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Sample records for chronic otitis media

  1. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss.

  2. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

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    ... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and Hearing ... learning important speech and language skills. Types of hearing loss Conductive hearing loss is a form of hearing ...

  3. Pattern of chronic suppurative otitis media.

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    Kabir, M S; Joarder, A H; Ekramuddaula, F M; Uddin, M M; Islam, M R; Habib, M A

    2012-04-01

    This observational study was conducted to know the bacteriological pattern of chronic suppurative otitis media. For this 110 patients of Chronic Suppurative Otitis Media (CSOM) were selected from January 2006 to December 2007 at the out patient department of Otolaryngology and Head Neck surgery, BSMMU and Dhaka Medical College Hospital, Dhaka. Among the 110 patients unilateral involvement was 76.36% and bilateral involvement was 23.64%. Ninety percent patients presented with tubotympanic variety and 10% patients presented with attico-antral variety. Bacteriologically pure growth was found in 79.09% cases, mixed growth in 10.91% cases, no growth in 10% cases. Only aerobic bacteria were isolated in the present series. Pseudomonas aeruginosa was the most common organism (43.68%) isolated in pure culture followed by staphylococcus aureus 27.59%, E. coli 10.35%, Kleibsiella spp. 9.19%, proteus spp. 8.04%. Amikacin was the most effective antibiotic followed by Gentamycin, Ciprofloxacin, Ceftazidime, Cetriaxone. Before giving therapy bacterial growth and sensitivity pattern is to be known where facilities are available.

  4. Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion

    NARCIS (Netherlands)

    Stol, K.; Verhaegh, S.J.; Graamans, K.; Engel, J.A.M.; Sturm, P.D.J.; Melchers, W.J.G.; Meis, J.F.; Warris, A.; Hays, J.P.; Hermans, P.W.M.

    2013-01-01

    OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiol

  5. Mitochondrial DNA deletions in patients with chronic suppurative otitis media.

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    Tatar, Arzu; Tasdemir, Sener; Sahin, Ibrahim; Bozoglu, Ceyda; Erdem, Haktan Bagis; Yoruk, Ozgur; Tatar, Abdulgani

    2016-09-01

    The aim of this study was to investigate the 4977 and 7400 bp deletions of mitochondrial DNA in patients with chronic suppurative otitis media and to indicate the possible association of mitochondrial DNA deletions with chronic suppurative otitis media. Thirty-six patients with chronic suppurative otitis media were randomly selected to assess the mitochondrial DNA deletions. Tympanomastoidectomy was applied for the treatment of chronic suppurative otitis media, and the curettage materials including middle ear tissues were collected. The 4977 and 7400 bp deletion regions and two control regions of mitochondrial DNA were assessed by using the four pair primers. DNA was extracted from middle ear tissues and peripheral blood samples of the patients, and then polymerase chain reactions (PCRs) were performed. PCR products were separated in 2 % agarose gel. Seventeen of 36 patients had the heterozygote 4977 bp deletion in the middle ear tissue but not in peripheral blood. There wasn't any patient who had the 7400 bp deletion in mtDNA of their middle ear tissue or peripheral blood tissue. The patients with the 4977 bp deletion had a longer duration of chronic suppurative otitis media and a higher level of hearing loss than the others (p media and the reactive oxygen species can cause the mitochondrial DNA deletions and this may be a predisposing factor to sensorineural hearing loss in chronic suppurative otitis media. An antioxidant drug as a scavenger agent may be used in long-term chronic suppurative otitis media.

  6. 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...

  7. [Microbial biocenoss in chronic purulent otitis media].

    Science.gov (United States)

    Beloglazova, N N; Vasil'eva, L I; Bragina, L E; Kiselev, V V; Naboka, Iu L

    2010-01-01

    The objective of the present work was to study microflora in the middle ear of 100 patients aged from 30 to 70 years presenting with chronic purulent otitis media (CPOM) by microbiological and genetic (PCR) methods. An important role of persistence factors, pathogenicity, and microbial antibiotic resistance in the development of CPOM was demonstrated. The frequency of occurrence of herpes and papilloma viruses was estimated. The most common form of the mixed infection was two-component virobacterial associations (46.2%). Three-component associations of viruses with bacteria (Chlamydiae or Mycoplasmas) formed less frequently (34.6%). In 19.2% of the cases, yeast-like fungi of the genus Candida were identified in these associations.

  8. AEROBIC BACTERIOLOGY OF CHRONIC SUPPURATIVE OTITIS MEDIA: OUR EXPERIENCE

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    Mahesh V .

