 90%, con especificidad de 78.6%; para la impedanciometría 75.8% y 71.4% respectivamente. El valor predictivo positivo de la neumatoscopia fue 93%, el valor predictivo negativo de 71%; 90% y 48% respectivamente para la impedanciometría. La razón de probabilidades positiva para la neumatoscopia fue de 4.2 y la razón de probabilidades negativa fue 0.12, para la impedanciometría fueron 2.65 y 0.34 respectivamente. El DOR para la neumatoscopia fue 35 y 7.7 para la impedanciometría. Conclusión. Los indicadores calculados mostraron un desempeño superior de la neumatoscopia para el diagnóstico de la efusión del oído medio.Background: the consequences of otitis media with effusion in audition, cognitive and linguistic development are very strong sense for an accuracy diagnosis and effective treatment of this disease in children. Objective: to compare the operative performance of pneumatic otoscopy and tympanometry as diagnostic tools in otitis media with effusion. Materials and methods: diagnostic test study, prospective registry of
Gilberto Eduardo Marrugo Pardo; Diana Lucía Gómez Rodríguez
Antecedentes: las consecuencias de la otitis media con efusión crónica en la audición, en el desarrollo cognitivo, lingüístico y de habilidades comunicativas son las principales razones a considerar para la búsqueda, diagnóstico y tratamiento adecuado de esta patología en los niños. Objetivo: comparar el rendimiento operativo de la neumatoscopia e impedanciometria como métodos diagnósticos de la efusión del oído medio. Material y métodos: estudio de pruebas diagnósticas, recolección prospecti...
Full Text Available Se realizó un estudio en 66 niños y 34 niñas de 2 a 12 años. Cincuenta fueron casos de otitis media con efusión (OME y 50 controles. El grupo etario más numeroso fue el de dos años. Los síntomas y signos más frecuentes fueron otalgia y fiebre (70% e hipoacusia (40%. Veintinueve casos (58% y sólo 12 controles (24% presentaron adenoides hipertróficas (p < 0.01 . La pérdida auditiva fue significativamente mayor en el grupo de casos y las curvas timpanométricas se relacionaron directamente con ella. No se demostró que la alergia fuera un elemento importante en la génesis de la OME, a diferencia de la hipertrofia de adenoides que constituyó nuestro hallazgo más importante.
Between July 1988 and May 1989 we studied 100 children aged2-14 years; there were fifty cases of otitis media with effusion (OME and fifty controls. Each group Included 33 boys and 17 girls. The predominant age group was 2 years. The most frequent clinical manifestations of OME were earache and fever (70% each and reduced hearing (40%. In 29 cases (58% and in only 12 controls (24% enlarged adenoids were found (p < 0.01 . impaired hearing was significantly most frequent In the cases and the tympanometric curves had direct relationship with reduced hearing. Despite Its high prevalence allergy was not found to be of importance In the etiology of OME; by contrast, enlarged adenoids were the most relevant determinant of this disease In our series.
Full Text Available PURPOSE To correlate the sensitivity and specificity of High Resolution Computed Tomography (HRCT findings of temporal bone in chronic otitis media with surgical findings. MATERIALS & METHODS HRCT of temporal bone of fifty patients with chronic otitis media were evaluated prospectively between July 2012 and December 2013. The various pathological findings, complications and important anatomical variations were evaluated. These findings were compared with intraoperative findings. Statistical methods were carried out using SPSS for Windows (Version 16.0 and Minitab (Version 11.0 for windows. The sensitivity, specificity, false positive and false negative rates were calculated. The level of significance was considered significant for P-values <0.05. RESULTS HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner’s septum, cholesteatoma extension in middle ear and mastoid, and presence of complications like mastoiditis, mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion, labyrinthine fistula and intracranial complications with a P value <0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Among the findings related to adjacent neurovascular structures, facial canal dehiscence was commonest followed by anterior lying sigmoid sinus and low lying dura. In ossicular erosion, incus was most commonly involved followed by stapes and malleus. Most of the mastoid in this study was sclerotic followed by pneumatised and diploic. The epitympanum and mastoid antrum were the most commonly involved areas in cholesteatoma followed by aditus, mastoid air cells, posterior tympanum, mesotympanum, hypotympanum, protympanum and perilabyrinthine air cells in decreasing order of frequency. CONCLUSIONS HRCT temporal bone is a reliable investigation in preoperative
Luo, Linghui; Gong, Shusheng; Bai, Guangping; Wang, Jibao
To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cases of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and bloody otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Temporal bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well-developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases, enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplasty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological etiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location, extension and severity of the lesion. The purpose of surgery is to remove the lesion and create an adequate
Gotsadze, K; Gogatishvili, R
Acute otitis media is one of the most common diseases in childhood and adolescence. Its incorrect and non-rational treatment increases the frequency of complicated acute forms of the disease. Objective of the study was to define effectiveness of mucoregulatory medication (namely Sinupret produced by Bionorica A.G. Germany) for treatment of complicated forms of AOM along with antibiotics in children. The trial has been conducted at Tbilisi M. Guramishvili Pediatric Clinic. It represented a randomized controlled trial of two prescribing strategies for acute otitis media. The participants have been 64 children with AOM-preperforation stage. Among them 32 patients (study group) got oral antibiotics--Amoxicillin along with the mucoregulatory remedy (Sinupret) and the rest 32 patients (control group) received Amoxicillin orally (Amoxicillin was used 40-45 mg/kg/24 h in children and 1,5-3 g/24 h in adults) divided in three administrations. The clinical effect of treatment was assessed according to the following data: subjectively-complaints of patients; objectively-clinical examination data (otoscopy), blood test data; tympanometric data. Measurements have been conducted at the beginning of treatment, on the third, seventh days, at the end of the course of treatment and two weeks later. Subjectively patients complained about unbearable pains in the ear, anxiety, abrupt reduction of hearing, murmurs in the ears acquiring pulsative nature, high temperature. For the treatment of complicated forms of acute otitis media (III stage) mucoregulatory remedies in combination with antibiotics were quite effective. It reduces necessity of paracentesys; increases the efficiency of accompanying antibiotic therapy and reduces frequency of complications. PMID:15988076
Full Text Available Background The aim of this study was to assess the prevalence of hospitalisation for otitis media across the different risk indicators for Western Australian children (less than 15 years old over a 10-year period. Method This retrospective population-based study usedthe de-identified detailed data of children under the age of 15 years, hospitalised for otitis media(OM, as determined by principal diagnosis (ICD-10AM and obtained from the Western Australian (WA Hospital Morbidity Dataset for 10 financial years from 1999–2000 to 2008–2009. Various risk indicators, including age, gender, Indigenous status, insurance status, hospital area, hospital type,and length of stay were also analysed. Results Out of 26,294 cases of in-hospital care, Indigenous children comprised 4.7per cent(n=1,226, while the non-Indigenous children comprised 95.3 per cent(n=25,068.The majority of the children, nearly 98.8 per cent were admitted for chronic OM. The children were grouped into three age groups, namely, 0–4 years, 5–9 years, and 10–14 years. Nearly two-thirds of all cases were in the 0–4-year age group.Significantly more non-Indigenous (51per cent than Indigenous children (2-percent had private health insurance. The hospitalisation rates were directly proportional between the number of Indigenous children living in the area and the increasing remoteness of the area along with greater socioeconomic disadvantage. There were 24 per cent more cases from very remote areas compared to highly accessible areas, and there were 60 per cent more cases from the most disadvantaged socioeconomic category, compared with the least disadvantaged category, for Indigenous children. Conclusion These data depict the variations in prevalence of otitis media hospitalisations within the community, as affected by various risk indicators.
