Determination of eustachius tube ventilation functioning among benign type chronic suppurative otitis media and non-otitis media subjects using sonotubometry

Science.gov (United States)

Ikhwan, M.; Hafil, A. F.; Bramanthyo, B.

2017-08-01

The Eustachian tube (ET) is responsible for the ventilation, protection, and cleaning of the middle ear. ET dysfunction plays an important role in the pathogenesis of otitis media cases, and thus the treatment and prognosis of these cases is extremely dependent on adequate ET function, which can ultimately affect the success rate of middle ear reconstruction practices. Data research on the ET’s ventilation function is needed to ensure the success of therapy and surgery treatments in the case of Chronic Suppurative Otitis Media (CSOM) patients. This study aims to investigate ET ventilation functioning in benign type CSOM and non-otitis media subjects and to develop another modality to measure ET ventilation functioning in patients with intact and perforated tympanic membranes. A comparative cross-sectional study of 36 benign type CSOM patients and 80 non-otitis media subjects will be conducted using sonotubometry and the rated parameter measurements of ET opening frequency, amplitude and ET opening duration. Malfunctioning ventilation of the ET is more common among benign type CSOM subjects (47%) than among non-otitis media subjects (18.75%). There is a significant difference (p = 0.002) between the ET ventilation functioning of benign type CSOM subjects and non-otitis media subjects—benign type CSOM subjects have rates of malfunctioning ET ventilation that are 3.88 times higher than those of non-otitis media subjects. Patients with benign type CSOM are more likely to experience malfunctioning ET ventilation than are non-otitis media subjects.

Computed tomography study of otitis media

International Nuclear Information System (INIS)

Bahia, Paulo Roberto Valle; Marchiori, Edson

1997-01-01

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)

Middle ear infection (otitis media) (image)

Science.gov (United States)

Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is ... which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked ...

Panel 7 : Otitis Media: Treatment and Complications

NARCIS (Netherlands)

Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice.

Assessment of senses of hearing and balance in chronic suppurative otitis media

Directory of Open Access Journals (Sweden)

Babić Borivoj

2008-01-01

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.

Bacterial Dynamics of Chronic Suppurative Otitis Media in Makurdi ...

African Journals Online (AJOL)

AOM) and chronic suppurative otitis media (CSOM) and their antibiotic susceptibility ... Screening of children < 5 years for CSOM at clinics, primary schools, nurseries and children rehabilitation centres should be considered and antibiotic ...

Management of chronic mucosal otitis media in children

NARCIS (Netherlands)

van der Veen, E.L.

2010-01-01

Chronic mucosal otitis media (COM) is one of the most common infectious diseases in children worldwide. As it causes considerable morbidity and is a major global cause of hearing impairment, establishing its most effective treatment is important. It is generally accepted that antibiotic eardrops

Paediatric chronic suppurative otitis media in the Free State ...

African Journals Online (AJOL)

Background. Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear cleft. In sub-Saharan Africa >50% of cases occur in children <10 years of age. Objectives. To describe the otological, audiological and bacteriological findings in children with CSOM. Methods. We conducted a prospective study at ...

Surgical success of boomerang-shaped chondroperichondrial graft in pediatric chronic otitis media cases.

Science.gov (United States)

Dundar, Riza; Kulduk, Erkan; Soy, Fatih Kemal; Aslan, Mehmet; Yukkaldiran, Ahmet; Guler, Osman Kadir; Ozbay, Can

2015-06-01

To reveal the success of boomerang-shaped chondroperichondrial graft (BSCPG) in pediatric chronic otitis media cases. A total of 43 pediatric patients (age 7-16 years) who had undergone type 1 tympanoplasty with the diagnosis of chronic otitis media between March 2010 and March 2013 were included in this retrospective study. The main outcome measures were the graft success rate and level of hearing improvement. Graft intake success rate was 90.7%. Mean preoperative and postoperative air-bone gap values were 20.51 ± 4.34 dB SPL and 9.32 ± 5.64 dB SPL, respectively (p Boomerang-shaped chondroperichondrial grafting technique seems to be a successful alternative in the management of pediatric chronic otitis media cases. It has relatively higher grade graft success rate. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Microbiological profile from middle ear and nasopharynx in patients suffering from chronic active mucosal otitis media

International Nuclear Information System (INIS)

Khattak, S.F.; Sheikh, N.A.; Aleem, A.; Farooq, M.; Nadeem, K.

2017-01-01

Chronic otitis media is described as a tympanic membrane perforation and ear discharge for more than six weeks duration. Ascending infection from the nasopharynx into the middle ear cleft has been attributed to prevent resolution of chronic otitis media. This research aims to determine the association between the microbiological flora of the nasopharynx with that of the middle ear in patients suffering from chronic (active) mucosal otitis media. Methods: Our study is a hospital-based cross-sectional survey. It was conducted from December 2015 to February 2017 at the Department of ENT, Combined Military Hospital, Abbottabad. Ear and nasopharyngeal swabs were obtained from 65 patients of chronic active mucosal otitis media and sent for microbiological analysis. Microbiological culture and sensitivity test was performed to identify the microbial spectrum of each specimen. Performa bearing the result of otoscopy, aspirate and swabs were completed for middle ear and the nasopharyngeal culture with reference to each patient. Descriptive statistics and Pearson's chi square analysis were performed using SPSS-22. Results: Staphylococcus aureus and Pseudomonas aeruginosa are foremost micro-organisms found in otorrhea culture isolated from patients of chronic active mucosal otitis media. Majority of the cultures from nasopharynx of these patients did not reveal any growth after incubation for 48 hours. Conclusion: A statistically insignificant association exists between the microbiological spectrum of the middle ear and the nasopharynx of patients suffering from chronic active mucosal otitis media. Micro organisms' exposure from a perforated tympanic membrane remains leading cause of persistent otorrhea, rather than ascending infection through the Eustachian tube. (author)

Sinusitis with eosinophilic otitis media

International Nuclear Information System (INIS)

Kawano, Toshiro; Ishitoya, Junichi; Tsukuda, Mamoru

2007-01-01

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)

Sinusitis with eosinophilic otitis media

Energy Technology Data Exchange (ETDEWEB)

Kawano, Toshiro; Ishitoya, Junichi [Yokohama City Univ., Medical Center, Yokohama, Kanagawa (Japan); Tsukuda, Mamoru [Yokohama City Univ., Graduate School of Medicine, Yokohama, Kanagawa (Japan)

2007-09-15

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)

Evidence-based management of otitis media: a 5S model approach.

Science.gov (United States)

Wasson, J D; Yung, M W

2015-02-01

The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

Polymorphisms in Toll-like receptors 2 and 4 genes and their expression in chronic suppurative otitis media.

Science.gov (United States)

Jotic, Ana; Jesic, Snezana; Zivkovic, Maja; Tomanovic, Nada; Kuveljic, Jovana; Stankovic, Aleksandra

2015-12-01

Toll-like receptors (TLRs) have a prominent role in inducing innate immune response. It has been suggested that regulation of TLRs is involved in the pathogenesis of chronic otitis media. TLR 2 and TLR 4 polymorphisms were connected with susceptibility to acute otitis and chronic otitis with effusion. The objective of this study was to establish expression of TLR 2 and 4 on middle ear mucosa in different types of chronic suppurative otitis media (CSOM), and the influence of gene polymorphisms TLR 2 Arg753Gln and TLR 4 Thr399Ile and Asp299Gly to susceptibility to CSOM. Middle ear mucosa and full blood samples were obtained from 85 patients with chronic suppurative otitis media with and without cholesteatoma. Control group for mucosal TLR expression consisted of 71 samples of middle ear mucosa taken from patients with otosclerosis, and control group for DNA polymorphism consisted of 100 full blood samples in healthy subjects. DNA polymorphism detection was done with restriction fragment length polymorphism in RT PCR. Expression of TLR 2 and 4 was determined with immunohistochemical staining. TLR 2 and TLR 4 expression on the middle ear mucosa was not influenced by age of the patients with chronic otitis media. Incidence of TLR 2 Arg753Gln polymorphism was significantly higher in patients with chronic otitis media, compared to control group. Significant association between TLR 2 Arg753Gln polymorphism and different types of mucosal changes in patients with chronic otitis media was established. TLR 2 and 4 expression on experimental group mucosa was significantly different compared to control group, where there was no expression (p=0.000). Strong dependence of TLR 2 and TLR 4 expression on middle ear mucosa with different mucosal changes and immunohistochemical activity after staining was detected. Certain polymorphisms in TLR genes could be indicative for susceptibility to chronic otitis media. Expression of TLR 2 and 4 on middle ear mucosa was more dependable on

CYTOLOGICAL FEATURES OF FENSPIRIDE USAGE IN TREATMENT OF CHRONIC EXUDATIVE OTITIS MEDIA

OpenAIRE

O. Yu. Mezentseva; F. N. Zavjyalov; A. A. Vorobjeva; L. P. Popova; M. V. Rodionova

2012-01-01

The cytological investigation of exudates, obtained during tympanostomies, showed the predomination of inflammatory-regenerative cytograms types when using Fenspiride (Eurespal) in treatment of secretory stage of chronic exudative otitis media. Received data confirm, that treatment with this drug shortens the course of exudative otitis media and contributes to more rapid change from destructive to reparative stage of inflammation, which prevents the development of adhesive process in the midd...

Bacterial strain changes during chronic otitis media surgery.

Science.gov (United States)

Kim, G J; Yoo, S; Han, S; Bu, J; Hong, Y; Kim, D-K

2017-09-01

Cultures obtained from pre-operative middle-ear swabs from patients with chronic otitis media have traditionally been used to guide antibiotic selection. This study investigated changes in the bacterial strains of the middle ear during chronic otitis media surgery. Pre-operative bacterial cultures of otorrhoea, and peri-operative cultures of the granulation tissue in either the middle ear or mastoid cavity, were obtained. Post-operative cultures were selectively obtained when otorrhoea developed after surgery. Bacterial growth was observed in 45.5 per cent of pre-operative cultures, 13.5 per cent of peri-operative cultures and 4.5 per cent of post-operative cultures. Methicillin-resistant Staphylococcus aureus was identified as the most common bacteria in all pre-operative (32.4 per cent), peri-operative (52.4 per cent) and post-operative (71.4 per cent) tests, and the percentage of Methicillin-resistant S aureus increased from the pre- to the post-operative period. The bacterial culture results for post-operative otorrhoea showed low agreement with those for pre-operative or peri-operative culture, and strain re-identification was required.

aerobic bacteria in safe type chronic suppurative otitis media

African Journals Online (AJOL)

PUBLICATIONS1

Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discour- aged. INTRODUCTION. Chronic suppurative otitis media (CSOM) is a persistent inflammatory disorder of the middle.

Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ.

Science.gov (United States)

Mawale, Mahesh B; Kuthe, Abhaykumar; Mawale, Anupama M; Dahake, Sandeep W

2018-06-01

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.

CYTOLOGICAL FEATURES OF FENSPIRIDE USAGE IN TREATMENT OF CHRONIC EXUDATIVE OTITIS MEDIA

Directory of Open Access Journals (Sweden)

O. Yu. Mezentseva

2012-01-01

Full Text Available The cytological investigation of exudates, obtained during tympanostomies, showed the predomination of inflammatory-regenerative cytograms types when using Fenspiride (Eurespal in treatment of secretory stage of chronic exudative otitis media. Received data confirm, that treatment with this drug shortens the course of exudative otitis media and contributes to more rapid change from destructive to reparative stage of inflammation, which prevents the development of adhesive process in the middle ear.

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups.

Science.gov (United States)

Hasegawa, Masayo; Shinnabe, Akihiro; Kanazawa, Hiromi; Iino, Yukiko; Yoshida, Naohiro

2017-08-01

We aimed to analyze preoperative and intraoperative clinical characteristics of chronic perforated otitis media by patient age. We analyzed 137 tympanoplasties for chronic perforated otitis media in 133 patients. Exclusion criteria were ear adhesions, cholesteatoma, and a history of tympanoplasty. Patients were divided into a younger group (aged 15-39 years), a middle group (40-64 years), and an elderly group (≥65 years). We compared tympanoplasty technique (using Wullstein classification), mastoid air-cell area measured by temporal bone computed tomography, preoperative aeration of the temporal bone, mean preoperative hearing (at 500 Hz, 1000 Hz, and 2000 Hz), and patch effect calculated by the pre- and post-patch air-bone gap at frequencies of 250 Hz and 500 Hz among the three age groups. Although type I tympanoplasty was performed most frequently in all age groups, it was performed significantly less often in the elderly group (pgroup (page groups (pgroups. The mean patch effect was significantly better in the younger group than in middle or elderly groups (p<0.05). The less pneumatized mastoid and ossicular diseases in elderly patients with chronic perforated otitis media suggest that they had longer lasting and more severe childhood middle ear pathologies than did younger patients.

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Background Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim The study sought to determine ...

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Background. Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim. The study sought to determine ...

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Abstract. Background. Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine ..... CSOM was most prevalent in children and young adults than in older participants. This is similar to studies reported by others in India and Pakistan9,10.

Validation of a Portuguese version of the health-related quality of life measure for active chronic otitis media (COMQ-12).

Science.gov (United States)

Fonseca, Anna Carolina Oliveira; Ramos, Pedro; Balsalobre, Fernando A; Freitas, Edson L; Phillips, John S; Yung, Matthew W; Bento, Ricardo F

2017-09-01

Measuring the impact on quality of life, especially after the beginning of the treatment, is becoming increasingly important in healthcare. The aim of this study was to translate the Chronic Otitis Media Questionnaire-12 (COMQ-12) into Portuguese language and validate this version in a group of patients with chronic otitis media. The Portuguese version of COMQ-12 was obtained by translation and back translation. Portuguese speaking patients with a history of active chronic otitis media were asked to complete the COMQ-12 Portuguese version. Cronbach's α coefficient was calculated for an estimation of the internal consistency of the questionnaire. A total of 100 patients were included in the study; 49 women and 51 men, with a mean age of 39 years (range 12-77 years, median 40 years). The average COMQ-12 score was 29, out of a maximum score of 60. Cronbach's α result for the Portuguese version of the COMQ-12 was 0.85, indicating a high internal consistency. The participants presented with different forms of chronic otitis media, and almost all domains of the COMQ-12 questionnaire were able to differentiate between patients with healed chronic otitis media and patients with cholesteatoma or wet tympanic membrane perforation. Showing that patients with healed chronic otitis media have a better quality of life, measured by the COMQ-12, is a first step to guarantee the questionnaire's validity. The next step will consist on routinely using the questionnaire in patients undergoing surgery for chronic otitis media in order to evaluate their quality of life after treatment. The COMQ-12 Portuguese version showed high reliability, and may be used as an assessment of quality of life in patients with chronic otitis media. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. All rights reserved.

Otitis media.

Science.gov (United States)

Schilder, Anne G M; Chonmaitree, Tasnee; Cripps, Allan W; Rosenfeld, Richard M; Casselbrant, Margaretha L; Haggard, Mark P; Venekamp, Roderick P

2016-09-08

Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.

Chronic otitis media sequelae in skeletal material from medieval Denmark

DEFF Research Database (Denmark)

Qvist, M; Grøntved, A M

2001-01-01

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...

Aerobic bacteria in safe type chronic suppurative otitis media in ...

African Journals Online (AJOL)

... cefuroxime, cefaclor and ceftriaxone. Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discouraged. Keywords: Aerobic bacteria, Chronic suppurative otitis media, Gezira ...

Morphological evidence of biofilm formation in Greenlanders with chronic suppurative otitis media

DEFF Research Database (Denmark)

Homøe, Preben; Bjarnsholt, Thomas; Wessman, Marcus

2009-01-01

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....

Computed tomography study of otitis media; A tomografia computadorizada no estudo das otites medias

Energy Technology Data Exchange (ETDEWEB)

Bahia, Paulo Roberto Valle; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

1997-03-01

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.

Pathogenic agents of chronic suppurative otitis media in Ilorin, Nigeria

African Journals Online (AJOL)

Conclusion: Chronic suppurative otitis media is still highly prevalent in our environment, affecting mainly children. The antibiotic susceptibility pattern of pathogenic isolates is different from those of other regions of Nigeria with increasing resistance recorded for some organisms. Hence, where possible and available, ...

Epidemiology of Intratemporal Complications of Otitis Media

Directory of Open Access Journals (Sweden)

Maranhão, André

2014-01-01

Full Text Available Introduction Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results A total of 1,816 patients were diagnosed with otitis media. For 592 (33% individuals, the diagnosis was chronic otitis media; for 1,224 (67%, the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis. Labyrinthine fistulae were diagnosed in 7 (36.8% individuals, mastoiditis in 5 (26.3%, facial palsy in 4 (21.1%, and labyrinthitis in 3 (15.8%. Conclusion The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.

Acute and chronic otitis media.

Science.gov (United States)

Morris, Peter S; Leach, Amanda J

2009-12-01

Otitis media (OM) is a common illness in young children. OM has historically been associated with frequent and severe complications. Nowadays it is usually a mild condition that often resolves without treatment. For most children, progression to tympanic membrane perforation and chronic suppurative OM is unusual (low-risk populations); this has led to reevaluation of many interventions that were used routinely in the past. Evidence from a large number of randomized controlled trials can help when discussing treatment options with families. Indigenous children in the United States, Canada, Northern Europe, Australia, and New Zealand experience more OM than other children. In some places, Indigenous children continue to suffer from the most severe forms of the disease. Communities with more than 4% of the children affected by chronic tympanic membrane perforation have a major public health problem (high-risk populations). Higher rates of invasive pneumococcal disease, pneumonia, and chronic suppurative lung disease (including bronchiectasis) are also seen. These children will often benefit from effective treatment of persistent (or recurrent) bacterial infection.

EXPERIENCE OF TREATMENT WITH FENSPIRIDE IN CHILDREN WITH CHRONIC EXUDATIVE OTITIS MEDIA AFTER TYMPANOSTOMY

Directory of Open Access Journals (Sweden)

L.A. Toropova

2009-01-01

Full Text Available The trial presents the analysis of factors predisposing to exudative otitis media development in 709 children, needing regular audiologist’s check-up. It was shown that dominating risk factor of auditory tube’s function disorders is hypertrophy of palatine tonsil (it was detected in 69% of children. Besides, doctors from children’s out-patient clinics often use conservative treatment in children with chronic exudative otitis media. Analysis of data obtained at the time of treatment of 180 hospitalized children under the age 1–17 years old with exudative otitis media showed that combination of tympanostomy with fenspiride (Erespal allows achieving of more significant decrease (1.3 times low audibility threshold of different oscillations than in children from control (treated without fenspiride.Key words: children, exudative otitis media, timpanostomy, fenspiride.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4:102-105

Panel 7: Otitis Media: Treatment and Complications.

Science.gov (United States)

Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

2017-04-01

Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.

Occurrence of otitis media in children and assessment of treatment options.

Science.gov (United States)

Nwokoye, N N; Egwari, L O; Olubi, O O

2015-08-01

Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

The Importance of Right Otitis Media in Childhood Language Disorders

Directory of Open Access Journals (Sweden)

Paulino Uclés

2012-01-01

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.

The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial

DEFF Research Database (Denmark)

Demant, Malene Nøhr; Jensen, Ramon Gordon; Jakobsen, Janus Christian

2017-01-01

BACKGROUND: The prevalence of otitis media in Greenlandic children is one of the highest in the world. International studies have shown that otitis-prone children may benefit from tubulation of the tympanic membrane. However, it is unknown whether these results can be applied to Greenlandic......) in Greenlandic children aged 9-36 months with chronic otitis media with effusion or recurrent acute otitis media. With randomization stratified by otitis media subtype and trial site, a type 1 error of 5% and a power of 80%, a total of 230 participants are needed to detect a decrease of two visits to a health...... clinic during 2 years, which is considered the minimal clinical relevant difference. The primary outcome measure will be assessed blindly by investigating medical records. Secondary outcome measures are number of episodes of acute otitis media, quality of life, number of episodes of antibiotics...

Clinical role of vitamin D in prognosis of otitis media with effusion.

Science.gov (United States)

Akcan, Fatih Alper; Dündar, Yusuf; Akcan, Hümeyra Bayram; Uluat, Ahmet; Cebeci, Derya; Sungur, Mehmet Ali; Ünlü, İlhan

2018-02-01

To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; otitis media with effusion and chronic otitis media with effusion. One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006). This study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion

[The observation and analysis the function and morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children].

Science.gov (United States)

Xia, Zhongfang; Wang, Zhinan; Xu, Zhongxiang; Cui, Long; Wei, Cuifen; Liu, Yan; Huang, Fang

2014-07-01

To observe and analyze the function and morphology of pharyngeal ostium of the eustachian tubes in secretory otitis media and chronic rhinosinusitis in children under direct vision,in order to provide an objective basis for clinical treatments. Fifty cases of secretory otitis media,50 cases of chronic rhinosinusitis and a control group of 50 cases with hoarseness were examined under video laryngoscope to observe the pharyngeal ostium morphological changes of the eustachian tubes, and their functional statuses were tested by using acoustic impedance instrument. All the data were analyzed by statistical methods. (1) In the secretory otitis group, the abnomal rate of the pharyngeal ostium of the eustachian tubes was 94% while the chronic rhinosinusitis group was 80%,and between them there was no significant differences (P > 0.05). But both of them had significant differences with the control group (P otitis group, the rate of the eustachian tube dysfunction was 70% while the chronic rhinosinusitis group was 26%, and between them there was significant differences (P otitis media and chronic rhinosinusitis in children. Eustachian tube dysfunction played a dominant role in the pathogenesis of secretory otitis media in children rather than the morphological change did compared to the chronic rhinosinusitis in children.

EXPERIENCE OF TREATMENT WITH FENSPIRIDE IN CHILDREN WITH CHRONIC EXUDATIVE OTITIS MEDIA AFTER TYMPANOSTOMY

OpenAIRE

L.A. Toropova; T.V. Zhuikova; N.I. Marysheva; A.I. Nikolaeva; Yu.S. Maiorova

2009-01-01

The trial presents the analysis of factors predisposing to exudative otitis media development in 709 children, needing regular audiologist’s check-up. It was shown that dominating risk factor of auditory tube’s function disorders is hypertrophy of palatine tonsil (it was detected in 69% of children). Besides, doctors from children’s out-patient clinics often use conservative treatment in children with chronic exudative otitis media. Analysis of data obtained at the time of treatment of 180 ho...

The Chronic Otitis Media Benefit Inventory (COMBI): Development and Validation of a Dynamic Quality of Life Questionnaire for Chronic Ear Disease.

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Phillips, John S; Haggard, Mark; Spencer, Helen; Yung, Matthew

2017-06-01

This study introduces a change-oriented short-form health-related quality of life questionnaire suited to symptoms of adult chronic middle ear disease and its consequences, and describes its properties. Two-centre prospective correlational study primarily for instrument development. Two otology secondary care centers in England. Fifty-two consecutive adult patients with active chronic otitis media undergoing surgery. The 12 items for the chronic otitis media benefit inventory (COMBI) were appraised chiefly for internal consistency of resulting score and for factor structure (exploratory factor analysis). The internal consistency of the COMBI was high within our cohort of patients, with a Cronbach's alpha value of 0.907. The three-factor solution from factor analysis explaining 73.6% of the variance was readily interpretable in terms of the intended item content: changes in hearing, ear symptoms, and daily activities plus healthcare uptake. The COMBI has suitable properties for the dynamic assessment of active chronic otitis media. Initial psychometric appraisal confirms its suitability for early adoption to acquire more comprehensive large-sample information with it and on it, for future refinement and application.

Bacteriology and Antimicrobial Susceptibility of Otitis Media at ...

African Journals Online (AJOL)

Bernt Lindtjorn

2Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia, ... chronic otitis media like meningitis and brain abscess (8). ... because of difference in geography, local antimicrobial .... Table 1: Age and sex distribution of bacterial isolates of otitis media at Dessie Regional Health Research Laboratory ...

The Role of Adenoid Mast Cells in the Pathogenesis of Secretory Otitis Media

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M. Faruk Oktay

2007-01-01

Full Text Available To investigate the possible role of adenoid mast cells in the etiology of secretory otitis media. Between 2001-2002, 25 patients with chronic adenoitis and chronic secretory otitis media and 25 patients with isolated adenoid hypertrophy were included to the study. Adenoidectomy performed to the all patients under general anesthesia. Adenoidectomy specimens were evaluated under the light microscopy and the number of mast cells were calculated for each patient. The number of mast cells were compared between two groups. The number of mast cells were between 4-84 in the otitis media with effusion and adenoid hypertrophy group (median:52, however it was between 2-63 (median: 23 in the isolated adenoid hypertrophy group. When comparing the two groups using Mann-Withney U test, the number of mast cells found to be significantly higher in the chronic secretory otitis media group (p<0.001.Based on our findings there is a relationship between increased adenoid mast cells and otitis media with effusion and these cells may have a possible role in the etiology of chronic secretory otitis media.

Chronic suppurative otitis media in a birth cohort of children in Greenland

DEFF Research Database (Denmark)

Koch, Anders; Homøe, Preben; Pipper, Christian Bressen

2011-01-01

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...

Eosinophilic Mucin Otomastoiditis and Otopolyposis: A Progressive Form of Eosinophilic Otitis Media.

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Azadarmaki, Roya; Westra, William; Prasad, Sanjay

2015-09-01

The purpose of this study is to introduce and define a disease entity on a continuum of eosinophilic otitis media: eosinophilic mucin otomastoiditis and otopolyposis. A case of a 66-year-old woman with complicated chronic otitis media is reported. A literature review of the National Library of Medicine's online database, with a focus on eosinophilic otitis media and eosinophilic mucin rhinosinusitis, was performed. The authors report the case of a 66-year-old woman with a history of asthma, chronic rhinosinusitis, nasal polyposis, and chronic otitis media who presented with allergic middle ear mucin and otic polyps. Treatment involved a tympanomastoidectomy with removal of otic polyps and steroid therapy. Eosinophilic mucin otomastoiditis with otopolyposis is a disease entity on a continuum of eosinophilic otitis media. This disease process shares similarities with eosinophilic mucin rhinosinusitis. Otic polypectomy and steroids are suggested therapeutic measures. © The Author(s) 2015.

[Validation of the Otitis Media-6 Questionnaire for European Portuguese].

Science.gov (United States)

Lameiras, Ana Rita; Silva, Deodato; O'Neill, Assunção; Escada, Pedro

2017-05-31

Otitis media is one of the most prevalent childhood diseases. The impact of otitis media on quality of life of Portuguese children is unknown, because of the unavailability of a tool validated in European Portuguese to assess this consequence of otitis media. The Otitis Media-6 questionnaire (Otitis Media-6) is the most frequently used tool to assess health-related quality of life in children with otitis media. This study aims to create a version in the Portuguese language and culturally adapted to Portugal of the otitis media-6 questionnaire. The Otitis Media-6 questionnaire was translated and culturally adapted to the Portuguese language and population. Then, to assess the instrument psychometric properties, it was applied to a sample of Portuguese children with chronic otitis media with effusion or recurrent acute otitis media. The Portuguese version of Otitis Media-6 questionnaire demonstrated the following psychometric properties: construct validity for baseline (rs = 0.98) and change scores (rs = 0.97), internal consistency (α = 0.780), test-retest reliability (rs = 0.89) and responsiveness to clinical change (t(59) = 10.104). The simplicity and brevity of application of the instrument make it ideal for use in research and in clinical practice, enabling a more objective assessment of the extension of the otitis media impact in children quality of life and a more targeted therapeutic decision. The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

Gradenigo's Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis.

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Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

2017-09-28

BACKGROUND Gradenigo's syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo's syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo's syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). CASE REPORT A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). The case was complicated by the development of palsy of the fourth (trochlear) cranial nerve, fifth (trigeminal) cranial nerve, and sixth (abducens) cranial nerve, with radiological changes indicating infection involving the seventh (facial) cranial nerve, and eighth (vestibulocochlear) cranial nerve. Cerebrospinal fluid (CSF) culture results were positive for Klebsiella pneumoniae, sensitive to ceftriaxone. The patient improved with surgery that included a left mastoidectomy and debridement of the petrous apex, followed by a ten-week course of antibiotics. Follow-up MRI showed resolution of the infection. CONCLUSIONS This report is of an atypical case of Gradenigo's syndrome. It is important to recognize that the classical triad of Gradenigo's syndrome, suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve, may also involve chronic suppurative otitis media (CSOM), which may lead to involvement of other cranial nerves, petrous apicitis (apical petrositis), and bacterial meningitis.

Retrospective results of radiation therapy of the Eustachian tube in chronic otitis media

International Nuclear Information System (INIS)

Schultze, J.; Reinke, C.; Kimmig, B.; Frese, K.A.

2003-01-01

Background: The treatment results of symptomatic radiation therapy of the Eustachian tube in chronic otitis media had to be evaluated retrospectively. Patients and Methods: Between 1980 and 1997, 66 patients were referred for therapy. The median age was 58 years. In the clinical presentation, all the patients had a hearing impairment, 35 patients complained of pain, 21 had otorrhea. In their history, 20 patients indicated chronic recurrent infections. The complaints lasted for 4.7 years in the median, primary conservative (adstringentia, antibiotics) and surgical treatment (paracentesis, tympanic tubule, tympanoplastic) did not lead to lasting cure. In 40 of 66 patients, finally radiation therapy was done of both Eustachian tubes. With opposed fields and cobalt-60 photons a total dose of 6 Gy at single doses of 1 Gy, three times a week, was applied. Under the causes for exclusion of radiation therapy were non-acceptance of the patients (nine), prior radiation therapies (six) or spontaneous improvement after initial presentation in our department. The treatment results were evaluated by interviews of the patients and regular otorhinolaryngological examinations. Results: There were no side effects noticed. 28 of 40 (70%) patients reported a significant improvement that could be verified by objective otorhinolaryngological examinations. In the group of 26 nonirradiated patients, 22 could be interviewed indicating in 16 cases (72%) that the complaints were unchanged and chronic otitis media was lasting. In a subgroup analysis concerning the duration of otitis media radiation therapy proved more effective in an acute and subacute stadium of disease of up to 5 years duration, while the patients resistant to radiation therapy were entirely in a chronic stage of disease exceeding 5 years duration. (orig.) [de

Long-term Tympanic Membrane Pathology Dynamics and Spontaneous Healing in Chronic Suppurative Otitis Media

DEFF Research Database (Denmark)

Jensen, Ramon Gordon; Koch, Anders; Homøe, Preben

2012-01-01

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......-based cohort of 591 children originally examined during 1993 to 1994 at 3 to 8 years of age. Follow-up was attempted among 348 individuals still living in the areas. Video otoscopy and tympanometry were used. Data on otologic disease, ear surgery, and antibiotic use for otitis media were collected from medical...... of spontaneous healing was not influenced by the age at which CSOM was diagnosed in the initial study. Thirty-nine individuals (17%) had CSOM in either the initial study or at follow-up. Of these, 2 had never received antibiotic treatment for otitis media, and 15 had been treated less than 3 times. Eighty...

Endoscopy-Assisted Ear Surgery for Treatment of Chronic Otitis Media With Cholesteatoma, Adhesion, or Retraction Pockets.

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Ulku, Cagatay Han

2017-06-01

The objective of this study was to analyze the results of endoscopy-assisted ear surgery for the treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets.Fifty-one patients who underwent oto-endoscopy-assisted canal wall up tympanomastoid surgery and/or limited anterior atticotomy with tympanoplasty for chronic otitis media with cholesteatoma, adhesion, or retraction pocket from 2006 to 2013 have been included in this study. Eradication of the disease from the middle ear and mastoid air cells was achieved by combination of the oto-microscobic and oto-endoscopic approaches. Second look surgery was performed 18 months later from the initial surgery in selected patients. Age, gender, pre-/postoperative otoscopy findings/audiograms, type of the used prostheses, and follow-up time were obtained from the patient's file. Anatomic integrity rates of the tympanic membrane, the mean gains of air bone gap, on pure-tone audiogram at 4 frequencies and existence of the residual disease were reviewed parameters. Functional evaluation was made in patients with intact tympanic membrane.Of the 51 patients, the ratios of the chronic otitis media with cholesteatoma and isolated adhesive otitis or retraction pocket cases were 74.5% (38/51) and 25.5% (13/51), respectively. Ossicular chain reconstruction was made with PORP in 27 patients and TORP in 20 patients, whereas the ossicular chain was intact in 4 patients. Anatomic integrity rates of the tympanic membrane were 90.2% (46/51). The overall (n = 46) pre-/postoperative mean ABG obtained at 4 frequencies were 28.3 ± 12.26 and 9.18 ± 5.68 dB (P otitis media with cholesteatoma patients. However, there was no recurrence or new cholesteatoma formation in isolated retraction pockets or adhesive otitis patients.Oto-endoscopic eradication of the cholesteatoma or epithelial tissue from hidden area after the all visible cholesteatoma removal by oto-microscope improves the quality of surgery

Otitis media with effusion

Science.gov (United States)

OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... from the tube and is swallowed. OME and ear infections are connected in two ways: After most ear ...