    2015-08-01

    Full Text Available Chronic Suppurative Otitis Media (CSOM is a condition of the middle ear that is characterized by persistent or recurrent discharge through a chronic perforation of the tympanic membrane from the middle ear cleft. Untreated cases of Chronic Suppurative Oti tis Media can result in a broad range of complications like mastoiditis, labyrinthitis, facial nerve paralysis and serious intracranial complications. In this study an attempt is made to know the aerobic bacteriology of Chronic Suppurative Otitis Media, wi th antimicrobial susceptibility testing of the bacterial isolates. The present prospective study was carried out on 50 patients presenting with Chronic Suppurative Otitis Media between January 2014 to December 2014 in the department of E.N.T, Basaveshwara Medical College Hospital and Research Centre, Chitradurga. The most common bacteria in Chronic Suppurative Otitis Media in this study was Pseudomonas aeruginosa (62% followed by Staphylococcus aureus (22%. Gentamicin was the most sensitive (100% antibio tic against Pseudomonas aeruginosa followed by Amikacin (96.77%. Ceftriaxone and Gentamicin were the most sensitive (100% antibiotic against Staphylococcus aureus followed by Amikacin (90.9%

  9. Temporal bone CT findings of tuberculous otitis media : comparison with chronic otitis media

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    Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook [Masan Samsung Hospital, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Jung, Keon Sik [Pohang Sunrin Hospital, Pohang (Korea, Republic of)

    1999-06-01

    To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.

  10. 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...

  11. Spectrum of facial paralysis in chronic suppurative otitis media

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    Shyam S Kumar

    2012-01-01

    Full Text Available Surgical management of facial paralysis associated with Chronic suppurative otitis media (CSOM may vary depending on the duration and extent of paralysis and also the pathology affecting the nerve. Four illustrative cases are described. The literature is reviewed with regard to the management of the facial nerve in different situations.

  12. Otitis media with effusion

    Science.gov (United States)

    OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... fluid drains from the tube and is swallowed. Otitis media with effusion (OME) and ear infections are ...

  13. 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 ...

  14. Aerobic bacteriology of chronic suppurative otitis media: a hospital based study

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    Asifa Nazir

    2014-08-01

    Conclusion: Otitis media linked with high levels of multiple antibiotic resistant bacteria is a major health concern in all age groups of the study population. An appropriate knowledge of the etiology and antibacterial susceptibility of microorganisms would contribute to a rational antibiotic use and the success of treatment for chronic supportive otitis media. [Int J Res Med Sci 2014; 2(4.000: 1521-1525

  15. Anaerobic bacteria in otitis media.

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    Fulghum, R S; Daniel, H J; Yarborough, J G

    1977-01-01

    Anaerobic bacteria, Peptostrepotococcus intermedius and Propionibacterium acnes, were found in mixed culture specimens from four to ten tested cases of chronic secretory otitis media. These anaerobic bacteria were in a mixed infection flora with aerobic bacteria most often Staphylococcus epidermidis and Cornybacterium sp. which do not fit any established species. The findings of anaerobic bacteria in otitis media is consistent with the sporadic report of the involvement of anaerobic bacteria in otitis media in the literature since 1898.

  16. 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

  17. Demographic influences on complicated chronic suppurative otitis media

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    Sameer Raisuddin Qureshi

    2015-01-01

    Full Text Available Objective: Chronic suppurative otitis media (CSOM can lead to dreadful and fatal complications. Objective of my study is an assessment of factors leading to the development of CSOM complications in different age groups and which age group is more prone to the development of complications. And to find out most frequent complication occurring in the target population. Introduction: CSOM is a long standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation. It affects both sexes and all age groups. Pathways of spread of infection: Direct bone erosion, venous thrombophlebitis, preformed pathways. Classification of complications: Intracranial - Mastoiditis, facial paralysis, labrynthitis, petrositis. Extracranial - Meningitis, extradural abscess, subdural abscess, brain abscess, lateral sinus thrombophlebitis, otitic hydrocephalus. Development of complications depends upon; organism′s virulence, poor resistance of the patient, systemic disease, resistance to antibiotics, poor socioeconomic status, lack of awareness about healthcare, lack of availability of trained specialist. Materials and Methods: A descriptive cross-sectional study was carried out from 2008 to 2013 in ENT Head and Neck Surgery Department, Jinnah Postgraduate Medical Centre, Karachi. Record of 65 patients was selected through nonprobability convenient sampling; sample was divided into two groups according to age Group A 10-18 years and Group B 18-45 years. Data were analyzed on SPSS software; Chi-square test was used and P < 0.05 was considered significant with confidence interval taken as 95%. Results: Population means age was found to be 18.28. Population sex dominant was male 63.1%. Mean duration of complaints is 1.69. There are strong associations between duration of complaints and family income (P = 0.05, and also between age of patient and diagnosed complication (P = 0.00. Conclusions: Most of the patients were of

  18. Tympanoplasty in chronic otitis media patients with an intact, but severely retracted malleus: a treatment challenge.

    NARCIS (Netherlands)

    Hol, M.K.S.; Nguyen, D.Q.; Schlegel-Wagner, C.; Pabst, G.; Linder, T.E.

    2010-01-01

    OBJECTIVE: To analyze the outcome of patients with chronic otitis media (COM) with an intact, but markedly medialized ossicular chain, treated by removing the malleus head and interposing an autologous incus and then an underlay myringoplasty. STUDY DESIGN: Retrospective clinical study. SETTING: Ter

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

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    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.