Rama Chandra Rao
Full Text Available INTRODUCTION: Chronic Suppurative otitis media (CSOM is the most common condition encountered by otolaryngologists in day to day practice. The importance of chronic otitis media lies in its dreaded complications and deafness. AIM: This study was under taken to identify the microbiological isolates of the ear discharge in CSOM cases and their sensitivity to antibiotics. SETTINGS AND DESIGN: Tertiary care hospital in north costal Andhra Pradesh. It was a Prospective study. MATERIALS & METHODS: About 100 patients having ear discharge who attended ENT outpatient department from July 2013 to Feb 2014 for a period of 8months were studied. Aural swabs were sent to microbiology lab for culture &sensitivity. RESULTS: Culture reports showed aerobic bacterial isolates in 85 cases, fungi in 7 cases and sterile in 8 cases. Of the 85 cases of aerobic bacteria, staphylococcus aureus was isolated in 34 cases (40% followed by Pseudomonas aeruginosa in 29 cases (34%, klebsiella in 16 cases (18.8%, E.coli in 4 cases (4.7% and proteus in 2 cases. Antibiotic sensitivity reports showed Staphylococcus was more susceptible to netilmycin (97%, amoxiclav (91.7% and least sensitive to ceftazidime (64.7%. Pseudomonas was more sensitive to amikacin (96.5%, gentamycin (93.1% and least sensitive to amoxyclav (79.3%, ampicillin + sulbactum (82.75%. CONCLUSION: Mono microbial etiology, especially Staphylococcus species was found to be the most common organism causing chronic otitis media. Knowledge of the prevailing flora and their susceptibility to antimicrobials will guide the clinicians for early and effective treatment thereby avoiding complications.
罗凌惠; 龚树生; 白广平; 汪吉宝
Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cas-es of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cas-es of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and blood-y otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Tem poral bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases,enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplas-ty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological e-tiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location,extension and severity of the lesion, The purpose of surgery is to remove the lesion and create an
Chinh C Ngo
Full Text Available Otitis media (OM is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention.A systematic review of published reports of microbiology of acute otitis media (AOM and otitis media with effusion (OME from January, 1970 to August 2014, was performed using PubMed databases.This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine.Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of
Al-Quaiz, Al-Joharaah M.
Purpose: To describe correlates of various modes of presentation and identify some surrogates of poor outcome of children less than 5 years with Acute Otitis Media (AOM). Patients and Methods: This is a cross-sectional survey conducted at 11 primary health care centers in Riyadh city over 3 month period. A total of 140 children, each less than 5 years of age and presenting with a new episode of AOM were enrolled. Twenty-eight family physicians participated in the study. Each physician made th...
Radiographs of the middle ear were made in five dogs 60 to 78 months after ventral bulla osteotomy was performed to treat otitis media. The clinical results of surgery were considered satisfactory in four dogs and unsatisfactory in one. In 4 dogs with satisfactory results, radiographs demonstrated complete reformation of the bulla in 3 operated middle ears (3 dogs), with partial bulla reformation in the three middle ears (3 dogs). Radiographs in one dog with unsatisfactory results showed complete bulla reformation with no increase in lumen opacity. The proliferative bony response obliterating the middle ear previously reported in normal dogs after ventral bulla osteotomy was not seen in any of these patients
Full text: 5-year-old child was admitted to our hospital's pediatrics service with the symptoms of acute otitis media. After 10 days antibiotherapy, he was readmitted with headache, diplopia and right sided retroauricular pain. In accordance with these symptomatologies, cranial MRI was performed to demonstrate the pathology and to make a further evaluation. According to clinical and MRI findings he was accepted as Gradenigo Syndrome and treated surgically. We just aimed to present the Gradenigo Syndrome's MRI findings in this case report
Feder, H M
The tolerabilities of ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole (TMP-SMX) suspensions were evaluated in 263 children with otitis media. Because of watery stools, therapy was discontinued in 6 of 83 patients treated with ampicillin, in none of 89 patients treated with amoxicillin (P less than 0.01), and in 1 of 91 patients treated with TMP-SMX (P less than 0.03). Of the patients who completed the treatment courses, 13 recipients of ampicillin suffered loose or watery stools fo...
Victoriano Machín González; Isabel Benito Soler; Rodolfo Vieito Espiñeira; Mildre Ortiz Núñez
Se revisaron 40 historias clínicas de pacientes a los cuales se les practicó una cirugía radical conservadora de la mastoides, por presentar otitis media crónica osteítica. Los pacientes recibieron atención en el servicio de Otorrinolaringología del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán", en el período comprendido entre 1990 y 1996. Se comprobó la presencia de Pseudomonas aeruginosa en un alto porcentaje de nuestros casos, y se logró un oído seco en 36 pacientes, con la consigu...
Pelegrín Hernández, Juan Pablo; Díaz Manzano, José A.; Menasalvas Ruíz, Ana I.; Hellín Meseguer, Diego
[ES] El síndrome de Gradenigo se caracteriza por dolor facial en la zona inervada por el trigémino y una oftalmoplejía externa unilateral (parálisis del VI par craneal) secundaria a petrositis apical aguda, por complicación evolutiva de una otitis media. Se trata de una complicación grave que requiere de un tratamiento inmediato para evitar secuelas permanentes y puede asociarse a otras complicaciones intracraneales como la trombosis del seno cavernoso. Presentamos el caso de un varón de 4 añ...
Francoz, David; Fecteau, Gilles; Desrochers, André; Fortin, Madeleine
Epidemiological data, clinical signs, complementary examination findings, antimicrobial treatments, and outcome were reviewed in 15 calves diagnosed with otitis media at the Centre hospitalier universitaire vétérinaire de l’Université de Montréal between 1987 and 2002. Age at presentation ranged from 2 to 18 weeks. A purulent ear discharge and epiphora were seen in 8/12 and 6/15 cases, respectively. Neurological signs observed were head tilt (13), eyelid ptosis (7), paresis/paralysis of the p...
Zafar Iqbal; Satish Chandra Sharma; Hiba Sami; Amit Kumar
Myiasis is a disease caused by fly larvae and aural myiasis is a rare clinic condition often occurring in children or mentally retarded people. We report the case of an unusual presentation of a unilateral aural myiasis in a 3-year-old female child patient belonging to a slum with unilateral chronic otitis media caused by Musca domestica (housefly) larvae. Eight larvae were removed from the external auditory canal while five more larvae were located in the middle ear cavity and were removed t...
Ten guinea pigs were irradiated with 30 Gy of x-radiation. Five were killed on the eighth day after irradiation, and the remainder were killed at the sixteenth day after irradiation. At the time of death, examination was made of the ciliary activity and the fine structure of the middle ear mucosa. Serous effusion was found in each tympanic cavity of all animals. It was shown also that the guinea pig, when irradiated with 30 Gy of x-radiation, exhibits pathologic abnormalities similar to those in humans with otitis media with effusion: degeneration of cilia or ciliated cells and changes in the vascular system (capillary injury and increased capillary permeability). Functional examinations showed that x-ray irradiation has delayed effects on ciliary activity, and the effects are much greater at the sixteenth day than at the eighth day. We speculate that the accumulation of effusion can be, at least partially, a consequence of ciliary dysfunction. The induction of sterile effusion by the use of x-ray irradiation provides a unique animal model for chronic otitis media with effusion of the serous type
Pereira, Agnes de Fátima Faustino
Full Text Available Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM. Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles selected by means of the medical databases: MEDLINE, Cochrane, PubMed (MeSH and Web of Science. Results: Studies have demonstrated the efficacy of xylitol to prevent the AOM, when it is administered five times a day in chewing gum. However, this sugar is not so effective in the prevention of AOM during upper airways infections. Final Comments: Xylitol seems to be an effective strategy in prevention of acute otitis media. However, new studies are necessary to establish ideal doses, frequencies and vehicles for the correct administration of the sugar, which allows for its utilization in the public health system.