Update on Otitis Media in Children.

Science.gov (United States)

Schoem, Scott R.

1997-01-01

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,…

KRITERIA DIAGNOSIS DAN PENATALAKSANAAN OTITIS MEDIA SUPURATIF KRONIS

Directory of Open Access Journals (Sweden)

Fairuziah Bader Alkatiri

2016-03-01

Full Text Available ABSTRACT Introduction: Otitis media is an inflammation of part or all of the mucosa of the middle ear, Eustachian tube, mastoid antrum, and mastoid cells. Patients with middle ear disease often comes as a chronic stage that causes hearing loss and expense secretions. Patients complain of hearing loss that disrupt the function of the social, educational and professional. School-age children may show poor results at school. One type of otitis media is chronic suppurative otitis media (CSOM, which is a chronic infection of the middle ear with tympanic membrane perforation and discharge of secretions from the middle ear continuous or intermittent, usually accompanied by hearing loss. Secretions may be thin or thick, clear or in the form of pus. CSOM formerly called otitis media with perforated. Diagnosis is made by history, physical examination. Two types of classification that is often used is CSOM types of benign and malignant types, and based on the activity of secretions out. Management of sudden deafness include conservative with some medical therapy depends on the type of CSOM and accompanying complications. Case: Male patient, 47 years old, came with complaints of discharge from the left ear since 1 month ago. Discharge yellowish-white, slightly viscous, odorless, out a little, and not itchy. Patients with a history of diabetes. Patients admitted before the water could get into the ear while swimming in the sea. At the present status and status generalist within normal limits. On the left ear found mucopurulent secretions. On the left tympanic membrane perforation in the visible region of the central part postero superior. Keywords:otitis, chronic, ear.

Mental health and quality of life in patients with chronic otitis media.

Science.gov (United States)

Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk

2013-02-01

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 sensitivity (p anxiety (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.

Otitis media in Brazilian human immunodeficiency virus infected children undergoing antiretroviral therapy.

Science.gov (United States)

Miziara, I D; Weber, R; Araújo Filho, B Cunha; Pinheiro Neto, C Diógenes

2007-11-01

To assess changes in the prevalence of otitis media, associated with the use of highly active antiretroviral therapy, in Brazilian human immunodeficiency virus (HIV) infected children. Division of otorhinolaryngology, Hospital das Clínicas, Sao Paulo University Medical School, Brazil. A cohort of 459 HIV-infected children aged below 13 years. The prevalence of otitis media and the serum cluster of differentiation four glycoprotein T lymphocyte count were compared for children receiving highly active antiretroviral therapy (with protease inhibitors) and those receiving standard antiretroviral therapy (without protease inhibitors). Otitis media was present in 33.1 per cent of the children. Children aged from zero years to five years 11 months receiving highly active antiretroviral therapy had a higher prevalence of acute otitis media (p=0.02) and a lower prevalence of chronic otitis media (p=0.02). Children who were receiving highly active antiretroviral therapy had a mean serum cluster of differentiation four glycoprotein T lymphocyte count greater than that of those who were receiving standard antiretroviral therapy (pBrazilian HIV-infected children was associated with a lower prevalence of chronic otitis media.

Is there a relationship between myeloperoxidase activity and conductive hearing loss in chronic otitis media complicated by cholesteatoma?

Science.gov (United States)

Celebi Erdivanli, Ozlem; Sanli, Arif

2015-01-01

We conducted a prospective, controlled study of patients with chronic otitis media and cholesteatoma (1) to examine the expression of myeloperoxidase (MPO) using immunohistochemical staining techniques and (2) to investigate the relationship between MPO activity and the degree of conductive hearing loss in these patients. Our study population included 51 adults-26 men and 25 women, aged 18 to 58 years (mean: 37.5)-who had been diagnosed with chronic otitis media and cholesteatoma by physical examination and computed tomography (study group). Another 30 patients-13 men and 17 women, aged 18 to 52 years (mean: 32.7)-who had chronic otitis media without cholesteatoma served as the control group. Following audiometric evaluations, all patients underwent appropriate surgery. Postoperatively, cholesteatoma samples were analyzed by immunostaining for MPO positivity as a marker for acute inflammation. We found that MPO activity was present in all 51 study patients (100%) but in only 10 controls (33.3%); the difference was statistically significant (pconductive hearing loss (χ(2) = 13.518; p < 0.001). We encourage further study of all steps in the process of cholesteatoma formation.

Laser treatment of otitis media in children

Energy Technology Data Exchange (ETDEWEB)

Podoynitsyna, L.F.

1984-08-01

Clinical trials were conducted with the helium-neon LG-75 laser (632.8 nm, 0.1 W/cm/sup 2/) in the management of 50 children with acute and chronic otitis media. The sessions consisted of 30 sec irradiation directed at the middle ear through the external meatus for a period of 5 days. Positive results were obtained in 45 of the patients with cessation of discharge on the 2nd or 3rd day, and return of hearing by the end of the week. The remission was not permanent in one patient with recurrent otitis media. These observations indicate that the anti-inflammatory effects of helium-neon irradiation constitute an effective treatment modality in children with otitis media. 6 references.

Retrospective results of radiation therapy of the Eustachian tube in chronic otitis media; Retrospektive Ergebnisse der perkutanen Strahlentherapie der Tuba Eustachii bei chronischer Otitis media

Energy Technology Data Exchange (ETDEWEB)

Schultze, J.; Reinke, C.; Kimmig, B. [Klinik fuer Strahlentherapie (Radioonkologie), Universitaetsklinikum Kiel (Germany); Frese, K.A. [Klinik fuer Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitaetsklinikum Kiel (Germany)

2003-01-01

Background: The treatment results of symptomatic radiation therapy of the Eustachian tube in chronic otitis media had to be evaluated retrospectively. Patients and Methods: Between 1980 and 1997, 66 patients were referred for therapy. The median age was 58 years. In the clinical presentation, all the patients had a hearing impairment, 35 patients complained of pain, 21 had otorrhea. In their history, 20 patients indicated chronic recurrent infections. The complaints lasted for 4.7 years in the median, primary conservative (adstringentia, antibiotics) and surgical treatment (paracentesis, tympanic tubule, tympanoplastic) did not lead to lasting cure. In 40 of 66 patients, finally radiation therapy was done of both Eustachian tubes. With opposed fields and cobalt-60 photons a total dose of 6 Gy at single doses of 1 Gy, three times a week, was applied. Under the causes for exclusion of radiation therapy were non-acceptance of the patients (nine), prior radiation therapies (six) or spontaneous improvement after initial presentation in our department. The treatment results were evaluated by interviews of the patients and regular otorhinolaryngological examinations. Results: There were no side effects noticed. 28 of 40 (70%) patients reported a significant improvement that could be verified by objective otorhinolaryngological examinations. In the group of 26 nonirradiated patients, 22 could be interviewed indicating in 16 cases (72%) that the complaints were unchanged and chronic otitis media was lasting. In a subgroup analysis concerning the duration of otitis media radiation therapy proved more effective in an acute and subacute stadium of disease of up to 5 years duration, while the patients resistant to radiation therapy were entirely in a chronic stage of disease exceeding 5 years duration. (orig.) [German] Hintergrund: Die Behandlungsergebnisse der symptomatischen Radiotherapie bei chronischer Otitis media sollten retrospektiv evaluiert werden. Patienten und

Determinants of Change in Air-Bone Gap and Bone Conduction in Patients Operated on for Chronic Otitis Media.

Science.gov (United States)

Wiatr, Maciej; Wiatr, Agnieszka; Składzień, Jacek; Stręk, Paweł

2015-08-11

Middle ear surgery aims to eliminate pathology from the middle ear, improve drainage and ventilation of the postoperative cavity, and reconstruct the tympanic membrane and ossicles. The aim of this work is to define the factors that affect ABG (air-bone gap) and bone conduction in the patients operated on due to chronic otitis media. A prospective analysis of patients operated on due to diseases of the middle ear during 2009-2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were analyzed. The analysis encompassed patients who had undergone middle ear surgery. The patients were divided into several groups taking into account the abnormalities of the middle ear mucous and damage of the ossicular chain observed during otosurgery. A significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a PORP was used in the reconstruction. Granulation tissue was an unfavorable factor of hearing improvement following tympanoplasty. A significant improvement of bone conduction was observed in the patients with dry perforation without other lesions in the middle ear. The elimination of granulation lesions was a positive factor for the future improvement of the function of the inner ear. The presence of granuloma-related lesions in the middle ear spaces is likely to impede hearing improvement. Damage to the ossicular chain rules out the possibility of bone conduction improvement after surgery. The prognosis on tube-related simple chronic otitis media after myringoplasty, with the preserved continuity of the ossicular chain, consists of closing the ABG and leads to significant improvement of bone conduction.

Otitis media in Indigenous Australian children: review of epidemiology and risk factors.

Science.gov (United States)

Jervis-Bardy, Jake; Sanchez, L; Carney, A S

2014-01-01

Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography.

Science.gov (United States)

Aksoy, S; Sayin, I; Yazici, Z M; Kayhan, F T; Karahasanoglu, A; Hocaoglu, E; Inci, E

2016-01-01

Chronic otitis media (COM), affecting all over the world and in a wide range of age groups in Turkey, is an important cause of ear discharge and hearing loss. The main clinical manifestations are tympanic membrane perforation, ear, nose and throat problems. On the tympanic membrane perforation becomes persistent and cholesteatoma development, there are a lot of opinions today. Especially in the pathology associated with otitis media with effusion eustachian tube, it is known that COM and cholesteatoma develop. In our study, we interpreted 210 patients' temporal computed tomography (CT). Seventy of these 210 patients had otitis media with cholesteatoma, 70 patients had only otitis media without cholesteatoma, and 70 patients had no otitis media. The eustachian tubes were evaluated using temporal CT multiplanar reconstruction method. Angles with the horizontal plane of the eustachian tube and Reid and tubotympanic angles were measured. The angles between eustachian tube and horizontally oriented Reid plane of the patients with cholesteatoma were found to be significantly lower than the patients with otitis media without cholesteatoma and the patients with no history of otitis media. For the tubotympanic angle, no statistically significant differences were observed between the groups. These results suggest that the decrease in the angle with the horizontal plane of Reid in the eustachian tube in adults may play a significant role in the etiology of cholesteatoma.

Three cases of tuberculous otitis media

International Nuclear Information System (INIS)

Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon

1998-01-01

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

Three cases of tuberculous otitis media

Energy Technology Data Exchange (ETDEWEB)

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)

1998-07-01

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.

The transcriptome of a complete episode of acute otitis media.

Science.gov (United States)

Hernandez, Michelle; Leichtle, Anke; Pak, Kwang; Webster, Nicholas J; Wasserman, Stephen I; Ryan, Allen F

2015-04-03

Otitis media is the most common disease of childhood, and represents an important health challenge to the 10-15% of children who experience chronic/recurrent middle ear infections. The middle ear undergoes extensive modifications during otitis media, potentially involving changes in the expression of many genes. Expression profiling offers an opportunity to discover novel genes and pathways involved in this common childhood disease. The middle ears of 320 WBxB6 F1 hybrid mice were inoculated with non-typeable Haemophilus influenzae (NTHi) or PBS (sham control). Two independent samples were generated for each time point and condition, from initiation of infection to resolution. RNA was profiled on Affymetrix mouse 430 2.0 whole-genome microarrays. Approximately 8% of the sampled transcripts defined the signature of acute NTHi-induced otitis media across time. Hierarchical clustering of signal intensities revealed several temporal gene clusters. Network and pathway enrichment analysis of these clusters identified sets of genes involved in activation of the innate immune response, negative regulation of immune response, changes in epithelial and stromal cell markers, and the recruitment/function of neutrophils and macrophages. We also identified key transcriptional regulators related to events in otitis media, which likely determine the expression of these gene clusters. A list of otitis media susceptibility genes, derived from genome-wide association and candidate gene studies, was significantly enriched during the early induction phase and the middle re-modeling phase of otitis but not in the resolution phase. Our results further indicate that positive versus negative regulation of inflammatory processes occur with highly similar kinetics during otitis media, underscoring the importance of anti-inflammatory responses in controlling pathogenesis. The results characterize the global gene response during otitis media and identify key signaling and transcription factor

Chronic suppurative otitis media, middle ear pathology and corresponding hearing loss in a cohort of Greenlandic children

DEFF Research Database (Denmark)

Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter

2016-01-01

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......-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. RESULTS: Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane...

Gradenigo’s Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis

Science.gov (United States)

Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

2017-01-01

Patient: Male, 58 Final Diagnosis: Bacterial meningitis Symptoms: Altered mental status • headache • neck stiffness • vomiting Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Gradenigo’s syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo’s syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo’s syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). Case Report: A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). The case was complicated by the development of palsy of the fourth (trochlear) cranial nerve, fifth (trigeminal) cranial nerve, and sixth (abducens) cranial nerve, with radiological changes indicating infection involving the seventh (facial) cranial nerve, and eighth (vestibulocochlear) cranial nerve. Cerebrospinal fluid (CSF) culture results were positive for Klebsiella pneumoniae, sensitive to ceftriaxone. The patient improved with surgery that included a left mastoidectomy and debridement of the petrous apex, followed by a ten-week course of antibiotics. Follow-up MRI showed resolution of the infection. Conclusions: This report is of an atypical case of Gradenigo’s syndrome. It is important to recognize that the classical triad of Gradenigo’s syndrome, suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve, may also involve chronic suppurative otitis media (CSOM), which may lead to involvement of other cranial nerves, petrous apicitis

Danish guidelines on management of otitis media in preschool children

DEFF Research Database (Denmark)

Heidemann, C. H.; Lous, J.; Berg, J.

2016-01-01

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 treatment...... for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update...... the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. Methods: The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation...

Pediatric otitis media in Fiji: Survey findings 2015.

Science.gov (United States)

Fang, Te-Yung; Rafai, Eric; Wang, Pa-Chun; Bai, Chiy-Huey; Jiang, Peng-Long; Huang, Shu-Nuan; Chen, You-Ju; Chao, Yi-Ting; Wang, Chen-Hsu; Chang, Chia-Hsiu

2016-06-01

Otitis media (OM), as a common infectious disease, is a major cause of hearing impairment among the general population. OM remains a major public health threat in the Pacific islands, but the risks of OM have not been thoroughly explored in this region. The objective of this study is to investigate the prevalence, clinical features, and quality-of-life impacts of OM in Fiji. In the medical service trip entitled "Healing and Hope - Taiwan Cathay Heart and Hearing Medical Mission to Fiji" (TCHHMMF), we conducted a cross-sectional OM survey study in Suva and Sigatoka areas (Korolevu, Cuvu, and Lomawai) in the summer of 2015. The otitis media - 6 (OM-6) was used to survey the OM-related quality of life. In the 467 pediatric patients (aged 0-18 years old) screened, 13 (2.78%) have acute otitis media (AOM), 37 (7.92%) have otitis media with effusion (OME), and 19 (4.1%) have chronic otitis media (COM). Age (OR 0.53, 95% CI: 0.36-0.77) is a significant predictor of AOM, whereas male gender (OR 2.46, 95% CI: 1.13-5.37), smoke exposure (OR 2.81, 95% CI: 1.01-7.82), and concomitant chronic sinusitis (OR 6.05, 95% CI: 2.31-15.88) are significant predictors of OME. The mean OM-6 item scores are highest in caregiver concerns (3.8), physical suffering (3.7), and hearing loss (3.4) domains. OM is an important primary care disease in Fiji that remains under-served. It is critical to educate professionals, parents, and patients to detect and to improve care for OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[The evaluation of the quality of life in the patients presenting with various forms of chronic otitis media].

Science.gov (United States)

Kosyakov, S Ya; Minavnina, Yu V; Gunenkov, A V

Chronic otitis media (COM) is a widespread pathological condition that affects up to 2% of the general population. Certain forms of this disease markedly deteriorate the quality of life of the patients which makes them overestimate the severity of harm to their health status and can be a cause of inflated expectations as regards the results of the planned surgical treatment. The linking element between the patient's expectations and the outcomes of the surgical intervention may be the recently developed questionnaires for the evaluation of the health-related quality of life (HRQoL). One of them, the COMQ-12 questionnaire, was devised to estimate the subjective reports by the patients concerning the deterioration of their quality of life attributable to chronic otitis media. The objective of the present study was to characterize the value of the 5-point Russian-language version of COMQ-12 for the evaluation of each of its 12 items concerning various aspects of health based on the personal opinions of the patients suffering from chronic otitis media The study included 108 patients 49 of whom were men and 59 women (45% and 55% respectively) at the age varying from 16 to 84 years. The COMQ-12 scores, according to the reports of individual patients, ranged from 4 to 43 of the 60 ones possible. The average score was 19.4 (SD=8.3). The overall median COMQ-12 score was 20, and the mode scored 14. The Cronbach-alpha index was equal to 0.860. The Russian-language version of the COMQ-12 questionnaire provides a reliable tool for the estimation of the quality of life in the patients presenting with various forms of chronic otitis media.

Trimethoprim-sulfamethoxazole in children with chronic otitis media: a randomized comparison of costs and effects.

NARCIS (Netherlands)

Boonacker, C.W.; Veen, E.L. van der; Wilt, G.J. van der; Schilder, A.G.M.; Rovers, M.M.

2008-01-01

OBJECTIVE: To study the cost-effectiveness of a 6- to 12-week course of high-dose oral trimethoprim-sulfamethoxazole in children with chronic active otitis media (COM). STUDY DESIGN: Cost-effectiveness study including both direct and indirect costs alongside a randomized placebo-controlled trial.

High resolution computed tomography of chronic otitis media

International Nuclear Information System (INIS)

Shirahata, Yuichi; Tachibana, Toshiro; Fukami, Masaya; Onishi, Toshiro; Doi, Osamu

1986-01-01

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)

Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort

DEFF Research Database (Denmark)

Jensen, Ramon Gordon; Homøe, Preben; Andersson, Mikael

2011-01-01

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...

Cost-effectiveness analysis of endoscopic tympanoplasty versus microscopic tympanoplasty for chronic otitis media in Taiwan.

Science.gov (United States)

Tseng, Chih-Chieh; Lai, Ming-Tang; Wu, Chia-Che; Yuan, Sheng-Po; Ding, Yi-Fang

2018-03-01

Health care systems and physicians need to conform to budgets and streamline resources to provide cost-effective quality care. Although endoscopic tympanoplasty (ET) has been performed for decades, no studies on the cost-effectiveness of ET and microscopic tympanoplasty (MT) for treating chronic otitis media have been published. The present study aimed to compare the cost-effectiveness of ET and MT for treating chronic otitis media. This study was performed using a Cohort-style Markov decision-tree economic model with a 30-year time horizon. The economic perspective was that of a third-party payer (Taiwan National Health Insurance System). Two treatment strategies were compared, namely ET and MT. The primary outcome was the incremental cost per quality-adjusted life year (QALY). Probabilities were obtained from meta-analyses. Costs were obtained from the published literature and Taiwan National Health Insurance System database. Multiple sensitivity analyses were performed to account for data uncertainty. The reference case revealed that the total cost of ET was $NT 20,901 for 17.08 QALY per patient. By contrast, the total cost of MT was $NT 21,171 for 17.15 QALY per patient. The incremental cost effectiveness ratio for ET versus that of MT was $NT 3703 per QALY. The cost-effectiveness acceptability curve indicated that ET was comparable to MT at a willingness-to-pay threshold of larger than $NT 35,000 per QALY. This cost-effectiveness analysis indicates that ET is comparable to MT for treating chronic otitis media in Taiwan. This result provides the latest information for physicians, the government, and third-party payers to select proper clinical practice. Copyright © 2017. Published by Elsevier Taiwan LLC.

Otitis Media and the Social Behavior of Day-Care-Attending Children.

Science.gov (United States)

Vernon-Feagans, Lynne; And Others

1996-01-01

Examined the relationship between early otitis media in children attending day care and children's subsequent behavior in the day care classroom when they were well. Found that day care children with chronic otitis media in the first three years of life play alone more often and have fewer verbal interactions with peers than nonchronic children.…

Mucosal biofilm detection in chronic otitis media

DEFF Research Database (Denmark)

Wessman, Marcus; Bjarnsholt, Thomas; Eickhardt-Sørensen, Steffen Robert

2015-01-01

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...... of the patients served as controls. PNA-FISH showed morphological signs of biofilms in 15 out of 35 (43 %) middle ear biopsies. In the control skin biopsies, there were signs of biofilms in eight out of 23 biopsies (30 %), probably representing skin flora. PCR and 16s sequencing detected bacteria in seven out...... of 20 (35 %) usable middle ear biopsies, and in two out of ten (20 %) usable control samples. There was no association between biofilm findings and PCR and 16s sequencing. Staphylococci were the most common bacteria in bacterial culture. We found evidence of bacterial biofilms in 43 % of middle ear...

Cochlear pathology in chronic suppurative otitis media.

Science.gov (United States)

Walby, A P; Barrera, A; Schuknecht, H F

1983-01-01

Chronic suppurative otitis media (COM) is reported to cause elevation of bone-conduction thresholds either by damage to cochlear sensorineural structures or by alteration in the mechanics of sound transmission in the ear. A retrospective study was made of the medical records of 87 patients with unilateral uncomplicated COM to document that abnormality in bone conduction does exist. In a separate study the cochlear pathology in 12 pairs of temporal bones with unilateral COM was studied by light microscopy. Infected ears showed higher than normal mean bone-conduction thresholds by amounts ranging from 1 dB at 500 Hz to 9.5 dB at 4,000 Hz. The temporal bones showed no greater loss of specialized sensorineural structures in infected ears than in normal control ears. Because there is no evidence that COM caused destruction of hair cells or cochlear neurons, alteration in the mechanics of sound transmission becomes a more plausible explanation for the hearing losses.

Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

International Nuclear Information System (INIS)

Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan

2012-01-01

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.

Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

Energy Technology Data Exchange (ETDEWEB)

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)

2012-06-15

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.

Acute otitis externa

OpenAIRE

Hui, Charles PS

2013-01-01

Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

[Computed tomography of the temporal bone in diagnosis of chronic exudative otitis media].

Science.gov (United States)

Zelikovich, E I

2005-01-01

Computed tomography (CT) of the temporal bone was made in 37 patients aged 2 to 55 years with chronic exudative otitis media (CEOM). In 21 of them the pathology was bilateral. The analysis of 58 CT images has identified CT signs of chronic exudative otitis media. They include partial (17 temporary bones) or complete (38 temporal bones) block of the bone opening of the auditory tube, pneumatic defects of the tympanic cavity (58 temporal bones), pneumatic defects of the mastoid process and antrum (47 temporal bones), pathologic retraction of the tympanic membrane. The examination of the temporal bone detected both CT-signs of CEOM and other causes of hearing disorders in 14 patients (26 temporal bones) with CEOM symptoms and inadequately high hypoacusis. Among these causes were malformation of the auditory ossicula (n=5), malformation of the labynthine window (n=2), malformation of the middle and internal ear (n=4), a wide aqueduct of the vestibule, labyrinthine anomaly of Mondini's type (n=1), cochlear hypoplasia (n=4), stenosis of the internal acoustic meatuses (n=2). Sclerotic fibrous dysplasia was suggested in 2 temporal bones (by CT data). CT was repeated after surgical treatment of 10 patients (14 temporal bones) and visual assessment of tympanostomy results was made.

Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.

Science.gov (United States)

Steele, Dale W; Adam, Gaelen P; Di, Mengyang; Halladay, Christopher H; Balk, Ethan M; Trikalinos, Thomas A

2017-06-01

Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. Abstracts and full-text articles were independently screened by 2 investigators. A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% credible interval: -14.0 to -3.4) at 1 to 3 months and 0.0 (95% credible interval: -4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. Sparse evidence is available, applicable only to otherwise healthy children. Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events. Copyright © 2017 by the American Academy of Pediatrics.

Acute otitis media in children

OpenAIRE

Cherpillod, Jacques

2011-01-01

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

Acute Otitis Media in Children.

Science.gov (United States)

Leung, Alexander K C; Wong, Alex H C

2017-01-01

Acute otitis media is a common childhood infection. Prompt diagnosis and appropriate treatment are very important. To review in depth the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications and particularly treatment of acute otitis media in children. A PubMed search was completed in Clinical Queries using the key term "acute otitis media". Patents were searched using the key term "acute otitis media" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Acute otitis media affects over 80% of children before their third birthday and 30 to 45% of these children have suffered two or more episodes. Streptococcus pneumoniae, nontypable Haemophilus influenzae, and Moraxella catarrhalis are the most frequently isolated middle-ear pathogens. The diagnosis is based on acute onset of symptoms such as otalgia and fever, middle ear inflammation such as erythema of the tympanic membrane, and middle ear effusion. The choice of treatment method depends on the age of the child, laterality, and the severity of the disease. Recent patents related to the management of acute otitis media are also retrieved and discussed. Antimicrobial treatment is recommended for all children less than two years of age, as well as in children ≥ two years of age who have a temperature ≥ 39oC; are toxic looking; have otalgia > 48 hours; have bilateral otitis media or otorrhea; have craniofacial abnormalities; are immunocompromised; or have uncertain access to follow-up. Amoxicillin is the drug of choice. Observation without antibiotic is an option in immunocompetent children ≥ two years of age who have an acute uncomplicated otitis media and non-severe illness if appropriate follow-up can be arranged. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Otoscopic diagnosis of otitis media.

Science.gov (United States)

Isaacson, Glenn

2016-12-01

Accurate diagnosis of otitis media is important to prevent suffering and complications when infection is present, and unnecessary antibiotic use when infection is absent. The usual signs and symptoms of acute otitis media are unreliable guides in infants and young children. Similarly, middle ear effusions may present with little discomfort in older children. We therefore depend on examination of the tympanic membrane with an otoscope to make most diagnoses. This article aims to improve the accuracy of middle ear diagnosis by pneumatic otoscopy. It includes descriptions and photographs of the normal ear drum and illustrates the pathologic changes seen in acute otitis media, long-standing eustachian tube dysfunction and otitis media with effusion.

Otitis media in indonesian urban and rural school children.

Science.gov (United States)

Anggraeni, Ratna; Hartanto, Widya W; Djelantik, Bulantrisna; Ghanie, Abla; Utama, Denny S; Setiawan, Eka P; Lukman, Erica; Hardiningsih, Chintriany; Asmuni, Suprihati; Budiarti, Rery; Rahardjo, Sutji Pratiwi; Djamin, Riskiana; Mulyani, Tri; Mutyara, Kuswandewi; Carosone-Link, Phyllis; Kartasasmita, Cissy B; Simões, Eric A F

2014-10-01

Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied. To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated. Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups. In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

Childhood suppurative otitis media in Abakaliki: Isolated microbes ...

African Journals Online (AJOL)

2011-03-05

Mar 5, 2011 ... Background: Suppurative otitis media (SOM) is the most common pediatric problem ... Objective: Determine the bacteriology of SOM in children in Abakaliki and .... to chronicity caused by its attendant social and neurological.

[Detection of split products of the immunoglobulins IgG, IgA and IgM during chronic otitis media (author's transl)].

Science.gov (United States)

Kastenbauer, E R; Hochgesand, K; Hochstrasser, K; Tappermann, G

1975-07-01

Proteolytic enzymes such as pepsine or papaine are able to split IgG antibodies into large fragments in vitro. These immunoglobulin fragments (IgG, IgA, IgM) were now detected in vivo from the purulent secretions of cholesteatoma, chronic otitis media and radical mastoid cavities. During chronic otitis media the intact immunoglobulins are split due to the proteolytic activity of neutral proteinases. These fragments were qualitatively and quantitatively investigated by means of various immunological procedures. After the immunoelectrophoretic separation of the purulent middle-ear-secretions and after diffusion against anti-IgG-, anti-IgA- and anti-IgM- serum double precipitate lines could be observed especially in middle-ear-secretion with a bacterial flora of pseudomonas aeruginosa (pyocyanea) and of the proteus-providencia-group. This was the first proof of the presence of split products of the immunoglobulins. The exact demonstration of these split products could be carried out by gel-filtration and fractionation of the intact and split immunoglobulins. During chronic otitis media intact immunoglobulins are split by leucocytic and extracellular bacterial proteinases into fragments of different molecular weight. The most malignant extracellular proteinases with the greatest proteolytic activity against intact immunoglobulins are the bacterial proteinases of pseudomonas aeruginosa. These proteinases can not be inhibited by the other serum proteinaseinhibitors except for alpha-2-macroglobulin of the human blood serum. This inhibitor has a very high molecular weight so that we can not find it in a higher concentration in the middle-ear-secretion. We can liberate this inhibitor by injuring the blood vessels during a tympanoplasty. In this way we get an inhibitory effect against these proteinases and combined with an appropriate antibiotic therapy we can cure a chronic otitis media.

Acute otitis media in children

Directory of Open Access Journals (Sweden)

Cherpillod J

2011-06-01

Full Text Available 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

Automated Diagnosis of Otitis Media: Vocabulary and Grammar

Science.gov (United States)

Kuruvilla, Anupama; Hoberman, Alejandro; Kovačević, Jelena

2013-01-01

We propose a novel automated algorithm for classifying diagnostic categories of otitis media: acute otitis media, otitis media with effusion, and no effusion. Acute otitis media represents a bacterial superinfection of the middle ear fluid, while otitis media with effusion represents a sterile effusion that tends to subside spontaneously. Diagnosing children with acute otitis media is difficult, often leading to overprescription of antibiotics as they are beneficial only for children with acute otitis media. This underscores the need for an accurate and automated diagnostic algorithm. To that end, we design a feature set understood by both otoscopists and engineers based on the actual visual cues used by otoscopists; we term this the otitis media vocabulary. We also design a process to combine the vocabulary terms based on the decision process used by otoscopists; we term this the otitis media grammar. The algorithm achieves 89.9% classification accuracy, outperforming both clinicians who did not receive special training and state-of-the-art classifiers. PMID:23997759

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population.

Science.gov (United States)

Santos-Cortez, Regie Lyn P; Reyes-Quintos, Ma Rina T; Tantoco, Ma Leah C; Abbe, Izoduwa; Llanes, Erasmo Gonzalo D V; Ajami, Nadim J; Hutchinson, Diane S; Petrosino, Joseph F; Padilla, Carmencita D; Villarta, Romeo L; Gloria-Cruz, Teresa Luisa; Chan, Abner L; Cutiongco-de la Paz, Eva Maria; Chiong, Charlotte M; Leal, Suzanne M; Abes, Generoso T

2016-11-01

To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population. Cross-sectional study. Indigenous Filipino community. Clinical history and information on breastfeeding, tobacco smoke exposure, and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for the presence and character of perforation or discharge. An A2ML1 duplication variant that confers otitis media susceptibility was Sanger sequenced in all DNA samples. Co-occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to A2ML1 genotype and social cluster. The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; P = .004); however, age was nonsignificant as a bistratal or continuous variable. There was no association between otitis media and sex, body mass index, breastfeeding, tobacco exposure, or deep swimming. In multivariate analyses, A2ML1 genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95% confidence interval: 1.3-10.8; P = .005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life, and chronic otitis media persisted up to adulthood, particularly in A2ML1-variant carriers. Among indigenous Filipinos, A2ML1 genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome, and social clusters might modulate the effect of the A2ML1 genotype. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Otitis media: viruses, bacteria, biofilms and vaccines.

Science.gov (United States)

Massa, Helen M; Cripps, Allan W; Lehmann, Deborah

2009-11-02

Otitis media typically presents as either acute otitis media (AOM), with symptoms including fever, otalgia, otorrhoea or irritability and short duration; or as otitis media with effusion (OME), which is often asymptomatic and characterised by accumulation of fluid in the middle ear. Diagnostic certainty of otitis media is challenging, given the young age of patients and variability of symptoms. Otitis media predominantly occurs as coincident to viral upper respiratory tract infections and/or bacterial infections. Common viruses that cause upper respiratory tract infection are frequently associated with AOM and new-onset OME. These include respiratory syncytial virus, rhinovirus, adenovirus, parainfluenza and coronavirus. Predominant bacteria that cause otitis media are Streptococcus pneumoniae, Moraxella catarrhalis, and non-typeable Haemophilus influenzae. Antibiotic therapy does not significantly benefit most patients with AOM, but long-term prophylactic antibiotic therapy can reduce the risk of otitis media recurrence among children at high risk. In Australia, 84% of AOM is treated with antibiotic therapy, which contributes to development of antibiotic resistance. Vaccine development is a key future direction for reducing the world burden of otitis media, but requires polymicrobial formulation and ongoing monitoring and modification to ensure sustained reduction in disease burden.

Ballondilatation af det eustakiske rør er ny behandling til kronisk otitis media

DEFF Research Database (Denmark)

Møller, Martin Nue; Wanscher, Jens; Larsen, Per Leganger

2014-01-01

Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe with promi......Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe...