  20. 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

    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......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...

  1. Detection of bacterial biofilms in different types of chronic otitis media.

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    Gu, Xingzhi; Keyoumu, Youlidusi; Long, Li; Zhang, Hua

    2014-11-01

    Biofilms are organized bacterial communities that may be homogeneous or heterogeneous. They play a significant role in the pathogenesis of chronic nasal sinusitis, chronic tonsillitis, cholesteatomas, and device-related infections. Despite this, few studies have been done that examine the presence of bacterial biofilms in tissues from patients with different types of COM or middle ear cholesteatomas. In the current study, we examined the presence of biofilms in surgical tissue specimens from humans with chronic ear infections using scanning electron microscopy (SEM). We hypothesize that bacterial biofilms present differently in patients with different types of chronic otitis media. Our results provide new insights regarding treatment of chronic otitis media. A prospective study was conducted in which middle ear tissues were obtained from 38 patients who underwent tympanoplasty and/or tympanomastoid surgery due to chronic ear infections. A total of 50 middle and mastoid tissue samples were processed for SEM analysis. In addition, 38 middle ear secretion specimens were obtained for routine bacterial culture analysis. Bacterial biofilms were present in 85 % (11 of 13) of patients with middle ear cholesteatoma, 92 % (12/13) of patients with chronic otitis suppurative media (CSOM), and 16 % of patients (2/12) with tympanic membrane perforation (TMP). Fungal biofilms were found in two cases of cholesteatoma. The positive coincidence rate between bacterial biofilms visualized by SEM and bacteria detected by culture was 82 %. Our findings suggest that bacterial biofilms are very common in CSOM and middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and cholesteatomas. As such, our results provide new insights regarding treatment of chronic otitis media.

  2. CHRONIC SUPPURATIVE OTITIS MEDIA: CLINICAL PRESENTATION OF INTRACRANIAL COMPLICATIONS IN A RURAL AREA

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    Sushant

    2015-09-01

    Full Text Available INTRODUCTION: Chronic suppurative otitis media (CSOM remains one of the most common childhood chronic infectious diseases worldwide. Microbial, immunological, and genetically determined factors, Eustachian tube characteristics, are supposed to be involved in the pathogenesis of CSOM. The objective of this study was to describe the clinical presentation of intracranial complications of chronic suppurative otitis media in a rural area of An warpur, Hapur. MATERIALS AND METHOD S: Patients suffering from CSOM attending outpatient department of Ear, Nose and Throat Department of Saraswathi institute of medical S ciences, anwrpur, Hapur from 2012 to 2015 were included in this study. All admitted cases of intracranial complications due to chronic suppurative otitis media of any age and gender were included. Cases of intracranial complications due to acute suppurative otitis media were excluded from the study. After confirmation of complications by computed tomography, a multidisciplinary approach was followed, including initial treatment by intravenous systemic antibiotics to the definitive final treatment of mastoid surgery. RESULTS: Out of the 50 reported cases of csom with intracranial complicati ons the age of patients ranged from 10 to 70 years, with majority, about 42%, being between 10 - 25 years of age . Male predominance was (62% . Majority of patients belonged to (69% poor socioeconomic status. Otorrhoea (92% was the commonest presentation. Pe rforation of the tympanic membrane was seen in in 80% cases, while only 64% cases were marginal or attic perforation. Meningitis (50% is the commonest intracranial complication of chronic suppurative otitis media followed by brain abscess (temporal lobe abscess . CONCLUSIONS: Meningitis (50% is the commonest intracranial complication of chronic suppurative otitis media followed by brain abscess which was found to be 24% (temporal lobe abscess was seen in 16% . In this era of antibiotics, a high degree

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

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    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....

  4. Eosinofiele otitis media

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    de Jong, Monique A M; Smithuis, L O M J Otto; Stokroos, Robert J

    2014-01-01

    BACKGROUND: Eosinophilic otitis media (EOM) is a rare middle ear disease that may closely resemble therapy-resistant otitis media with effusion (OME). The diagnosis is made if eosinophil-rich fluid is present with two or more of the following minor criteria: (a) history of nasal polyps or, (b) bronc

  5. 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...... in young children in Sisimiut, the second biggest town of Greenland (population 5400), where living conditions are relatively western and approximately 90% are Inuits....

  6. Case of Chronic Otitis Media with Intracranial Complication and Contralateral Extracranial Presentation

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    Lim, P. S.; Pua, K. C.