Full Text Available AIM: Study; we aimed the isolation of bacteria and establishment of their susceptibility to antibiotics in patients diagnosed as Chronic Supurative Otitis Media. METHOD: Sixty-three patients were included in the study. The samples of suppurative material were cultured. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI and species was identified. RESULTS: S.aureus was isolated in 36,5 % of the 63 patients enrolled in the study. For this bacterium, increased rates of resistance to antibiotics penicillin G, ampicillin /sulbactam, gentamicin, amicacin ve TMP/SMX are detected. The other mostly isolated bacteria are P. aeruginosa (32.69% and E. coli (23.07% in turn. P. aeruginosa showed increased ratio of resistance to ceftriaxone, cefuroxime, amicacin, gentamicin, ampicillin, TMP/SMX and amoxicillin/clavulanate and also E. coli showed increased rates of resistance to gentamicin, ampicillin, ampicillin /sulbactam and amoxicillin/clavulanate. CONCLUSION: We consider Chronic Supurative Otitis Media therapy regarding antimicrobial susceptibility rates will be more rational and satisfying. [TAF Prev Med Bull 2010; 9(1.000: 51-54
Full Text Available OBJECTIVE: To study the role of adenoidectomy in the management of otitis media with effusion. TYPE OF STUDY: A prospective clinical study. MATERIALS AND METHODS: 20cases studied in department of ENT, GMCH. The duration of study was from February 2011 to December 2011. Hearing loss assessment in the form of PTA & TYMPANOMETRY before and after adenoidectomy was done. OBSERVATIONS AND RESULTS: Children <14 years were included in the study. Sex wise distribution was observed. Patients categorized according to the symptoms, gender and degree of hearing loss. Satisfactory results observed after adenoidectomy in relation to the improvement in hearing loss. There can be some complications after adenoidectomy but in our studies proper precautions were taken and no complications seen. CONCLUSION: Adenoidectomy is a very effective surgical modality of treatment in patients who are having otitis media with effusion due to adenoid hypertrophy. Conservative management has no role and grommet insertion is not of much value. Adenoidectomy alone has been shown to produce otoscopic clearance of middle ear effusion, alteration of tympanometric status and improvement of hearing loss.
Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk
The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p depression (p social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests. PMID:22566178
Full Text Available Chronic Suppurative Otitis Media (CSOM is one of the most common chronic diseases of childhood. It is one of the common causes of deafness and can also cause permanent perforation. AIM This study was carried out to know the bacterial aetiology of CSOM and their antibiotic susceptibility pattern. MATERIALS AND METHODS Hundred patients with symptoms of CSOM who were not on antibiotics were included in the present study. Gram stain, culture and sensitivity and biochemical reactions were carried out to identify the organism and to assess their antibiotic susceptibility pattern. RESULTS The most common organism isolated in this study was Staphylococcus aureus (45.6% followed by Pseudomonas aeruginosa (34.7%, Klebsiella pneumoniae (6.5%, Proteus mirabilis (4.3%, Enterococcus fecalis (2.1%, Citrobacter koseri (2.1%, Acinetobacter baumannii (2.1% and Bacteroides (2.1%. Staphylococcal isolates showed highest susceptibility to commonly used antibiotics, gentamycin, ciprofloxacin. Most of the gram negative isolates showed susceptibility to amikacin, ciprofloxacin, third generation cephalosporins. CONCLUSION The study of microbial pattern and their antibiotic susceptibility determines the prevalent bacterial organisms causing CSOM in local area and helps to decide empirical treatment of otitis media and its complications for successful outcome, thus to prevent the emergence of resistant strains.
Nourizadeh, Navid; Ghazvini, Kiarash; Gharavi, Vahideh; Nourizadeh, Niloufar; Movahed, Rahman
Acute otitis media and otitis media with effusion (OME) are the main causes of hearing impairment in children which require proper treatment, mainly antibiotic therapy. Patients whom were appropriate candidates for adenoidectomy were divided into two groups regarding the presence of middle ear effusion. Adenoid tissue specimens were cultured in both groups and the bacterial flora and anti-microbial resistance pattern were determined. 72 patients were studied, 42 % had OME while 58 % did not. The following bacteria were isolated and cultured from both groups with no meaningful difference in prevalence: Streptococcus viridans (p = 0.265), Staphylococcus aureus (p = 0.72), H. influenza (p = 0.806), Entrococcus. spp (0.391), Streptococcus pneumonia (p = 0.391), nonhemolytic Streptococcus (p = 0.230). Bacterial sensitivity was similar for Amoxicillin-clavulanate (p = 0.935), Amoxicillin (p = 0.935), Cephalexin (p = 0.806), Cefixime (p = 0.391) and Azithromycin in both groups. The two groups showed no meaningful difference considering the bacterial flora of nasopharynx and their sensitivity. Bacteria in both groups were sensitive to Amoxicillin and Amoxicillin-clavulanate and resistant to Azithromycin, Cefixime and Cephalexin. PMID:25929414
Brygge, K; Sørensen, C H; Colding, H; Ejlertsen, T; Højbjerg, T; Bruun, B
heterogeneity of 78 cultures of M. catarrhalis obtained from different localities in the nasopharynx of nine young children with secretory otitis media. Using HindIII and PstI as endonucleases, five different ribotypes were recognized, representing at least five different genotypes of M. catarrhalis. The...
M.A. Elemraid; I.J. Mackenzie; W.D. Fraser; G. Harper; B. Faragher; Z. Atef; N. Al-Aghbari; B.J. Brabin
Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings, but there are few studies of their interactions. The aim is to evaluate nutritional factors associated with CSOM in Yemeni children. A case-control study of 75 children with CSOM and 74 health
Di Pierro F
Full Text Available Francesco Di Pierro,1 Daniele Di Pasquale,2 Maurizio Di Cicco2 1Velleja Research, Milan, Italy; 2ORL Department, Ospedale Maggiore Policlinico Ca’ Grande IRCCS, Milan, Italy Abstract: Secretory otitis media (SOM remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM, is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®. After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. Keywords: BLIS K12, Bactoblis®, acute otitis media, exudative otitis media
Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.
Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…
Bogaert, D.; Veenhoven, R.H.; Ramdin, R.; Luijendijk, I.H.; Rijkers, G.T.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.
AIM: In a prospective controlled study in young children with a history of recurrent acute otitis media, we analyzed the salivary IgA and IgG antibody titers upon vaccination with a 7-valent pneumococcal conjugate vaccine (PCV) given once or twice, followed by a 23-valent polysaccharide booster vacc
Bogaert, D.; Veenhoven, R.H.; Sluijter, M.; Wannet, W.J.B.; Rijkers, G.T.; Mitchell, T.J.; Clarke, S.C.; Goessens, W.H.F.; Schilder, A.G.M.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.
A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotyp
Vernon-Feagans, Lynne; Manlove, Elizabeth E.
The purpose of this study was to examine the effects of otitis media (OM) and the quality of child care on the social and communicative behaviors of toddlers, using a cumulative risk framework that included moderation. The study followed 72 children who began child care in infancy. Both process and structural aspects of the quality of 11 child…
Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Kujala, Teija; Jansson-Verkasalo, Eira
Many children experience recurrent acute otitis media (RAOM) in early childhood. In a previous study, 2-year-old children with RAOM were shown to have immature neural patterns for speech sound discrimination. The present study further investigated the consonant inventories of these same children using natural speech samples. The results showed…
Jensen, Ramon Gordon; Homøe, Preben; Andersson, Mikael;
Chronic suppurative otitis media (CSOM) is the leading cause of mild to moderate hearing impairment in children worldwide and a major public health problem in many indigenous populations. There is a lack of basic epidemiological facts and knowledge on the development of CSOM, as the disease...