The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media

DEFF Research Database (Denmark)

Jensen, Ramon Gordon; Koch, Anders; Homøe, Preben

2013-01-01

Chronic suppurative otitis media (CSOM) affects 65-330 million people in the developing part of the world and develops in early childhood. Knowledge of the long-term effects on hearing is scarce. Hearing loss (HL) can cause reduced ability to communicate, impair language development and academic...

Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study.

Science.gov (United States)

Aarhus, Lisa; Tambs, Kristian; Hoffman, Howard J; Engdahl, Bo

2016-08-01

The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individuals underwent screening audiometry in a longitudinal school hearing investigation. Children found with hearing loss underwent an ear, nose and throat specialist examination. Adults diagnosed with childhood chronic suppurative otitis media (n = 102) and childhood hearing loss after recurrent acute otitis media (n = 590) were significantly more likely to have increased risk of reported dizziness when compared to adults with normal hearing as children at the school investigation and also a negative history of recurrent otitis media (n = 21,270), p otitis media and childhood hearing loss after recurrent acute otitis media are associated with increased risk of dizziness in adulthood. This might reflect a permanent effect of inflammatory mediators or toxins on the vestibular system. The new finding stresses the importance of treatment and prevention of these otitis media conditions.

Effects of eustachian tube function in outcome of graft in tympanoplasty or tympanomastoidectomy for chronic otitis media

Directory of Open Access Journals (Sweden)

Malakooti B

2001-07-01

Full Text Available Chronic otitis media is a common disease which can lead to serious complications or even death. Betterment of eustachian tube function is effective on results of operations. The main goal of this study was to determine the effect of eustachian tube function on outcome of graft in tympanoplasty or tympanomastoidectomy for chronic otitis media. We prospectively studied 126 patients who underwent these operations in Amir Alam hospital in 1998. Eustachian tube function, technique of operation, use of silastic, age, sex, presence of cholesteatoma were evaluated in each patient and graft vascularization after 6 to 8 weeks of surgery was considered as successful outcome. Among 126 ears, 59 had good ETF and among those 59 ears 88.1% or 52 had successful outcome. Among 67 patients with poor ETF 46 or 68.7% got successful results. This significant difference shows the role of Eustachian tube function on the result of surgery.

Importance of viruses in acute otitis media.

Science.gov (United States)

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

[Surgical treatment of patients with exudative otitis media].

Science.gov (United States)

Dmitriev, N S; Mileshina, N A

2003-01-01

The article concerns peculiarities of surgery for chronic exudative otitis media (CEOM). The significance of miringotomy, tympanostomy, tympanotomy and tympanoantrotomy is demonstrated. The experience of the authors in surgical treatment and postoperative management of CEOM is reviewed. Of primary importance is valid selection of patients for each operation and choice of ventilatory tubes depending on the disease stage. Incidence rate and causes of recurrences in respect to the patients' age are presented and the role of follow-up in prevention of CEOM recurrences is shown. Use of temporal bone computed tomography in CEOM is specified. Key words: exudative otitis media, tympanostomy, ventilation tubes, CT of the temporal bone.

Otitis media with effusion:diagnosis and treatment

Directory of Open Access Journals (Sweden)

Ozgur Surmelioglu

2013-04-01

Full Text Available Otitis media with effusion (serous otitis media is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000: 194-208

Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children.

Science.gov (United States)

Casselbrant, Margaretha L; Mandel, Ellen M; Doyle, William J

2016-06-01

Determine if a 2-Step multivariate analysis of historical symptom/sign data for comorbid diseases can abstract high-level constructs useful in assigning a child's "risk" for different Otitis Media expressions. Seventeen items related to the symptom/sign expression of hypothesized Otitis Media comorbidities were collected by history on 141 3-year-old children. Using established criteria, the children were assigned to 1 of 3 groups: Control (no significant past Otitis Media, n=45), Chronic Otitis Media with Effusion (n=45) and Recurrent Acute Otitis Media (n=51). Principal Component Analysis was used to identify factors representing the non-redundant shared information among related items and Discriminant Analysis operating on those factors was used to estimate the best predictor equation for pairwise group assignments. Six multivariate factors representing the assignable comorbidities of frequent colds, nasal allergy, gastroesophageal disease (specific and general), nasal congestion and asthma were identified and explained 81% of the variance in the 17 items. Discriminant Analysis showed that, for the Control-Chronic Otitis Media with Effusion comparison, a combination of 3 factors and, for the Control-Recurrent Acute Otitis Media comparison, a combination of 2 factors had assignment accuracies of 74% and 68%, respectively. For the contrast between the two disease expressions, a 2-factor combination had an assignment accuracy of 61%. These results show that this analytic methodology can abstract high-level constructs, comorbidities, from low-level data, symptom/sign scores, support a linkage between certain comorbidities and Otitis Media risk and suggest that specific comorbidity combinations contain information relevant to assigning the risk for different Otitis Media expressions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cervical spinal tuberculosis with tuberculous otitis media ...

African Journals Online (AJOL)

Prompt and effective response to anti tuberculosis drugs informed the diagnosis of tuberculosis of the cervical vertebra and tuberculous otitis media with multiple cranial nerve palsies. This case underscores the value of high index of suspicion, thorough and complete clinical evaluation in any patient with chronic symptoms ...

A Preliminary Investigation of Associations between Disorders of Behavior and Language in Children with Chronic Otitis Media.

Science.gov (United States)

Funk, Jeanne B.; Ruppert, Elizabeth S.

1986-01-01

The relationship between language and behavior disorders was investigated. The teacher and parents of 12 children in a special public preschool for children with documented chronic otitis media and language disorders completed the Louisville Behavior Checklist. Most deviant behavior was reported on scales measuring cognitive and social-interactive…

Parental views on otitis media: systematic review of qualitative studies.

Science.gov (United States)

Chando, Shingisai; Young, Christian; Craig, Jonathan C; Gunasekera, Hasantha; Tong, Allison

2016-10-01

This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience). The additional medical responsibilities and anxieties of parents caring for a child with otitis media, often discounted by clinicians, can be disempowering and disruptive. Chronicity can raise doubt about treatment efficacy and parental competency, and fears regarding their child's development. Care that fosters parental confidence and addresses their concerns about the child's development may improve treatment outcomes for children with otitis media. • Otitis media is a leading cause of conductive hearing loss in children. • Parental perception of the treatment burden of otitis media can potentially affect their confidence and ability to care for their child. What is New: • We identified five themes to reflect parental perspectives: diminishing competency, disrupting life schedules, social isolation, threatening normal development, taking ownership, valuing support, and cherishing health. �

Risk factors for chronic and recurrent otitis media-a meta-analysis.

Directory of Open Access Journals (Sweden)

Yan Zhang

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.

Effects of eustachian tube function in outcome of graft in tympanoplasty or tympanomastoidectomy for chronic otitis media1

Directory of Open Access Journals (Sweden)

Malakooti B

2000-07-01

Full Text Available Chronic otitis media is a common disease which can lead to serious complications or even death. Betterment of eustachian tube function is effective on results of operations. The main goal of this study was to determine the effect of eustachian tube function on outcome of graft in tympanoplasty or tympanomastoidectomy for chronic otitis media. We prospectively studied 126 patients who underwent these operations in Amir Alam hospital in 1998. Eustachian tube function, technique of operation, use of silastic, age, sex, presence of cholesteatoma were evaluated in each patient and graft vascularization after 6 to 8 weeks of surgery was considered as successful outcome. Among 126 ears, 59 had good ETF and among those 59 ears 88.1% or 52 had successful outcome. Among 67 patients with poor ETF 46 or 68.7% got successful results. This significant difference shows the role of Eustachian tube function on the result of surgery.

The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial: study protocol for a randomized controlled trial.

Science.gov (United States)

Demant, Malene Nøhr; Jensen, Ramon Gordon; Jakobsen, Janus Christian; Gluud, Christian; Homøe, Preben

2017-01-19

The prevalence of otitis media in Greenlandic children is one of the highest in the world. International studies have shown that otitis-prone children may benefit from tubulation of the tympanic membrane. However, it is unknown whether these results can be applied to Greenlandic children and trials on the effects of ventilation tubes in high-risk populations have, to our knowledge, never been conducted. The trial is an investigator-initiated, multicentre, randomized, blinded superiority trial of bilateral ventilation tube insertion versus treatment as usual (no tube) in Greenlandic children aged 9-36 months with chronic otitis media with effusion or recurrent acute otitis media. With randomization stratified by otitis media subtype and trial site, a type 1 error of 5% and a power of 80%, a total of 230 participants are needed to detect a decrease of two visits to a health clinic during 2 years, which is considered the minimal clinical relevant difference. The primary outcome measure will be assessed blindly by investigating medical records. Secondary outcome measures are number of episodes of acute otitis media, quality of life, number of episodes of antibiotics administration and proportion of children with tympanic membrane perforations. This trial will provide evidence-based knowledge of the effects of ventilation tubes in children with middle ear infections from the high-risk Greenlandic population. Furthermore, this trial will improve the understanding of conducting randomized clinical trials in remote areas, where management of logistical aspects is particularly challenging. ClinicalTrials.gov, NCT02490332 . Registered on 14 February 2016.

Infant otitis media and the use of secondary heating sources.

Science.gov (United States)

Pettigrew, Melinda M; Gent, Janneane F; Triche, Elizabeth W; Belanger, Kathleen D; Bracken, Michael B; Leaderer, Brian P

2004-01-01

This prospective study investigated the association of exposure to indoor secondary heating sources with otitis media and recurrent otitis media risk in infants. We enrolled mothers living in nonsmoking households and delivering babies between 1993 and 1996 in 12 Connecticut and Virginia hospitals. Biweekly telephone interviews during the first year of life assessed diagnoses from doctors' office visits and use of secondary home heating sources, air conditioner use, and day care. Otitis media episodes separated by more than 21 days were considered to be unique episodes. Recurrent otitis media was defined as 4 or more episodes of otitis media. Repeated-measures logistic regression modeling evaluated the association of kerosene heater, fireplace, or wood stove use with otitis media episodes while controlling for potential confounders. Logistic regression evaluated the relation of these secondary heating sources with recurrent otitis media. None of the secondary heating sources were associated with otitis media or with recurrent otitis media. Otitis media was associated with day care, the winter heating season, birth in the fall, white race, additional children in the home, and a maternal history of allergies in multivariate models. Recurrent otitis media was associated with day care, birth in the fall, white race, and a maternal history of allergies or asthma. We found no evidence that the intermittent use of secondary home heating sources increases the risk of otitis media or recurrent otitis media. This study confirms earlier findings regarding the importance of day care with respect to otitis media risk.

The Otitis Media-6 questionnaire

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse

2013-01-01

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...

High-frequency conductive hearing loss as a diagnostic test for incomplete ossicular discontinuity in non-cholesteatomatous chronic suppurative otitis media.

Directory of Open Access Journals (Sweden)

Krishnamurti M A Sarmento

Full Text Available Chronic suppurative otitis media, with or without cholesteatoma, may lead to erosion of the ossicles and discontinuity of the ossicular chain. In incomplete ossicular discontinuity (IOD, partial erosion of the ossicles occurs, but some sound transmission is noted throughout the ossicular chain. High-frequency conductive hearing loss (HfCHL has been considered a hallmark of incomplete ossicular discontinuity. This study aims to evaluate the use of HfCHL as a preoperative predictor of IOD in patients with non-cholesteatomatous chronic suppurative otitis media. The HfCHL test was defined as the preoperative air-bone gap (ABG at 4 kHz minus the average of the ABG at 0.25 and 0.5 kHz. The test was applied in 328 patients before surgery and compared to intraoperative findings as the gold standard. At surgery, 201 (61.3% patients had an intact ossicular chain, 44 (13.4% had a complete ossicular discontinuity, and 83 (25.3% exhibited an IOD. The best cutoff level was calculated as 10 dB. The HfCHL test to diagnose IOD had a sensitivity of 83% and a specificity of 92% with a post-test probability of 78% and a likelihood ratio of 10.2. We concluded that the HfCHL test is highly effective in predicting IOD in patients with non-cholesteatomatous chronic suppurative otitis media and that it should be used routinely as a screening test prior to surgery.

Update on otitis media – prevention and treatment

Directory of Open Access Journals (Sweden)

Qureishi A

2014-01-01

Full Text Available Ali Qureishi,1 Yan Lee,2 Katherine Belfield,3 John P Birchall,4 Matija Daniel,21Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK; 2NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK; 3Biomaterials Related Infection Group, 4Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UKAbstract: Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.Keywords: otitis media, ear, hearing, infection, biofilm, antibiotics

Acute otitis media.

Science.gov (United States)

Dickson, Gretchen

2014-03-01

One in 4 children will have at least 1 episode of acute otitis media (AOM) by age 10 years. AOM results from infection of fluid that has become trapped in the middle ear. The bacteria that most often cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Differentiating AOM from otitis media with effusion (OME) is a critical skill for physicians, as accurate diagnosis will guide appropriate treatment of these conditions. Although fluid is present in the middle ear in both conditions, the fluid is not infected in OME as is seen in AOM patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Radio-Tympano-Sinu-Orthesis - a new therapy of recurrent otitis media and chronic sinusitis

International Nuclear Information System (INIS)

Czech, N.; Godbersen, G.S.

2006-01-01

The practicability, safety and clinical efficacy of intracavitary therapy with Re-186-colloid in patients with recurrent otitis media and paranasal sinusitis, resistant to pharmacotherapy and surgical treatment is demonstrated based on a preliminary treatment trial. Methods: the authors report on a total of 39 applications of 5-35 MBq 186 Re-colloid into the tympanon and the paranasal sinuses in six patients. Biodistribution and biokinetics were studied by gamma camera imaging. Clinical success was documented 6-20 months after therapy both by patients self-evaluation and by objective rhinootological follow-up, using a four-step score from -1 to+2. Results: no serious side effects were seen. There was good to excellent clinical improvement with a mean score of +1.44 ± 0.5 by patients self-evaluation and by physicians scoring of +0.81 ± 0.9 with only negligible extracranial tracer deposition. Conclusion: this novel treatment option using intracavitary application of Re-186-colloid in chronic otitis media and sinusitis is safe and effective. The term Radio-Tympano-Sinu-Orthesis (RTSO) might be proposed analogously to the well-known radiosynoviorthesis (RSO). (orig.)

What Does Tympanostomy Tube Placement in Children Teach Us About the Association Between Atopic Conditions and Otitis Media?

Science.gov (United States)

Juhn, Young J.; Wi, Chung-Il

2014-01-01

Otitis media is the most common infection second only to viral upper respiratory infection in the outpatient setting. Tympanostomy tube insertion (TTI) is the most common ambulatory surgical procedure in the United States. While many risk factors for otitis media have been identified, atopic conditions have been under-recognized as risk factors for recurrent and persistent otitis media. Given that asthma and other atopic conditions are the most common chronic conditions during childhood, it is worth examining the association between atopic conditions and risk of otitis media, which can provide insight into how atopic conditions influence the risk of microbial infections. This paper focuses its discussion on otitis media, however it is important that the association between atopic conditions and risk of otitis media be interpreted in the context of the association of atopic conditions with increased risks of various microbial infections. PMID:24816652

Contemporary concepts in management of acute otitis media in children.

Science.gov (United States)

Rettig, Eleni; Tunkel, David E

2014-10-01

Acute otitis media (AOM) is a common disease of childhood. AOM is most appropriately diagnosed by careful otoscopy with an understanding of clinical signs and symptoms. The distinction between AOM and chronic otitis media with effusion should be emphasized. Treatment should include pain management, and initial antibiotic treatment should be given to those most likely to benefit, including young children, children with severe symptoms, and those with otorrhea and/or bilateral AOM. Tympanostomy tube placement may be helpful for those who experience frequent episodes of AOM or fail medical therapy. Recent practice guidelines may assist the clinician with such decisions. Copyright © 2014 Elsevier Inc. All rights reserved.

Acute otitis media with spontaneous tympanic membrane perforation.

Science.gov (United States)

Principi, N; Marchisio, P; Rosazza, C; Sciarrabba, C S; Esposito, S

2017-01-01

The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.

Mucin production and mucous cell metaplasia in otitis media

DEFF Research Database (Denmark)

Lin, Jizhen; Caye-Thomasen, Per; Tono, Tetsuya

2012-01-01

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...

Fatal Lemierre's syndrome as a complication of chronic otitis media ...

African Journals Online (AJOL)

a high index of suspicion should be maintained, as it remains a ... developed Lemierre's syndrome secondary to untreated chronic otitis ... This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body ...

Inflation-deflation test as a predictor of aditus patency in patients with chronic suppurative otitis media.

Science.gov (United States)

Kurien, Regi; Chrisolyte, Shipra; Rupa, V

2009-09-01

To assess eustachian tubal function (ETF) preoperatively in patients with chronic suppurative otitis media (CSOM) with central perforation by performing the inflation-deflation test. To correlate the results of the inflation-deflation test with the finding of aditus patency or block in patients with CSOM STUDY DESIGN: Prospective, cohort Tertiary care hospital Eighty adult patients with chronic suppurative otitis media and central perforation were recruited into the study. There were 45 males and 35 females. All patients underwent preoperative inflation-deflation test followed by cortical mastoidectomy and tympanoplasty. The patency of the aditus was assessed intraoperatively. Equalization of pressure on inflation-deflation test and intraoperative assessment of aditus patency Of a total of 80 patients, 49 patients were found to have discharging ears and 31 had dry ears at the time of surgery. In dry ears the inflation-deflation test had a sensitivity of 93% in predicting aditus patency although the specificity was lower at 67%. In discharging ears the sensitivity in predicting aditus patency was 72% and the specificity was 67%. The eustachian tube inflation-deflation test is a sensitive test for predicting aditus patency in patients with dry ears but less so in patients with discharging ears. Hence, it could be used in the former to avoid unnecessary exploration of the mastoid.

Neutrophil Extracellular Traps and Fibrin in Otitis Media: Analysis of Human and Chinchilla Temporal Bones.

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Schachern, Patricia A; Kwon, Geeyoun; Briles, David E; Ferrieri, Patricia; Juhn, Steven; Cureoglu, Sebahattin; Paparella, Michael M; Tsuprun, Vladimir

2017-10-01

Bacterial resistance in acute otitis can result in bacterial persistence and biofilm formation, triggering chronic and recurrent infections. To investigate the middle ear inflammatory response to bacterial infection in human and chinchilla temporal bones. Six chinchillas underwent intrabullar inoculations with 0.5 mL of 106 colony-forming units (CFUs) of Streptococcus pneumoniae, serotype 2. Two days later, we counted bacteria in middle ear effusions postmortem. One ear from each chinchilla was processed in paraffin and sectioned at 5 µm. The opposite ear was embedded in epoxy resin, sectioned at a thickness of 1 µm, and stained with toluidine blue. In addition, we examined human temporal bones from 2 deceased donors with clinical histories of otitis media (1 with acute onset otitis media, 1 with recurrent infection). Temporal bones had been previously removed at autopsy, processed, embedded in celloidin, and cut at a thickness of 20 µm. Sections of temporal bones from both chinchillas and humans were stained with hematoxylin-eosin and immunolabeled with antifibrin and antihistone H4 antibodies. Histopatological and imminohistochemical changes owing to otitis media. Bacterial counts in chinchilla middle ear effusions 2 days after inoculation were approximately 2 logs above initial inoculum counts. Both human and chinchilla middle ear effusions contained bacteria embedded in a fibrous matrix. Some fibers in the matrix showed positive staining with antifibrin antibody, others with antihistone H4 antibody. In acute and recurrent otitis media, fibrin and neutrophil extracellular traps (NETs) are part of the host inflammatory response to bacterial infection. In the early stages of otitis media the host defense system uses fibrin to entrap bacteria, and NETs function to eliminate bacteria. In chronic otitis media, fibrin and NETs appear to persist.

STUDY OF EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

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Sanal Mohan

2016-10-01

Full Text Available BACKGROUND Chronic Suppurative Otitis Media (CSOM refers to a chronic inflammatory condition of the middle ear and mastoid cavity. There is acute inflammation of middle ear leading to irritation and then inflammation of the mucosa producing oedema. Breakdown of the epithelium causes ulceration subsequent infection and formation of granuloma/granulation tissue. Granuloma formation leads to the development of polyps in middle ear. Factors influencing development of complications are, age, low socio-economic status, virulence of organism, immune compromised host, previous surgeries, fractures, fistulas, cholesteatoma. The complications developed spread through various modes like direct bone erosion, thrombophlebitis, preformed pathways, congenital bony defects, sutures of skull that remains patent, old fractures-heal by fibrosis, defects caused by surgery, oval and round windows, infection from labyrinth. The extracranial complications which can be encountered in chronic suppurative otitis media are, acute mastoiditis, petrositis, facial nerve palsy, labyrinthitis and discharging sinuses. MATERIALS AND METHODS Sample size for the present study was fifty four. This study was done in the Department of ENT, Travancore Medical College, Kollam. This study was done from January 2015 To January 2016. Detailed clinical history was taken and the clinical examination was conducted. The extracranial complications were noted and reported. RESULTS In the present study, maximum number of cases belonged male sex which was thirty eight cases. Sixteen cases belonged to female sex. Maximum number of cases which amounted to forty one in number belonged to age group zero to twenty years, followed by age group twenty to forty years which amounted to eleven cases, followed by age group forty to sixty which amounted to two cases. No cases were reported in age group more than sixty years in our study. Based on socioeconomic data, maximum number of cases belonged to low

Chronic suppurative otitis media in a birth cohort of children in Greenland: population-based study of incidence and risk factors

DEFF Research Database (Denmark)

Koch, Anders; Homøe, Preben; Pipper, Christian Bressen

2011-01-01

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...

Otitis Media: Beyond the Examining Room.

Science.gov (United States)

Welling, Deborah R; Ukstins, Carol A

2018-02-01

The management of hearing loss associated with otitis media is multifaceted. Clinical practice guidelines set the collaborative prescriptive standards for the medical management of otitis media in children. Treatment of this condition does not end with the medical practitioner. There are far-reaching effects of otitis media and its sequelae that permeate every aspect of patients' lives including physiological, educational, and psychosocial. Therefore, a comprehensive interprofessional treatment plan must be designed taking into consideration best practices from a range of professions to maximize clinical outcomes, including the treating physician, speech-language pathologist, clinical audiologist, educational audiologist, and professionals in the educational setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Panel 3: Genetics and Precision Medicine of Otitis Media.

Science.gov (United States)

Lin, Jizhen; Hafrén, Hena; Kerschner, Joseph; Li, Jian-Dong; Brown, Steve; Zheng, Qing Y; Preciado, Diego; Nakamura, Yoshihisa; Huang, Qiuhong; Zhang, Yan

2017-04-01

Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.

Otitis media

NARCIS (Netherlands)

Rovers, MM; Schilder, AGM; Zielhuis, GA; Rosenfeld, RM

2004-01-01

Otitis media (OM) continues to be one of the most common childhood infections and is a major cause of morbidity in children. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, Eustachian-tube dysfunction, viral and bacterial load, and genetic and environmental

Comportamiento de la otitis media aguda

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Gladys Fuentes Fernández

Full Text Available Introducción: la otitis media aguda es una complicación de las infecciones respiratorias agudas altas, frecuente en los niños menores de 5 años. Objetivos: caracterizar su comportamiento, según edad y sexo, e identificar algunos factores de riesgo en este grupo de edad. Métodos: se realizó un estudio descriptivo retrospectivo de 554 niños ingresados en el hospital Pediátrico de Centro Habana con el diagnóstico de otitis media aguda, durante los años 2006-2010. Los datos se recogieron de las historias clínicas. Resultados: la otitis media aguda fue más frecuente en el sexo masculino (58,7 % y en los menores de 1 año (53,1 %. El antecedente de bajo peso (33,9 % y la prematuridad (27,5 %, la asistencia a círculos infantiles (43,5 % y el hábito de fumar de los padres (58,4 %, además del antecedente de ingresos hospitalarios por otitis media en el mes previo a la aparición del episodio actual (59,0 %, constituyeron los principales factores de riesgo en el presente estudio. Conclusiones: la otitis media es una causa frecuente de ingresos hospitalarios, y se identifican como principales factores de riesgo la asistencia a círculos infantiles y el tabaquismo de algunos de los padres.

Tuberculous otitis media: a resurgence?

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Kameswaran, M; Natarajan, K; Parthiban, M; Krishnan, P V; Raghunandhan, S

2017-09-01

Tuberculosis is a global health problem that is especially prevalent in developing countries such as India. Recently, atypical presentation has become more common and a high index of suspicion is essential. This study analysed the various presenting symptoms and signs of tuberculous otitis media and the role of diagnostic tests, with the aim of formulating criteria for the diagnosis. A total of 502 patients underwent tympanomastoidectomy over a two-year period. Microbiological and histopathological examinations and polymerase chain reaction analysis of tissue taken during tympanomastoidectomy were performed. A total of 25 patients (5 per cent) were diagnosed with tuberculous otitis media. Severe mixed hearing loss, facial palsy, labyrinthine fistula, post-aural fistula, perichondritis and extradural abscess were noted. There seems to be a resurgence in tuberculous otitis media in India. Microbiological, histopathological and polymerase chain reaction tests for tuberculosis are helpful for its diagnosis.

Zinc supplements for preventing otitis media.

Science.gov (United States)

Gulani, Anjana; Sachdev, Harshpal S

2014-06-29

Otitis media is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent otitis media. To evaluate whether zinc supplements prevent otitis media in adults and children of different ages. We searched CENTRAL (2014, Issue 1), MEDLINE (1950 to February week 4, 2014) and EMBASE (1974 to March 2014). Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media. Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. No new trials were identified for inclusion in this update. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There were a total of 6820 participants. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc-supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow-up (3191 participants); another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of otitis media (mean difference (MD) -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause any serious adverse

Otitis Media and Children with Hearing Impairments: A Sequela.

Science.gov (United States)

Beattie, R. G. John L.

1991-01-01

This review of research on otitis media in children with existing hearing impairments concludes that the incidence of otitis media is probably higher than in the general population. The possible reasons for higher incidence, effects of otitis media on children with known losses, and the role of the classroom teacher are discussed. (Author/DB)

Danish guidelines on management of otitis media in preschool children.

Science.gov (United States)

Heidemann, C H; Lous, J; Berg, J; Christensen, J J; Håkonsen, S J; Jakobsen, M; Johansen, C J; Nielsen, L H; Hansen, M P; Poulsen, A; Schousboe, L P; Skrubbeltrang, C; Vind, A B; Homøe, P

2016-08-01

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 treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists. 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. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Otitis media with effusion in children younger than 1 year].

Science.gov (United States)

Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

2016-06-01

To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Traffic-related air pollution and otitis media

NARCIS (Netherlands)

Brauer, Michael; Gehring, Ulrike; Brunekreef, Bert; de Jongste, Johan; Gerritsen, Jorrit; Rovers, Maroeska; Wichmann, Heinz-Erich; Wijga, Alet; Heinrich, Joachim

BACKGROUND: Otitis media is one of the most common infections in young children. Although exposure to environmental tobacco smoke is a known risk factor associated with otitis media, little information is available regarding the potential association with air pollution. OBJECTIVE: We set out to

Pneumococcal conjugate vaccines for preventing otitis media

NARCIS (Netherlands)

Jansen, Angelique G S C; Hak, Eelko; Veenhoven, Reinier H; Damoiseaux, Roger A M J; Schilder, Anne G M; Sanders, Elisabeth A M

2009-01-01

BACKGROUND: Acute otitis media (AOM) is a very common early infancy and childhood disease. The marginal benefits of antibiotics on AOM, the increasing problem of bacterial resistance to antibiotics, and the huge estimated direct and indirect annual costs associated with otitis media (OM) have

Nonencapsulated Streptococcus pneumoniae causes otitis media during single-species infection and during polymicrobial infection with nontypeable Haemophilus influenzae.

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Murrah, Kyle A; Pang, Bing; Richardson, Stephen; Perez, Antonia; Reimche, Jennifer; King, Lauren; Wren, John; Swords, W Edward

2015-07-01

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. © FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Skull Base Osteomyelitis from Otitis Media Presenting as the Collet-Sicard Syndrome

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Wong-Kein Low

2018-01-01

Full Text Available Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae, this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media. This case report illustrates the possibility of retained cotton swabs contributing to the development of otitis media, skull base osteomyelitis, and ultimately the Collet-Sicard syndrome in the ears of immune-compromised patients with chronically perforated eardrums.

PSEUDOMONAS AERUGINOSA IN CHRONIC SUPPURATIVE OTITIS MEDIA- A DRUGSENSITIVITY STUDY

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Anoop M

2017-05-01

Full Text Available BACKGROUND Chronic suppurative otitis media is one among the commonest ENT disease seen in day-to-day practice. It is seen mainly among low socioeconomic class. MATERIALS AND METHODS The present study was conducted in the Department of ENT, Shadan Institute of Medical Sciences. Fifty patients with CSOM of all age groups and both sexes attending the Outpatient Department of ENT were selected randomly for the study. RESULTS From our study, we found mainly children of age group 10-11 years commonly affected. They belong to poor socioeconomic background. Pseudomonas aeruginosa is the most common organism isolated in the present study. Ciprofloxacin was found to be the most sensitive antibiotic to Pseudomonas aeruginosa. CONCLUSION We noticed that drug resistance is on the rise due to misuse of antibiotics, over-the-counter treatment, inadequate period of therapy and less awareness among public regarding drug resistance. Constant monitoring of antibiotic sensitivity is needed to prevent drug resistance in CSOM.

Eustachian tube three-dimensional reconstruction of secretory otitis media

International Nuclear Information System (INIS)

Yu Yafeng; Zhou Weirong; Bao Xueping; Li Min; Hu Zhenmin

2006-01-01

Objective: To study relationship between Eustachian tube and secretory otitis media and to explore the pathogeny of secretory otitis by three-dimensional reconstruction of Eustachian tube. Methods: Thirty cases of secretory otitis media (male 19, female 11) were selected randomly. Everyone was checked by otoscope and audiometry. Their bilateral Eustachian tubes were scanning by helix CT while making Valsalva's action. All images were passed on to work station to make three-dimensional reconstruction. Results: Four patients were found have Eustachian tube diseases, while most of patients' Eustachian tubes ventilated normally. Conclusions: Three-dimensional reconstruction of Eustachian tube can open out some pathogens of some secretory otitis medias. It will be helpful to diagnosis and therapy of secretory otitis media. (authors)

Surgical considerations and safety of cochlear implantation in otitis media with effusion.

Science.gov (United States)

Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

2018-06-01

To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (peffusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Progression of changes in the sensorial elements of the cochlear and peripheral vestibular systems: The otitis media continuum.

Science.gov (United States)

Monsanto, Rafael da Costa; Schachern, Patricia; Paparella, Michael M; Cureoglu, Sebahattin; Penido, Norma de Oliveira

2017-08-01

Our study aimed to evaluate pathologic changes in the cochlear (inner and outer hair cells and stria vascularis) and vestibular (vestibular hair cells, dark, and transitional cells) sensorial elements in temporal bones from donors who had otitis media. We studied 40 temporal bones from such donors, which were categorized in serous otitis media (SOM), serous-purulent otitis media (SPOM), mucoid/mucoid-purulent otitis media (MOM/MPOM), and chronic otitis media (COM); control group comprised 10 nondiseased temporal bones. We found significant loss of inner and outer cochlear hair cells in the basal turn of the SPOM, MOM/MPOM and COM groups; significant loss of vestibular hair cells was observed in the MOM/MPOM and COM groups. All otitis media groups had smaller mean area of the stria vascularis in the basal turn of the cochlea when compared to controls. In conclusion, our study demonstrated more severe pathologic changes in the later stages of the continuum of otitis media (MOM/MPOM and COM). Those changes seem to progress from the basal turn of the cochlea (stria vascularis, then inner and outer hair cells) to the middle turn of the cochlea and to the saccule and utricle in the MOM/MPOM and COM stages. Copyright © 2017 Elsevier B.V. All rights reserved.

Otitis media with effusion in children younger than 1 year

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Renata Cantisani Di Francesco

2016-06-01

Full Text Available Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position, type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death.

Science.gov (United States)

Ueki, Shigeharu; Ohta, Nobuo; Takeda, Masahide; Konno, Yasunori; Hirokawa, Makoto

2017-05-01

Eosinophilic otitis media (EOM) is a refractory disease characterized by the accumulation of eosinophils in middle ear effusion and mucosa. We summarize current knowledge regarding the clinical characteristics and management of EOM. Although eosinophil activation in inflamed foci is involved in the pathogenesis of EOM, little is known about the fate of the eosinophils and aftermath of their cell death. We discuss the possibility that eosinophils undergo non-apoptotic cell death that worsens tissue damage and increases effusion viscosity. Unlike chronic otitis media, EOM is strongly associated with an allergic background. Corticosteroids are currently the only effective pharmacological treatment, and surgical intervention is often required. Mucosal eosinophils infiltrate extensively into the middle ear cavity where they are stimulated by locally produced activators including interleukin-5 and eotaxin. The eosinophils undergo cytolysis in the effusion, which represents a major fate of activated eosinophils in vivo. Recent data revealed cytolysis could be renamed as extracellular trap cell death (ETosis). ETosis represents suicidal cell death involving total cell degranulation and development of sticky chromatin structures (extracellular traps (ETs)). The characteristics of eosinophil- and neutrophil-derived ET polymers might contribute to the difference in viscosity of secretions between EOM and common chronic otitis media. The extracellular products remaining after eosinophil ETosis are an important aspect of EOM pathology. The concept of ETosis also has novel implications for potential therapeutic modalities in various eosinophilic disorders.