    2016-01-01

    Intracranial complications of chronic otitis media have been on the decline with advent of antibiotics. Septic thrombosis of the sigmoid sinus is rarer compared to commoner complications such as otogenic brain abscesses and meningitis. This patient presented with recurrent infection after left mastoidectomy secondary to cholesteatoma and a contralateral internal jugular vein thrombosis with parapharyngeal abscess, which was drained. He recovered well postoperatively with antibiotics. PMID:27668115

  7. Cervicofacial necrotizing fasciitis: an unusual complication of chronic suppurative otitis media.

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    Sethi, Ashwani; Sabherwal, Anup; Puri, Rajeev; Jain, Pooja

    2006-03-01

    Necrotizing fasciitis is a rare microbial soft tissue infection characterized by rapidly spreading areas of necrosis and a high mortality rate. It may be of odontogenic or traumatic origin or may arise from insect bites, burns or surgical infections. We present a clinical case of an eight-year-old child with facial and cervical necrotizing fasciitis as a complication of chronic suppurative otitis media. The causes, diagnosis and management of necrotizing fasciitis are reviewed.

  8. Evaluation of bacteriology of middle ear in early quiescent stage of chronic otitis media

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    Ramesh Bhandari

    2013-09-01

    Full Text Available Objectives The objectives of this study were to determine whether any organism does exist in middle ear cavity during the early quiescent stage of chronic otitis media and to isolate their types. Materials and methods Forty-seven patients of age 13 years and above with diagnosis of chronic otitis media mucosal type in early quiescent stage were included. Swab was collected from middle ear cavity for culture and sensitivity in operation theatre prior to middle ear surgery and brought to microbiology laboratory within half an hour to inoculate in Blood agar, Chocolate agar and Mac Conkey agar. The isolates were identified with the use of standard bacteriological technique. Results Aerobic bacteria were isolated from 15 cases (31.9%. Staphylococcus aureus isolated in 12(80%, Pseudomonas aeruginosa in 2(13.3% and E. coli in 1(6.7%. Conclusion Aerobic bacteria were isolated from middle ear cavity in quiescent stage of chronic otitis media in 15(32% cases. Staphylococcus aureus was the most common organism. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 22-26 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8696

  9. 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...... amplification in classrooms and otosurgical capacity should be further promoted in Greenland....

  10. Attenuated TLRs in middle ear mucosa contributes to susceptibility of chronic suppurative otitis media.

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    Si, Yu; Zhang, Zhi Gang; Chen, Sui Jun; Zheng, Yi Qing; Chen, Yu Bin; Liu, Yi; Jiang, Huaili; Feng, Lian Qiang; Huang, Xi

    2014-08-01

    The variability in the recovery of otitis media (OM) is not well understood. Recent data have shown a critical role for toll-like receptors (TLRs) in inflammatory responses to bacteria. It remains unclear whether TLRs-mediated mucosal immunity plays a role in the OM recovery. The etiology, pathological profile, expression levels of TLR2, TLR4, TLR5, TLR9 and proinflammatory cytokines were measured in human middle-ear mucosae sampled from three subject groups: non-OM group, chronic otitis-media (COM) group, and chronic suppurative otitis-media (CSOM) group. Of the 72 ears, 86.11% CSOM patients were positive for bacteria. The cellular makeup of the middle ear mucosa differs among the three groups. Mucosae from the CSOM group presented chronic inflammation or suppurative inflammation in the rudimentary stroma, mainly with infiltration of monocytes and macrophages. The mRNA and protein levels of TLR2, TLR4, and TLR5 exhibited no difference between the non-OM and COM groups but were significantly lower in the CSOM group. Conversely, there was no significant difference in the TLR9 level among the three groups. Furthermore, proinflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6 were up-regulated in the CSOM group. This study provides evidence that the variability in clinical otitis media recovery might be associated with the variability in the expression of mucosal TLRs. Reduced TLR levels in the middle-ear mucosa might cause weak host response to bacteria, persistent inflammation and susceptibility to CSOM.

  11. LOCAL COMPLEX TREATMENT EXPERIENCE FOR PATIENTS WITH CHRONIC PURULENT OTITIS MEDIA

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    Nilufar Jurakulovna Khushvakova

    2015-09-01

    Full Text Available  In this article, we have analyzed the results of the application of the combined solution of decasan and ozone-oxygen mixture, as a local conservative treatment, for 135 patients with acute exacerbation of chronic purulent medial otitis (CPOM. Its use increases the effectiveness of treatment and reduces time. The study of long-term results has shown persistence of sustained remission in 91,4% of patients.A comparative analysis of traditional treatments and topical administration of antiseptic 0.002 % solution of “Dekasan” (dekametansin, in combination with ozone-oxygen mixture in patients with suppurative otitis media, was carried out. The analysis was conducted using ozone-oxygen mixture along with a local irrigation of middle ear cavity with “Dekasan.”