Eguchi, M; Kariya, S; Okano, M; Higaki, T; Makihara, S; Fujiwara, T; Nagata, K; Hirai, H; Narumiya, S; Nakamura, M; Nishizaki, K
Otitis media is one of the most common and intractable ear diseases, and is the major cause of hearing loss, especially in children. Multiple factors affect the onset or development of otitis media. Prostaglandin D₂ is the major prostanoid involved in infection and allergy. However, the role of prostaglandin D₂ and prostaglandin D2 receptors on the pathogenesis of otitis media remains to be determined. Recent studies show that D prostanoid receptor (DP) and chemoattractant receptor-homologous molecule expressed on T helper type 2 (Th2) cells (CRTH2) are major prostaglandin D₂ receptors. In this study, homozygous DP single gene-deficient (DP⁻(/)⁻) mice, CRTH2 single gene-deficient (CRTH2⁻(/)⁻) mice and DP/CRTH2 double gene-deficient (DP⁻(/)⁻ CRTH2⁻(/)⁻) mice were used to investigate the role of prostaglandin D₂ and its receptors in otitis media. We demonstrate that prostaglandin D₂ is induced by lipopolysaccharide (LPS), a major component of Gram-negative bacteria, and that transtympanic injection of prostaglandin D₂ up-regulates macrophage inflammatory protein 2 (MIP-2), interleukin (IL)-1β and IL-6 in the middle ear. We also show that middle ear inflammatory reactions, including infiltration of inflammatory cells and expression of MIP-2, IL-1β and IL-6 induced by LPS, are reduced significantly in DP⁻(/)⁻ mice and DP⁻(/)⁻ CRTH2⁻(/)⁻ mice. CRTH2⁻(/)⁻ mice display inflammatory reactions similar to wild-type mice. These findings indicate that prostaglandin D₂ may play significant roles in LPS-induced experimental otitis media via DP. PMID:21166666
Full Text Available Risk factors associated with chronic otitis media (COM and recurrent otitis media (ROM have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13-1.64; P = 0.001. An upper respiratory tract infection (URTI significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13-13.89; P<0.00001. Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78-2.16; P<0.00001. A patient history of acute otitis media (AOM/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06-116.44; P = 0.04. Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02-1.89 P = 0.04. Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11-13.15; P = 0.03. Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.
Mucociliary clearance (MCC), which exists in many systems, is the first defensive mechanism of the human body. Nasal MCC has an important role in transporting the secretions of the nasal cavity and paranasal sinuses along with the trapped inhaled pathogens to the nasopharynx. Physiologic or pathologic situations that effect nasal MCC, such as temperature, humidity, nasal obstruction, allergic rhinitis, chronic infections, etc., lead to impaired MCC and related local or circumjacent system disorders. With this perspective, when a unified airway with a multiple disease principle is considered, investigating the relationship between adenoid hypertrophy (AH), otitis media with effusion (OME) and nasal MCC is logical. In this review, histological and physiologic properties of nasal MCC and its possible role involving pathologic situations such as AH and OME is discussed together with recent literature findings. PMID:26496764
Kirankumar Navnitlal Patel
Results: Out of 140 samples 114 (81.43% had positive culture. out of 114 cases, 64 (56.14% were male. Majority of the cases (32.45% were in the age group of 0-14 years. Out of 114 positive cases, single organism was isolated in 99 (86.8% cases. Out of total 116 strains 44 (37.9% were gram positive and 72 (62.1% were gram negative organisms. Among gram positive organisms, Staphylococcus aureus (63.63% was predominant organisms isolated followed by coagulase negative Staphylococci (20.45% and among gram negative organism Pseudomonas (69.44% was predominant organisms isolated followed by proteus species. Conclusions: Staphylococcus aureus and Pseudomonas sp. were found to be the common cause of otitis media in our study. [Int J Res Med Sci 2016; 4(9.000: 3891-3894
Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM). Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032). Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.
Xu, Qingfu; Pichichero, Michael E; Casey, Janet R; Zeng, Mingtao
After our recent discovery of a Streptococcus pneumoniae 19A "superbug" (Legacy strain) that is resistant to all Food and Drug Administration-approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) that expressed the 19A capsule, and 8 (88%) of the 9 multidrug-resistant strains were serotype 19A, including the Legacy strain with the new ST-2722. In genetic relatedness, ST-2722 belonged to a cluster of reported strains of S. pneumoniae in which all strains had 6 of the same alleles as ST-156. The multidrug-resistant strains related to ST-156 expressed different capsular serotypes: 9V, 14, 11A, 15C, and 19F. PMID:19331730
Chaput de Saintonge, D M; Hathaway, N R
Diagnostic and prescribing practices in otitis media vary, and audit is difficult because doctors may not see comparable cases. Seven general practitioners took part in a pilot study to discover if simulated patients evoked the same diagnostic and treatment responses as reveal patients. Forty-eight patients entered the study over three weeks and provided data for two simulations; one included the doctor's description of the ear and the other a photograph instead. Each doctor was shown the two sets of simulations and asked to state his diagnosis and treatment. The diagnoses each doctor reached agreed significantly with those reached on the simulations of the same patients. The decisions to prescribe antibiotics also showed good agreement. PMID:6793159
Wierzbicka, Małgorzata; Gawecki, Wojciech; Leszczyńska, Małgorzata; Kopeć, Tomasz
The authors would like to present a rare case of the middle ear cancer which has been developed in postoperative cave in 67 years old patient operated for cholesteatoma 50 years earlier. The patient was admitted to the ENT Department of Poznań University of Medical Sciences because of the ear suppuration and headache occurring for 3 months. CT and MR images suggested granulation tissue filling the postoperative spaces with bone destruction, infiltration of the dura and temporal lobe abscess formation. Intraoperative findings allowed excluding the preliminary diagnosis of intracranial complication in the course of chronic otitis media, revealing the tissue masses resembling neoplastic infiltration. The histopathology examination confirmed the final diagnosis of squamous cell cancer. The patient was directed to radiotherapy. The authors report a case of middle ear squamous cell carcinoma and discuss its diagnostic aspect. PMID:19205537
MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M
Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice. PMID:27409041
Gan, Rong Z.; Zhang, Xiangming; Guan, Xiying
A comprehensive finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was developed using histological sections of human temporal bone. The cochlea was modeled with three chambers separated by the basilar membrane and Reissner's membrane and filled with perilymphatic fluid. The viscoelastic material behavior was applied to middle ear soft tissues based on dynamic measurements of tissues in our lab. The model was validated using the experimental data obtained in human temporal bones and then used to simulate various stages of otitis media (OM) including the changes of morphology, mechanical properties, pressure, and fluid level in the middle ear. Function alterations of the middle ear and cochlea in OM were derived from the model and compared with the measurements from temporal bones. This study indicates that OM can be simulated in the FE model to predict the hearing loss induced by biomechanical changes of the middle ear and cochlea.
Full Text Available Myiasis is a disease caused by fly larvae and aural myiasis is a rare clinic condition often occurring in children or mentally retarded people. We report the case of an unusual presentation of a unilateral aural myiasis in a 3-year-old female child patient belonging to a slum with unilateral chronic otitis media caused by Musca domestica (housefly larvae. Eight larvae were removed from the external auditory canal while five more larvae were located in the middle ear cavity and were removed through perforation of the tympanic membrane. Management of ear myiasis is based on removal of the maggots and cleansing of the ear with ethanol, chloroform, or physiological saline. Physiological saline is preferred in patients who have tympanic membrane perforation. Myiasis is related to personal hygiene. Therefore, to decrease the incidence of these infestations, care, and hygiene standards should be carried out for those at risk through information, education, and communication.
Full Text Available Aim: To assess radiological findings in Chronic otitis media (COM, its involvement in middle ear and adjacent structure and to compare with similar published data. The ability of the radiological investigations to detect the various pathological and anatomical variations were evaluated and compared with intraoperative findings. COM is a long standing inflammation of the middle ear cleft without reference to etiology or pathogenesis. Due to the strategic location of the tympanomastoid compartment, separated from the middle and posterior cranial fossa by the thinnest of bony partitions, otitis media has the potential for intracranial extension. Hence, it becomes very important to know the location and extent of the disease before proceeding to surgical treatment. Radiological examination of the temporal bone helps us to achieve this objective. The present work has been undertaken to study the role of radiological imaging of the temporal bone as a diagnostic modality in COM and its use in determining the lines of management as in the type of surgical intervention required. Materials and Methods: This is a prospective study in which total of 50 cases with COM were studied. Results: HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner′s septum, cholesteatoma extension in the middle ear and mastoid, and presence of complications such as mastoiditis and mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion and labyrinthine fistula and intracranial complications with a P < 0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Conclusion: HRCT is highly reliable and findings are in par with intraoperative findings in this study.