Vestibular evaluation in children with otitis media with effusion.

Science.gov (United States)

Kolkaila, E A; Emara, A A; Gabr, T A

2015-04-01

Fifty per cent of children with serous otitis media may have some balance disturbances. To evaluate vestibular function in children with otitis media with effusion. The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air-bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing. Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group. The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

Role of adenoid biofilm in chronic otitis media with effusion in children.

Science.gov (United States)

Saafan, Magdy Eisa; Ibrahim, Wesam Salah; Tomoum, Mohamed Osama

2013-09-01

To study the extent of surface adenoid biofilm and to evaluate its role in the pathogenesis of chronic otitis media with effusion (COME) in children. The study was carried out on 100 children between 3 and 14 years of age, who were divided into two groups. The first group (50 children) had otitis media with effusion associated with adenoid hypertrophy, whereas the second group (50 children) had adenoid hypertrophy without middle ear effusion. Adenoidectomy with ventilation tube insertion was done for group 1 cases, whereas, only Adenoidectomy was done for group 2 cases. Microbiological study, Scanning electron microscope and multiplex- PCR were done for suspected adenoid biofilms and specimens from middle ear effusion. Adenoids removed from children with COME had higher grade biofilm formation (74 %) than the second group (42 %). No correlation was found between adenoid size and biofilm formation. Culture of adenoid tissue in group 1 patients was positive in 52 % of cases compared to 96 % by PCR, while in group 2 culture of adenoid tissue was positive in 38 % compared to 48 % by PCR. Culture of middle ear fluid was positive in 32 % of cases only compared to 80 % by PCR. A positive correlation was found between results of bacterial biofilm visualized by SEM and bacteria detected and identified by PCR technique. On the other hand, no correlation was found between results of bacterial biofilm visualized by SEM and bacteria detected by culture. The size of the adenoid is not the main determinant factor in OME pathogenesis but the degree of bacterial colonization is much more important. Adenoids in COME may act as a reservoir of chronic infection rather than causing mechanical Eustachian obstruction. Higher grade biofilm formation was found in cases with middle ear effusion than those with adenoid hypertrophy only. These findings support the hypothesis that there would be an association between adenoidal biofilm formation and COME. This study focused on the value of PCR

Risk factors for chronic and recurrent otitis media-a meta-analysis.

Science.gov (United States)

Zhang, Yan; Xu, Min; Zhang, Jin; Zeng, Lingxia; Wang, Yanfei; Zheng, Qing Yin

2014-01-01

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; Pmedia (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.

Chronic suppurative otitis media, middle ear pathology and corresponding hearing loss in a cohort of Greenlandic children.

Science.gov (United States)

Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter; Jensen, Ramon Gordon

2016-04-01

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. 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. 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-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane sequelae of OM. The median pure tone average in low-frequencies/high-frequencies were: CSOM: 34.2/31.3dB, OME: 23.3/22.5dB, Sequelae of OM: 13.3/15dB and normal ears: 11.7/12.5dB. We found a significant difference (pchildren a HL>15dB in any frequency was found, while 6.5% suffered from a bilateral low-frequency HL>25dB. The severity of OM significantly corresponded to increased HL. The burden of CSOM and HL remains high in young Greenlandic children. Aggressive treatment with antibiotics, improved hearing rehabilitation, sound field amplification in classrooms and otosurgical capacity should be further promoted in Greenland. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Computed tomography in diagnostics of effluent otitis media

International Nuclear Information System (INIS)

Imomova, L.S.; Norboev, Z.; Kalandarov, S.Ch.

2011-01-01

This article is devoted to computed tomography in diagnostics of effluent otitis media. The purpose of present work is to assess the possibilities of computed tomography method of temporal bone in the diagnostics of otitis media.

Frequency of otitis media based on otoendoscopic evaluation in preterm infants.

Science.gov (United States)

Coticchia, James; Shah, Priyanka; Sachdeva, Livjot; Kwong, Kelvin; Cortez, Josef M; Nation, Javan; Rudd, Tracy; Zidan, Marwan; Cepeda, Eugene; Gonik, Bernard

2014-10-01

This study was conducted to determine the frequency of otitis media in preterm neonates using otoendoscopy and tympanometry. Prospective study. Wayne State University, Hutzel Women's Hospital Neonatal Intensive Care Unit. Eighty-six preterm infants were included (gestational age otitis media. Kappa statistic and logistic regression were used for statistical analysis. Otoendoscopy was performed in 85 patients. The frequency of otoendoscopy-diagnosed otitis media was 72.9% (62/85). Tympanometry could be performed on 69.76% of the ears. There was 73.5% agreement between the findings of tympanometry and those of otoendoscopy. The association between the presence of otitis media and gestational age at birth was statistically significant. The lower the gestational age, the higher the frequency of otoendoscopy-diagnosed otitis media (P = .001). Otoendoscopically diagnosed otitis media is frequent in preterm neonates. There was agreement between the results of tympanometry and those of otoendoscopy. The frequency of otitis media increased with lower gestational age. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

[The role of gastroesophageal reflux disease in the development of chronic exudative otitis media in the children during the first year of life].

Science.gov (United States)

Rakhmanova, I V; Soldatsky, Yu L; Matroskin, A G; Marenich, N S; Shelamova, V N

2018-01-01

The objective of the present study was the determination of the incidence of gastroesophageal reflux disease and the evaluation of its possible influence on the development and duration of chronic exudative otitis media in the children during the first year of life. A total of 141 infants at the age of 3 months presenting with exudative otitis media refractory to the conservative treatment throughout the first 1-1.5 months of life were available for the examination. The effectiveness of the anti-reflux therapy was estimated based on the middle ear condition (the presence or absence of exudate) within 3 and 6 months after the initiation of the treatment. The signs of aspiration of gastric chimus and gastroesophageal reflux disease were documented in 92% of the cases. The anti-reflux treatment during 3 months resulted in the disappearance of the manifestations of exudative otitis media in 43% of the patients. The further prolongation of such therapy up to 6 months allowed to normalize the state of the middle ear in 69% of the children although the remaining 40% failed to respond. It is concluded that the treatment of the children presenting with exudative otitis media during first year of life should be performed taking into consideration the possible involvement of gastroesophageal reflux disease in pathogenesis of this pathological condition.

Recurrent acute otitis media detracts from health-related quality of life.

Science.gov (United States)

Kujala, T; Alho, O-P; Kristo, A; Uhari, M; Renko, M; Pokka, T; Koivunen, P

2017-02-01

Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

Science.gov (United States)

Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

2016-10-01

Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

Ballondilatation af det eustakiske rør er ny behandling til kronisk otitis media

DEFF Research Database (Denmark)

Møller, Martin Nue; Wanscher, Jens; Larsen, Per Leganger

2014-01-01

Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe...

Korean clinical practice guidelines: otitis media in children.

Science.gov (United States)

Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

2012-08-01

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

Learning Disabilities and Conductive Hearing Loss Involving Otitis Media.

Science.gov (United States)

Reichman, Julie; Healey, William C.

1983-01-01

A review of research on the relationship of otitis media (ear infection) and learning/language/hearing disorders revealed that incidence of otitis media was twice as common in learning disabled as nonLD students; and that, in general, otitis-prone children scored below controls with frequent evidence of performance deficits. (CL)

Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

DEFF Research Database (Denmark)

Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

2010-01-01

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...

Serous otitis media and immunological reactions in the middle ear mucosa

NARCIS (Netherlands)

van der Baan, S.; Seldenrijk, C. A.; Henzen-Logmans, S. C.; Drexhage, H. A.

1988-01-01

An immunohistochemical study was performed on the middle ear mucosa of 21 children with chronic serous otitis media (SOM). In 86% of the patients a highly organized lymphatic tissue was found in the middle ear mucosa which can be regarded as part of the mucosa associated lymphoid tissue (MALT).

Radio-Tympano-Sinu-Orthesis - a new therapy of recurrent otitis media and chronic sinusitis; Die Radio-Tympano-Sinu-Orthese - ein neues Verfahren zur Therapie von rezidivierender Otitis media und chronischer Sinusitis

Energy Technology Data Exchange (ETDEWEB)

Czech, N. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Schleswig-Holstein, Campus Kiel (Germany); Godbersen, G.S. [Abt. fuer Hals-Nasen-Ohrenheilkunde, Praxisklinik Kiel (Germany)

2006-03-15

The practicability, safety and clinical efficacy of intracavitary therapy with Re-186-colloid in patients with recurrent otitis media and paranasal sinusitis, resistant to pharmacotherapy and surgical treatment is demonstrated based on a preliminary treatment trial. Methods: the authors report on a total of 39 applications of 5-35 MBq {sup 186}Re-colloid into the tympanon and the paranasal sinuses in six patients. Biodistribution and biokinetics were studied by gamma camera imaging. Clinical success was documented 6-20 months after therapy both by patients self-evaluation and by objective rhinootological follow-up, using a four-step score from -1 to+2. Results: no serious side effects were seen. There was good to excellent clinical improvement with a mean score of +1.44 {+-} 0.5 by patients self-evaluation and by physicians scoring of +0.81 {+-} 0.9 with only negligible extracranial tracer deposition. Conclusion: this novel treatment option using intracavitary application of Re-186-colloid in chronic otitis media and sinusitis is safe and effective. The term Radio-Tympano-Sinu-Orthesis (RTSO) might be proposed analogously to the well-known radiosynoviorthesis (RSO). (orig.)

Otitis Media in a New Mouse Model for CHARGE Syndrome with a Deletion in the Chd7 Gene

Science.gov (United States)

Tian, Cong; Yu, Heping; Yang, Bin; Han, Fengchan; Zheng, Ye; Bartels, Cynthia F.; Schelling, Deborah; Arnold, James E.; Scacheri, Peter C.; Zheng, Qing Yin

2012-01-01

Otitis media is a middle ear disease common in children under three years old. Otitis media can occur in normal individuals with no other symptoms or syndromes, but it is often seen in individuals clinically diagnosed with genetic diseases such as CHARGE syndrome, a complex genetic disease caused by mutation in the Chd7 gene and characterized by multiple birth defects. Although otitis media is common in human CHARGE syndrome patients, it has not been reported in mouse models of CHARGE syndrome. In this study, we report a mouse model with a spontaneous deletion mutation in the Chd7 gene and with chronic otitis media of early onset age accompanied by hearing loss. These mice also exhibit morphological alteration in the Eustachian tubes, dysregulation of epithelial proliferation, and decreased density of middle ear cilia. Gene expression profiling revealed up-regulation of Muc5ac, Muc5b and Tgf-β1 transcripts, the products of which are involved in mucin production and TGF pathway regulation. This is the first mouse model of CHARGE syndrome reported to show otitis media with effusion and it will be valuable for studying the etiology of otitis media and other symptoms in CHARGE syndrome. PMID:22539951

Eustachian tube diameter: Is it associated with chronic otitis media development?

Science.gov (United States)

Paltura, Ceki; Can, Tuba Selçuk; Yilmaz, Behice Kaniye; Dinç, Mehmet Emre; Develioğlu, Ömer Necati; Külekçi, Mehmet

To evaluate the effect of ET diameter on Chronic Otitis Media (COM) pathogenesis. Retrospective. Patients with unilateral COM disease are included in the study. The connection between fibrocartilaginous and osseous segments of the Eustachian Tube (ET) on axial Computed Tomography (CT) images was defined and the diameter of this segment is measured. The measurements were carried out bilaterally and statistically compared. 154 (76 (49%) male, 78 (51%) female patients were diagnosed with unilateral COM and included in the study. The mean diameter of ET was 1947mm (Std. deviation±0.5247) for healthy ears and 1788mm (Std. deviation±0.5306) for diseased ears. The statistical analysis showed a significantly narrow ET diameter in diseased ear side (p<0.01). The dysfunction or anatomical anomalies of ET are correlated with COM. Measuring of the bony diameter of ET during routine Temporal CT examination is recommended for our colleagues. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk of childhood otitis media with focus on potentially modifiable factors

DEFF Research Database (Denmark)

Kørvel-Hanquist, Asbjørn; Koch, Anders; Lous, Jørgen

2018-01-01

Introduction Otitis media is the primary cause of antibiotic prescription in children. Two-thirds of all children experience at least one episode of otitis media before the age of 7 years. The aim of this study was to characterise the attributable effect of several modifiable risk exposures...... on the risk of >3 episodes of otitis media at age 18 months and 7 years within a large prospective national birth cohort. Methods The study used the Danish National Birth Cohort comprising information about otitis media and risk exposures from more than 50,000 mother-child pairs from the period 1996...... with an increased risk of >3 episodes of otitis media at 18 months of age and at 7 years of age. The fraction of children with otitis media attributed from breastfeeding lasting for less than 6 months was 10%. Introduction to daycare before the age of 12 months attributed with 20% of the cases of >3 episodes...

Can Serum Neutrophil-to-Lymphocyte Ratio Be a Predictive Biomarker to Help Differentiate Active Chronic Otitis Media From Inactive Chronic Otitis Media?

Science.gov (United States)

Tansuker, Hasan Deniz; Eroğlu, Sinan; Yenigün, Alper; Taşkin, Ümit; Oktay, Mehmet Faruk

2017-05-01

The authors' aim was to investigate whether serum neutrophil to lymphocyte ratio might be used as a predictive biomarker to help differentiate active from inactive chronic otitis media (COM). Two hundred fifty-nine patients having inactive COM received tympanoplasty without mastoidectomy and were identified as Group 1. On the other hand, 254 patients having active COM received tympanoplasty with mastoidectomy and were identified as Group 2. Routine hemogram tests were performed preoperatively for both the groups. By performing a chart review, white blood cell count, red blood cell count, hemoglobin, hematocrit, platelet, and mean platelet volume values were compared between the groups in an age-matched and sex-matched manner. A total of 513 COM patients with age range of 7 to 65 years were included in the study. Two hundred seventy-five patients (53.6%) were male, 238 were (46.4%) female. Preoperatively both serum neutrophil and lymphocyte counts were significantly higher in Group 2 (P = 0.015 and P = 0.004, respectively). However, the neutrophil-to-lymphocyte ratios between the groups were not significantly different (P = 0.511). No statistically significant differences were identified from preoperative neutrophil-to-lymphocyte ratios between patients having active COM and inactive COM. Level NA.

THE TREATMENT OF AERO-OTITIS MEDIA BY REDECOMPRESSION,

Science.gov (United States)

The precipitating event preceding the appearance of aero- otitis media is the development of a relative vacuum within the middle ear. The aim of...obtaining normal pressure relationships between the middle ear and the environment. In 27 of a group of 33 men with severe aero- otitis media , this

Allergic rhinitis is associated with otitis media with effusion

DEFF Research Database (Denmark)

Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye

2012-01-01

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....

Do the angle and length of the eustachian tube influence the development of chronic otitis media?

Science.gov (United States)

Dinç, Aykut Erdem; Damar, Murat; Uğur, Mehmet Birol; Öz, Ibrahim Ilker; Eliçora, Sultan Şevik; Bişkin, Sultan; Tutar, Hakan

2015-09-01

To compare the eustachian tube (ET) angle (ETa) and length (ETl) of ears with and without chronic otitis media (COM), and to determine the relationship between ET anatomy and the development of COM. A retrospective case-control study. The study group comprised 125 patients (age range, 8-79 years; 64 males and 61 females) with 124 normal ears and 126 diseased ears, including ears with chronic suppurative otitis media (CSOM) with central perforation, intratympanic tympanosclerosis (ITTS), cholesteatoma, and a tympanic membrane with retraction pockets (TMRP). ET angle and length were measured using computed tomography employing the multiplanar reconstruction technique. The ETa was significantly more horizontal in diseased versus normal ears of all study groups (P = .030), and there was no group difference in ETl (P = .160). ETl was shorter in CSOM versus ITTS ears and normal ears (P = .007 and P = .003, respectively) and in cholesteatoma versus TMRP ears (P = .014). In the unilateral COM group, there were no significant differences in the ETa or ETl of diseased versus contralateral normal ears (P = .155 and P = .710, respectively). The ETa was significantly more horizontal in childhood-onset diseased versus normal ears (P = .027), and there was no group difference in ETl (P = .732). The ETa (P = .002) and ETl (P < .001) were significantly greater in males than females. A more horizontal ETa and shorter ETl could be contributory (though not significantly) etiological factors in the development of COM. 3b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

A Rare Complication of Acute Otitis Media: Otitic Hydrocephalus

Directory of Open Access Journals (Sweden)

Ahmet Mutlu

2013-06-01

Full Text Available Acute otitis media is very common disorder in childhood. In this article we present a 6-years old boy who applied with diplopia, dysfunction of lateral eye movements on left eye, nausea, at 10th day of acute otitis media treatment. After the radiological images case was described as an otitic hydrocephalus clinic. Patient underwent medical treatment, lomboperitoneal shunt operation and simple mastoidectomy. We wanted to share the evaluation and the management steps of this very rare complication of acute otitis media.

[Quality of Life of Children with Otitis Media and Impact of Insertion of Transtympanic Ventilation Tubes in a Portuguese Population].

Science.gov (United States)

Lameiras, Ana Rita; Silva, Deodato; O Neill, Assunção; Escada, Pedro

2018-01-31

Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children's quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media. This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure. The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains 'caregiver concerns', 'hearing loss' and 'physical suffering' had the highest scores. The domain 'hearing loss' was correlated with the domain 'speech impairment' (rs = 0.41; p Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.

Radiographic and computed tomographic evaluation of otitis media in the dog

International Nuclear Information System (INIS)

Love, N.E.; Kramer, R.W.; Spodnick, G.J.; Thrall, D.E.

1995-01-01

The purpose of this study was to compare computed tomography (CT) and radiography in the identification of canine middle ear disease. Fourteen canine patients underwent a radiographic “bullae series” and CT examination of the tympanic bullae. Confirmation of otitis media was based on surgery. The overall diagnostic accuracy of CT and radiographs regarding the diagnosis of otitis media was similar. Although a marked difference was not detected between radiographs and CT for detecting otitis media using Youden's index values, CT was a more sensitive test for the detection of otitis media

Otitis Media Diagnosis for Developing Countries Using Tympanic Membrane Image-Analysis.

Science.gov (United States)

Myburgh, Hermanus C; van Zijl, Willemien H; Swanepoel, DeWet; Hellström, Sten; Laurent, Claude

2016-03-01

Otitis media is one of the most common childhood diseases worldwide, but because of lack of doctors and health personnel in developing countries it is often misdiagnosed or not diagnosed at all. This may lead to serious, and life-threatening complications. There is, thus a need for an automated computer based image-analyzing system that could assist in making accurate otitis media diagnoses anywhere. A method for automated diagnosis of otitis media is proposed. The method uses image-processing techniques to classify otitis media. The system is trained using high quality pre-assessed images of tympanic membranes, captured by digital video-otoscopes, and classifies undiagnosed images into five otitis media categories based on predefined signs. Several verification tests analyzed the classification capability of the method. An accuracy of 80.6% was achieved for images taken with commercial video-otoscopes, while an accuracy of 78.7% was achieved for images captured on-site with a low cost custom-made video-otoscope. 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.

[Acute otitis media: could it be a sentinel indicator of health care?].

Science.gov (United States)

Cabrera-Gaytán, David Alejandro; Valle-Alvarado, Gabriel; Krug-Llamas, Ernesto; Grajales-Muñiz, Concepción

2014-01-01

Acute otitis media is the most common bacterial disease in children under five years; therefore, is one of the most common causes of pediatric consultation. Our objective was to determine the feasibility to consider this disease as a sentinel factor of medical attention. All the new cases of acute otitis media registered between 2008 and 2011 were collected and analyzed. Proportions, ratios, and incidence rates were determined. Also, the limits for proportions were calculated using mid P exact test. In children under five years, we observed 20 % of the cases of non-suppurative otitis media, and suppurative otitis media in 17 %. The reason for acute respiratory infection in relation to cases of otitis media in children of this age increased from 87:1 in 2008 to 53:1 in 2011. The reason of suppurative otitis media decreased in children under five years, even in 2009, when it was registered the highest number of new cases of acute respiratory infection. It was not feasible to determine if acute otitis media is a sentinel indicator; however, we could monitor medical attention indirectly.

HIF-VEGF pathways are critical for chronic otitis media in Junbo and Jeff mouse mutants.

Directory of Open Access Journals (Sweden)

Michael T Cheeseman

2011-10-01

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

Validation of the Otitis Media-6 Questionnaire for European Portuguese

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Ana Rita Lameiras

2017-05-01

Conclusion: The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

Values Range of Tympanometric Gradient in Otitis Media With Effusion.

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Duzer, Sertac; Sakallioglu, Oner; Akyigit, Abdulvahap; Polat, Cahit; Cetiner, Hasan; Susaman, Nihat

2017-05-01

The aim of this study was to establish how reliable a given tympanogram is in predicting the presence or absence of a middle ear effusion, and to provide new views for the diagnostic information of tympanometry. The use of tympanometric gradient in addition to static admittance is the focus of this study. The authors enrolled 146 female and 129 male patients. The participants were allocated into groups as follow: Group A1 consisted of 50 healthy children. Group A2 consisted of 86 children with otitis media with effusion. Group B1 consisted of 85 healthy adults. Group B2 consisted of 54 adults with otitis media with effusion. All diagnostic otoscopic examination and tympanometry were performed in both ears. The authors analyzed the distribution of tympanograms in patients with otitis media with effusion and healthy controls. When the right and left ear canal volume of either children or adults with otitis media with effusion compared with healthy controls, no statistically significant different was observed (P > 0.05). On the other hand, the statistically significant difference was detected for the values of compliance, pressure and gradient of either children or adults with otitis media with effusion compared with healthy controls (P effusion. The authors think that tympanometric gradient may be useful to detect the otitis media with effusion.

Treatment of acute otitis media in general practice

DEFF Research Database (Denmark)

Plejdrup Hansen, Malene; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente

2012-01-01

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......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...

Otitis Media and Its Sequelae in Kenyan Schoolchildren.

Science.gov (United States)

Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

2016-12-01

The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Complicaciones de las otitis medias agudas y crónicas en el niño Complications of acute and chronic otitis media in the child

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Julianis Loraine Quintero Noa

2013-03-01

Full Text Available Gracias al descubrimiento de los antibióticos, la incidencia de complicaciones en las otitis medias agudas y crónicas ha descendido significativamente, aunque continúan siendo un peligro potencial de morbilidad y mortalidad. La disminución de las complicaciones puede condicionar retrasos diagnósticos por falta de sospecha clínica, enmascaramiento por tratamientos antibióticos previos y mal pronóstico, por lo cual siguen siendo procesos graves que ponen en peligro la vida del enfermo. Se definen actualmente con igual sistema de clasificación: extracraneales e intracraneales. Las primeras se subdividen en extratemporal e intratemporal, y constituyen un problema de salud en la población pediátrica a pesar del uso extendido de antibióticos. La evaluación clínico-otomicroscópica e imaginológica se reporta como criterio diagnóstico predictivo de sospecha y de confirmación. La parálisis facial, el vértigo, los vómitos, la cefalea, el dolor irradiado a la mastoides o a la región temporoparietal, y la hipertermia, deben alertar al médico sobre la presencia de una complicación supurada.Thanks to the discovery of antiobiotics, the incidence of complications in the chronic and acute otitis media has significantly decreased, though they remain a potential mortality and morbidity risk. The reduction of complications can be conditional on some diagnostic delays, on account of lack of clinical suspicions, symptoms disguised by previous antibiotic treatments and wrong prognosis; therefore, the complications continue to be severe processes that endanger the patient's life. They are currently classified as extracranial and intracranial. The former are divided into extratemporal and intratemporal and represent a health problem for the pediatric population despite the extended use of antibiotics. The clinical, otomicroscopic and imaging assessment is reported as a diagnostic criterion predictive of suspicions and of confirmation. Facial

Pro-inflammatory interleukins in middle ear effusions from atopic and non-atopic children with chronic otitis media with effusion.

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Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

2016-06-01

Chronic otitis media with effusion (OME) is associated with irreversible changes in the middle ear, sometimes leading to hearing loss and abnormal language development in children. While the pathogenesis of OME is not fully understood, inflammatory and allergic factors are thought to be involved. The study aimed to investigate the role of cytokines in the local development of chronic OME, and assess differences in the cytokine profiles between atopic and non-atopic children. 84 atopic and non-atopic children with chronic OME (mean age of 6 years 7 months) were studied. Age-matched children with hypertrophy of the adenoids and Eustachian tube dysfunction served as the control group. The number of past acute otitis media (AOM) episodes, their age, and the type of effusion were recorded for all children. Pro-inflammatory cytokine concentrations (TNF-α, IL-1β, IL-6 and IL-8) were determined and the presence of pathogenic bacteria in the patients' effusions was examined. High concentrations of TNF-α, IL-1β, IL-6 and IL-8 were found in the effusions in all children with chronic OME, with the highest levels observed in the non-atopic group. The atopic group showed persistently high IL-1β levels, while in the non-atopic children, IL-1β and TNF-α levels positively correlated with the patient's age and the number of past AOM episodes. Pathogenic bacteria were more frequently isolated from effusions in non-atopic children. In both atopic and non-atopic children, pro-inflammatory cytokines are found at high concentrations. This argues in favor of instituting anti-inflammatory management for treating OME, regardless of atopy.

[The clinical classification of acute otitis media with special reference to tympanometry].

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Subbotina, M V

We have developed a new clinical classification of acute otitis media (AOM) based on the previously proposed classifications of V.T. Palchun with co-workers (1997) and J. Jeger (1970) in which the letter near the stage of the pathological process roughly corresponds to the type of the tympanogram as follows: stage I (acute tubootitis): A, B, C; stage II (acute catarrhal otitis media): A, B, C; stage III (acute purulent otitis media, perforation stage); stage IV (acute purulent otitis media, post-perforation stage); stage V (resolution of otitis media): A - convalescence or recovery, B1 - exudate present in the tympanic cavity; B2 - persisting perforation; C - block of the auditory tube, O - the development of complications. This classification implies the necessity of tympanometry at the stage of diagnostics of AOM although it is not mandatory because the detection of exudate as a result of paracentesis at any of the stages of otitis media will allow to designate the stage of otitis either by letter A, B or C. The application of the new classification described in this article permits to more accurately than before determine the character of the pathological process in the middle ear during the course of acute otitis media which is of special importance in the clinical pediatric practice for the timely and adequate treatment of the children.

Complementary and alternative medicine for pediatric otitis media.

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Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

2013-06-01

To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain

Otitis Media: Coping with the Effects in the Classroom.

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Davis, Dorinne S.

This curriculum adaptation provides a methodology that enables the classroom teacher to recognize the needs of the otitis media-affected child in the classroom. It discusses areas of concern related to otitis media; suggests activities that can enhance these children's language skills; and shows ways to enhance the learning environment by…

Pathogenesis and diagnosis of otitis media with ANCA-associated vasculitis.

Science.gov (United States)

Yoshida, Naohiro; Iino, Yukiko

2014-12-01

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is histologically characterized by systemic necrotizing vasculitis and is clinically classified into two phases, systemic or localized. Recently, otological symptoms such as otitis media and hearing loss, not previously often associated with AAV, have been reported in AAV cases. In these cases we propose a diagnosis of otitis media with AAV (OMAAV). The ANCA titer is important for the diagnosis of OMAAV, and in most cases rapid progressive hearing loss is observed as localized AAV. Peripheral facial nerve palsy or hypertrophic pachymeningitis are coupled with 25% of cases and 18% of cases respectively. Proteinase 3-ANCA (PR3-ANCA) positive otitis media causes granulomatous formation or middle ear effusion in the middle ear, on the other hand myeloperoxidase-ANCA (MPO-ANCA) positive otitis media predominantly presents as otitis media with effusion. The early diagnosed case and the sensorineural hearing loss not progressed deaf could be recovered by the immunosuppressive therapy. Delayed diagnosis of AAV occasionally leads to progression to the irreversible phase; therefore, diagnosis at the early-localized stage is important for treating AAV. In this review, we discuss the current understanding of this newly proposed concept of OMAAV.

Rare A2ML1 variants confer susceptibility to otitis media

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Santos-Cortez, Regie Lyn P.; Chiong, Charlotte M.; Reyes-Quintos, Ma. Rina T.; Tantoco, Ma. Leah C.; Wang, Xin; Acharya, Anushree; Abbe, Izoduwa; Giese, Arnaud P.; Smith, Joshua D.; Allen, E. Kaitlynn; Li, Biao; Cutiongco-de la Paz, Eva Maria; Garcia, Marieflor Cristy; Llanes, Erasmo Gonzalo D.V.; Labra, Patrick John; Gloria-Cruz, Teresa Luisa I.; Chan, Abner L.; Wang, Gao T.; Daly, Kathleen A.; Shendure, Jay; Bamshad, Michael J.; Nickerson, Deborah A.; Patel, Janak A.; Riazuddin, Saima; Sale, Michele M.; Chonmaitree, Tasnee; Ahmed, Zubair M.; Abes, Generoso T.; Leal, Suzanne M.

2015-01-01

A duplication variant within middle-ear-specific gene A2ML1 co-segregates with otitis media in an indigenous Filipino pedigree (LOD score=7.5 at reduced penetrance) and lies within a founder haplotype that is also shared by three otitis-prone European- and Hispanic-American children, but is absent in non-otitis-prone children and >62,000 next-generation sequences. Seven additional A2ML1 variants were identified in six otitis-prone children. Collectively our studies support a role for A2ML1 in the pathophysiology of otitis media. PMID:26121085

Increased susceptibility to otitis media in a Splunc1-deficient mouse model

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Bartlett, Jennifer A.; Meyerholz, David K.; Wohlford-Lenane, Christine L.; Naumann, Paul W.; Salzman, Nita H.; McCray, Paul B.

2015-01-01

ABSTRACT Otitis media (inflammation of the middle ear) is one of the most common diseases of early childhood. Susceptibility to otitis is influenced by a number of factors, including the actions of innate immune molecules secreted by the epithelia lining the nasopharynx, middle ear and Eustachian tube. The SPLUNC1 (short palate, lung, nasal epithelial clone 1) protein is a highly abundant secretory product of the mammalian nasal, oral and respiratory mucosa that is thought to play a multifunctional role in host defense. In this study we investigated Splunc1 expression in the ear of the mouse, and examined whether this protein contributes to overall host defense in the middle ear and/or Eustachian tube. We found that Splunc1 is highly expressed in both the surface epithelium and in submucosal glands in these regions in wild-type mice. In mice lacking Splunc1, we noted histologically an increased frequency of otitis media, characterized by the accumulation of leukocytes (neutrophils with scattered macrophages), proteinaceous fluid and mucus in the middle ear lumens. Furthermore, many of these mice had extensive remodeling of the middle ear wall, suggesting a chronic course of disease. From these observations, we conclude that loss of Splunc1 predisposes mice to the development of otitis media. The Splunc1−/− mouse model should help investigators to better understand both the biological role of Splunc1 as well as host defense mechanisms in the middle ear. PMID:25765466

Otitis Media and Related Complications among Children with Autism Spectrum Disorders

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Adams, Daniel J.; Susi, Apryl; Erdie-Lalena, Christine R.; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M.

2016-01-01

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…

The Predictive Value of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio for the Effusion Viscosity in Otitis Media With Chronic Effusion.

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Elbistanli, Mustafa Suphi; Koçak, Hasan Emre; Acipayam, Harun; Yiğider, Ayşe Pelin; Keskin, Mehmet; Kayhan, Fatma Tülin

2017-05-01

The objective of the authors' study was to investigate the predictive value of the neutrophil-lymphocyte rate (NLR) and platelet-lymphocyte rate (PLR) in otitis media with effusion and the correlation of the effusion type with these ratios. Retrospective case-control study. One hundred twenty-six pediatric patients diagnosed otitis media with chronic effusion and had ventilation tube inserted between October 2015 and July 2016 were included in the study group and 124 healthy children, who applied for the routine examination and had blood count analysis, were included in the control group. The patients in the study group were divided into 2 groups regarding the effusion viscosity, which was obtained from the patients' operation files. Seventy-one patients were included in the serous group and 55 patients in the mucous group. The NLR and PLR rates of the groups were compared and statistically evaluated. The average NLR and PLR rates were significantly higher in the study group than in the control group (P = 0.000, P = 0.004 respectively). Comparison of the serous and mucous groups with the control group revealed a significant difference between the control group and the serous group regarding the NLR and PLR (P = 0.000; P = 0.000 respectively), but not between the control group and mucous group (P = 0.694; P = 0.691 respectively). Neutrophil-lymphocyte rate and PLR had a predictive value for otitis media with effusion and additionally it was a laboratory indicator supporting the typing of the viscosity of the fluid accumulated in the middle ear.