  12. Otitis media: conceptos actuales

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    Hernán Sierra Fernández

    2004-09-01

    Full Text Available La otitis media aguda es uno de los motivos más frecuentes de consulta en la edad pediátrica. Los gérmenes que con mayor frecuencia se aíslan en el oído medio de estos pacientes son el Streptococcus pneumoniae, el Haemophilus influenzae, la Moraxella catarrhalis y el Streptococcus pyogenes. El patrón de resistencia antibiótica de estas bacterias varía dependiendo de la región geográfica. y es la base fundamental para establecer recomendaciones terapéuticas. El análisis en Costa Rica. de la microbiología de la otitis media aguda, otitis media recurrente y otitis media catalogada como falla terapéutica, sugiere que la amoxicilina en una dosis de 50 mg/Kg/día por 10 días, debe ser considerada el antibiótico de primera línea en los casos de otitis media aguda. En los pacientes con otitis media recurrente, falla antimicrobiana o cuando se sospeche la presencia de un Streptococcus pneumoniae resistente a la penicilina, se debe considerar el uso de amoxicilina en dosis más elevadas, amoxicilina con ácido clavulánico, macrólidos o ceftrlaxona.

  13. MICROBIOLOGICAL STUDY OF EAR DISCHARGE AND THEIR ANTIBIOTIC SENSITIVITY PATTERN IN CHRONIC SUPPURATIVE OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Rama Chandra Rao

    2014-09-01

    Full Text Available INTRODUCTION: Chronic Suppurative otitis media (CSOM is the most common condition encountered by otolaryngologists in day to day practice. The importance of chronic otitis media lies in its dreaded complications and deafness. AIM: This study was under taken to identify the microbiological isolates of the ear discharge in CSOM cases and their sensitivity to antibiotics. SETTINGS AND DESIGN: Tertiary care hospital in north costal Andhra Pradesh. It was a Prospective study. MATERIALS & METHODS: About 100 patients having ear discharge who attended ENT outpatient department from July 2013 to Feb 2014 for a period of 8months were studied. Aural swabs were sent to microbiology lab for culture &sensitivity. RESULTS: Culture reports showed aerobic bacterial isolates in 85 cases, fungi in 7 cases and sterile in 8 cases. Of the 85 cases of aerobic bacteria, staphylococcus aureus was isolated in 34 cases (40% followed by Pseudomonas aeruginosa in 29 cases (34%, klebsiella in 16 cases (18.8%, E.coli in 4 cases (4.7% and proteus in 2 cases. Antibiotic sensitivity reports showed Staphylococcus was more susceptible to netilmycin (97%, amoxiclav (91.7% and least sensitive to ceftazidime (64.7%. Pseudomonas was more sensitive to amikacin (96.5%, gentamycin (93.1% and least sensitive to amoxyclav (79.3%, ampicillin + sulbactum (82.75%. CONCLUSION: Mono microbial etiology, especially Staphylococcus species was found to be the most common organism causing chronic otitis media. Knowledge of the prevailing flora and their susceptibility to antimicrobials will guide the clinicians for early and effective treatment thereby avoiding complications.

  14. Otitis media: conceptos actuales

    Directory of Open Access Journals (Sweden)

    Hernán Sierra Fernández

    2004-09-01

    Full Text Available La otitis media aguda es uno de los motivos más frecuentes de consulta en la edad pediátrica. Los gérmenes que con mayor frecuencia se aíslan en el oído medio de estos pacientes son el Streptococcus pneumoniae, el Haemophilus influenzae, la Moraxella catarrhalis y el Streptococcus pyogenes. El patrón de resistencia antibiótica de estas bacterias varía dependiendo de la región geográfica. y es la base fundamental para establecer recomendaciones terapéuticas. El análisis en Costa Rica. de la microbiología de la otitis media aguda, otitis media recurrente y otitis media catalogada como falla terapéutica, sugiere que la amoxicilina en una dosis de 50 mg/Kg/día por 10 días, debe ser considerada el antibiótico de primera línea en los casos de otitis media aguda. En los pacientes con otitis media recurrente, falla antimicrobiana o cuando se sospeche la presencia de un Streptococcus pneumoniae resistente a la penicilina, se debe considerar el uso de amoxicilina en dosis más elevadas, amoxicilina con ácido clavulánico, macrólidos o ceftrlaxona.Otitis media is one of the most common causes of consultation among the pediatric population. The pathogens most frequently isolated from middle ear fluid are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. Antimicrobial resistance patterns vary by region and their knowledge is considered important in order to achieve proper antimicrobial selection. In Costa Rica the microbiology of patients with acute, recurrent and tteattnent failure otitis media has been recently analyzed. The results of these studies indicate that amoxicillin at 50 mg/kg/day for 10 days should be considered first line of therapy for patients with acute otitis media. In patients with recurrent otitis media, therapeutic failures or in patients at risk of having a penicillin non-susceptible Streptococcus pneumoniae, one of the second line agents should be considered.

  15. Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience.