Michael T Cheeseman
Full Text Available Otitis media with effusion (OME is the commonest cause of hearing loss in children, yet the underlying genetic pathways and mechanisms involved are incompletely understood. Ventilation of the middle ear with tympanostomy tubes is the commonest surgical procedure in children and the best treatment for chronic OME, but the mechanism by which they work remains uncertain. As hypoxia is a common feature of inflamed microenvironments, moderation of hypoxia may be a significant contributory mechanism. We have investigated the occurrence of hypoxia and hypoxia-inducible factor (HIF mediated responses in Junbo and Jeff mouse mutant models, which develop spontaneous chronic otitis media. We found that Jeff and Junbo mice labeled in vivo with pimonidazole showed cellular hypoxia in inflammatory cells in the bulla lumen, and in Junbo the middle ear mucosa was also hypoxic. The bulla fluid inflammatory cell numbers were greater and the upregulation of inflammatory gene networks were more pronounced in Junbo than Jeff. Hif-1α gene expression was elevated in bulla fluid inflammatory cells, and there was upregulation of its target genes including Vegfa in Junbo and Jeff. We therefore investigated the effects in Junbo of small-molecule inhibitors of VEGFR signaling (PTK787, SU-11248, and BAY 43-9006 and destabilizing HIF by inhibiting its chaperone HSP90 with 17-DMAG. We found that both classes of inhibitor significantly reduced hearing loss and the occurrence of bulla fluid and that VEGFR inhibitors moderated angiogenesis and lymphangiogenesis in the inflamed middle ear mucosa. The effectiveness of HSP90 and VEGFR signaling inhibitors in suppressing OM in the Junbo model implicates HIF-mediated VEGF as playing a pivotal role in OM pathogenesis. Our analysis of the Junbo and Jeff mutants highlights the role of hypoxia and HIF-mediated pathways, and we conclude that targeting molecules in HIF-VEGF signaling pathways has therapeutic potential in the treatment of
Gisselsson-Solén, Marie; Henriksson, Gunnel; Hermansson, Ann; Melhus, Åsa
Abstract Conclusion: Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage.
Clarke, Susan; Richmond, Robyn; Worth, Heather; Wagle, Rajendra Raj
Background Chronic Suppurative Otitis Media (CSOM) is the commonest cause of preventable deafness, affecting 164 million people worldwide, 90 % of whom live in low resource countries, such as Nepal. Simple, inexpensive treatment of acute otitis media can prevent the development of CSOM and its sequelae: deafness, abscess, encephalitis, and, rarely, death. CSOM is a disease of poverty and its social determinants: low parental education, overcrowding, poor hygiene and malnutrition. Previous stu...
Vishal Sharma* and Gagandeep Kaur
Full Text Available Chronic suppurative otitis media (CSOM is a chronic inflammation of the middle ear and mastoid cavity that presents as ear discharge. If untreated it can lead to various intracranial and extra cranial complications. This prospective study was carried out to find out various agents causing chronic suppurative otitis media and do determine the antibiogram. A total of 170 patients presenting with ear discharge were included in this study. Specimen processing, organism isolation, identification and antibiotic susceptibility were performed as per standard protocols. Pseudomonas aeruginosa was the most common organism isolated followed by Staphylococcus aureus, coagulase negative staphylococci, Klebsiella, Proteus, Aspergillus and Candida. Antimicrobial sensitivity pattern of bacterial isolates showed a variable pattern. Of the most common antibiotics available as topical preparations, gentamicin and ciprofloxacin were highly effective against study isolates. Empirical therapy followed by definitive treatment can help prevent emergence of resistance to various antimicrobial agents in these cases.
Full Text Available This study presents the treatment of 68 children with secretory otitis media. Children underwent adenoid vegetations, nasal speech, conductive hearing loss, ventilation disturbance in Eustachian tube. In all children adenoidectomy was indicated.38 boys and 30 girls at the age of 3-17 were divided in two main groups: * 29 children without hypertrophic (enlarged adenoids, * 39 children with enlarged (hypertrophic adenoids.The surgical treatment included insertion of ventilation tubes and adenoidectomy where there where hypertrophic adenoids.Clinical material was analyzed according to hearing threshold, hearing level, middle ear condition estimated by pure tone audiometry and tympanometry before and after treatment. Data concerning both groups were compared.The results indicated that adenoidectomy combined with the ventilation tubes facilitates secretory otitis media heeling as well as decrease of hearing impairments. That enables prompt restoration of the hearing function as an important precondition for development of the language, social, emotional and academic development of children.
Hafrén, Lena; Einarsdottir, Elisabet; Kentala, Erna; Hammarén-Malmi, Sari; Bhutta, Mahmood F.; MacArthur, Carol J.; Wilmot, Beth; Casselbrant, Margaretha; Conley, Yvette P; Weeks, Daniel E.; Mandel, Ellen M.; Vaarala, Outi; Kallio, Anna; Melin, Merit; Nieminen, Janne K.
Background Predisposition to childhood otitis media (OM) has a strong genetic component, with polymorphisms in innate immunity genes suspected to contribute to risk. Studies on several genes have been conducted, but most associations have failed to replicate in independent cohorts. Methods We investigated 53 gene polymorphisms in a Finnish cohort of 624 cases and 778 controls. A positive association signal was followed up in a tagging approach and tested in an independent Finnish cohort of 20...
Mortensen Marie; Nielsen Rikke Beck; Fisker Niels; Nørgaard Mette
Abstract Background Otitis media (OM) is a very common condition in children and occurs during years that are critical to the development of learning, literacy, and math skills. Therefore, among a large cohort of Danish conscripts, we aimed to examine the association between hospitalisation with OM in early childhood and cognitive function and educational level in early adulthood. Methods We conducted a population-based prevalence study using linked data from healthcare databases and conscrip...
Zemek, Roger; Szyszkowicz, Mieczysław; Rowe, Brian H
Background Otitis media (OM) is one of the most common early childhood infections, resulting in an enormous economic burden to the health care system through unscheduled doctor visits and antibiotic prescriptions. Objectives The objective of this study was to investigate the potential association between ambient air pollution exposure and emergency department (ED) visits for OM. Materials and Methods Ten years of ED data were obtained from Edmonton, Alberta, Canada, and linked to levels of ai...
Bogaert, D.; Veenhoven, R.H.; Sluijter, M.; Wannet, W. J. W.; Rijkers, G.T.; Mitchell, T J; Clarke, S. C.; Goessens, W.H.F.; Schilder, A. G.; Sanders, E. A. M.; de Groot, R.; Hermans, P. W. M.
A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotype distribution was clearly observed (R. Veenhoven et al., Lancet 361:2189-2195, 2003). We investigated the molecular epidemiology of 921 pneumococcal isolates retrieved from both the pneumococcal v...
Westman, E.; Lundin, S.; Hermansson, Ann; Melhus, Åsa
Acute otitis media (AOM) is the most common reason for outpatient antimicrobial therapy. Mixed infections pose a potential problem, since the first-line drug used for the treatment of AOM, amoxicillin, can be neutralized by ß-lactamase-producing pathogens of the upper respiratory tract. To study the effects of a 5-day course of amoxicillin on a mixed middle ear infection, rats were challenged with Streptococcus pneumoniae alone or in combination with ß-lactamase-producing nontypeable Haemophi...
Westman, Eva; Lundin, Susanne; Hermansson, Ann; Melhus, Åsa
Acute otitis media (AOM) is the most common reason for outpatient antimicrobial therapy. Mixed infections pose a potential problem, since the first-line drug used for the treatment of AOM, amoxicillin, can be neutralized by β-lactamase-producing pathogens of the upper respiratory tract. To study the effects of a 5-day course of amoxicillin on a mixed middle ear infection, rats were challenged with Streptococcus pneumoniae alone or in combination with β-lactamase-producing nontypeable Haemophi...
Brook, Itzhak; Gober, Alan E.