Acute otitis media: characterization and risk factors

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Amalia Nieves Álvarez

2011-03-01

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.

191 bacterial agents of otitis media and their sensitivity to some ...

African Journals Online (AJOL)

DR. AMINU

2010-06-01

Shamsuddeen, U., Usman A. D., Bukar, ... Key Words: Bacterial agents, otitis media, sensitivity, antibiotics, AKTH. INTRODUCTION. Otitis media is an .... Atlas R.M (1998) Microbiology Fundamentals and. Applications. Second edition ...

Pathogenesis of otitis externa and otitis media in dogs and cats

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Popović Nikola

2005-01-01

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

The microbiome of otitis media with effusion.

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Chan, Chun Ling; Wabnitz, David; Bardy, Jake Jervis; Bassiouni, Ahmed; Wormald, Peter-John; Vreugde, Sarah; Psaltis, Alkis James

2016-12-01

The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Quality of life in children with otitis media--a cohort study.

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Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen; Munck, Anders; Larsen, Pia V; Thomsen, Janus L

2014-02-01

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 with different factors like insertion of VT and use of antibiotics. We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental smoking were associated with the long-term HRQOL in children with otitis media. A cohort study including 397 children was carried out. The children were followed for 13 months, and symptoms, HRQOL and so on were identified by means of questionnaires. HRQOL in children with otitis 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 months due to the child' s otitis media compared with children with parents not being absent from their work. There were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period compared with children without a VT. 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 were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period.

Household crowding associated with childhood otitis media hospitalisations in New Zealand.

Science.gov (United States)

Bowie, Christopher; Pearson, Amber L; Campbell, Malcolm; Barnett, Ross

2014-06-01

To examine the association between hospitalisations for otitis media and area-level measures of household crowding among children in New Zealand. Counts of hospital admissions for otitis media by census area unit were offset against population data from the 2006 national census. Area-level household crowding, exposure to tobacco smoke in the home, equivalised income and individual-level characteristics age and sex were adjusted for. To examine effect modification by ethnicity, three separate poisson models were examined for the total, Māori and non-Māori populations. Household crowding was significantly associated with hospital admissions for otitis media after adjustment in all three models. Neighbourhoods with the highest compared to the lowest proportion of crowded homes exhibited incidence rate ratios of 1.25 (95%CI 1.12-1.37) in the total population, 1.59 (95%CI 1.21-2.04) in the Māori restricted model and 1.17 (95%CI 1.06-1.32) in the non-Māori restricted model. Otitis media hospitalisations are associated with area-level measures of household crowding and other risk factors in this ecological study. The largest increase in otitis media incidence relative to neighbourhood rates of household crowding was exhibited among Māori cases of otitis media. This study adds weight to the growing body of literature linking infectious disease risk to overcrowding in the home. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Otitis media: is precursor of delayed reading in Arabic speaking children?

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Azab, Safinaz Nagib; Rhman, Samir Shokr A

2014-04-01

To investigate the relation between otitis media in the language acquisition years and the occurrence of delayed reading between the ages of 7 and 10. Participants were 40 children, half of whom had a history of otitis media between the ages of birth and three years and half who were free of the disease. These children, now ages 7-10, were tested with the Stanford Beint and Arabic Dyslexia Assessment Test. Children with a history of otitis media scored over a year below grade level in reading and significantly below controls on Arabic Dyslexia Assessment tests as well as on the Verbal IQ factor on the Stanford Binet. Children with early onset otitis media (birth to three years) tend to be at greater risk for delayed reading than age-matched controls. Published by Elsevier Ireland Ltd.

Pneumococcal Conjugate Vaccines and Otitis Media: An Appraisal of the Clinical Trials

Science.gov (United States)

Fletcher, Mark A.; Fritzell, Bernard

2012-01-01

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 (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis?

Science.gov (United States)

Laulajainen-Hongisto, Anu; Saat, Riste; Lempinen, Laura; Aarnisalo, Antti A; Jero, Jussi

2015-09-01

To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis. A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time. The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis. Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media

New vaccines against otitis media: projected benefits and cost-effectiveness.

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O'Brien, Megan A; Prosser, Lisa A; Paradise, Jack L; Ray, G Thomas; Kulldorff, Martin; Kurs-Lasky, Marcia; Hinrichsen, Virginia L; Mehta, Jyotsna; Colborn, D Kathleen; Lieu, Tracy A

2009-06-01

New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed. We created a computerized model to compare the projected benefits and costs of (1) the currently available 7-valent pneumococcal conjugate vaccine, (2) a candidate pneumococcal-nontypeable H influenzae vaccine that has been tested in Europe, (3) a hypothetical pneumococcal-nontypeable H influenzae-Moraxella vaccine, and (4) no vaccination. The clinical probabilities of acute otitis media and of otitis media with effusion were generated from multivariate analyses of data from 2 large health maintenance organizations and from the Pittsburgh Child Development/Otitis Media Study cohort. Other probabilities, costs, and quality-of-life values were derived from published and unpublished sources. The base-case analysis assumed vaccine dose costs of $65 for the 7-valent pneumococcal conjugate vaccine, $100 for the pneumococcal-nontypeable H influenzae vaccine, and $125 for the pneumococcal-nontypeable H influenzae-Moraxella vaccine. With no vaccination, we projected that 13.7 million episodes of acute otitis media would occur annually in US children aged 0 to 4 years, at an annual cost of $3.8 billion. The 7-valent pneumococcal conjugate vaccine was projected to prevent 878,000 acute otitis media episodes, or 6.4% of those that would occur with no vaccination; the corresponding value for the pneumococcal-nontypeable H influenzae vaccine was 3.7 million (27%) and for the pneumococcal-nontypeable H influenzae-Moraxella vaccine was 4.2 million (31%). Using the base-case vaccine costs, pneumococcal-nontypeable H influenzae vaccine use would result in net savings compared with nontypeable 7-valent pneumococcal conjugate use. Conversely, pneumococcal-nontypeable H influenzae-Moraxella vaccine use would not

Comparison between Microscopic and Endoscopic Approaches for Evaluation of Anatomic Areas in Surgically Treated Chronic Otitis Media

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M.T. Goodarzi

2013-07-01

Full Text Available Introduction & Objective: The diagnostic value of endoscopic and microscopic procedures for viewing different structures of middle ear has been widely assessed however, no published study is available for comparing the diagnostic value of them in chronic otitis media patients. The present study conducted to compare diagnostic value of these two procedures for as-sessment of middle ear normal structures and possible defects in these patients. Materials & Methods: In a prospective descriptive analytical study, fifty eight consecutive pa-tients older than 15 years who suffered from chronic otitis media and were candidates for tympanoplasty with or without mastoidectomy were included into the study and underwent operation. After entering the middle ear by post auricular incision and elevation of a tym-panomeatal flap, and prior to surgery , the middle ear was first examined by an operating mi-croscope in different bed and microscope positions and by performing gentle maneuvers on the head and then was reevaluated using a rigid 0 & 30 degree sinoscope. The visible areas of middle ear were separately noted. Results: Structures of epitympanum, posterior mesotympanum, and hypotympanum structures were more visible using endoscope compared with microscope(P0.05. Conclusion: Endoscopic and microscopic procedures had similar diagnostic values to view ossicular chain mobility and reflexes of round window as well as to detect ossicular chain erosions, but different anatomical parts and more hidden pits of the middle ear such as epitympanum, posterior mesotympanum, and hypotympanum are more visible by an endoscopic tool.In case of pathologic conditions, endoscopic approach is recommended for better observation and adequate evaluation of the location before and after the removal of the lesion. (Sci J Hamadan Univ Med Sci 2013; 20 (2:95-100

Microbiology of otitis media in Indigenous Australian children: review.

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Jervis-Bardy, J; Carney, A S; Duguid, R; Leach, A J

2017-07-01

To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions. Literature review. Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children. Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities ('microbiomes') of samples obtained from Indigenous children with otitis media.

Psychometric characteristics of the chronic Otitis media questionnaire 12 (COMQ - 12): stability of factor structure and replicability shown by the Serbian version.

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Bukurov, Bojana; Arsovic, Nenad; Grujicic, Sandra Sipetic; Haggard, Mark; Spencer, Helen; Marinkovic, Jelena Eric

2017-10-23

Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have risen throughout the world healthcare. Our contribution to meeting that demand has been translating and culturally adapting the Chronic Otitis Media Questionnaire-12 (COMQ-12) for adults into Serbian and enhancing its psychometric base on the relatively large Serbian COM caseload. Chronic otitis media can seriously affect quality of life progressively and in long-term, and it remains the major source of hearing problems in the developing world. The translated questionnaire was given twice to 60 adult patients with chronic otitis media of three types (inactive, active mucosal and active squamous disease) and to 60 healthy volunteers. Both patients and volunteers also filled the generic Short-Form 36 questionnaire (SF-36). Conventional statistical procedures were used in strategically driven development of scoring. Additionally, item responses were scaled by linear mapping against the provisional total score. Generalizability, detailed factor interpretation and supportability of scores were criteria, for the best compromise factor solution. Test-retest reliability was very high (0.924 to 0.989, depending on score). The a priori content dimensions of the questionnaire were strongly supported by 3-factor exploratory and confirmatory factor analyses for content validity, separating (i) ear symptoms from (ii) hearing problems, from (iii) daily activity restriction plus healthcare uptake. The 3-factor structure was furthermore highly stable on replication. The very large effect sizes when contrasting patients with healthy volunteers, and active with inactive disease established construct validity for the total score. A strong association with disease activity and a moderate one with generic health-related quality of life (HRQoL), the SF-36, supported construct validity for two of three factors extracted (ear symptoms, and impact on daily activities plus healthcare uptake). Given

Serum Antibody Response to Five Streptococcus pneumoniae Proteins during Acute Otitis Media in Otitis Prone and Non-Otitis Prone Children

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Kaur, Ravinder; Casey, Janet R.; Pichichero, Michael E.

2011-01-01

Background Streptococcus pneumoniae (Spn) is one of the common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (otitis-prone) and AOM treatment failure (AOMTF) in children. Objective From a population of 268 children we sought to compare the serum IgG antibody titers to five different Spn proteins (PhtD, LytB, PcpA, PhtE and Ply) that are vaccine candidates in children with episodic AOM (n=34), who were otitis prone (n=35), and who had AOMTF (n=25) caused by Spn. Methods Antibody was quantitated by ELISA. Results At their acute AOM visit, anti-PhtD, -LytB, -PhtE and −Ply IgG antibody titers in otitis-prone children were significantly lower compared to non-otitis prone children (p otitis-prone, AOMTF and non-otitis prone children had no significant change in geometric mean IgG antibody titers against the five proteins (except for PhtE in children with AOMTF), but detailed analysis showed that about one-third of the children in each cohort had a 2-fold rise in antibody to the studied antigens. While non-otitis prone children had significant increases (p otitis-prone children either failed to show rises or the rises were significantly less than the non-otitis prone children. Conclusion Otitis-prone and AOMTF children mount less of an IgG serum antibody response than non-otitis prone children to Spn proteins following AOM and nasopharyngeal colonization. PMID:21487325

Frequent carriage of resistance mechanisms to beta-lactams and biofilm formation in Haemophilus influenzae causing treatment failure and recurrent otitis media in young children

NARCIS (Netherlands)

Garcia-Cobos, Silvia; Moscoso, Miriam; Pumarola, Felix; Arroyo, Margarita; Lara, Noelia; Perez-Vazquez, Maria; Aracil, Belen; Oteo, Jesus; Garcia, Ernesto; Campos, Jose

Objectives: Non-typeable Haemophilus influenzae are a major cause of acute otitis media (AOM), including chronic and recurrent otitis in young children. The objective of this study was to determine whether non-typeable H. influenzae isolates causing these infections produce biofilms and carry

Otitis Media, Learning and Community.

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McSwan, David; Clinch, Emma; Store, Ron

2001-01-01

A 3-year research project in Queensland (Australia) implemented educational and health strategies to ameliorate effects of otitis media at three schools in remote Aboriginal communities. The interdisciplinary model brought together health and education professionals, teacher aides, and the community, with the school being the lead agency. However,…

Mcph1-deficient mice reveal a role for MCPH1 in otitis media.

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Jing Chen

Full Text Available Otitis media is a common reason for hearing loss, especially in children. Otitis media is a multifactorial disease and environmental factors, anatomic dysmorphology and genetic predisposition can all contribute to its pathogenesis. However, the reasons for the variable susceptibility to otitis media are elusive. MCPH1 mutations cause primary microcephaly in humans. So far, no hearing impairment has been reported either in the MCPH1 patients or mouse models with Mcph1 deficiency. In this study, Mcph1-deficient (Mcph1(tm1a (/tm1a mice were produced using embryonic stem cells with a targeted mutation by the Sanger Institute's Mouse Genetics Project. Auditory brainstem response measurements revealed that Mcph1(tm1a (/tm1a mice had mild to moderate hearing impairment with around 70% penetrance. We found otitis media with effusion in the hearing-impaired Mcph1(tm1a (/tm1a mice by anatomic and histological examinations. Expression of Mcph1 in the epithelial cells of middle ear cavities supported its involvement in the development of otitis media. Other defects of Mcph1(tm1a (/tm1a mice included small skull sizes, increased micronuclei in red blood cells, increased B cells and ocular abnormalities. These findings not only recapitulated the defects found in other Mcph1-deficient mice or MCPH1 patients, but also revealed an unexpected phenotype, otitis media with hearing impairment, which suggests Mcph1 is a new gene underlying genetic predisposition to otitis media.

WITHDRAWN: Grommets (ventilation tubes) for recurrent acute otitis media in children.

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Lau, Loretta; Mick, Paul; Nunez, Desmond A

2018-04-06

This is an update of a Cochrane review first published in The Cochrane Library in Issue 4, 2008 and previously updated in 2011.Acute suppurative otitis media is one of the most common infectious diseases in childhood. Recurrent acute otitis media is defined for the purposes of this review as either three or more acute infections of the middle ear cleft in a six-month period, or at least four episodes in a year. Strategies for managing the condition include the assessment and modification of risk factors where possible, repeated courses of antibiotics for each new infection, antibiotic prophylaxis and the insertion of ventilation tubes (grommets). To establish whether grommet insertion reduces the frequency of episodes of recurrent acute otitis media and the proportion of symptomatic children. The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2014, Issue 10); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 6 November 2014. Randomised controlled trials comparing grommet insertion versus control (antibiotics/other treatments/no treatment) for recurrent acute otitis media in children aged from 0 to 16 years. Two authors independently selected studies. Three authors independently assessed study quality and extracted data. We synthesised data descriptively. Two randomised controlled trials with a total of 148 participants are included in this review. The overall risk of bias in the studies is unclear.The first study randomised 95 children to grommets or control (antibiotic treatment of acute otitis media episodes). For the primary outcome, this study showed that grommet insertion leads to a mean reduction of 1.5 episodes of acute otitis media in the first six months after treatment. In six months of follow-up significantly more children in the

(Central Auditory Processing: the impact of otitis media

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Leticia Reis Borges

2013-07-01

Full Text Available OBJECTIVE: To analyze auditory processing test results in children suffering from otitis media in their first five years of age, considering their age. Furthermore, to classify central auditory processing test findings regarding the hearing skills evaluated. METHODS: A total of 109 students between 8 and 12 years old were divided into three groups. The control group consisted of 40 students from public school without a history of otitis media. Experimental group I consisted of 39 students from public schools and experimental group II consisted of 30 students from private schools; students in both groups suffered from secretory otitis media in their first five years of age and underwent surgery for placement of bilateral ventilation tubes. The individuals underwent complete audiological evaluation and assessment by Auditory Processing tests. RESULTS: The left ear showed significantly worse performance when compared to the right ear in the dichotic digits test and pitch pattern sequence test. The students from the experimental groups showed worse performance when compared to the control group in the dichotic digits test and gaps-in-noise. Children from experimental group I had significantly lower results on the dichotic digits and gaps-in-noise tests compared with experimental group II. The hearing skills that were altered were temporal resolution and figure-ground perception. CONCLUSION: Children who suffered from secretory otitis media in their first five years and who underwent surgery for placement of bilateral ventilation tubes showed worse performance in auditory abilities, and children from public schools had worse results on auditory processing tests compared with students from private schools.

New Insights into Eosinophilic Otitis Media.

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Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

2015-12-01

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.

Thrombectomy approach using pediatric Foley catheter in lateral sinus thrombosis developed as a complication of chronic otitis media in a patient with sickle cell anemia

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Ercan Akbay

2014-04-01

Full Text Available Lateral sinus thrombophlebitis (LST is a rarely seen intracranial complication of chronic otitis media. Even single case report may guide in this entity given the lack of larger series. In the present manuscript, we will discuss removal of infected thrombus localized in transverse sinus via Foley catheter in a 46-years old man with sickle cell anemia underwent surgery due to LST.

Otitis Media: Effect on a Child's Learning.

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Gdowski, Becky S.; And Others

1986-01-01

The paper reviews the relationship between otitis media, auditory processing, language, and learning development. Suggestions are provided for identifying and managing students with suspected histories of the condition. (CL)

Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

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Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

2017-06-01

Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

Otitis Media and Caregiver Quality of Life

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse

2014-01-01

OBJECTIVE: Otitis media in children may have a considerable impact on caregiver quality of life. The disease-specific Caregiver Impact Questionnaire is designed to assess caregiver quality of life in relation to child otitis media. Assessment of the psychometric properties of this instrument...... is limited. This study assesses the psychometric properties of this instrument including validity, reproducibility, responsiveness, and interpretability. STUDY DESIGN: Longitudinal validation study. SETTING: Secondary care units. METHODS: Analyses were based on data from 435 families. Validity was assessed...... Danish version of the Caregiver Impact Questionnaire is a valid and reproducible measurement tool that is also sensitive to measuring change in the current setting. A change score representing minimal important change as perceived by the respondent is proposed. Results of this study support the use...

The human otitis media with effusion: a numerical-based study.

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Areias, B; Parente, M P L; Santos, C; Gentil, F; Natal Jorge, R M

2017-07-01

Otitis media is a group of inflammatory diseases of the middle ear. Acute otitis media and otitis media with effusion (OME) are its two main types of manifestation. Otitis media is common in children and can result in structural alterations in the middle ear which will lead to hearing losses. This work studies the effects of an OME on the sound transmission from the external auditory meatus to the inner ear. The finite element method was applied on the present biomechanical study. The numerical model used in this work was built based on the geometrical information obtained from The visible ear project. The present work explains the mechanisms by which the presence of fluid in the middle ear affects hearing by calculating the magnitude, phase and reduction of the normalized umbo velocity and also the magnitude and phase of the normalized stapes velocity. A sound pressure level of 90 dB SPL was applied at the tympanic membrane. The harmonic analysis was performed with the auditory frequency varying from 100 Hz to 10 kHz. A decrease in the response of the normalized umbo and stapes velocity as the tympanic cavity was filled with fluid was obtained. The decrease was more accentuated at the umbo.

Aetiology and pathology of otitis media with effusion in adult life.

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Mills, R; Hathorn, I

2016-05-01

To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults. A review of the English language literature from 1970 to the present was conducted. The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease. There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

Role of preoperative air-bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus.

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Kim, Hong Chan; Jang, Chul Ho; Kim, Young Yoon; Seong, Jong Yuap; Kang, Sung Hoon; Cho, Yong Beom

Previous reports indicated that middle ear surgery might partially improve tinnitus after surgery. However, until now, no influencing factor has been determined for tinnitus outcome after middle ear surgery. The purpose of this study was to investigate the association between preoperative air-bone gap and tinnitus outcome after tympanoplasty type I. Seventy-five patients with tinnitus who had more than 6 months of symptoms of chronic otitis media on the ipsilateral side that were refractory to medical treatment were included in this study. All patients were evaluated through otoendoscopy, pure tone/speech audiometer, questionnaire survey using the visual analog scale and the tinnitus handicap inventory for tinnitus symptoms before and 6 months after tympanoplasty. The influence of preoperative bone conduction, preoperative air-bone-gap, and postoperative air-bone-gap on tinnitus outcome after the operation was investigated. The patients were divided into two groups based on preoperative bone conduction of less than 25dB (n=50) or more than 25dB (n=25). The postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was less than 15dB showed no improvement in postoperative tinnitus using the visual analog scale (p=0.889) and the tinnitus handicap inventory (p=0.802). However, patients whose preoperative air-bone-gap was more than 15dB showed statistically significant improvement in postoperative tinnitus using the visual analog scale (ptinnitus handicap inventory (p=0.016). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using visual analog scale (p=0.006). However, the correlation between reduction in the visual analog scale score and air-bone-gap (p=0.202) or between reduction in tinnitus handicap inventory score and air-bone-gap (p=0.290) was not significant. We suggest that the preoperative air-bone-gap can be a predictor of tinnitus outcome after

[Incidence of complications of otitis media].

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Zernotti, M E; Casarotto, C; Tosello, M L; Zernotti, M

2005-02-01

Determine the incidence of otological and endocranial complications of acute otitis media, taking into account previous treatments and the development of complications. Retrospective follow-up study between March 1996-2003 including 16 patients: 9 men, 7 women. Nine patients (56.25%) had intracranial complications and seven otological ones. In the first group, 6 developed meningitis by Streptococcus pneumoniae, one sigmoid sinus thromboflebitis, one multiple abscesses, and one subdural empiema and encephalitis. Otological complications were six acute mastoiditis and the other one a facial paralysis. The child with thromboflebitis underwent mastoidectomy and closed meningeal comunication; 5 of the acute mastoiditis were operated on and the other received traditional treatment. The meningitis received medication. Two died, one because of a subdural empiema and the other due to meningitis. Despite the advances made by antibiotherapy and diagnosis, the complications of otitis media are still frequent. The pediatrician and otorhinolaryngologist should be on the alert for these as well as for Pneumococcus and its high resistance.

Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial.

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Cantekin, E I; Mandel, E M; Bluestone, C D; Rockette, H E; Paradise, J L; Stool, S E; Fria, T J; Rogers, K D

1983-02-10

In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine maleate, 0.35 mg per kilogram per day) with that of placebo. Among patients with initially unilateral disease, resolution of middle-ear effusion occurred at four weeks in 38 per cent of those treated with placebo and 34 per cent of those treated with drug (P = 0.74). Among patients with initially bilateral disease the corresponding proportions were 19 and 21 per cent, respectively (P = 0.67). Side effects were reported more often among drug-treated than placebo-treated patients. Decongestant-antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

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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.

2015-01-01

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

Epidemiology and Management of Otitis Media in Children.

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Giebink, G. Scott; Daly, Kathy

1990-01-01

This article focuses on definitions of middle ear inflammation (otitis media), the epidemiology of this disorder, brief considerations of pathophysiology and management, and possible future therapies. (DB))

A Study of Ossiculoplasty in Chronic Otitis Media using different types of Prostheses

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Parthapratim Laha

2013-12-01

Full Text Available Abstract Introduction: A wide range of prostheses, autologus and synthetic are available for use these days. Ideally, the ossicular reconstruction prosthesis should be biocompatible, safe, easy to handle and capable of efficient sound transmission. Aim and objectives: To study operative ease and post-operative hearing results in patients undergoing ossiculoplasty with different types of prostheses. Materials and methods: A prospective randomized study of 25 patients with Chronic Otitis Media, undergoing ossiculoplasty was conducted at Command Hospital, Kolkata. Tragal cartilage was used in 05 patients, conchal cartilage in 05, refashioned incus in 05, hydroxyapatite in 05 and titanium prostheses in 05 patients. Subjects with mixed hearing loss, multiple co-morbidities and revision surgeries were excluded. Hearing assessment was done by pure tone audiometry pre-operatively and 04 and 12 weeks postoperatively. Results were analyzed statistically. Results: Using tragal or conchal cartilage took almost equal time as autologus incus. Using synthetic material saved time. Titanium prosthesis gives maximum surgical ease. Post-operative air-bone gap reduction within 20 dB was seen in all, irrespective of type of prostheses.  Conclusion: Surgical ease is considerably better with titanium prostheses; however hearing results are equally good in all.

[Usefulness of fenspiride in the treatment of acute otitis media in children].

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Zielnik-Jurkiewicz, Beata; Jurkiewicz, Dariusz

2005-06-01

Acute otitis media is very general disease and concerns every child practically. The shortening the time of treatment as well as quick decrease of symptoms, and mainly the pain have large meaning in treatment of this disease. Combined treatment of fenspiride and typical treatment of otitis media permits as our investigations show on quicker and observed at children's larger number decrease of symptoms in children with acute otitis media. The aim of the study was to observe effectiveness of combined treatment with antibiotic and fenspiride in children with acute otitis media. The study comprised 40 children (mean age 8.2 years). The diagnosis of acute otitis media based on medical history data, otolaryngological examination and audiometry (tone and impedance). Children with GERD, hypersensitivity to amoxicillin and fenspiride as well as hypertrophy of adenoid were excluded from the study. Children were divided in two equal groups randomly. All children received amoxicillin in dose 80 mg/kg/day in three partite doses (Amotaks, Polfa Tarchomin Poland) as well as oxymethazolin 0.05% nasal drops 3 x day 1-2 drops (0.05% Nasivin, Merck Germany). In children from second group fenspiride was applied in dose 2 ml/kg/day in three divided doses (Eurespal, Servier Francja) additionally. Treatment was provided by 10 days. During the treatment parents made record of recession in 10 point scale, estimating following parameters: the pain of ear, bother, raised the temperature of body, loss of appetite, vomiting, diarrhea, otorrhea and crying. After end of treatment control otolaryngological and audiological examinations were performed. In studied children symptoms were similar, and the pain of ear was in both groups main suffering. Vomiting and diarrhea the most seldom were observed. In children with acute otitis media treated additionally with fenspiride statistically significant (pfenspiride in comparison to children treated only with antibiotic. Earlier return of hearing and

Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients.

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Akazawa, K; Doi, H; Ohta, S; Terada, T; Fujiwara, M; Uwa, N; Tanooka, M; Sakagami, M

2018-02-01

This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion. The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose-volume histogram parameters. Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes. The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

Serous otitis media (S.O.M.). A bacteriological study of the ear canal and the middle ear

NARCIS (Netherlands)

Cabenda, S. I.; Peerbooms, P. G.; van Asselt, G. J.; Feenstra, L.; van der Baan, S.

1988-01-01

A bacteriological study of the middle-ear effusions and the ear canals in children with chronic serous otitis media (S.O.M.) was performed. Sixty-eight children (127 ears) were investigated. From this study it appeared that cleansing of the ear canal with 0.5% chlorhexidine in 70% ethanol for 30 s

Mucosal pathology of an experimental otitis media with effusion after X-ray irradiation

International Nuclear Information System (INIS)

Ohashi, Y.; Nakai, Y.; Ikeoka, H.; Esaki, Y.; Koshimo, H.; Onoyama, Y.

1987-01-01

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

Recovery time for inflamed middle ear mucosa in chronic otitis media.

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Pakır, Onur; Dinç, Aykut Erdem; Damar, Murat; Akyıldız, İlker; Eliçora, Sultan Şevik; Erdem, Duygu

2016-01-01

The present study shows that 2-3 weeks after medical treatment the status of middle ear mucosa in draining ears is similar to that of dry ears for at least 3 months. To measure the time required for an inflamed middle ear mucosa to return into optimal state after appropriate medical treatment in chronic suppurative otitis media (CSOM). To assess optimal timing for elective surgical treatment of draining ears in uncomplicated CSOM. In this prospective study, the Eustachian tube (ET) mucociliary clearance time (MCT) was used as the method to demonstrate the status of middle ear mucosa. In group 1 (28 patients) ET-MCT was measured in ears that were free of drainage for at least 3 months. In Group 2 (21 patients), ET-MCT was measured in draining ears, who responded to 10-14 days medical treatment, at presentation, after 10 days and 1 month. The ET-MCT was 8.63 ± 1.32 min in group 1 and 28.96 ± 8.19 min in group 2 at presentation; and the difference was statistically significant (p < 0.001). The ET-MCT was 14.76 ± 5.11 min after 10 days and 9.31 ± 2.33 min after 1 month in group 2. The ET-MCT was indifferent between groups 1 and 2 after 1 month (p = 0.235).

Antibiotics for acute otitis media in children

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María Pía Nitsche

2015-10-01

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.

Fisetin administration improves LPS-induced acute otitis media in mouse in vivo

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Li, Peng; Chen, Dan; Huang, Yang

2018-01-01

Acute otitis media is one of the most common infectious diseases worldwide in spite of the widespread vaccination. The present study was conducted to explore the effects of fisetin on mouse acute otitis media models. The animal models were established by lipopolysaccharide (LPS) injection into the middle ear of mice via the tympanic membrane. Fisetin was administered to mice for ten days through intragastric administration immediate after LPS application. Hematoxylin and eosin (H&E) staining was performed and the pro-inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6 and VEGF, were measured through enzyme-linked immunosorbent assay (ELISA) method and RT-qPCR analysis. Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway was detected by immunoblotting assays. Reactive oxygen species (ROS) generated levels were determined through assessment of anti-oxidants, and TXNIP/MAPKs signaling pathways were explored to reveal the possible molecular mechanism for acute otitis media progression and the function of fisetin. Fisetin reduced mucosal thickness caused by LPS. In fisetin-treated animals, pro-inflammatory cytokine release was downregulated accompanied with TLR4/NF-κB inactivation. ROS production was significantly decreased in comparison to the LPS-treated group. The TXNIP/MAPKs signaling pathway was inactivated for fisetin treatment in LPS-induced mice with acute otitis media. The above results indicated that fisetin improved acute otitis media through inflammation and ROS suppression via inactivating TLR4/NF-κB and TXNIP/MAPKs signaling pathways. PMID:29568876

Fisetin administration improves LPS-induced acute otitis media in mouse in vivo.

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Li, Peng; Chen, Dan; Huang, Yang

2018-07-01

Acute otitis media is one of the most common infectious diseases worldwide in spite of the widespread vaccination. The present study was conducted to explore the effects of fisetin on mouse acute otitis media models. The animal models were established by lipopolysaccharide (LPS) injection into the middle ear of mice via the tympanic membrane. Fisetin was administered to mice for ten days through intragastric administration immediate after LPS application. Hematoxylin and eosin (H&E) staining was performed and the pro-inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6 and VEGF, were measured through enzyme-linked immunosorbent assay (ELISA) method and RT-qPCR analysis. Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway was detected by immunoblotting assays. Reactive oxygen species (ROS) generated levels were determined through assessment of anti-oxidants, and TXNIP/MAPKs signaling pathways were explored to reveal the possible molecular mechanism for acute otitis media progression and the function of fisetin. Fisetin reduced mucosal thickness caused by LPS. In fisetin-treated animals, pro-inflammatory cytokine release was downregulated accompanied with TLR4/NF-κB inactivation. ROS production was significantly decreased in comparison to the LPS-treated group. The TXNIP/MAPKs signaling pathway was inactivated for fisetin treatment in LPS-induced mice with acute otitis media. The above results indicated that fisetin improved acute otitis media through inflammation and ROS suppression via inactivating TLR4/NF-κB and TXNIP/MAPKs signaling pathways.

Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

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Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

2016-01-01

Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (potitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0

Microbiological profile of chronic suppurative otits media among HIV ...

African Journals Online (AJOL)

Background: Immune compromised HIV/AIDS infected children have consistently shown a higher prevalence of chronic suppurative otitis media than their immune competent counterparts.This study aimed to compare the microbial isolates from ear discharges in HIV infected and non infected children. Method: This was a ...

Risk of childhood otitis media with focus on potentially modifiable factors: A Danish follow-up cohort study.

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Kørvel-Hanquist, Asbjørn; Koch, Anders; Lous, Jørgen; Olsen, Sjurdur Frodi; Homøe, Preben

2018-03-01

Otitis media is the primary cause of antibiotic prescription in children. Two-thirds of all children experience at least one episode of otitis media before the age of 7 years. The aim of this study was to characterise the attributable effect of several modifiable risk exposures on the risk of >3 episodes of otitis media at age 18 months and 7 years within a large prospective national birth cohort. The study used the Danish National Birth Cohort comprising information about otitis media and risk exposures from more than 50,000 mother-child pairs from the period 1996-2002. Logistic regression models were used to estimate odds ratios for the risk factors and to calculate the population attributable fraction. Short time with breastfeeding, early introduction to daycare, cesarean section, and low compliance to the national vaccination program were all associated with an increased risk of >3 episodes of otitis media at 18 months of age and at 7 years of age. The fraction of children with otitis media attributed from breastfeeding lasting for less than 6 months was 10%. Introduction to daycare before the age of 12 months attributed with 20% of the cases of >3 episodes of otitis media. Short duration of breastfeeding, early introduction into daycare, cesarean section, and low compliance with the national vaccination program increased the risk of experiencing >3 episodes of otitis media at 18 months, and at 7 years of age. These are factors that all can be modulated. Copyright © 2018 Elsevier B.V. All rights reserved.