    Science.gov (United States)

    Vincenti, V; Pasanisi, E; Bacciu, A; Bacciu, S; Zini, C

    2014-08-01

    Cochlear implantation in the setting of chronic otitis media or previous middle ear surgery poses several problems for the surgeon: possible spread of infection to the cochlea and the subarachnoid spaces with consequent meningitis, risk of electrode array extrusion and possible recurrence of the original disease. Several surgical strategies have been proposed to overcome these problems. In the present study, clinical and functional results of cochlear implantation in 26 patients with chronic otitis media (8 cases) or previous middle ear surgery (18 cases) in the ear most suitable for implantation were retrospectively reviewed. Among the 8 patients with chronic otitis media, in 7 cases a subtotal petrosectomy associated with external auditory canal closure and mastoid and Eustachian tube obliteration was performed, while in the remaining patient cochlear implantation was done 6 months after a myringoplasty. The only complication observed was a reperforation of the tympanic membrane in this latter patient. Among the 18 patients with previous middle ear surgery, 2 had undergone intact canal wall tympanomastoidectomy and were implanted utilising the previous surgical approach. In the remaining 16 patients who had a radical cavity, an open technique was maintained in 3 cases; a cavity revision associated to external auditory canal closure, Eustachian tube and mastoid obliteration was performed in 12 patients, while in one case a middle cranial fossa approach was utilised. Two of the 3 patients in whom an open technique was maintained have experienced electrode array extrusion. The only complication observed in the remaining patients was the breakdown of the external auditory canal closure in one case. No problems were noted in patients who had undergone intact canal wall tympanomastoidectomy as well as in the subject implanted via the middle cranial fossa approach. All patients achieved and maintained good hearing performance over time. Subtotal petrosectomy associated

  16. 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,…

  17. 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

  18. Ear infections: otitis externa and otitis media.

    Science.gov (United States)

    Lee, Hobart; Kim, Jeffrey; Nguyen, Van

    2013-09-01

    This article reviews the diagnosis and treatment of acute otitis externa and acute otitis media, and will be helpful to primary care physicians who diagnose and treat these common diseases in the clinic. The pathophysiology, microbiology, clinical features, diagnosis, treatment, prognosis, and complications are discussed.

  19. Surgical management of chronic otitis media: beyond tympanotomy tubes.

    Science.gov (United States)

    Haynes, David S; Harley, David H

    2002-08-01

    Chronic ear disease encompasses a wide range of clinical entities amenable to medical and surgical intervention. The otolaryngologist must always consider the goals of surgery--first and foremost to achieve a safe ear. The least invasive procedure capable of eradicating disease is generally chosen. During surgery, a delicate balance has to exist between the careful preservation of function and the aggressive prevention of potentially recurrent disease. Postoperatively, thorough follow-up and good judgment are paramount in avoiding complications and preventing unnecessary additional surgical procedures.

  20. 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 health perception (p social functioning (p 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.

  1. The use of subtotal petrosectomy in cochlear implant candidates with chronic otitis media.

    Science.gov (United States)

    Szymański, Marcin; Ataide, Andre; Linder, Thomas

    2016-02-01

    Cochlear implants (CI) candidates with chronic otitis media require special attention and management. The need of opening of the inner ear creates potential routes of spread of infection to subarachnoid spaces and lead to meningitis. The aim of the study was to analyse the technique and complications of subtotal petrosectomy (SP) in cochlear implant candidates with chronic otitis media at three different CI centres. A retrospective study was carried out in three Territory Referral Hospitals. The centres follow Fisch's philosophy and surgical techniques of SP. The study group consisted of 19 patients, 4 men and 15 women, aged 12-82 years. All patients underwent SP with either primary or staged CI implantation. Indications for single or a staged management, difficulties during surgery and complications were analysed. Skin and muscle flap design in primary and revision cases as well as imaging follow-up strategy are discussed. In 14 patients implantation was performed in a single stage and in 5 cases in two stages. Follow-up ranged from 8 months to 10 years. All the patients use their implants and there were no major nor minor complications. The use of subtotal petrosectomy with cochlear implants is a safe and efficient technique when strict surgical steps and rules are applied. Closure of the external ear canal after previous meatoplasty can be challenging and extreme care dissecting the skin flaps is required. In patients with extensive cholesteatoma, active discharge from the ear with resistant bacteria or an "unstable" situation, the procedure can be staged.

  2. Acute otitis media in neonatal life: a review.

    Science.gov (United States)

    Syggelou, A; Fanos, V; Iacovidou, N

    2011-06-01

    Acute otitis media is frequently encountered by general practitioners and pediatricians. In the neonatal period acute otitis media may present as an isolated local infection or as part of septicemia. Diagnosis of the condition by otoscopy is difficult. Considering the wide spectrum of middle ear disorders (acute otitis media, otitis media with effusion, chronic suppurative otitis media) one can appreciate why opinions on the management of the condition are diverse. This is a review of the literature on clinical presentation, etiology, risk factors, treatment and prevention of acute otitis media in neonatal life.

  3. 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.

  4. 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...

  5. 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...... skills....