Nasopharyngeal cultures were obtained from 60 children with acute otitis media before and after treatment with either 45 or 90 mg of amoxicillin (given as amoxicillin-clavulanate) per kg of body weight per day for 10 days. The number of Streptococcus pneumoniae isolates in the 45-mg/kg group was reduced from 12 to 6 and was reduced from 14 to 1 (P = 0.0261) in the 90-mg/kg group.
Riazantsev, S V; Chernushevich, I I
Betaleukin was given to 60 patients with various forms of otitis media purulenta chronica (OMPC). Symptoms of the purulent exacerbation were relieved in 43.3% of the patients, the clinical course improved in 18.3%. No response was achieved in 40% of the treated patients. Betaleukin proved highly effective in management of exacerbations of uncomplicated OMPC though it has no direct antimicrobial activity. PMID:10846490
Armbruster, Chelsie E.; Hong, Wenzhou; Pang, Bing; Weimer, Kristin E.D.; Juneau, Richard A.; Turner, James; Swords, W. Edward
Otitis media (OM) is among the leading diseases of childhood and is caused by opportunists that reside within the nasopharynx, such as Haemophilus influenzae and Moraxella catarrhalis. As with most airway infections, it is now clear that OM infections involve multiple organisms. This study addresses the hypothesis that polymicrobial infection alters the course, severity, and/or treatability of OM disease. The results clearly show that coinfection with H. influenzae and M. catarrhalis promotes...
Hazem Mohammed Abdel Tawab; Fadi Mahmoud Gharib; Algarf, Tareq M; ElSharkawy, Louay S
OBJECTIVE To compare the outcome and success of repair of uncomplicated tympanic membrane perforations with myringoplasty alone and when combined with mastoidectomy. METHODS A prospective study where 40 patients with non-cholesteatomatous chronic suppurative otitis media (CSOM) were recruited during the period of June 2013 to December 2013 from the outpatient clinic of Otorhinolaryngology department, Faculty of medicine, Cairo University. Patients were managed medically and after dryness of t...
Kim, Yun Hee; Son, Mi Ju; Kim, Young-Eun; Lee, Hye Won; Lee, Myeong Soo
Introduction The purpose of this systematic review is to investigate the efficacy of the oral administration of herbal medicines for otitis media with effusion through analysing trial data. Methods and analysis Electronic searches of the following 11 databases will be performed: MEDLINE, CINAHL, EMBASE, AMED, the Cochrane CENTRAL, 3 Chinese databases (CNKI, Wangfang Data and VIP Information) and 5 Korean databases (KoreaMed, Research Information Service System, Korea Studies Information Syste...
Full Text Available Chronic suppurative otitis media (CSOM is the result of an initial episode of acute otitis media and is characterized by recurrent discharge from the middle ear through a tympanic perforation. It is an important cause of preventable hearing loss, especially in developing countries. Most approaches to treatment have been unsatisfactory or are very expensive and difficult. As per Acharya Sushruta Karnasrava is a disease characterized by ear discharge. Gandhaka taila is a unique oil based herbo-mineral formulation especially mentioned for Karnasrava with the procedure of karnapurana. To provide clinical evidence and to prove Gandhaka taila as a safe and effective medicine in chronic suppurative otitis media, this study has been carried out. In this study, 23 patients fulfilling the diagnostic and inclusion criteria of CSOM were selected and Gandhaka taila was instilled in to the affected ear for 7 days. The efficacy of the drug was analyzed in terms of the relief produced in the signs and symptoms before and after treatment. The paired t-test was used to check the significance of subjective and objective criteria. The results of the study were found encouraging and there was also a significant reduction in ear discharge.
Full Text Available Abstract Background The nontypeable Haemophilus influenzae (NTHi are associated with a spectrum of respiratory mucosal infections including: acute otitis media (AOM; chronic otitis media with effusion (COME; otorrhea; locally invasive diseases such as mastoiditis; as well as a range of systemic disease states, suggesting a wide range of virulence phenotypes. Genomic studies have demonstrated that each clinical strain contains a unique genic distribution from a population-based supragenome, the distributed genome hypothesis. These diverse clinical and genotypic findings suggest that each NTHi strain possesses a unique set of virulence factors that contributes to the course of the disease. Results The local and systemic virulence patterns of ten genomically characterized low-passage clinical NTHi strains (PittAA – PittJJ obtained from children with COME or otorrhea were stratified using the chinchilla model of otitis media (OM. Each isolate was used to bilaterally inoculate six animals and thereafter clinical assessments were carried out daily for 8 days by blinded observers. There was no statistical difference in the time it took for any of the 10 NTHi strains to induce otologic (local disease with respect to any or all of the other strains, however the differences in time to maximal local disease and the severity of local disease were both significant between the strains. Parameters of systemic disease indicated that the strains were not all equivalent: time to development of the systemic disease, maximal systemic scores and mortality were all statistically different among the strains. PittGG induced 100% mortality while PittBB, PittCC, and PittEE produced no mortality. Overall Pitt GG, PittII, and Pitt FF produced the most rapid and most severe local and systemic disease. A post hoc determination of the clinical origins of the 10 NTHi strains revealed that these three strains were of otorrheic origin, whereas the other 7 were from patients
Marie S Rye
Full Text Available BACKGROUND: Otitis media (OM is a common childhood disease characterised by middle ear inflammation and effusion. Susceptibility to recurrent acute OM (rAOM; ≥ 3 episodes of AOM in 6 months and chronic OM with effusion (COME; MEE ≥ 3 months is 40-70% heritable. Few underlying genes have been identified to date, and no genome-wide association study (GWAS of OM has been reported. METHODS AND FINDINGS: Data for 2,524,817 single nucleotide polymorphisms (SNPs; 535,544 quality-controlled SNPs genotyped by Illumina 660W-Quad; 1,989,273 by imputation were analysed for association with OM in 416 cases and 1,075 controls from the Western Australian Pregnancy Cohort (Raine Study. Logistic regression analyses under an additive model undertaken in GenABEL/ProbABEL adjusting for population substructure using principal components identified SNPs at CAPN14 (rs6755194: OR = 1.90; 95%CI 1.47-2.45; P(adj-PCA = 8.3 × 10(-7 on chromosome 2p23.1 as the top hit, with independent effects (rs1862981: OR = 1.60; 95%CI 1.29-1.99; P(adj-PCA = 2.2 × 10(-5 observed at the adjacent GALNT14 gene. In a gene-based analysis in VEGAS, BPIFA3 (P(Gene = 2 × 10(-5 and BPIFA1 (P(Gene = 1.07 × 10(-4 in the BPIFA gene cluster on chromosome 20q11.21 were the top hits. In all, 32 genomic regions show evidence of association (P(adj-PCA<10(-5 in this GWAS, with pathway analysis showing a connection between top candidates and the TGFβ pathway. However, top and tag-SNP analysis for seven selected candidate genes in this pathway did not replicate in 645 families (793 affected individuals from the Western Australian Family Study of Otitis Media (WAFSOM. Lack of replication may be explained by sample size, difference in OM disease severity between primary and replication cohorts or due to type I error in the primary GWAS. CONCLUSIONS: This first discovery GWAS for an OM phenotype has identified CAPN14 and GALNT14 on chromosome 2p23.1 and the BPIFA gene cluster on chromosome 20q11.21 as
Mittal, Rahul; Lisi, Christopher V; Gerring, Robert; Mittal, Jeenu; Mathee, Kalai; Narasimhan, Giri; Azad, Rajeev K; Yao, Qi; Grati, M'hamed; Yan, Denise; Eshraghi, Adrien A; Angeli, Simon I; Telischi, Fred F; Liu, Xue-Zhong
Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. PMID:26248613
Full Text Available BACKGROUND: Acute otitis media (OM is a common disease which often develops through complex interactions between the host, the pathogen and environmental factors. We studied single nucleotide polymorphisms (SNPs of genes involved in innate and adaptive immunity, and other host and environmental factors for their role in OM. METHODS: Using Sequenom Massarray platform, 21 SNPs were studied in 653 children from prospective (n = 202 and retrospective (n = 451 cohorts. Data were analyzed for the relationship between SNPs and upper respiratory infection (URI frequency, risk of acute OM during URI episodes, and proneness to recurrent OM. RESULTS: Increased risk for OM proneness was associated with CX3CR1 (Thr280Met SNP and with a jointly interactive group of IL-10 (-1082 SNP, IL-1β (-511 wild type genotype and white race. Family history of OM proneness independently increased the risk for frequent URIs, OM occurrence during URI, and OM proneness. Additionally, IL-1β (-31 SNP was associated with increased risk for frequent URIs, but IL-10 (-592, IL-1β (-511, IL-5 (-746 and IL-8 (-251 SNPs were associated with decreased risk of URI. CONCLUSION: IL-1β (-31, CX3CR1 (Thr280Met, IL-10 (-1082 and IL-1β (-511 SNPs were associated with increased risk for frequent URIs or OM proneness.