Pneumococcal conjugate vaccines for preventing otitis media

NARCIS (Netherlands)

Fortanier, Alexandre C.; Venekamp, Roderick P.; Boonacker, Chantal W. B.; Hak, Eelko; Schilder, Anne G. M.; Sanders, Elisabeth A. M.; Damoiseaux, Roger A. M. J.

2014-01-01

BACKGROUND: Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual

Antibiotics in Pregnancy Increase Children's Risk of Otitis Media and Ventilation Tubes

DEFF Research Database (Denmark)

Pedersen, Tine Marie; Stokholm, Jakob; Thorsen, Jonathan

2017-01-01

OBJECTIVES: To study the association between antibiotic intake in pregnancy and the development of otitis media and placement of ventilation tubes (VTs) in the offspring under the hypothesis that antibiotics in pregnancy may alter the offspring's propensity for disease. STUDY DESIGN: Data from...... the 700 children in the Copenhagen Prospective Studies on Asthma in Childhood 2010 unselected birth cohort study were used. Information on maternal antibiotic use and other exposures during pregnancy was collected prospectively from interviews and validated in national registries. Otitis media episodes...... were registered in a prospective diary for 3 years. Information regarding children's VTs was obtained from national registries. RESULTS: There were 514 children who had diary information and were included in the analysis regarding otitis media episodes. For VTs analysis, 699 children were included...

Theories of otitis media pathogenesis, with a focus on Indigenous children.

Science.gov (United States)

Wiertsema, Selma P; Leach, Amanda J

2009-11-02

Otitis media is a common childhood illness associated with hearing loss, social disadvantage and medical costs. Prevalence and severity are high among Indigenous children. Respiratory bacterial and viral pathogens ascend the eustachian tube from the nasopharynx to the middle ear, causing inflammation, fluid accumulation, and bulging of the tympanic membrane, with or without pain. Among Australian Indigenous children, ear disease commences earlier in life, and involves multiple strains of bacterial pathogens at high density that persist longer. Persistent nasal discharge, overcrowded living conditions (particularly exposure to many children) and poor facilities for washing children perpetuate a vicious cycle of transmission and infection. Risk factors include environmental tobacco smoke, season, lack of breastfeeding, younger age and immature immune system, and possibly genetic factors. The innate immune system is a critical first response to infection, particularly as passive maternal antibodies decline and during the maturation of the infant adaptive immune response. The relative contributions of innate factors to protection from otitis media are currently not well understood. A diversity of antibodies that target strain-specific and conserved antigens are generated in response to natural exposure to otitis media pathogens (or to vaccines). Deficiencies in these antibodies may explain susceptibility to recurrent infections. Incremental contributions from all these elements are likely to be important in otitis media susceptibility versus protection. Effective medical and social strategies to prevent early age of onset are urgently needed.

Hearing Loss in otitis media with effusion- Types and management- A study of hundred cases

Directory of Open Access Journals (Sweden)

Sriram Nathan

2012-01-01

Full Text Available Introduction- Serous Ottis media or otitis media with effusion is a common cause of hearing loss of acute onset. The common presentation will be a block or reduced hearing possible after a travel or flight. Most of the cases present with conductive hearing loss while some may present with mixed or even pure sensory hearing loss. Background- we study hundred patients diagnosed with serous otitis media for the type of hearing loss and characterize the management strategy. Conclusion- Serous otitis media is a common cause of hearing loss which is mostly conductive and is amenable to treatment while some rare cases which may persist may require assistive hearing with amplification. Although sensorineral hearing loss is rare in otitis media, it is seen in practice along with mixed hearing loss. The pathophysiology of the neural affection of hearing loss remains a mystery although many theories exist.

Indications and radiological findings of acute otitis media and its complications.

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Pont, Elena; Mazón, Miguel

Most cases of acute otitis media resolve with antibiotics and imaging is not required. When treatment fails or a complication is suspected, imaging plays a crucial role. Since the introduction of antibiotic treatment, the complication rate has decreased dramatically. Nevertheless, given the critical clinical relevance of complications, the importance of early diagnosis is vital. Our objective was to review the clinical and radiological features of acute otitis media and its complications. They were classified based on their location, as intratemporal or intracranial. Imaging makes it possible to diagnose the complications of acute otitis media and to institute appropriate treatment. Computed tomography is the initial technique of choice and, in most cases, the ultimate. Magnetic resonance is useful for evaluating the inner ear and when accurate evaluation of disease extent or better characterization of intracranial complications is required. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

[Diagnosis and treatment of the complications of otitis media in adults. Case series and literature review].

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Govea-Camacho, Luis Humberto; Pérez-Ramírez, Ramón; Cornejo-Suárez, Arnulfo; Fierro-Rizo, Roberto; Jiménez-Sala, Claudia Janet; Rosales-Orozco, Carlos Silvino

2016-01-01

The complications of otitis media (intra-cranial and extra-cranial) used to have a high morbidity and mortality in the pre-antibiotic era, but these are now relatively rare, mainly due to the use of antibiotics and the use of ventilation tubes, reducing the incidence of such complications significantly. Currently, an early suspicion of these complications is a major challenge for diagnosis and management. The cases of 5 patients (all male) are presented, who were diagnosed with complicated otitis media, 80% (4) with a mean age of 34.6 years (17-52). There was major comorbidity in 60% (3), with one patient with diabetes mellitus type 2, and two with chronic renal failure. There were 3 (60%) intra-cranial complications: one patient with thrombosis of the sigmoid sinus and a cerebellar abscess; another with a retroauricular and brain abscess, and a third with meningitis. Of the 2 (40%) extra-cranial complications: one patient had a Bezold abscess, and the other with a soft tissue abscess and petrositis. All patients were managed with surgery and antibiotic therapy, with 100% survival (5), and with no neurological sequelae. The clinical course of otitis media is usually short, limiting the infection process in the majority of patients due to the immune response and sensitivity of the microbe to the antibiotic used. However, a small number of patients (1-5%) may develop complications. Otitis media is a common disease in our country, complications are rare, but should be suspected when the picture is of torpid evolution with clinical worsening and manifestation of neurological signs. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Co-morbidities in children presenting with chronic suppurative otitis media--a South African study.

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Hallbauer, Ute M; Atkins, Mark D; Tiedt, Nicholas J; Butler, Iain R T; Pieters, Madeleine; Elliott, Eugene; Joubert, Gina; Seedat, Riaz Y

2014-06-01

Chronic suppurative otitis media (CSOM) is common among children in southern Africa. Managing associated co-morbidities may result in earlier disease resolution. Children 4 weeks were recruited to the study. Each child underwent a full clinical examination, a blood count, an HIV test and CD4 cell count, if found to be infected. The study included 86 children, and the median age was 4.6 years. HIV infection was present in 45 of 83 children (54.2%), of which 23 (51.1%) were receiving antiretroviral treatment at the time of presentation. Underweight was present in 22 of 85 (25.9%) children and in 17 of the 45 (37.8%) HIV-infected children. One or more clinical signs (not aural-related) were found in 46 of 86 (53.4%) children. Cholesteatoma was found in 23 of 113 (20.4%) ears, and 9 of 86 (10.5%) children had serious associated aural or intracranial complications. A high percentage of children with CSOM have associated pathology that needs to be diagnosed to optimally manage CSOM. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media.

Science.gov (United States)

Picciotti, P M; Della Marca, G; D'Alatri, L; Lucidi, D; Rigante, M; Scarano, E

2017-05-01

The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing. Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed. In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation. This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.

Antibiotics for acute otitis media in children

NARCIS (Netherlands)

Venekamp, R.P.; Sanders, S.; Glasziou, P.P.; Mar, C.B. Del; Rovers, M.M.

2013-01-01

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

Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Worden Katherine A

2008-10-01

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

[Acute otitis media in the children: etiology and the problems of antibacterial therapy].

Science.gov (United States)

Protasova, I N; Per'yanova, O V; Podgrushnaya, T S

The objective of the present review was to summarize the currently available literature data on etiology of acute otitis media in the children, the role of biofilms in the development of this pathology, and sensitivity of its principal causative factors to various antibiotic medications. The secondary objective was to elaborate the practical guidelines for the prevention of acute otitis media in the children.

Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.

Science.gov (United States)

Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro

2015-01-01

The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (potitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.

Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion.

Science.gov (United States)

Hussein, A; Fathy, H; Amin, S M; Elsisy, N

2017-10-01

To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2-11 years. A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry. The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months. Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

Molecular analysis of bacterial pathogens in otitis media with effusion.

Science.gov (United States)

Post, J C; Preston, R A; Aul, J J; Larkins-Pettigrew, M; Rydquist-White, J; Anderson, K W; Wadowsky, R M; Reagan, D R; Walker, E S; Kingsley, L A; Magit, A E; Ehrlich, G D

To determine if the polymerase chain reaction (PCR) can detect bacterial DNA in pediatric middle ear effusions that are sterile by standard cultural methods. Single-center, blinded, comparative study of diagnostic assays. The PCR-based detection systems for Moraxella catarrhalis, Haemophilus influenzae, and Streptococcus pneumoniae were designed and validated using a battery of DNAs obtained from cultured bacteria. Chronic middle ear effusion specimens were collected and comparatively analyzed by culture and the PCR. Tertiary care pediatric hospital. A total of 97 middle ear effusions were collected from pediatric outpatients at Children's Hospital of Pittsburgh (Pa) during myringotomy and tube placement for chronic otitis media with effusion (duration > 3 months). All patients had failed multiple courses of antimicrobial therapy and were diagnosed by a combination of validated otoscopy and tympanograms. Differences in the percentage of positive test results between PCR-based assays and culture for M catarrhalis, H influenzae, and S pneumoniae. Of the 97 specimens of otitis media with effusion, 28 (28.9%) tested positive by both culture and PCR for M catarrhalis, H influenzae, or S pneumoniae. An additional 47 specimens (48%) were PCR positive/culture negative for these three bacterial species. Thus, 75 (77.3%) of the 97 specimens tested PCR positive for one or more of the three test organisms. The minimum number of bacterial genomic equivalents present in the average culture-negative ear was estimated to be greater than 10(4) based on dilutional experiments. The PCR-based assay systems can detect the presence of bacterial DNA in a significant percentage of culturally sterile middle ear effusions. While this finding is not proof of an active bacterial infectious process, the large number of bacterial genomic equivalents present in the ears is suggestive of an active process.

Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review.

Science.gov (United States)

Ngo, Chinh C; Massa, Helen M; Thornton, Ruth B; Cripps, Allan W

2016-01-01

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 otopathogens within

Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

Science.gov (United States)

Ngo, Chinh C.; Massa, Helen M.; Thornton, Ruth B.; Cripps, Allan W.

2016-01-01

Background 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. Methods 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. Results 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. Conclusions 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

[Erespal effectiveness in exudative otitis media].

Science.gov (United States)

Levina, Iu V; Luchikhin, L A; Krasiuk, A A

2003-01-01

Standard conservative treatment of exudative otitis media (EOM) was performed in 82 patients, but 44 of them received adjuvant fenspiride (erespal) in a dose 80 mg per os 3 times a day for 10 days. Dynamic pure tone audiometry, tympanometry and subjective response demonstrated higher treatment efficiency in the erespal group. Therefore, it is recommended to include erespal in combined conventional therapy of EOM.

[Analysis of related factors of recurrent otitis media with effusion in children].

Science.gov (United States)

Zhu, Z; Zheng, G X; Li, Q; Shi, Q L; Zhou, H G; Fang, R P

2017-08-05

Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children. Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed. Result: Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference ( P gender, passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance ( P > 0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in > 3-6 years old group has significant effect ( P 3-6 years OME recurrence has significant effect ( P different conditions to take symptomatic treatment, 75 cases (123 ears) were cured 96 ears (78.05%), 19 ears were improved (15.45%), the total effective rate was 93.50%, ineffective in 8 ears (6.50%). Conclusion: Adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best treatment as soon as possible. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Antibiotics for acute otitis media in children

NARCIS (Netherlands)

Venekamp, Roderick P.; Sanders, Sharon L.; Glasziou, Paul P.; Del Mar, Chris B.; Rovers, Maroeska M.

2015-01-01

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

Otitis Media in Young Children with Disabilities.

Science.gov (United States)

Zeisel, Susan A.; Roberts, Joanne E.

2003-01-01

This study examined the prevalence of otitis media with effusion (OME) in 14 children (ages 8-66 months) with developmental disabilities attending center-based childcare. Although younger children had more OME than older children, children with Down syndrome had the highest incidence of OME regardless of age. Implications of OME for fluctuating…

Consequences of evolution: is rhinosinusitis, like otitis media, a unique disease of humans?

Science.gov (United States)

Bluestone, Charles D; Pagano, Anthony S; Swarts, J Douglas; Laitman, Jeffrey T

2012-12-01

We hypothesize that if otitis media is most likely primarily a human disease due to consequences of evolution, rhinosinusitis may also be limited to humans for similar reasons. If otitis media, with its associated hearing loss, occurred in animals in the wild, they probably would have been culled out by predation. Similarly, if rhinosinusitis occurred regularly in animals, they likely would have suffered from severely decreased olfactory abilities, crucial for predator avoidance, and presumably would likewise have been selected against evolutionarily. Thus, both otitis media and rhinosinusitis-common conditions particularly in infants and young children-appear to be essentially human conditions. Their manifestation in our species is likely due to our unique evolutionary trajectory and may be a consequence of adaptations, including adaptations to bipedalism and speech, loss of prognathism, and immunologic and environmental factors.

Evaluation of cholesteatoma frequency in patients with chronic otitis media

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Amad Meimaneh Jahromi

2010-04-01

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.

The Effect of Breastfeeding on Childhood Otitis Media

DEFF Research Database (Denmark)

Kørvel-Hanquist, Asbjørn; Djurhuus, B D; Homøe, P

2017-01-01

PURPOSE OF REVIEW: The purpose of this review is to summarize the literature regarding the association between breastfeeding and childhood otitis media (OM), with focus on the literature published within the past 5 years. The review comprises original articles and recent reviews. RECENT FINDINGS...

Childhood hospitalisation for otitis media in Western Australia: A 10-year retrospective analysis

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Nicholas Liu

2016-04-01

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 used the deidentified 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 4.7 per 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 (51 per cent than Indigenous children (2 per cent 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.

Association of microRNA 146 with middle ear hyperplasia in pediatric otitis media.

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Samuels, Tina L; Yan, Justin; Khampang, Pawjai; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Kerschner, Joseph E

2016-09-01

Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours. Middle ear biopsies were collected from children with otitis media with effusion (n = 20), recurrent otitis media (n = 9), and control subjects undergoing cochlear implantation (n = 10). miR-146a, miR-146b expression was assayed by quantitative PCR (qPCR). Expression of miR-146 targets involved in TLR signaling, IRAK1 and TRAF6, was assayed by qPCR in middle ear biopsies. Middle ear biopsies were cryosectioned and epithelial thickness measured by a certified pathologist. Proinflammatory cytokines induced expression of miR-146 in middle ear epithelial cells in vitro. Middle ear miR-146a and miR-146b expression was elevated in otitis media patients relative to control subjects and correlated with middle ear epithelial thickness. A trend towards inverse correlation was observed between miR-146 and TRAF6 expression in the clinical population. This report is the first to assess miRNA expression in a clinical population with OM. Findings herein suggest miR-146 may play a role in OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

OTITIS MEDIA CON EFUSIÓN: DIAGNÓSTICO Y MANEJO PRÁCTICO

OpenAIRE

Tocornal, Francisco; Labatut, Tomás

2016-01-01

La otitis media con efusión (OME) u otitis media serosa, se define por la presencia de fluido en el oído medio. Se trata de una de las patologías más frecuentes del oído. Tiene un curso autolimitado en la mayoría de los casos, sin embargo puede comprometer la audición del paciente por periodos de tiempo variable, llegando a veces a comprometer el desarrollo del lenguaje, el habla o el aprendizaje del sujeto. Puede tener manifestaciones en el equilibrio del paciente o producir cambios en la me...

Otitis media with effusion: experiences of children with cleft palate and their parents.

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Tierney, Stephanie; O'Brien, Kevin; Harman, Nicola L; Sharma, Ravi K; Madden, Colm; Callery, Peter

2015-01-01

To explore the views of children with cleft palate and their parents about daily life with otitis media with effusion and associated hearing loss. A qualitative study. Semistructured interviews were used to collect data from parents. Participatory techniques, including activities on a tablet computer, were used to collect data from children. Framework analysis was applied to interview transcripts. Two English cleft units. A purposive sample of parents of 37 children aged 0 to 11 years with experience of otitis media with effusion. Their children also took part if aged 6 to 11 years (n = 22). Themes related to the following: (1) emotions (frustration, anger, sadness, happiness, anxiety), (2) educational experiences (struggling at school, having to sit at the front of the class, requiring extra support, missing lessons for appointments or due to ear infections), (3) social interactions (isolation, communication, reliance on siblings, participation in activities). A number of areas of interviewees' everyday life were affected by the presence of otitis media with effusion. Parents may need to be forewarned about the possible ongoing nature of this condition and its impact on a child's social and emotional experiences. Children may also benefit from age-appropriate information about otitis media with effusion and its treatment, including information on hearing tests, to help reduce any anxiety.

Trends in doctor consultations, antibiotic prescription, and specialist referrals for otitis media in children : 1995-2003

NARCIS (Netherlands)

Plasschaert, Astrid I O; Rovers, Maroeska M; Schilder, Anne G M; Verheij, Theo J M; Hak, Eelko

BACKGROUND: Reported trends regarding the incidence of otitis media and antibiotic prescription rates are inconsistent. OBJECTIVE: Our goal was to assess changes in incidence of consultation rates, antibiotic prescription, and referral rates for otitis media in children over the years 1995-2003.

Antibody levels after regular childhood vaccinations in the immunological screening of children with recurrent otitis media.

NARCIS (Netherlands)

Wiertsema, S.P.; Sanders, E.A.M.; Veenhoven, R.H.; Heerbeek, N. van; Hof, S. van den; Berbers, G.A.; Rijkers, G.T.

2004-01-01

Recurrent otitis media may be related to defects in specific antibody production, as suggested previously. This might be reflected in lower antibody responses to vaccinations administered in the context of the national childhood vaccination program in children suffering from recurrent otitis media.

Antibiotics for otitis media with effusion in children

NARCIS (Netherlands)

Venekamp, R.P.; Burton, M.J.; van Dongen, T.M.A.; van der Heijden, G.J.; van Zon, A.; Schilder, A.G.M.

2016-01-01

Background Otitis media with effusion (OME) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Since most cases of OME will resolve spontaneously, only children with persistent middle ear effusion and

The effect of indoor air pollutants on otitis media and asthma in children

Energy Technology Data Exchange (ETDEWEB)

Daigler, G.E.; Markello, S.J.; Cummings, K.M. (State Univ. of New York, Buffalo (USA))

1991-03-01

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.

[The specific microbiological and clinical features of acute otitis media].

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Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

Correlative mRNA and protein expression of middle and inner ear inflammatory cytokines during mouse acute otitis media.

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Trune, Dennis R; Kempton, Beth; Hausman, Frances A; Larrain, Barbara E; MacArthur, Carol J

2015-08-01

Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 h. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 h samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2-122 fold higher at 18 h, declining slightly from there at 24 h. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media. Copyright © 2015 Elsevier B.V. All rights reserved.

Cervical spinal tuberculosis with tuberculous otitis media ...

African Journals Online (AJOL)

The case of a 65 year old Nigerian trader who presented with headache, chronic ear ache with otorrhoea, persistent neck pain and found to be diabetic on further evaluation is presented. She was hitherto managed as a case of otitis external malignans without any improvement but rather her clinical condition worsened with ...

Acute otitis media associated bilateral sudden hearing loss: case report and literature review.

Science.gov (United States)

Smith, A; Gutteridge, I; Elliott, D; Cronin, M

2017-07-01

Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.

[The influence of interleukin gene polymorphism on the serum cytokine level in the patients presenting with chonic suppurative otitis media].

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Baike, E V; Vitkovsky, Yu A; Dutova, A A

The objective of the present work was to study the influence of allelic variant associations of 1-beta interleukin (C3953T, &511C, T31C), interleukin-6 (C174G), and tumour necrosis factor-alpha (G308A) gene polymorphisms on the serum cytokine level in the patients presenting with chronic suppurative otitis media. A total of 299 patients at the age varying from 16 to 55 years with this condition divided into three groups were examined. Group 1 was comprised of 146 patients suffering from the tubotympanic form of chronic suppurative otitis media (CSOM). Group 2 was composed of 153 patients with epitympanic antral form of this condition. The control group included 183 subjects who have never suffered pathological changes in the middle ear. Human genomic DNA was analyzed with the use of the polymerase chain reaction (PCR). The serum cytokine levels were measured by the solid-state enzyme immunoassay in the beginning and at the end of the treatment period. The study has demonstrated that 56.2% of the healthy residents of the trans-Baikal region had the C/T Il-1b (C3953T) genotype. 79.1% of the patients presenting with the carious carious-destructive form of chronic suppurative otitis media were the heterozygous carriers of the T511C gene of 1-beta interleukin and had the maximally high concentrations of this interleukin in the blood serum. A rise in the production of the pro-inflammatory mediator (IL-6) was found to be related to the severity of the inflammatory process in the middle ear. The TNF-alpha content in the patients with CSOM during the active period of the disease proved to increase by a factor of 6 in comparison with that in the subjects of the control group irrespective of the type of mutation.

Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media

NARCIS (Netherlands)

Emonts, Marieke; Veenhoven, Reinier H.; Wiertsema, Selma P.; Houwing-Duistermaat, Jeanine J.; Walraven, Vanessa; de Groot, Ronald; Hermans, Peter W. M.; Sanders, Elisabeth A. M.

2007-01-01

OBJECTIVE. Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS. DNA samples from

Association of surfactant protein A polymorphisms with otitis media in infants at risk for asthma

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Bracken Michael B

2006-08-01

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.

A CLINICAL STUDY ON EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

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Devi Prasad

2015-06-01

Full Text Available OBJECTIVES : The Objective is to study the risk of extra - cranial complications in cases of CSOM and to study the common extra - cranial complications of CSOM with respect to age , sex and socio - economic status . METHODS: The present study comprises of 60 patients with extra - cranial complications secondary to Chronic Suppurative Otitis media who attended to the Dept . o f E. N. T S rivenkateswara G overnment General Hospital, T irupathi . An analysis was made regarding the demographic profile , clinical features , surgical techniques , operative findings , and the outcome of the study . RESULTS : In this study of 60 cases , the most common ext racranial complication of CSOM is Postauralabscess . These extra cranial complications are associated with 15% of intracranial complications of which Meningitis is most common . The complications are more commonly seen in the younger population in second to third decades of life with Male predominance . The duration of ear discharge is not associated with the increasing number of complications . Cholesteatoma is commonly responsible for the development of Extracranial complications of CSOM . Pseudomonas aerugino sa is the commonest organism found in the complications . Canal wall down surgery is the main mode of treatment in this category of patients . The Facial canal dehiscence is associated with a poor outcome in the cases of Facial nerve paralysis . CONCLUSION: The extra - cranial complications of CSOM pose a great challenge to the Developing countries despite its declining incidence . It is in this situation that early diagnosis and prompt surgical intervention are most important for the decreased morbidity and mor tality of patients .

Otitis media with effusion in an allergic animal model: A functional and morphological study.

Science.gov (United States)

Kim, Dong-Kee; Park, Hyu Eun; Back, Sang-A; Park, Hyang Rim; Kim, Soo Whan; Park, Yooyeon; Yeo, Sang Won; Park, Shi-Nae

2016-05-01

Allergy is considered as one of important etiologic factor of otitis media with effusion (OME). In present study, we evaluated the causal effect of allergy on OME in an animal model, and investigated the secondary effect of bacterial infection. Allergy and control animals were subdivided into groups with and without intratympanic injection of lipopolysaccharide (IT-LPS). Allergic otitis media was induced via intraperitoneal ovo-albumin injection with intranasal challenge. We assessed the occurrence of OME in allergic animals and the effect of IT-LPS on allergic otitis media. We also investigated the Th1 and Th2 responses in the middle-ear mucosa. Hearing of the animals was measured by ABR and DPOAE. OME was observed in 75% of the allergic animals. After IT-LPS, 100% of the control and allergy groups showed otitis media. Light microscopy revealed that the middle-ear mucosa of animals of both groups also was significantly increased after IT-LPS, and the Th1 response (IL-2 and IFN-γ) and Th2 response (IL-5 and IL-13) cytokines were expressed at higher levels in the allergy group with IT-LPS than in control group with IT-LPS. Hearing tests between the allergy and control group with IT-LPS did not reveal any differences. Our findings may be direct evidence of an allergic causal effect on OME. Th2 response cytokines were strongly expressed in allergic OME, and the inflammatory reaction to LPS was more intense in the allergic group, which indicates that otitis media related to allergy can be severely aggravated by an inflammatory reaction to bacterial infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The psychosocial impact of hearing aids in children with otitis media with effusion.

Science.gov (United States)

Qureishi, A; Garas, G; Mallick, A; Parker, D

2014-11-01

In children, otitis media with effusion is treated using grommets or hearing aids. Parents considering treatment options express concerns regarding the psychosocial impact of hearing aids in terms of self-esteem and bullying. This study assessed the psychosocial impact of hearing aid use. A cross-sectional study was undertaken comparing hearing aid users to non hearing aid users with regard to their attitudes towards hearing aids. All subjects, who had been diagnosed with otitis media with effusion, were aged less than 16 years, were without disability and attended mainstream schools. A questionnaire was designed and utilised. The study comprised 47 children with hearing aids and 50 with grommets. Significant between-group differences (p negative perceptions of non hearing aid users were not reported by hearing aid users. Children with hearing aids do not suffer from bullying or low self-esteem to the extent perceived by parents. This information is useful for informed decisions regarding treatment of otitis media with effusion.

Human evolutionary history: consequences for the pathogenesis of otitis media.

Science.gov (United States)

Bluestone, Charles D; Swarts, J Douglas

2010-12-01

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 interaction of bipedalism and increased brain size, and the loss of facial prognathism resulting from speech or cooking. As a consequence of our adaptation for bipedalism, the female pelvic outlet is constricted, which, in the context of a rapidly enlarging brain, results in humans being born 12 months too soon. Significantly, immature eustachian tube structure and function, in conjunction with an immature immune system, helps to explain the high incidence of otitis media in the first year of life. But the persistence of middle-ear disease beyond this stage is not explained by "immaturity." The morphology of the palate changed with the adaptations that produced facial flattening, with concomitant effects on eustachian tube function. These changes resulted in relatively poor human physiologic tubal function in comparison to the nonhuman primate. Copyright © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

DEFF Research Database (Denmark)

Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

2010-01-01

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...

High-Dose Amoxicillin with Clavulanate for the Treatment of Acute Otitis Media in Children

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Chia-Huei Chu

2014-01-01

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.

Is there a role for virtual otoscopy in the preoperative assessment of the ossicular chain in chronic suppurative otitis media? Comparison of HRCT and virtual otoscopy with surgical findings

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Pandey, A.K. [University of British Columbia, Department of Radiology, St. Paul Hospital, Vancouver, BC (Canada); Bapuraj, J.R. [University of Michigan, Division of Neuroradiology, Department of Radiology, University Hospital, Ann Arbor, MI (United States); Gupta, A.K. [Post Graduate Institute of Medical Education and Research, Department of Otolaryngology, Chandigarh (India); Khandelwal, N. [Post Graduate Institute of Medical Education and Research, Department of Radiodiagnosis, Chandigarh (India)

2009-06-15

The aim of this study was to assess the role of virtual otoscopy and 3D ossicular reconstruction in the preoperative assessment of the ossicles in chronic suppurative otitis media. Thirty three patients of chronic suppurative otitis media with conductive deafness (air-bone gap > 35 dB) were included in this prospective study. All patients underwent axial multidetector CT. The axial CT data set was utilized for multiplanar 2D reformations as well as virtual otoscopy (VO) and 3D reconstructions. The imaging findings on these two techniques were read independently by two radiologists with respect to different parts of the ossicular chain by using a three-point scoring system and were compared with surgical findings. Both imaging techniques had comparable accuracy for evaluation of larger ossicular parts. However, for evaluation of stapes superstructure, VO/3D images were more accurate (85.29%) than 2D images (76.97%). Assessment of the lenticular process and incudostapedial joint by HRCT and 2D reformatted images was not reliable (P > 0.1); however, significant correlation (P < 0.001) was present between VO/3D and the operative findings. Virtual otoscopy improves evaluation of the ossicular chain particularly that of smaller structures such as the lenticular process, incudostapedial joint and stapes superstructure which may influence decisions regarding planning of ossiculoplasty. (orig.)

Is there a role for virtual otoscopy in the preoperative assessment of the ossicular chain in chronic suppurative otitis media? Comparison of HRCT and virtual otoscopy with surgical findings

International Nuclear Information System (INIS)

Pandey, A.K.; Bapuraj, J.R.; Gupta, A.K.; Khandelwal, N.

2009-01-01

The aim of this study was to assess the role of virtual otoscopy and 3D ossicular reconstruction in the preoperative assessment of the ossicles in chronic suppurative otitis media. Thirty three patients of chronic suppurative otitis media with conductive deafness (air-bone gap > 35 dB) were included in this prospective study. All patients underwent axial multidetector CT. The axial CT data set was utilized for multiplanar 2D reformations as well as virtual otoscopy (VO) and 3D reconstructions. The imaging findings on these two techniques were read independently by two radiologists with respect to different parts of the ossicular chain by using a three-point scoring system and were compared with surgical findings. Both imaging techniques had comparable accuracy for evaluation of larger ossicular parts. However, for evaluation of stapes superstructure, VO/3D images were more accurate (85.29%) than 2D images (76.97%). Assessment of the lenticular process and incudostapedial joint by HRCT and 2D reformatted images was not reliable (P > 0.1); however, significant correlation (P < 0.001) was present between VO/3D and the operative findings. Virtual otoscopy improves evaluation of the ossicular chain particularly that of smaller structures such as the lenticular process, incudostapedial joint and stapes superstructure which may influence decisions regarding planning of ossiculoplasty. (orig.)

Alterations in the Contra lateral Ear in Chronic Otitis Media

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Mohammad Ali Damghani

2013-03-01

Full Text Available Introduction: Chronic otitis media (COM, a persistent and durable inflammation and infection of the middle ear, is a common disorder. Alterations in the contralateral ear in sufferers have been observed in recent years. Because only a few studies have been reported in this area, we performed this study in order to assess alterations in the contralateral ear of patients with COM.   Materials and Methods: Cross-sectional and descriptive methods were used in 100 patients with COM who were selected for surgical treatment and admitted to hospital. An information form was completed for all patients including demographic data, medical history of otoscopy and paraclinical examinations such as pure tone audiometry (PTA, tympanometry, Schuller radiography, and high resolution computed tomography (HRCT. All data were processed using SPSS (version 18 software and descriptive statistical tests.   Results: According to otoscopy, PTA, tympanometry and graphical analysis, 60% of patients experienced disorders of the contralateral ear. Otoscopy analysis showed 54% of patients had a disorder of the contralateral ear, with the most common disorder being perforation of the ear drum. PTA showed a 48% incidence of contralateral ear problems (85% conductive hearing impairment; 12.5% sensorineural hearing impairment; 1.2% mixed. A total of 73.2% of patients with conductive hearing loss had a problem across all frequencies, while half of the patients with sensorineural hearing impairment had problems at frequencies greater than 1000 Hz. According to tympanometry, 38% of patients had problem in the contralateral ear. HRCT and Schuller graphical analyses indicated 31.5% and 36% occurrence of contralateral ear disorders, respectively.   Conclusion:  More than 50% of patients with COM in one ear have a chance of also presenting with the disease in the other ear. Outcomes of this study and previous studies have shown that COM should not be perceived as a disease limited

Diagnosis of extraesophageal reflux in children with chronic otitis media with effusion using Peptest.