  6. 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

  7. Unusual pseudomyiasis with Musca domestica (housefly larvae in a child with chronic otitis media

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    Zafar Iqbal

    2016-01-01

    Full Text Available Myiasis is a disease caused by fly larvae and aural myiasis is a rare clinic condition often occurring in children or mentally retarded people. We report the case of an unusual presentation of a unilateral aural myiasis in a 3-year-old female child patient belonging to a slum with unilateral chronic otitis media caused by Musca domestica (housefly larvae. Eight larvae were removed from the external auditory canal while five more larvae were located in the middle ear cavity and were removed through perforation of the tympanic membrane. Management of ear myiasis is based on removal of the maggots and cleansing of the ear with ethanol, chloroform, or physiological saline. Physiological saline is preferred in patients who have tympanic membrane perforation. Myiasis is related to personal hygiene. Therefore, to decrease the incidence of these infestations, care, and hygiene standards should be carried out for those at risk through information, education, and communication.

  8. Rehabilitative challenges in the bilateral aural stenosis post chronic suppurative otitis media surgery: A case study

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    Himanshu Verma

    2015-01-01

    Full Text Available Introduction: Chronic suppurative otitis media (CSOM is an infection characterized by recurrent ear discharge through a persistent tympanic membrane perforation. In cases such as these, an ASLP is concerned with early prevention, assessment and provision of suitable client based rehabilitation options. Case Report: A 3.5yrs old male with bilateral aural stenosis post CSOM surgery reported to clinic with a complaint of reduced hearing sensitivity to soft sounds with delayed in speech and language. A test battery approach for Audiological and Speech and Language evaluation was conducted. Recommendations and referrals were suggested at the end. Discussion: Regardless of all the restrictions, this study highlights the challenges encountered by an ASLP in dealing with post operative aural stenotic case. This case study highlights the occurrence of stenosis post surgery of bilateral CSOM, which is rarely found.

  9. Tympanomastoid obliteration for recalcitrant attico-antral chronic suppurative otitis media

    Directory of Open Access Journals (Sweden)

    C Preetam

    2011-01-01

    Full Text Available Though the standard canal wall up and canal wall down mastoidectomies provide for reliable disease removal and good functional outcome in most cases with atticoantral chronic suppurative otitis media (CSOM, few cases remain unresponsive to such treatment. This report describes the application of tympanomastoid obliteration with blind sac closure of the EAC as a surgical technique for recurrent CSOM persisting despite multiple previous surgical treatments. Though maximal conductive deafness is an inevitable consequence of this procedure, such morbidity may even otherwise be inevitable in this clinical situation, as scarring and destruction consequent to disease and previous surgical treatments often lead to clinical situations not amenable to tympanoplasty and hearing reconstruction. Further concerns of recurrent epithelial pearls and implantation cholesteatoma can be currently addressed by follow-up MR scanning.

  10. Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

    DEFF Research Database (Denmark)

    Homøe, P; Sørensen, H C Florian; Tos, M

    2009-01-01

    OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas...... was assessed using median air conduction pure tone average gain, and the 'take rate' (i.e. the percentage of total ears with a closed perforation) was evaluated. RESULTS: All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent...... of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of ear. In total, 71 per cent of the patients...

  11. 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.

  12. 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...... properties including structural validity and interpretability of the OM-6 in a Danish population of children suffering from otitis media....

  13. 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

  14. Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children.

    Science.gov (United States)

    Elsayed Yousef, Yousseria; Abo El-Magd, Essam A; El-Asheer, Osama M; Kotb, Safaa

    2015-01-01

    Background. Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups in both developing and industrialized countries. Aim of the Study. This study aimed to assess the impact of educational program on the management of children with CSOM. Subjects and Methods. An experimental study design was used. This study included 100 children of both sexes of 2 years and less of age with CSOM. Those children were divided into 3 groups: group I: it involved 50 children with CSOM (naive) who received the designed educational program; control group: it involved 50 children who were under the traditional treatment and failed to respond; group II: those children in the control group were given the educational program and followed up in the same way as group I and considered as group II. Tools of the Study. Tool I is a structured questionnaire interview sheet for mothers. It consists of four parts: (1) personal and sociodemographic characteristics of child and (2) data about risk factors of otitis media (3) assessment of maternal practice about care of children with suppurative otitis medi (4) diagnostic criteria for suppurative otitis media. Tool II is the educational program: an educational program was developed by the researchers based on the knowledge and practices needs. This study was carried out through a period of 9 months starting from September 2013 to May 2014. The educational program was implemented for mothers of children with CSOM in the form of 5 scheduled sessions at the time of diagnosis, after one week, 1, 3, and 6 months. Results. There were significant differences between children who received the educational program and control group regarding the response to treatment after one and 3 months. The percentages of complete cure increased progressively 32%, 60%, and 84% after 1, 3, and 6 months in group I while they were 24%, 44%, and 64% in group II

  15. 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.

  16. 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.

  17. Chronic Suppurative Otitis Media and Its Association with Socio-Econonic Factors Among Rural Primary School Children of Bangladesh

    OpenAIRE

    Shaheen, Md. Mazharul; Raquib, Ahmed; Ahmad, Shaikh Muniruddin

    2011-01-01

    Chronic Suppurative Otitis Media (CSOM) is a common community health disorder of children in all developing countries like Bangladesh which causes significant impact in speech, cognitive, educational and psychological development. The aim of the study was to determine the prevalence of CSOM and its association with certain socio-economic factors and health related practice and believes among rural primary school children of Bangladesh. The study was done among 1468 rural school going children...