Khavarghazalani, Bahare; Farahani, Farhad; Emadi, Maryam; Hosseni Dastgerdi, Zahra
Conclusion The study results indicate that children with a history of otitis media with effusion (OME) suffer from auditory processing disorder to some degree. The findings support the hypothesis that fluctuating hearing loss may affect central auditory processing during critical periods. Objectives Evidence suggests that prolonged OME in children can result in an auditory processing disorder, presumably because hearing has been disrupted during an important developmental period. A lack of auditory stimulation leads to the abnormal development of the hearing pathways in the brain. The aim of the present study was to determine the effects of OME on binaural auditory function and auditory temporal processing. Method In the present study, the dichotic digit test (DDT) was used for binaural hearing, and the gap in noise (GIN) test was used to evaluate temporal hearing processing. Results The average values of GIN differed significantly between children with a history of OME and normal controls (p < 0.001). The mean values of the DDT score were significantly different between the two groups (p = 0.002). PMID:26881324
Yildirim-Baylan, Muzeyyen; Ozmen, Cihan Akgul; Gun, Ramazan; Yorgancilar, Ediz; Akkuş, Zeki; Topcu, Ismail
This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, the status of the ossicles, presence or absence of facial canal dehiscence and semicircular canal (SCC) dehiscence and the presence or absence of dural plate erosion, and sigmoid sinus thrombosis. Fifty-six patients were recruited in the study, 30 males and 26 females. The age range was from 16 to 67 years with a mean of 26.51 ± 1.4 years. The preoperative CT scan imaging in cases of cholesteatoma, ossicular chain erosion and SCC dehiscence have good correlation with the intraoperative findings. The specificity of preoperative CT scan in detecting facial canal dehiscence, dural plate erosion and sigmoid sinus thrombosis in patient of COM were weak. Preoperative computed tomography evaluation is fairly useful especially in cases of cholesteatoma. According to the results of this study, CT is of value particularly in the definition of cholesteatoma, and in determining ossicular chain erosion and semicircular canal fistula. PMID:23449285
Prata, Anelise Abrahao Salge
Full Text Available Introduction: The chronic otitis media (COM is a prevalent disease and the most frequent cause of indication to mastoidectomy. Many studies have evaluated the use of tomography (CT of temporal bones for preoperative evaluation of COM and its indication in the preoperative approach is still controversial nowadays. Objective: To evaluate the sensitivity of the clinical and radiological findings of COM according to the intraoperative surgical results and histopathological findings. Method: Transversal retrospective study through collection of record data of patients with COM submitted to mastoidectomy in the period from 2007 through 2008 in our service. Results: From a total of 82 ears, 40.24% had cholesteatoma. The CT presented 72.73% of sensitivity in the identification of cholesteatoma, 56.67% in the identification of changes to the ossicular chain and 100% in that of erosion of the lateral semicircular canal. Conclusion: The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, large changes of the ossicular chain and erosion of the lateral semicircular canal. For minor changes to the ossicular chain, the facial nerve canal and the tympanic tegmen they described low sensitivity.
Kariya, S; Okano, M; Fukushima, K; Nomiya, S; Kataoka, Y; Nomiya, R; Akagi, H; Nishizaki, K
Helicobacter pylori is a Gram-negative bacterium that is recognized as one of the key factors in gastric diseases such as gastritis, peptic ulcer and gastric cancer. Recent studies have shown relationships between H. pylori and extra-digestive diseases, and the presence of H. pylori in the middle ear and upper respiratory tract has been reported. However, the role of H. pylori in middle ear disease remains unclear. The present study demonstrated that H. pylori whole-cell protein directly induces macrophage migration inhibitory factor, macrophage inflammatory protein 2, interleukin 1 beta and tumor necrosis factor alpha in middle ear epithelium in mice, and severe proliferation of inflammatory cells was observed in middle ear cavity inoculated with H. pylori whole-cell protein. In addition, trans-tympanic injection of macrophage migration inhibitory factor up-regulated expression of macrophage inflammatory protein 2 in the middle ear. These findings indicate that H. pylori infection causes immunological inflammation in middle ear epithelium, and H. pylori may play a significant role in otitis media. PMID:18727622
Verhoeven, D; Pichichero, M E
Acute otitis media (AOM), induced by respiratory bacteria, is a significant cause of children seeking medical attention worldwide. Some children are highly prone to AOMs, suffering three to four recurrent infections per year (prone). We previously determined that this population of children could have diminished anti-bacterial immune responses in peripheral blood that could fail to limit bacterial colonization in the nasopharynx (NP). Here, we examined local NP and middle ear (ME) responses and compared them to peripheral blood to examine whether the mucosa responses were similar to the peripheral blood responses. Moreover, we examined differences in effector cytokine responses between these two populations in the NP, ME and blood compartments at the onset of an AOM caused by either Streptococcus pneumoniae or non-typeable Haemophilus influenzae. We found that plasma effector cytokines patterned antigen-recall responses of CD4 T cells, with lower responses detected in prone children. ME cytokine levels did not mirror blood, but were more similar to the NP. Interferon (IFN)-γ and interleukin (IL)-17 in the NP were similar in prone and non-prone children, while IL-2 production was higher in prone children. The immune responses diverged in the mucosal and blood compartments at the onset of a bacterial ME infection, thus highlighting differences between local and systemic immune responses that could co-ordinate anti-bacterial immune responses in young children. PMID:24889648
Yaman, Huseyin; Yilmaz, Suleyman; Alkan, Nihal; Subasi, Bugra; Guclu, Ender; Ozturk, Ozcan
The objective of this study was to determine tympanostomy tube complications in children with chronic otitis media with effusion who were treated with Shepard grommet tympanostomy tube insertion. This tube type was selected as it is the most commonly used one in our clinic. The medical records of 162 ears of 87 children (52 male and 35 female) were reviewed retrospectively. The children were between 3 to 16 years old (mean age = 8.1 +/- 3.1). The patients were followed up 6-66 months (mean 23.3 +/- 14.9 months) after tympanostomy tube insertion. We reviewed age, sex, time to tube extrusion and complications. In all patients the indication for surgery was chronic middle ear effusion. Otorrhea occurred in nine ears (5.6%). Granulation tissue was seen in two ears (1.2%). Complications after tympanostomy tube extrusion included myringosclerosis (34.6%), persistent perforation (5.6%), atrophy (23.5%), retraction (16.7%) and medial displacement of tubes (1.2%). The average extrusion time was 8.5 +/- 4.6 months (range 1-24) for Shepard grommet tympanostomy tubes. Complications of tympanostomy tube insertion are common. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most frequently appearing complications. But they are generally insignificant and cosmetic. Consequently, in the majority of these complications there is no need for any management. PMID:20204390
Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna
Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated.We performed a search in MEDLINE (accessed via PubMed) using the following terms: "CAM" in conjunction with "OM" and "children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies.The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications.The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802
Full Text Available The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 °C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16th postoperative day in good condition.