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Formánek, Martin; Zeleník, Karol; Komínek, Pavel; Matoušek, Petr

2015-05-01

The aim of the study was to investigate whether Peptest, an immunoassay used to detect pepsin, could be used to diagnose extraesophageal reflux (EER) in children with chronic otitis media with effusion (OME). The results obtained using this fast, simple and non-expensive method were compared with the results of previous studies. Children 1-7 years old who had been diagnosed with OME and who were undergoing myringotomy with insertion of a ventilation tube were included in the prospective study. Middle ear fluid obtained during myringotomy was analyzed with Peptest to determine the presence of pepsin, and hence EER. Bilateral and unilateral myringotomy was performed in 15/44 (34.1%) and 29/44 (65.9%) children, respectively. Pepsin in the middle ear was detected in 14/44 (31.8%) children and in 19/59 (32.2%) middle ear specimens. Serous and mucous samples were positive for pepsin in 11/32 (34.4%) and 6/27 (22.2%) cases, respectively. Pepsin in the middle ear was detected in 3/7 children (42.9%) with bronchial asthma (p=0.662). Pepsin was detected in 1/3 of middle ear specimens of patients with OME. These patients probably suffer from more severe reflux and therefore would be potential candidates for antireflux therapy. However, this has to be confirmed in further studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Complications of otitis media - The importance of early recognition

NARCIS (Netherlands)

Albers, FWJ

Objective: The purpose of this study was to determine the factors that are important for the early diagnosis of intracranial and intratemporal complications of otitis media. Study design: The study design was a retrospective follow-up study. Setting: The study took place at a tertiary referral

Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry

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Sharath Babu K

2016-04-01

Full Text Available Background :  Otitis Media with Effusion(OME also known as  Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy. Aims and Objectives :  To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion. Materials and Methods:  A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A, adenoidectomy with bilateral grommet insertion (Group B, bilateral grommet insertion (Group C,  bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D. Result : The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.   Conclusion : Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis

Herbal medicines for treating acute otitis media: A systematic review of randomised controlled trials.

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Son, Mi Ju; Kim, Young-Eun; Song, Young Il; Kim, Yun Hee

2017-12-01

This systematic review aimed to assess the clinical evidence for the widespread use of herbal medicines in treating acute otitis media. Eleven electronic databases, including MEDLINE, EMBASE, and the CENTRAL were searched, without language limitations. All randomised controlled trials involving the use of herbal medicines, alone or in combination with conventional therapies, for acute otitis media were included. We identified 4956 studies, of which seven randomised clinical trials met the inclusion criteria. The overall risk of bias of the included trials was relatively high or unclear. Treatment with Longdan-xiegan decoction or Shenling-baizhu powder, combined with antibiotics, appeared to be more effective than treatment with antibiotics alone in terms of the proportion of patients with total symptom recovery. Moreover, combination treatment of Sinupret ® and antibiotics facilitated the recovery of middle ear conditions and hearing acuity. Despite some indications of potential symptom improvement, the evidence regarding the effectiveness and efficacy of herbal medicine for acute otitis media is inconclusive due to the poor quality of trials included. Moreover, we only analysed seven trials in this review. Therefore, to properly evaluate the effectiveness of herbal medicine for acute otitis media, systematic reviews based on more rigorously designed randomized trials are warranted in the future. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Complications of otitis media - a potentially lethal problem still present

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Norma de Oliveira Penido

Full Text Available ABSTRACT INTRODUCTION: It is an erroneous but commonly held belief that intracranial complications (ICCs of chronic and acute otitis media (COM and AOM are past diseases or from developing countries. These problems remain, despite improvements in antibiotic care. OBJECTIVE: This paper analyzes the occurrence and clinical characteristics and course of the main ICCs of otitis media (OM. METHODS: Retrospective cohort study of 51 patients with ICCs from OM, drawn from all patients presenting with OM to the emergency room of a large inner-city tertiary care hospital over a 22-year period. RESULTS: 80% of cases were secondary to COM of which the incidence of ICC was 0.8%; 20% were due to AOM. The death occurrence was 7.8%, hearing loss in 90%, and permanent neurological sequelae in 29%. Patients were 61% male. In the majority, onset of ear disease had occurred during childhood. Delay of diagnosis of both the initial infection as well as the secondary ICC was significant. ICCs included brain abscess and meningitis in 78%, and lateral sinus thrombosis, empyema and otitic hydrocephalus in 13%, 8% and 1% of cases, respectively. Twenty-seven neurosurgical procedures and 43 otologic surgery procedures were performed. Two patients were too ill for surgical intervention. CONCLUSION: ICCs of OM, although uncommon, still occur. These cases require expensive, complex and long-term inpatient treatment and frequently result in hearing loss, neurological sequelae and mortality. It is important to be aware of this potentiality in children with COM, especially, and maintain a high index of suspicion in order to refer for otologic specialty care before such complications occur.

Tympanic membrane changes in experimental acute otitis media and myringotomy

DEFF Research Database (Denmark)

Alzbutiene, G.; Hermansson, A.; Caye-Thomasen, P.

2008-01-01

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...

Depletion of mucosal substance P in acute otitis media

DEFF Research Database (Denmark)

Cayé-Thomasen, Per; Schmidt, Peter Thelin; Hermansson, Ann

2004-01-01

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...

Otitis Media and Learning Disabilities: More Than a Relationship?

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Quick, Carol; Mandell, Colleen

The relationship between recurrent otitis media (middle ear infection characterized by the presence of middle ear fluid and possibly leading to a temporary conductive hearing loss) and learning disabilities (LD) is examined. Traditional treatment approaches (antibiotic medication and surgery) are reviewed. The definition of LD is presented and the…

Reconsidering management for otitis media with effusion in children ...

African Journals Online (AJOL)

Recent research findings have led to a more conservative approach to treatment of otitis media with effusion as opposed to previous recommendations for prompt insertion of tympanostomy tubes to avoid suspected developmental delays due to the mild conductive hearing loss. A large scale longitudinal clinical trial has ...

Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

NARCIS (Netherlands)

Labout, J.A.; Duijts, L.; Lebon, A.; Groot, R. de; Hofman, A.; Jaddoe, V.V.; Verbrugh, H.A.; Hermans, P.W.M.; Moll, H.A.

2011-01-01

Acute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based

Otitis Media: Implications of Fluctuating, Conductive Hearing Loss on Learning and Behaviour in High School Age Students.

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Stenton, Jan

This paper provides an overview of the effects of otitis media on the learning and behavior of children and youth. It begins by describing the conductive hearing loss that is caused by otitis media and the classroom behavior that can result, including poor concentration and attention, disobedience, irritability, and poor social skills. Discussed…

Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

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Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

2011-10-01

The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Auditory Deprivation and Early Conductive Hearing Loss from Otitis Media.

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Gunnarson, Adele D.; And Others

1990-01-01

This article reviews auditory deprivation effects on anatomy, physiology, and behavior in animals and discusses the sequelae of otitis media with effusion (OME) in children. Focused on are central auditory processing disorders associated with early fluctuating hearing loss from OME. (DB)

Tratamiento Quirúrgico de la Otitis Media y el Colesteatoma

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Jorge García Gómez

1991-06-01

%.

La otitis media y el colesteatoma son un serio problema en América Latina, debido a factores de malnutrición, pobreza, falta de atención médica, contaminación de las aguas y polución ambiental. Un alto porcentaje de estos pacientes requieren tratamiento quirúrgico.

La cirugía del colesteatoma debe orientarse en forma radical, eliminando totalmente la patología para evitar la recurrencia y ojalá practicarla en un solo tiempo quirúrgico.

Abstract

Surgical Treatment of Chronic Otitis Media and Cholesteatoma

The authors present their experience of thirty years in the surgical treatment of Chronic Otitis Media and Cholesteatoma. They describe the techniques used in 6.000 operations performed at the “San José” Hospital in Bogotá, Colombia, as well as in private practice. Emphasis is placed on the indications for open or closed, tecniques,and the recidivism rate of these approaches in the term, with periodical follow-ups.

Presentation of tympanoplasty methods, as well as descriptions of the materials used to reconstruct the ossicular chain (homografts-implants, together with our functional results, will be provided. Complications of the cholesteatoma and the management of techniques in case of recurrence will be covered. Philosophy, techniques and procedures used by the authors to obtain a dry, safe hearing ear will be discussed. This course will present practical techniques for surgical reconstruction of the tympanic membrane and ossicular chain.

The effect of ventilating tubes in Young children with recurrent acute otitis media

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Homøe, Preben; Lous, Jørgen

2017-01-01

Purpose of Review. Ventilating tube treatment (VT) is a common surgical procedure in preschool children. Twenty to fifty percent of children treated with VT suffer from recurrent acute otitis media (RAOM). The aim of this review is to update current knowledge on the topic. Recent Findings. Therre...... is still controversy regarding the use of VT for children with RAOM. So far, only six randomized trials have been published. From the limited data pool, it seems that children with RAOM treated with VT experienced less time with acute otitis media and experienced less recurrence compared to controls...

A case of a temporal bone meningioma presenting as a serous otitis media

International Nuclear Information System (INIS)

Nicolay, Simon; De Foer, Bert; Bernaerts, Anja; Van Dinther, Joost; Parizel, Paul M

2014-01-01

We report the imaging features of a case of a temporal bone meningioma extending into the middle ear cavity and clinically presenting as a serous otitis media. Temporal bone meningioma extending in the mastoid or the middle ear cavity, however, is very rare. In case of unexplained or therapy-resistant serous otitis media and a nasopharyngeal tumor being ruled out, a temporal bone computed tomography (CT) should be performed. If CT findings are suggestive of a temporal bone meningioma, a magnetic resonance imaging (MRI) examination with gadolinium will confirm diagnosis and show the exact extension of the lesion

Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study.

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Linder, T; Mulazimoglu, S; El Hadi, T; Darrouzet, V; Ayache, D; Somers, T; Schmerber, S; Vincent, C; Mondain, M; Lescanne, E; Bonnard, D

2017-06-01

To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. Multicentre retrospective study in eight tertiary referral hospitals over 17 years. Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery. © 2016 John Wiley & Sons Ltd.

Otitis Media and Speech/Language Development in Late-Talkers.

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Paul, Rhea; And Others

This study examines otitis media as a possible factor associated with increased risk for communicative handicap in a group of children with a possible vulnerability for language delay: "late-talkers." Speech and language outcomes at ages 3 and 4 were examined in 28 late talkers and 24 children with normal language development. Late…

Long-term hearing outcomes after recurrent acute otitis media during early childhood.

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Krakau, Mattias; Dagöö, Britta Rynnel; Hellström, Sten; Granath, Anna

2017-12-01

To survey long-term hearing outcomes and middle ear pathology in a 30-year follow-up in individuals with onset of recurrent acute otitis media (rAOM) before three years of age. 28 adults, aged 30.1-31.8 years, who originally - at the age of 12-32 months - participated in a study on rAOM between 1979 and 1983, were re-examined regarding self-reported ear problems, current tympanic membrane changes and audiology. Thirteen subjects had suffered from rAOM during early childhood and 15 subjects served as a control group. Recurrent acute otitis media subjects reported hearing problems comparable to those of the controls. Pure tone audiometry, at 125-8000 Hz, did not differ between groups. The rAOM group had a trend for impaired high-frequency (9000-14,000 Hz) threshold levels (9000-14,000 Hz); implying that their cochlear function seemed to have deteriorated. Adults, who suffered from recurrent acute otitis media as infants, did not show any clinically significant hearing loss for pure tone audiometry when compared to controls, but there was a trend for impaired results regarding extended high frequency audiometry (9-14 kHz). Children suffering from rAOM will be at low risk of developing hearing loss and severe middle ear disease.

The Role of Mannose-Binding Lectin Serum Level in Tubotympanic Chronic Suppurative Otitis Media

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Anton Budhi Darmawan

2018-01-01

Full Text Available Background. Chronic suppurative otitis media (CSOM is a common public health problem worldwide and a major cause of hearing impairment especially in developing countries. The role of Mannose-Binding Lectin (MBL, a component of innate immunity, in CSOM has not been studied. The aim of the study was to examine whether MBL deficiency was more frequently present in cases group of tubotympanic CSOM patients rather than healthy subjects. Material and Methods. This was an analytic observational study. Subjects were enrolled in the Otorhinolaryngology Clinic at Margono Soekarjo Hospital, Purwokerto, Indonesia. An independent t-test was used to compare the mean of MBL serum concentration between tubotympanic CSOM subjects and control. Results. From 36 tubotympanic CSOM patients, there were 8 (22.22% patients with MBL deficiency (MBL level < 100 ng/ml, while no deficiency was found in the control group. The mean of MBL level in cases group was 354.88 ng/ml, with the lowest level being 0.001 ng/ml and the highest level 690.24 ng/ml, while in the control group MBL level mean was 376.27 with the lowest level being 188.71 and the highest level 794.54 ng/ml. Conclusion. There was no significant difference of MBL serum level between tubotympanic CSOM and control group. However, the presence of subjects with MBL deficiency in the tubotympanic CSOM group might be considered as playing a role in the tubotympanic CSOM.

Gustatory Dysfunction and Decreased Number of Fungiform Taste Buds in Patients With Chronic Otitis Media With Cholesteatoma.

Science.gov (United States)

Saito, Takehisa; Ito, Tetsufumi; Ito, Yumi; Yamada, Takechiyo; Okamoto, Masayuki; Manabe, Yasuhiro

2016-09-01

To compare the number of fungiform taste buds among patients with chronic otitis media (COM), those with pars flaccida retraction type cholesteatoma, and those with pars tensa retraction type cholesteatoma in combination with gustatory function. Thirty-seven patients with COM, 22 patients with pars flaccida retraction type cholesteatoma, and 17 patients with pars tensa retraction type cholesteatoma were included. An average of 10 fungiform papillae (FP) per patient in the midlateral region of the tongue were observed by confocal laser scanning microscopy in vivo, and the average number of taste buds were counted. Just before the observation of FP, electrogustometry (EGM) was performed to evaluate gustatory function. A significant decrease of the average number of fungiform taste buds and significant elevation of EGM thresholds were clarified in the pars tensa retraction type cholesteatoma group but not in the COM or pars flaccida type cholesteatoma group. It was suggested that some neurotoxic cytokines produced by cholesteatoma tissue might affect the CTN morphology, resulting in a decreased number of fungiform taste buds and elevation of EGM threshold in patients with pars tensa retraction type cholesteatoma. © The Author(s) 2016.

Association of cytokine gene polymorphisms and risk factors with otitis media proneness in children.

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Miljanović, Olivera; Cikota-Aleksić, Bojana; Likić, Dragan; Vojvodić, Danilo; Jovićević, Ognjen; Magić, Zvonko

2016-06-01

In order to assess the association between gene polymorphisms and otitis media (OM) proneness, tumor necrosis factor alpha (TNFA) -308, interleukin (IL) 10-1082 and -3575, IL6 -597, IL2 -330, and CD14 -159 genotyping was performed in 58 OM-prone children and 85 controls who were exposed to similar number and frequency of environmental and host risk factors. The frequencies of genotypes (wild type vs. genotypes containing at least one polymorphic allele) were not significantly different between groups, except for IL10 -1082. Polymorphic genotypes IL10 -1082 GA and GG were more frequent in OM-prone children than in control group (RR 1.145, 95 % CI 1.011-1.298; p = 0.047). However, logistic regression did not confirm IL10 -1082 polymorphic genotypes as an independent risk factor for OM proneness. The present study indicates that high-producing IL10 -1082 GA/GG genotypes may increase the risk for OM proneness in its carriers when exposed to other environmental/host risk factors (day care attendance, passive smoking, male sex, respiratory infections, and atopic manifestations). This study revealed no significant independent genetic association, but the lack of breastfeeding in infancy was found to be the only independent risk factor for development of OM-prone phenotype, implying that breastfeeding had a protective role in development of susceptibility to OM. • The pathogenesis of OM is of multifactorial nature, dependent on infection, environmental factors, and immune response of the child. • Cytokines and CD14 play an important role in the presentation and clinical course of otitis media, but a clear link with otitis media proneness was not established. What is new: • This is the first clinical and genetic study on Montenegrin children with the otitis media-prone phenotype. • The study revealed that high-producing IL10 -1082 genotypes may influence otitis media proneness in children exposed to other environmental/host risk factors.

Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate: Cumulative Incidence and Outcome of the Management.

Science.gov (United States)

Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

2018-04-01

To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Retrospective cohort study in the tertiary care center. Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

Comparative prevalence of otitis media in children living in urban slums, non-slum urban and rural areas of Delhi.

Science.gov (United States)

Chadha, Shelly K; Gulati, Kriti; Garg, Suneela; Agarwal, Arun K

2014-12-01

The study aimed to determine the prevalence and profile of otitis media in different parts of a city, i.e. non-slum urban areas, urban slums and rural areas. A door to door survey was conducted in identified areas of Delhi. A total of 3000 children (0-15 years) were randomly selected and examined for presence of otitis media. These children were equally distributed in the three areas under consideration. Data was analyzed to establish the prevalence of different types of otitis media. Chi-square test was then applied to compare disease prevalence among the three areas. 7.1% of the study population was identified with otitis media, which includes CSOM (4.26%), OME (2.5%) and ASOM (0.4%). In the non-slum urban parts of the city, 4.6% children had otitis media. This was significantly lower compared to 7% children in rural parts of Delhi and 9.9% in urban slums of the city. The prevalence of CSOM was considerably higher in slum areas (7.2%) as compared with rural (3%) and non-slum urban areas (2.6%). Ear infections are significantly more common in urban slums as compared to non-slum city areas and rural parts of Delhi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Long-term follow-up after tympanostomy tube insertion in children with serous otitis media].

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Fekete-Szabó, Gabriella; Kiss, Fekete; Rovó, László

2015-11-15

The authors report about the efficacy of inserted tympanostomy tube in children with serous otitis media. The aim of the authors was to assess the status of eardrum, the function of Eustachian tube and hearing level 10 years after the use of tympanostomy tube. Patients filled out a questionnaire and microscopic examination of tympanic membrane, tympanometry, Eustachian tube function examination, and audiometry tests were performed. In the period of 2003-2004, ventilation tube insertion was performed in 711 patients in the ENT Department of Pediatric Health Center of University of Szeged. In 349 patients adenotomy and tympanostomy tube insertion, in 18 cases tonsillectomy and grommet insertion and in 344 patients only typmanostomy tube insertion were performed. Due to objective difficulties (address change, no phone number) 453 patients were asked for control test and 312 persons accepted the invitation. Normal hearing level was found in 84.6% of patients and normal tympanometry result occurred in 82%. Tympanic ventilation disorder, perforation of tympanic membrane, sensorineural hearing loss and sensorineural hearing loss due to noise exposure were diagnosed. Application of tympanostomy tube is effective in the treatment of serous otitis media resulting from ventilation disorder. The authors draw attention to the importance of tympanometry examination to prevent the adhesive processes and cholesteatoma in chronic ventilation disorder of the middle ear.

The Incidence of Exudative Otitis Media in HIV Infected Children

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Nuriddin U. Narzullaev, PhD

2012-09-01

Full Text Available Diseases of the ENT organs are among the commonly prevalent and dangerous pathologies of childhood, occurring as a complication of respiratory, bacterial diseases and HIV infection. One of the serious complications of HIV infection in children is the lesion of ENT organs. In HIV infected children, in addition to suppurative diseases occur middle ear diseases with nonsuppurative origin. A total of 79 HIV infected children aged 3-14 years with different pathologies of the nasal cavity, nasopharynx and paranasal sinuses were included into the current study. The control group included 20 healthy children of comparable age and sex. The survey was conducted in the ENT department of the Children’s Multi-Medical Center, in Bukhara region. Children with a diagnosis of suppurative otitis media and/or history of suppurative otitis media were not included into the study. All HIV infected children, along with physical examination, were performed ENT examination, finger study, X-ray examination of the paranasal sinuses, audiological research and impedancemetry.

Otitis media with effusion in children with in Down syndrome.

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Austeng, Marit Erna; Akre, Harriet; Øverland, Britt; Abdelnoor, Michael; Falkenberg, Eva-Signe; Kværner, Kari Jorunn

2013-08-01

To determine the prevalence of otitis media with effusion (OME) in children with Down syndrome (DS), and the associated to hearing loss at the age of 8 years. A national population based clinical study of all children with DS born in Norway in 2002. OME was found in 20 out of 52 (38%) children. Those with OME had a significant lower hearing level with a mean pure tone average (PTA) of 33.4 dB HL compared to children with no OME whose mean PTA was 21.7 dB HL (p children with DS as current otitis media was found in one of three. This reduced hearing ability in children with DS due to OME at age of 8 strongly emphasizes the need for optimal treatment and follow up to optimize hearing rehabilitation. The findings are further supported by the population based study design, the focus on the narrow age band and the high response rate. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998–2004

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Gambler Angela S

2009-06-01

Full Text Available Abstract Background Overuse of broad-spectrum antibiotics is associated with antibiotic resistance. Acute otitis media (AOM is responsible for a large proportion of antibiotics prescribed for US children. Rates of broad-spectrum antibiotic prescribing for AOM are unknown. Methods Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1998 to 2004 (N = 6,878. Setting is office-based physicians, hospital outpatient departments, and emergency departments. Patients are children aged 12 years and younger prescribed antibiotics for acute otitis media. Main outcome measure is percentage of broad-spectrum antibiotics, defined as amoxicillin/clavulanate, macrolides, cephalosporins and quinolones. Results Broad-spectrum prescribing for acute otitis media increased from 34% of visits in 1998 to 45% of visits in 2004 (P Conclusion Prescribing of broad-spectrum antibiotics for acute otitis media has steadily increased from 1998 to 2004. Associations with non-clinical factors suggest potential for improvement in prescribing practice.

Quality of life of children with otitis media - a cohort study

DEFF Research Database (Denmark)

Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen

2014-01-01

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...... with different factors like insertion of VT and use of antibiotics. OBJECTIVE: We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental...... 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 months due...

Otitis Media in Young Children: Medical, Developmental, and Educational Considerations.

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Roberts, Joanne E., Ed.; Wallace, Ina F., Ed.; Henderson, Frederick W., Ed.

The 12 chapters of this book provide a synthesis of what is currently known about otitis media and its sequelae on aspects of child development. Chapters are grouped into four sections: definition, prevalence, and diagnosis; auditory, language, and learning sequelae; medical and surgical management; and international perspectives and future…

Attention to Language in Day Care Attending Children: A Mediating Factor in the Developmental Effects of Otitis Media.

Science.gov (United States)

Feagans, Lynne V.; And Others

Three ways in which otitis media may affect development of hearing are explored. First, developmental effects may be due to illness in general; second, otitis media may cause fluctuating hearing loss which may lead to deficits in language in many areas; and, third, fluctuating hearing loss may have only a temporary effect on the acquisition of…

Comparative effectiveness of the methods adenoidectomy in cнildren with exudative otitis media

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Gusakov A.

2016-03-01

Full Text Available Actuality: A thorough sanation of the nasopharynx is essential for successful treatment of the exudative otitis media (EOM. The literature describes in detail the state of the nasopharynx after different types of adenoidectomy. The classifications of the location of the remnants of lymphoid tissue and the extent of scarring in the nasopharynx are given.The subject of this work is to trace the relationship of postoperative nasopharyngeal changes with recurrent EOM. Objective: To study the immediate and long-term results of different methods of surgical treatment of hypertrophy of the nasopharyngeal lymphoid tissue in children with exudative otitis media. Materials and Methods: This paper presents information on the results of treatment of 62 children of 5–7 years suffering from exudative otitis media. Observations were carried out in two groups of patients. The first group included 28 children previously undergone adenoidectomy, with the signs of recurrent exudative otitis. The second group included 34 children with exudative otitis previously untreated surgically. The task of the investigation is to study the effectiveness of endonasal and extranasal methods of surgical removal of nasopharengeal lymphoid tissue with a minimum probability of scar obliteration of the mouth of the Eustachian tube. Results and discussion: The priority method in nasopharengeal surgery in children is extranasal access with shaver technology in conjunction with cold plasma surgery. The using of these methods gives a clear visualization of the operating field under conditions of moderately bleeding wound. On the other hand, endonasal approach is associated with traumatization of the nasal mucosa with incomplete volume visualization of the surgical field. This combination can result in a longer healing of the surgical wound, the formation of adhesions of the nasal cavity and scarring in the nasopharynx. Complete visualization of the operating field significantly

Otitis media aguda: nuevo enfoque terapéutico

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Ileana Alvarez Lam

2004-03-01

Full Text Available La otitis media aguda continúa siendo una de las enfermedades infecciosas más frecuentes en la infancia. Se hace una revisión del tema haciendo énfasis en la conducta terapéutica actual luego del surgimiento de complejos mecanismos de resistencia bacteriana creados por los microorganismos causantes de la enfermedad. Como toda enfermedad infecciosa las esperanzas están cifradas en el surgimiento de una vacuna que impacte de forma positiva en nuestra población infantil. En tal sentido se hace una reflexión sobre el uso de la vacuna antineumocócica de 7 valencias (Prevnar y su repercusión sobre esta enfermedad.Acute otitis media is still one of the most common infectious diseases among children. A review of the topic is made giving emphasis to the present therapeutic conduct after the appearance of complex mechanisms of bacterial resistance created by the microorganisms causing the disease. As in every infectious disease, we place our hopes on the emergence of a vaccine with a positive impact on our infantile population. In this sense, a reflection is made on the use of the heptavalent antipneumococcic vaccine (Prevnar and its repercussion on this disease.

Influence of Ossicular Chain Damage on Hearing After Chronic Otitis Media and Cholesteatoma Surgery: A Systematic Review and Meta-analysis.

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Blom, Erik F; Gunning, Marlise N; Kleinrensink, Nienke J; Lokin, Alexander S H J; Bruijnzeel, Hanneke; Smit, Adriana L; Grolman, Wilko

2015-11-01

Physicians should ideally be able to provide patients with chronic otitis media and/or cholesteatoma specific information about postoperative hearing outcome, based on their level of preoperative ossicular chain damage (OCD). To identify the influence of preoperative OCD on hearing outcomes in patients after chronic otitis media and/or cholesteatoma surgery. PubMed, EMBASE, and the Cochrane Library databases were systematically searched for available evidence, without any constraints, on December 13, 2014, for articles published between January 1, 1975, and December 13, 2014. We reviewed the literature for articles assessing the prognostic value of OCD on postoperative hearing outcome (air-bone gap [ABG] in decibels), using Austin-Kartush criteria or independent OCD classification systems. We assessed relevance and validity using a self-designed critical appraisal tool based on the Cochrane Collaboration's risk of bias tool. Characteristics of study populations and postoperative ABGs in decibels were extracted from all included studies by 4 authors (E.F.B., M.N.G., N.J.K., A.S.H.J.L.). The tested hypothesis was formulated before data collection. Primary study outcome was defined as postoperative adult hearing outcomes after COM and/or cholesteatoma surgery defined as mean postoperative ABG. Our search yielded 5661 articles. Nine articles with high relevance were included. Pooled results of studies using the Austin-Kartush criteria showed a significant (P influence of stapes structure (intact stapes suprastructure, 13.5 [95% CI, 10.3-16.7], 15.1 [95% CI, 11.8-18.3], and 21.9 [95% CI, 15.0-28.8] dB vs absent stapes structure, 12.8 [95% CI, 9.5-16.1], 19.5 [95% CI, 14.9-24.1], and 30.2 [95% CI, 24.7-35.8] dB) on postoperative ABG. One study reported a significant (P = .04) difference in mean ABG between patients with present (18.9 [95% CI, 15.7-22.1] dB) and absent (24.4 [95% CI, 20.2-28.6] dB) malleus. Pooled results of Austin-Kartush studies showed that in

A mouse model of otitis media identifies HB-EGF as a mediator of inflammation-induced mucosal proliferation.

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Keigo Suzukawa

Full Text Available Otitis media is one of the most common pediatric infections. While it is usually treated without difficulty, up to 20% of children may progress to long-term complications that include hearing loss, impaired speech and language development, academic underachievement, and irreversible disease. Hyperplasia of middle ear mucosa contributes to the sequelae of acute otitis media and is of important clinical significance. Understanding the role of growth factors in the mediation of mucosal hyperplasia could lead to the development of new therapeutic interventions for this disease and its sequelae.From a whole genome gene array analysis of mRNA expression during acute otitis media, we identified growth factors with expression kinetics temporally related to hyperplasia. We then tested these factors for their ability to stimulate mucosal epithelial growth in vitro, and determined protein levels and histological distribution in vivo for active factors.From the gene array, we identified seven candidate growth factors with upregulation of mRNA expression kinetics related to mucosal hyperplasia. Of the seven, only HB-EGF (heparin-binding-epidermal growth factor induced significant mucosal epithelial hyperplasia in vitro. Subsequent quantification of HB-EGF protein expression in vivo via Western blot analysis confirmed that the protein is highly expressed from 6 hours to 24 hours after bacterial inoculation, while immunohistochemistry revealed production by middle ear epithelial cells and infiltrating lymphocytes.Our data suggest an active role for HB-EGF in the hyperplasia of the middle ear mucosal epithelium during otitis media. These results imply that therapies targeting HB-EGF could ameliorate mucosal growth during otitis media, and thereby reduce detrimental sequelae of this childhood disease.

Societal costs and burden of otitis media in Portugal

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Speets AM

2011-04-01

Full Text Available Anouk Speets1, Judith Wolleswinkel1, Cristina Cardoso21Pallas health research and consultancy, Rotterdam, the Netherlands; 2GlaxoSmithKline, Algés, PortugalAbstract: This study aimed to estimate the resource consumption and societal impact of otitis media (OM in children younger than five years of age in Portugal. An Internet survey on generic childhood symptoms and diseases was administered to a sample of parents. This self-report survey had been previously implemented in other European countries. Medically confirmed OM was defined as symptoms of earache or “running ear” and/or a diagnosis of OM provided by a medical doctor. Direct medical, nonmedical, and indirect nonmedical costs were calculated for individual cases. Mean total costs per OM episode were estimated at €334. This corresponds to an estimated societal impact of 72 million €/year, of which 39% were indirect nonmedical costs. An epidemiological study should help to confirm the results of this study, and evaluate whether an intervention to reduce the occurrence and/or duration of OM may have an impact on societal costs and quality of life for affected families.Keywords: otitis media, costs, societal burden, Portugal

Otitis Media in high-risk infants | Louw | South African Family Practice

African Journals Online (AJOL)

Background: Delayed communication development is the most common symptom of developmental disability in children under three. Recurrent otitis media is an important contributing factor to a developmental communication delay. Young children under the age of three years who have a communication delay due to ...

IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

Science.gov (United States)

Wiertsema, Selma P; Corscadden, Karli J; Mowe, Eva N; Zhang, Guicheng; Vijayasekaran, Shyan; Coates, Harvey L; Mitchell, Timothy J; Thomas, Wayne R; Richmond, Peter C; Kirkham, Lea-Ann S

2012-01-01

Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply) and 3 NTHi (P4, P6 and PD) proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion) and 63 healthy age-matched controls, using a newly developed multiplex bead assay. Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

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Selma P Wiertsema

Full Text Available BACKGROUND: Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. METHODS: We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply and 3 NTHi (P4, P6 and PD proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion and 63 healthy age-matched controls, using a newly developed multiplex bead assay. RESULTS: Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. CONCLUSIONS: Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

Noninvasive in vivo optical coherence tomography tracking of chronic otitis media in pediatric subjects after surgical intervention

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Monroy, Guillermo L.; Pande, Paritosh; Nolan, Ryan M.; Shelton, Ryan L.; Porter, Ryan G.; Novak, Michael A.; Spillman, Darold R.; Chaney, Eric J.; McCormick, Daniel T.; Boppart, Stephen A.

2017-12-01

In an institutional review board-approved study, 25 pediatric subjects diagnosed with chronic or recurrent otitis media were observed over a period of six months with optical coherence tomography (OCT). Subjects were followed throughout their treatment at the initial patient evaluation and preoperative consultation, surgery (intraoperative imaging), and postoperative follow-up, followed by an additional six months of records-based observation. At each time point, the tympanic membrane (at the light reflex region) and directly adjacent middle-ear cavity were observed in vivo with a handheld OCT probe and portable system. Imaging results were compared with clinical outcomes to correlate the clearance of symptoms in relation to changes in the image-based features of infection. OCT images of most all participants showed the presence of additional infection-related biofilm structures during their initial consultation visit and similarly for subjects imaged intraoperatively before myringotomy. Subjects with successful treatment (no recurrence of infectious symptoms) had no additional structures visible in OCT images during the postoperative visit. OCT image findings suggest surgical intervention consisting of myringotomy and tympanostomy tube placement provides a means to clear the middle ear of infection-related components, including middle-ear fluid and biofilms. Furthermore, OCT was demonstrated as a rapid diagnostic tool to prospectively monitor patients in both outpatient and surgical settings.

Laser Myringotomy Versus Ventilation Tubes In Otitis Media With Effusion.

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Yousaf, Mohammad; Malik, Suhail Ahmad; Haroon, Tahir

2016-01-01

Otitis media with effusion (OME) is a leading cause of difficulty in hearing in paediatric population. Otitis media with effusion must be detected and managed early to prevent conductive hearing loss in children. It was aimed to compare results of laser myringotomy and ventilation tube insertion, in terms of hearing improvement and recurrence of Middle ear effusion (MEE). This randomized controlled trial was conducted from February 2012 to January 2015. Children of 4- 12 years of age with decreased hearing due to OME were included in the study. These children were investigated with pure tone audiometry (PTA) and tympanometry to confirm conductive hearing loss. Patients were put in 2 groups, group one comprised of patients treated with laser myringotomy and group 2, treated with ventilation tube insertion. The objective was to evaluate and compare results of the two procedures in terms of resolution of middle ear effusion (MEE) and improvement of hearing. The two procedures were also compared in terms of complications like otorrhea, persistence of perforation, hypertrophic scar and thinning of tympanic membrane (TM). Middle ear effusion cleared in 35 out of 68 ears with laser myringotomy (LM) as compared to 52 out of 62 ears with ventilation tubes (VT). The myringotomy was still patent in 21 ears treated with LM while tube was in site in 50 years with VT after 3 months. The hearing level improved with LM by 10-15 dB after first 3 months. The aim in Otitis media with effusion is ventilation of tympanic cavity. Laser myringotomy can be substitute to ventilation tube insertion (VT). But it remains patent for shorter time and less effective than VT. The ears with refractory or recurrent MEE should have VT insertion.