Guler, Adem; Sahin, Mehmet Ali; Gurkan Yesil, Fahri; Yildizoglu, Uzeyir; Demirkol, Sait; Arslan, Mehmet
The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 (°)C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16(th) postoperative day in good condition. PMID:26110009
Park, Jae Hong; Noh, MinHo; Park, Seung Bum; Park, Kye Hoon; Han, Jong Kyu; Kim, Hyun Jeong
Background and Objectives Pneumatization of air cells in the mastoid bone is decreased in chronic otitis media (COM). A decrease in the size of the external auditory canal (EAC) is also found frequently in patients with COM, but this has been little studied. We compared the size of affected bony EACs and the contralateral side in patients with single-side COM using high-resolution computed tomography. Subjects and Methods In total, 99 patients with single-side COM were included. Four indicators related to the size of the bony EAC and IAC were measured using high-resolution computed tomography: the axial and coronal lengths of the tympanic membrane, the length of the isthmus, and the area of the bony ear canal. We also compared both internal auditory canals as negative controls. These assessments were made by radiologists who were blinded to the objective of this study. Results In patients with single-side COM, the axial length of the tympanic membrane was significantly shorter than normal, and the volume of the EAC was also significantly smaller. The length of the isthmus of the EAC was shorter on the affected side, but the difference was not significant. The IAC volume showed no difference between the two sides. Conclusions COM affects general temporal bony development, including the bony EAC and mastoid bone. Therefore, whether to correct this should be considered when preparing for COM surgery. PMID:27144233
Full Text Available Otitis media (OM, inflammation of the middle ear, remains the most common cause of hearing impairment in children. It is also the most common cause of surgery in children in the developed world. There is evidence from studies of the human population and mouse models that there is a significant genetic component predisposing to OM, yet nothing is known about the underlying genetic pathways involved in humans. We identified an N-ethyl-N-nitrosourea-induced dominant mouse mutant Junbo with hearing loss due to chronic suppurative OM and otorrhea. This develops from acute OM that arises spontaneously in the postnatal period, with the age of onset and early severity dependent on the microbiological status of the mice and their air quality. We have identified the causal mutation, a missense change in the C-terminal zinc finger region of the transcription factor Evi1. This protein is expressed in middle ear basal epithelial cells, fibroblasts, and neutrophil leukocytes at postnatal day 13 and 21 when inflammatory changes are underway. The identification and characterization of the Junbo mutant elaborates a novel role for Evi1 in mammalian disease and implicates a new pathway in genetic predisposition to OM.
Bhutta, Mahmood F
Otitis media (OM; inflammation of the middle ear) comprises a group of disorders that are among the most common disorders of childhood. OM is also heritable and has effects on fecundity. This means that OM is subject to evolution, yet the evolutionary forces that may determine susceptibility to OM have not been adequately explored. Here I analyze evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those affecting function of the middle ear, host immunity, or colonization by and pathogenicity of bacteria. I review existing evolutionary models of host-pathogen interaction and coevolution and apply these to better understand the complex evolutionary landscape of middle ear infection and inflammation in humans, including factors determining transition between stable evolutionary strategies for host and bacteria. This understanding is then applied to an analysis of OM in indigenous populations to devise a new theory for OM prevalence in Australian Aborigine, Native American, Inuit, and Maori populations. I suggest that high prevalence in such groups may have resulted from encounters of these previously isolated populations with European immigrants in the 15th and 16th centuries. This exposed them to new strains of bacteria to which their immune system had not evolved immunity, perturbing a previously stable host-pathogen coevolutionary state. PMID:26829293
Schwartz, R H; Puglise, J; Rodriguez, W J
A bedtime dose of sulphamethoxazole was effective in preventing ear infections in otitis-prone young children. Thirty-three such children were studied by means of a random, double-blind, placebo-controlled, cross-over protocol. Nine (27%) of 33 children treated with sulphamethoxazole experienced 10 episodes of acute suppurative otitis media or otitis media with effusion while 19 (58%) of 33 children given a placebo experienced 27 episodes of acute otitis media or otitis media with effusion. N...
Miriam de la C Sánchez Segura; Julianis Quintero Noa; Vianed Marsán Suárez; Elisa Leyva Montero; Isabel M Torres Leyva; René M González García; Consuelo Macías Abraham
Se estudiaron 40 pacientes con otitis media supurativa crónica no colesteatomatosa a los que se les realizó tratamiento quirúrgico (técnica cerrada). Se analizaron los resultados de las pruebas inmunológicas y la evolución clínica de 20 pacientes con tratamiento inmunológico preoperatorio por un período de 6 a 12 meses y se compararon con la de 20 pacientes operados sin dicho tratamiento. El seguimiento evolutivo se realizó durante un año posterior a la intervención quirúrgica. La alteración ...
André Souza de Albuquerque Maranhão
Full Text Available Otite média (OM é considerada doença potencialmente grave em razão dos riscos de complicações que podem ocorrer em sua evolução. OBJETIVO: Estabelecer a incidência anual de complicações intratemporais de OM e avaliar prospectivamente os pacientes por meio da análise dos aspectos epidemiológicos e clínicos. MÉTODO: Estudo de coorte contemporânea. Durante o período de um ano, os pacientes admitidos em um Hospital Universitário, com diagnóstico de OM e de complicação intratemporal (CIT de OM foram incluídos no estudo. Os dados avaliados foram: idade, sexo, tipo de complicação intratemporal, tratamento e desfecho clínico. A incidência geral das complicações e de cada complicação foi determinada. RESULTADOS: 1.816 pacientes foram diagnosticados com OM. Em 592 (33% indivíduos, o diagnóstico foi de otite média crônica; em 1224 (67% o diagnóstico foi de otite média aguda. CIT de OM foi diagnosticada em 15 pacientes, perfazendo uma incidência anual de CIT 0,8%. Foram identificados 19 diagnósticos de CIT em 15 pacientes. Fístula labiríntica foi diagnosticada em sete (36,8% indivíduos, mastoidite em cinco (26,3%, paralisia facial periférica em quatro (21,1% e labirintite em três (15,8%. CONCLUSÃO: A incidência das complicações intratemporais permanece significativa quando comparada à de países desenvolvidos. A otite média crônica colesteatomatosa é a etiologia mais frequente das complicações intratemporais. A fístula labiríntica é a complicação intratemporal mais comum.Otitis media (OM is considered a potentially severe disease due to the risk of complications. OBJECTIVE: To establish the annual incidence of intratemporal complications (ITC resulting from OM and to prospectively assess patients for epidemiological and clinical factors. METHOD: This prospective cohort study included patients admitted during one year at a university hospital diagnosed with intratemporal complications of OM. Patients
Leah J McGrath
Full Text Available OBJECTIVES: Guidelines to treat acute otitis media (AOM were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure. STUDY DESIGN: Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year. RESULTS: We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%. CONCLUSIONS: In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.
Vernacchio, Louis; Vezina, Richard M.; Mitchell, Allen A.
Objective. Xylitol, given as two grams orally five times-a-day, significantly reduces the incidence of acute otitis media (AOM) in children. A less frequent dosing schedule, if tolerable and efficacious, would promote the more widespread use of this treatment. We sought to determine the tolerability and acceptability in young children of oral xylitol solution at doses of 5 grams three times-a-day (TID) and 7.5 grams once daily (QD). Methods. The study was a three-month randomized placebo-controlled trial of the tolerability and acceptability of oral xylitol solution in 120 children 6-36 months of age performed in the SCOR Network. Results. Study withdrawals and unscheduled medical visits for gastrointestinal complaints did not differ significantly among the study groups. The proportions of subjects in the xylitol TID group who experienced excessive gas or diarrhea at months one, two, and three were 22.7%, 10.0%, and 14.3%, respectively, and in the xylitol QD group were 27.3%, 17.4%, and 14.3%, respectively, and these did not differ from the placebo groups. The proportions who accepted the study solution easily or with only minor difficulty at one, two, and three months in the xylitol TID group were 77.3%, 90.0%, and 90.5% and in the xylitol QD group, 77.3%, 82.6%, and 90.5%, respectively. Conclusions. Oral xylitol solution at dosages of 5 grams TID and 7.5 grams QD is well-tolerated by young children. Given the potential for xylitol as a safe, inexpensive option for AOM prophylaxis, clinical trials using these dosages of xylitol can be conducted. PMID:17097152