Three-dimensional multislice CT imaging of otitis media

International Nuclear Information System (INIS)

Suzuki, Miyako; Yoshikawa, Hiroshi; Hosokawa, Akira; Furukawa, Tomoyasu; Ichikawa, Ginichiro; Wada, Akihiro; Ando, Ichiro

2002-01-01

In recent years, the multislice CT system has come into practical use that enables table movement of half mm, resulting in a significant improvement in resolution. The use of this CT system enables to depict the entire auditory ossicles, including the stapes. 3D reconstruction was performed using helical CT data in 5 patients with chronic otitis media and 5 patients with cholesteatoma. An Aquilion Multi (Toshiba) multislice helical CT scanner and a Xtension (Toshiba) image workstation were used in this study. We demonstrated the 3D display with axial, coronal and sagittal images. Compared with the normal ears, it was necessary to set a higher threshold for the affected ears. It is important to select suitable threshold for demonstration of 3D images optimally. Bone destruction of the stapes was confirmed at surgery in 2 ears. The stapes was observed at 3D-CT imaging in other 18 ears. It was found that the 3D images of the ossicular destruction in ears with cholesteatoma were consistent with surgical findings. It is therefore concluded that 3D imaging of the middle ear using a multislice CT scanner is clinically useful. (author)

Three-dimensional multislice CT imaging of otitis media

Energy Technology Data Exchange (ETDEWEB)

Suzuki, Miyako [Yanagibasi Hospital, Tokyo (Japan); Yoshikawa, Hiroshi; Hosokawa, Akira; Furukawa, Tomoyasu; Ichikawa, Ginichiro [Juntendo Univ., Tokyo (Japan). School of Medicine; Wada, Akihiro; Ando, Ichiro [Juntendo Univ., Chiba (Japan). Urayasu Hospital

2002-07-01

In recent years, the multislice CT system has come into practical use that enables table movement of half mm, resulting in a significant improvement in resolution. The use of this CT system enables to depict the entire auditory ossicles, including the stapes. 3D reconstruction was performed using helical CT data in 5 patients with chronic otitis media and 5 patients with cholesteatoma. An Aquilion Multi (Toshiba) multislice helical CT scanner and a Xtension (Toshiba) image workstation were used in this study. We demonstrated the 3D display with axial, coronal and sagittal images. Compared with the normal ears, it was necessary to set a higher threshold for the affected ears. It is important to select suitable threshold for demonstration of 3D images optimally. Bone destruction of the stapes was confirmed at surgery in 2 ears. The stapes was observed at 3D-CT imaging in other 18 ears. It was found that the 3D images of the ossicular destruction in ears with cholesteatoma were consistent with surgical findings. It is therefore concluded that 3D imaging of the middle ear using a multislice CT scanner is clinically useful. (author)

Tuberculous otitis media: findings on high-resolution CT

International Nuclear Information System (INIS)

Lungenschmid, D.; Buchberger, W.; Schoen, G.; Schoepf, R.; Mihatsch, T.; Birbamer, G.; Wicke, K.

1993-01-01

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.)

Incidence of Otitis Media in a Contemporary Danish National Birth Cohort

DEFF Research Database (Denmark)

Todbjerg, Tanja; Koch, Anders; Andersson, Mikael

2014-01-01

OBJECTIVES: In recent years welfare in Denmark has increased which might be expected to reduce otitis media (OM) incidence. We examined the age-specific incidence of OM in a nation-wide cohort of children aged 0-7 years born in 1996-2003 (Danish National Birth Cohort, DNBC). Only selection...

Burden and outcome of acute otitis media in rural Bangladesh | Roy ...

African Journals Online (AJOL)

Objectives. To report on the burden and outcome of episodes of acute otitis media (AOM) based on awareness of AOM and compliance to referral by community health workers (CHWs) in rural children aged under 2 in Bangladesh. Study design. Retrospective population-based cohort study. Method. Secondary data ...

Vestibular Dysfunction in Preschool Children with a History of Otitis Media.

Science.gov (United States)

Denning, Jennifer; Mayberry, Wanda

1987-01-01

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)

Gradenigo Syndrome: Unusual Consequence of Otitis Media

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Jennie M. Valles

2014-07-01

Full Text Available Introduction: In 1904, Giuseppe Gradenigo published his case series on the triad of ipsilateral abducens nerve palsy, facial pain in the trigeminal nerve distribution, and suppurative otitis media, which would subsequently be referred to as Gradenigo syndrome. Case Report: Our patient was a 36-year-old female, 23 weeks pregnant, with a 6-day history of right-sided otalgia and hearing loss and a 4-day history of purulent otorrhea, who presented with severe, holocephalic headache, meningeal signs, fever, photophobia, and mental status decline. Lumbar puncture yielded a white blood cell count of 1,559 cells/mm3 with 95% polymorphonuclear leukocytes, a red blood cell count of 111 cells/mm3, a protein level of 61 mg/dl, and a glucose level of Streptococcus pneumoniae and treated with ceftriaxone. On the second hospital day, she developed horizontal diplopia due to right abducens nerve palsy and right mydriasis. Both symptoms resolved on the third hospital day. Erosion of temporal bone and opacification of mastoid air cells was shown on CT scan. A CT venogram showed an irregularity of the left transverse and superior sagittal sinuses. She was treated with enoxaparin for possible sinus thrombosis. Discussion: This case demonstrates rare but serious sequelae of otitis media and Gradenigo syndrome. Holocephalic headache from meningitis masked trigeminal pain. Involvement of the ipsilateral petrous apex and surrounding structures on imaging and clinical improvement with antibiotic treatment supports Gradenigo syndrome over intracranial hypertension due to venous sinus thrombosis as the cause of the abducens nerve palsy.

Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media.

Science.gov (United States)

Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse; Faber, Christian Emil; Johansen, Eva Charlotte Jung; Godballe, Christian

2015-10-01

The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to investigate possible predictors for clinical success. Longitudinal observational study. Secondary care units. 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 completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube treatment. A diagnosis of rAOM was found to predict baseline quality of life. Children with rAOM with or without OME were found to suffer significantly more than children with only OME before treatment. Factors associated with disease severity were found to predict clinical success. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

Statistical model estimating the occurrence of otitis media from temporal bone pneumatization

DEFF Research Database (Denmark)

Homøe, P; Lynnerup, N; Rasmussen, N

1994-01-01

In order to investigate the relationship between the pneumatization of temporal bones and the occurrence of otitis media in Greenlandic Inuit, 36 Greenlandic Inuit were examined by radiography of the temporal bones. The pneumatized cell area was measured planimetrically. All subjects answered...

Quality of life and psycho-social development in children with otitis media with effusion.

Science.gov (United States)

Bellussi, L; Mandalà, M; Passàli, F M; Passàli, G C; Lauriello, M; Passali, D

2005-12-01

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 otitis media study was conducted, retrospectively, in two primary public schools in Colle Val D'Elsa (Siena) on 252 children (6-11 years old). The State-Trait Anxiety Inventory test had been administered to the parents or caregivers of 20 paediatric outpatients (4-12 years, mean 6.8) at the ENT Department of Siena University. The results of the OM survey showed a correlation between OM and difficulties in speech and reading, delayed answering and limited vocabulary. All these problems improved as children grew up. On the other hand, psycho-social development appeared to be more problematic even in the 4th and 5th class, mostly due to persistent attention disturbances. In the State-Trait Anxiety Inventory test, 50% of parents or caregivers had a high state-anxiety score and so were mostly concerned with health status of the children. The State-Trait Anxiety Inventory results indicated that 50% of parents or caregivers had a high trait-anxiety score and thus had an anxious personality. These findings could be helpful in understanding the real severity of symptoms. The two proposed tests could provide complementary data to evaluate children with OME: the OM survey can be used as a screening test to detect children with non-symptomatic OME, to establish whether delayed language development may be associated with OME, to predict prognosis and children's quality of life as well as social costs of OME; the State-Trait Anxiety Inventory test can be used to reveal a state or a trait

Causative organisms in chronic suppurative otitis media and their drug sensitivity in a tertiary hospital of southern punjab, pakistan

International Nuclear Information System (INIS)

Hydri, A.S.; Alam, M.J.; Anwar, K.

2017-01-01

Objective: To diagnose common organisms causing Chronic Suppurative Otitis Media (CSOM) and their in vitro sensitivity. Methodology: This descriptive study was carried out at Ear Nose and Throat (ENT) Department, Combined Military Hospital (CMH) Multan from July 2014 to June 2015. A total of 140 patients with active CSOM were included in this study. Ear swabs were collected from the discharging ear and sent for aerobic cultures only. Antibiotic sensitivity testing was done with standard antibiotic discs using Kirby Bauer disk diffusion method. Results: Pathogens were isolated in all except 13 ears. Pseudomonas aeruginosa was the most common organism isolated alone in 76 ears and in combination with other micro-organisms in 18 ears, followed by staphylococcus aureus in 23 and MRSA in four ears. Mixed organisms were found in 20 patients. Antibiotic sensitivity of Pseudomonas aeruginosa showed that 100% isolates were sensitive to imipenem and meropenem while Staphylococcus aureus was 100% sensitive to Chloramphenicol. Conclusion: Pseudomonas aeruginosa and staphylococcus aureus were commonest organism isolated in CSOM. Similar studies should periodically be conducted in various regions to have a current knowledge of the offending organisms and their sensitivity patterns against various antibiotics before commencing treatment of CSOM. (author)

Ribotyping of strains of Moraxella (Branhamella) catarrhalis cultured from the nasopharynx and middle ear of children with otitis media

DEFF Research Database (Denmark)

Brygge, K; Sørensen, C H; Colding, H

1998-01-01

Moraxella (Branhaomella) catarrhalis is frequently present in the nasopharyngeal microflora of small children, especially during episodes of acute otitis media . By means of ribotyping (restriction endonuclease analysis of chromosomal DNA combined with rRNA probing), we studied the genetic...... 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 distribution of these types was found to be almost identical to the distribution among 16 M. catarrhalis strains cultured from middle ear exudates of 16 children with acute otitis media. Ribotype HAPA was found in two-thirds of all the cultures investigated, and 44% of the children harboured more than one...

Predictors of Phonologic Inadequacy in Young Children Prone to Otitis Media.

Science.gov (United States)

Paden, Elaine Pagel; And Others

1987-01-01

Assessments of 18-to 35-month-olds (N=40) documented as having persistent otitis media with effusion indicated that a combination of low production scores for velars, liquids, and obstruents as well as early onset and late remission were important in characterizing children who would need speech remediation or intervention. (Author/CB)

The role of adenoidal obstruction in the pathogenesis of Otitis media ...

African Journals Online (AJOL)

Background: Although adenoidectomy is generally applied in the treatment of otitis media with effusion (OME), there is still much debate about the role of adenoid in the pathogenesis of OME. The purpose of this study is to determine the incidence of OME in children with obstructive adenoid disease in comparison with ...

Surgery for Otitis Media in a Universal Health Care Model: Socioeconomic Status and Race/Ethnicity Effects.

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Ambrosio, Art; Brigger, Matthew T

2014-07-01

(1) To determine the association between socioeconomic status (SES), race/ethnicity, and other demographic risk factors in surgically managed otitis media within a model of universal health care. 2) To determine quality of life (QOL) outcomes of surgically managed otitis media in this model. Tertiary academic medical center. Prospective cohort study. A prospective study was conducted between June 2011 and December 2012 with dependent children of military families. TRICARE provides equal access to care among all beneficiaries regardless of a wide range of annual incomes. Caretakers of children scheduled for bilateral myringotomy and tympanostomy tube (BMT) placement were administered a demographic survey, as well as OM-6 QOL instrument preoperatively and 6 weeks postoperatively. A control group who did not undergo BMT was also administered both the survey and OM-6 for comparison. Two hundred forty patients were enrolled (120 surgical patients and 120 controls). Logistic regression demonstrated age younger than 6 years old (P otitis media-6 (OM-6) scores after surgical management from 3.00 (95% confidence interval [CI], 2.79-3.20) to 1.35 (95% CI, 1.22-1.47). In a universal health care model serving more than 2 million children, previously reported proxies of low SES as well as minority race/ethnicity were not associated with surgically managed otitis media contrary to reported literature. Caucasian race, young age, and day care attendance were associated with surgery. Surgery improved QOL outcomes 6 weeks postoperatively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Effect of Otitis Media upon Reading Scores of Indian Children in Ontario.

Science.gov (United States)

Scaldwell, William A.

1989-01-01

Finds that lower reading scores were related to evidence of past or present middle ear infection among 524 American Indian children in northern and southern Ontario. Discusses the high incidence of otitis media among young Indian children, and educational implications. Contains 29 references. (SV)

The Effect of Otitis Media on Articulation in Children with Cerebral Palsy.

Science.gov (United States)

Van der Vyver, Marguerite; And Others

1988-01-01

A study involving 20 Afrikaans-speaking children with cerebral palsy found that recurrent otitis media in early childhood had a negative effect on articulation abilities of the 7 to 11-year-old children but that other factors such as intelligence also played a role. (JDD)

Identification of bacteria causing acute otitis media using Raman microspectroscopy

Science.gov (United States)

Ayala, Oscar D.; Wakeman, Catherine A.; Skaar, Eric P.; Mahadevan-Jansen, Anita

2016-03-01

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.

Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination

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Mackenzie Grant

2009-02-01

Full Text Available Abstract Background Aboriginal children in remote Australia have high rates of complicated middle ear disease associated with Streptococcus pneumoniae and other pathogens. We assessed the effectiveness of pneumococcal vaccination for prevention of otitis media in this setting. Methods We compared two birth cohorts, one enrolled before (1996–2001, and the second enrolled after introduction of 7-valent pneumococcal conjugate and booster 23-valent polysaccharide vaccine (2001–2004. Source populations were the same for both cohorts. Detailed examinations including tympanometry, video-recorded pneumatic otoscopy and collection of discharge from tympanic membrane perforations, were performed as soon as possible after birth and then at regular intervals until 24 months of life. Analyses (survival, point prevalence and incidence were adjusted for confounding factors and repeated measures with sensitivity analyses of differential follow-up. Results Ninety-seven vaccinees and 51 comparison participants were enrolled. By age 6 months, 96% (81/84 of vaccinees and 100% (41/41 of comparison subjects experienced otitis media with effusion (OME, and by 12 months 89% and 88% experienced acute otitis media (AOM, 34% and 35% experienced tympanic membrane perforation (TMP and 14% and 23% experienced chronic suppurative otitis media (CSOM. Age at the first episode of OME, AOM, TMP and CSOM was not significantly different between the two groups. Adjusted incidence of AOM (incidence rate ratio: 0.88 [95% confidence interval (CI: 0.69–1.13] and TMP (incidence rate ratio: 0.63 [0.36–1.11] was not significantly reduced in vaccinees. Vaccinees experienced less recurrent TMP, 9% (8/95 versus 22% (11/51, (odds ratio: 0.33 [0.11–1.00]. Conclusion Results of this study should be interpreted with caution due to potential bias and confounding. It appears that introduction of pneumococcal vaccination among Aboriginal infants was not associated with significant changes

ROLE OF MASTOIDECTOMY IN TYPE 1 TYMPANOPLASTY OF SAFE TYPE CHRONIC SUPPURATIVE OTITIS MEDIA- A PROSPECTIVE STUDY

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Sami Ullah

2016-12-01

Full Text Available BACKGROUND Chronic Suppurative Otitis Media (CSOM is one of the most common diseases of younger age in middle class population of the developing countries. Loss of hearing due to CSOM has a role in learning and intelligence of the students. There are multiple factors, which affect the tympanic membrane repair, mastoidectomy is one. MATERIALS AND METHODS This study at Era’s Lucknow Medical College and Hospital was planned to assess the effect of cortical mastoidectomy in safe type CSOM. For that, 120 patients were taken who were divided in two groups of 60 each. One group was subjected to tympanoplasty type 1 and other to cortical mastoidectomy and type 1 tympanoplasty. RESULTS After six months of follow up, it was found that graft rejection was 13 in group 1 compared to 12 in group2 and cortical mastoidectomy has almost no effect on graft acceptance and hearing gain in pure tone audiometry. CONCLUSION This study was planned to find the effect of cortical mastoidectomy in tympanoplasty type 1 in safe type CSOM. Two groups of 60 patients were taken. In one group, only tympanoplasty type 1 while in other cortical mastoidectomy along with tympanoplasty type 1 was done. After 6 months of follow up, no statistically significant difference was found in the graft rejection and hearing gain between the two groups.

Literature review: use of xylitol for prevention of acute otitis media

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Pereira, Agnes de Fátima Faustino

2009-03-01

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.

The effect of a pneumococcal conjugate vaccine on the risk of otitis media with effusion at 7 and 24 months of age.

NARCIS (Netherlands)

Straetemans, M.; Palmu, A.; Auranen, K.; Zielhuis, G.A.; Kilpi, T.

2003-01-01

OBJECTIVE: To explore the effect of a pneumococcal conjugate vaccine on the risk of otitis media with effusion and to search for subgroups in which the vaccine had a higher or lower effect. METHODS: Analyses were performed on data from the Finnish Otitis Media Vaccine Trial, a randomised controlled

Drænbehandling af recidiverende otitis media hos børn

DEFF Research Database (Denmark)

Lous, Jørgen; Trankjær, Christina Ryborg; Thomsen, Janus Laust

2010-01-01

I et nyligt publiceret Cochrane-review om effekten af indsættelse af trommehindedræn hos børn med recidiverende akut otitis media (RAOM) fandt man kun to studier, som opfyldte inklusionskriterierne. De inkluderede studier påviste en absolut risikoreduktion for at få AOM på 0,34 på seks måneder. Ved...

The continuing challenge of early detection of acute otitis media in ...

African Journals Online (AJOL)

Objective: The aim of the study is to highlight the clinical problem of acute otitis media in children as seen in Uyo with particular reference to difficulties of early detection over a 6 year period (1999-2004). Methodology: A six-year retrospective study (1999-2004) was carried out to evaluate the clinical presentation and early ...

Caracterización clínico-epidemiológica de la otitis media aguda en pacientes pediátricos Clinicoepidemiological characterization of the acute otitis media in children

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Ileana Álvarez Lam

2011-09-01

Full Text Available Introducción: la otitis media aguda es una de las enfermedades infecciosas más frecuentes en la infancia, y constituye una de las causas más importantes de consultas médicas y prescripción de antibióticos en los menores de 5 años. Objetivo: determinar el comportamiento clínico epidemiológico de la enfermedad. Métodos: se realizó un estudio descriptivo, longitudinal prospectivo con 60 pacientes entre 1 mes y 14 años de edad con diagnóstico de otitis media aguda purulenta en el Hospital Pediátrico Docente "William Soler", durante el período de 1 año (enero a diciembre de 2008. Los datos clínicos se obtuvieron mediante una encuesta a los padres o tutores de los pacientes. A todos se les realizó timpanocentesis con cultivo y exudado nasofaríngeo. Las cepas aisladas fueron enviadas al Laboratorio Nacional de Referencia de S. pneumoniae y H. influenzae del Instituto de Medicina Tropical "Pedro Kourí" para la caracterización microbiológica y determinación de susceptibilidad antimicrobiana. Resultados: la enfermedad predominó en el grupo ubicado entre 12 y 23 meses (55 %, con mayor afectación del sexo masculino (52 %. La fiebre y las manifestaciones locales referidas a oído medio (irritabilidad, otalgia, llanto nocturno fueron los elementos clínicos referidos con mayor frecuencia. El cuidado fuera del hogar, la exposición al humo de tabaco y el destete precoz fueron los factores de riesgo más frecuentes. S. pneumoniae, H. influenzae no tipificable y S. epidermidis fueron los gérmenes aislados con mayor frecuencia. El 25 % de las cepas de S. pneumoniae tuvieron resistencia intermedia a la penicilina, pero no se reportó resistencia a cefalosporinas de tercera generación. El 98,4 % de los pacientes evolucionaron satisfactoriamente. Las complicaciones de la enfermedad se presentaron en 1,6 % de los casos. Conclusiones: la otitis media aguda es frecuente en niños menores de 36 meses, y está muy relacionada con la presencia

Psychometric qualities of questionnaires for the assessment of otitis media impact.

Science.gov (United States)

Timmerman, A A; Meesters, C M G; Speyer, R; Anteunis, L J C

2007-12-01

The assessment of impact and evaluation of treatment effects in chronic otitis media (OM) calls for a much broader approach than just examining the presence of middle ear effusion or hearing loss. It is increasingly recognised that this condition may result in a comprised quality of life. Several studies have used proxy completed questionnaires to objectify the illness experience associated with chronic OM. To review questionnaires which have been developed to describe the effects of chronic OM on the daily functioning of children. Psychometric properties have been evaluated, in addition to discriminative and evaluative qualities. A systematic review of publications pertaining to developed questionnaires related with chronic OM. Systematic literature searches of PubMed (1966-January 2007) and EMBASE (1989-January 2007) were conducted, supplemented by using free text words to identify publications after January 2005. The included 15 questionnaires were developed for children with recurrent or persistent OM, describing functional health status (FHS), while two questionnaires also evaluate the effect of tympanostomy tubes insertion. The questionnaires generally cover six impact areas (physical symptoms, child development, educational performance, emotional/practical burden and general health status) with physical symptoms being the most prominant. The OM8-30, OMO-22 and OM-6 adequately reflect the multidimensional aspects of FHS in chronic OM. The OMO-22 and OM8-30 show the best psychometric properties for the discrimination of impact severity between children, while the OM-6 was found to have the best qualities for the evaluation of clinical change. Clinical applicability is crucial for the assessment of FHS in chronic OM, but requires a trade-off with necessary psychometric properties.

The evaluation of HRCT in the diagnosis of chronic otitis and mastoiditis

International Nuclear Information System (INIS)

Tang Yong; Zhao Jun; Liu Fangying; Zhang Xuelin

2005-01-01

Objective: To explore the value of' HRCT in the diagnosis of chronic otitis and mastoiditis. Method: Thirty-five patients with chronic otitis and mastoiditis received high resolution CT scan (HRCT). Results: (1) In cases of cholesteatoma, the mass was seen in tympanic sinus and the tympanum area; where the positive rate of' drum damage was 92% and most of the damage of substantia ossea involved the adjacent tissue. The positive rate of the disappearance, damage and cirrhosis of otosteon was 94% in patients with granuloma-type mastoiditis. The damage of eardrum wall was revealed in 15% cases of granuloma-type, in which ossicular chain was revealed wrapped with granulation tissue. The damage of ossicular chain was 23% in cases of granuloma-type. In cases of simple type, the damage of eardrum wall and the substantia ossea adjacent the ossicular chain was rare, and there was no mass. Conclusions: The HRCT is useful in the diagnosis of chronic mastoiditis. (authors)

Interactions between the otitis media gene, Fbxo11, and p53 in the mouse embryonic lung.

Science.gov (United States)

Tateossian, Hilda; Morse, Susan; Simon, Michelle M; Dean, Charlotte H; Brown, Steve D M

2015-12-01

Otitis media with effusion (OME) is the most common cause of hearing loss in children, and tympanostomy (ear tube insertion) to alleviate the condition remains the commonest surgical intervention in children in the developed world. Chronic and recurrent forms of otitis media (OM) are known to have a very substantial genetic component; however, until recently, little was known of the underlying genes involved. The Jeff mouse mutant carries a mutation in the Fbxo11 gene, a member of the F-box family, and develops deafness due to a chronic proliferative OM. We previously reported that Fbxo11 is involved in the regulation of transforming growth factor beta (TGF-β) signalling by regulating the levels of phospho-Smad2 in the epithelial cells of palatal shelves, eyelids and airways of the lungs. It has been proposed that FBXO11 regulates the cell's response to TGF-β through the ubiquitination of CDT2. Additional substrates for FBXO11 have been identified, including p53. Here, we have studied both the genetic and biochemical interactions between FBXO11 and p53 in order to better understand the function of FBXO11 in epithelial development and its potential role in OM. In mice, we show that p53 (also known as Tp53) homozygous mutants and double heterozygous mutants (Jf/+ p53/+) exhibit similar epithelial developmental defects to Fbxo11 homozygotes. FBXO11 and p53 interact in the embryonic lung, and mutation in Fbxo11 prevents the interaction with p53. Both p53 and double mutants show raised levels of pSMAD2, recapitulating that seen in Fbxo11 homozygotes. Overall, our results support the conclusion that FBXO11 regulates the TGF-β pathway in the embryonic lung via cross-talk with p53. © 2015. Published by The Company of Biologists Ltd.

First report of a Staphylococcus caprae isolated from middle ear fluid of an infant with recurrent acute otitis media

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Elżbieta Mazur

2017-09-01

Full Text Available Staphylococcus caprae was originally isolated from goat milk. This uncommon coagulase-negative staphylococcus, usually associated with animals, has only infrequently been detected in human clinical specimens. Its association with acute otitis media has not been demonstrated so far. The study reports the first isolation of S. caprae from the middle ear fluid of a 12-month-old infant with recurrent, bilateral acute otitis media. Biochemical traits and susceptibility pattern of the isolated strain are also presented

Identification and antimicrobial susceptibility patterns of Staphylococcus spp. isolated from canine chronic otitis externa

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Silva N.

2001-01-01

Full Text Available Swab samples obtained from 96 dogs with chronic otitis externa were cultured for the isolation of Staphylococcus species. Of 57 staphylococcal strains, 41 (72% were coagulase-negative (CNS. The identification of staphylococci strains was made by standard procedures for the routine identification of staphylococci in clinical practice. S. sciuri was the most frequent species isolated (22.8% from chronic otitis externa in dogs followed by S. intermedius (12.3%, S. auricularis (10.5% and S. aureus (8.8%. Three (5.2% CNS strains could not be identified. Bacterial isolates were susceptible to enrofloxacin, gentamicin, cephalothin, chloramphenicol and neomycin. Resistance was most common to penicillin G, oxacillin and ampicillin.

[Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase].

Science.gov (United States)

Lorente, J; Sabater, F; Maristany, M; Jiménez, R; Menem, J; Viñas, J; Quesada, P; Traserra, J; Dicenta, M; Abelló, P

1995-01-01

A multicentre double-blind randomized study was carried out to compare topical ciprofloxacin and topical gentamicin in the treatment of simple non-cholesteatomatous purulent chronic otitis media. Three hundred and eight patients were included in the study, 159 treated with ciprofloxacin and 149 treated with gentamicin. The percentage of clinical success (elimination of otorrhoea) was 95% with ciprofloxacin and 94% with gentamicin (ns). Likewise, the percentage of bacteriological erradication was 96% with ciprofloxacin and 93% with gentamicin. Both drugs were well tolerated, without changes in the audiometric values. In these patients, topical ciprofloxacin shows the same efficacy as topical gentamicin without any potential ototoxic effect.

Long-Term Effects of Early-Life Otitis Media on Language Development

Science.gov (United States)

Zumach, Anne; Gerrits, Ellen; Chenault, Michelene; Anteunis, Lucien

2010-01-01

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;…

Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion.

Science.gov (United States)

Mel-Hennawi, D; Ahmed, M R

2015-11-01

To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion. The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole). In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent). H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.

The Effects of Otitis Media on Articulation. Final Report for 1982-1983.

Science.gov (United States)

Roberts, Joanne Erwick

The study examined the relationship in 44 preschoolers (considered to have varying degrees of predicted risk for poor school performance) between otitis media (middle ear disease) during the first 3 years of life and speech production (articulation) during preschool and school age years. Speech production accuracy was assessed by the number of…

Comparison of Three Methods Used in the Diagnosis of Extraesophageal Reflux in Children with Chronic Otitis Media with Effusion

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Martin Formánek

2015-01-01

Full Text Available Objectives. Detection of extraesophageal reflux (EER in children with chronic otitis media with effusion (OME using three different diagnostic methods. Methods. Children between 1 and 7 years with OME who underwent adenoidectomy and myringotomy with insertion of a ventilation tube were included in this prospective study. EER was detected using three methods: oropharyngeal pH was monitored for 24 hours using the Restech system; detection of pepsin in middle ear fluid obtained during myringotomy was done using Peptest, and detection of pepsin in an adenoid specimen was done immunohistochemically. Results. Altogether 21 children were included in the study. Pathological oropharyngeal pH was confirmed in 13/21 (61.9% children. Pepsin in the middle ear fluid was present in 5/21 (23.8% children; these 5 patients were diagnosed with the most severe EER established through monitoring of oropharyngeal pH. No specimen of adenoids tested was positive for pepsin upon immunohistochemical examination. Conclusions. Diagnosis of EER in patients with OME using Restech is sensitive but less specific when compared to the detection of pepsin in middle ear fluid using Peptest. Pepsin in the middle ear was consistently present in patients with RYAN score above 200, and these patients in particular could potentially profit from antireflux therapy.

The effect of the leukotriene antagonist pranlukast on pediatric acute otitis media.

Science.gov (United States)

Nakamura, Yoshihisa; Hamajima, Yuki; Suzuki, Motohiko; Esaki, Shinichi; Yokota, Makoto; Oshika, Masanori; Takagi, Ippei; Yasui, Keiko; Miyamoto, Naoya; Sugiyama, Kazuko; Nakayama, Meiho; Murakami, Shingo

2016-08-01

Conventional treatment for acute otitis media mainly targets bacteria with antibiotics, neglecting to control for mediators of inflammation. Mediators of inflammation, such as leukotrienes, have been identified in patients with acute otitis media (AOM) or subsequent secretory otitis media (SOM). They can cause functional eustachian tube dysfunction or increase mucous in the middle ear, causing persistent SOM following AOM. The objective of the present study was to evaluate whether or not administration of pranlukast, a widely used leukotriene C4, D4, and E4 antagonist, together with antibiotics could inhibit the progression to SOM. Children with AOM, who were from two to 12 years old, were randomly divided into two groups as follows: a control group in which 50 patients received antibiotic-based conventional treatment according to guidelines for treating AOM proposed by the Japan Otological Society (version 2006); and a pranlukast group, in which 52 patients were administered pranlukast for up to 28 days as well as given conventional treatment. Cases were regarded as persistent SOM when a tympanogram was type B or C2 four weeks after treatment was initiated. Two patients in the pranlukast group and 3 patients in the control group were excluded because they relapsed AOM within 28 days after initial treatment. Therefore, the analysis included 50 and 47 subjects in the pranlukast and control groups, respectively. The percentage of patients diagnosed with persistent SOM (22.0%) was significantly smaller in the pranlukast group compared with the control group (44.7%) (p = 0.018, chi-squared test). The results indicate that combined treatment of AOM with antibiotics and a leukotriene antagonist to control inflammation is useful for preventing progression to persistent SOM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Otitis Media in Young Children with Disabilities--Practical Strategies. FPG Snapshot #16

Science.gov (United States)

FPG Child Development Institute, University of North Carolina, 2004

2004-01-01

Studies have shown that some children are at higher risk for otitis media. Those at risk may include children with some developmental disorders such as Down syndrome, Williams syndrome, Apert syndrome, fragile X syndrome, Turner syndrome, cleft palate, and autism; as well as all children attending childcare. It has been hypothesized that the link…

Diet as a risk factor for pneumococcal carriage and otitis media: a cross-sectional study among children in day care centers.

Science.gov (United States)

Tapiainen, Terhi; Paalanne, Niko; Arkkola, Tuula; Renko, Marjo; Pokka, Tytti; Kaijalainen, Tarja; Uhari, Matti

2014-01-01

Pharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children. Our study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother. The dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04). The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient -0.51, 95% CI -0.98 to -0.03, P=0.04). A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P=0.03) was associated with an increased risk of caries. Diet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media.

Bacteriology of chronic discharging ears in Port Harcourt, Nigeria

African Journals Online (AJOL)

the most common reason for out-patient antibiotic therapy in children."2 There also is great concern with regards to the social burden and indirect cost due to time lost from school work.3 Knowledge of which micro organisms are the most common pathogens in acute otitis media (AOM) and/0r chronic suppurative otitis media ...

Cellular Immune Response in Young Children Accounts for Recurrent Acute Otitis Media

Science.gov (United States)

Sharma, Sharad K.; Pichichero, Michael E.

2013-01-01

Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae(Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis-prone (sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B-& T- cell responses and an immaturity in antigen presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children. PMID:24022464