  18. 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...... primarily affects developing countries where research capacities often are limited. The purpose of this study was to determine the long-term outcome of CSOM in a high-risk population and to identify risk factors....

  19. Epidemiology of Intratemporal Complications of Otitis Media

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    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.

  20. TREATMENT OF CHRONIC SUPPURATIVE OTITIS MEDIA IN ERA OF INCREASING ANTIBIOTIC RESISTANCE

    Directory of Open Access Journals (Sweden)

    Sharad B .

    2015-10-01

    Full Text Available Conservative medical management of chronic suppurative otitis media (CSOM is an important step in achieving a dry ear which is a prerequisite for the definitive surgical management of non - cholesteotomatous CSOM. Like other chronic diseases, CSOM can limit an individual's employability and quality of life. The microbial profile, antibiotic sensitivity & resistance pattern of CSOM has been changing according to geographical variation and various differences in patient population. A prospective, randomized open study of 110 patients was conduc ted to isolate aerobic & anaerobic organisms and their sensitivity & resistance patterns to various antibiotics among the patients suffering from non - cholesteotomatous CSOM at a charitable tertiary healthcare center located in Navi Mumbai. Pseudomonas aeruginosa was most common aerobic organism isolated (37.7% followed by Staphylococcus aureus ( 31.5 % . Linezolid was found to be most effective drug followed by Amikacin, Streptomycin, and ciprofloxacin. A periodic review of microbiological profile of and antibiotic sensitivity & resistance pattern of the isolates is important for effective management of CSOM

  1. 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

  2. Bacterial otitis media: current vaccine development strategies.

    Science.gov (United States)

    Cripps, Allan W; Kyd, Jennelle

    2003-02-01

    Otitis media is the most common reason for children less than 5 years of age to visit a medical practitioner. Whilst the disease rarely results in death, there is significant associated morbidity. The most common complication is loss of hearing at a critical stage of the development of speech, language and cognitive abilities in children. The cause and pathogenesis of otitis media is multifactorial. Among the contributing factors, the single most important are viral and bacterial infections. Infection with respiratory syncytial virus, influenza viruses, para-influenza viruses, enteroviruses and adenovirus are most commonly associated with acute and chronic otitis media. Streptococcus pneumoniae, non-typeable Haemophilus influenzae and Moraxella catarrhalis are the most commonly isolated bacteria from the middle ears of children with otitis media. Treatment of otitis media has largely relied on the administration of antimicrobials and surgical intervention. However, attention has recently focused on the development of a vaccine. For a vaccine to be effective against bacterial otitis media, it must, at the very least, contain antigens that induce a protective immune response in the middle ear against the three most common infecting bacteria. Whilst over the past decade there has been significant progress in the development of vaccines against invasive S. pneumoniae disease, these vaccines are less efficacious for otitis media. The search for candidate vaccine antigens for non-typeable H. influenzae are well advanced whilst less progress has been made for M. catarrhalis. No human studies have been conducted for non-typeable H. influenzae or M. catarrhalis and the concept of a tribacterial vaccine remains to be tested in animal models. Only when vaccine antigens are determined and an understanding of the immune responses induced in the middle ear by infection and immunization is gained will the formulation of a tribacterial vaccine against otitis media be possible.

  3. CLINICAL EVALUATION OF EFFECT OF GANDHAKA TAILA IN KARNASRAVA WITH SPECIAL REFERENCE TO CHRONIC SUPPURATIVE OTITIS MEDIA

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    Sujatha.K

    2013-10-01

    Full Text Available Chronic suppurative otitis media (CSOM is the result of an initial episode of acute otitis media and is characterized by recurrent discharge from the middle ear through a tympanic perforation. It is an important cause of preventable hearing loss, especially in developing countries. Most approaches to treatment have been unsatisfactory or are very expensive and difficult. As per Acharya Sushruta Karnasrava is a disease characterized by ear discharge. Gandhaka taila is a unique oil based herbo-mineral formulation especially mentioned for Karnasrava with the procedure of karnapurana. To provide clinical evidence and to prove Gandhaka taila as a safe and effective medicine in chronic suppurative otitis media, this study has been carried out. In this study, 23 patients fulfilling the diagnostic and inclusion criteria of CSOM were selected and Gandhaka taila was instilled in to the affected ear for 7 days. The efficacy of the drug was analyzed in terms of the relief produced in the signs and symptoms before and after treatment. The paired t-test was used to check the significance of subjective and objective criteria. The results of the study were found encouraging and there was also a significant reduction in ear discharge.

  4. 慢性化脓性中耳炎伴蛛网膜下腔出血病例分析%Chronic suppurative otitis media induced subarachnoid hemorrhage: case analysis

    Institute of Scientific and Technical Information of China (English)

    王冠楠; 杨文强; 张怡; 孙圣荣

    2012-01-01

    Summary We present a case of subarachnoid hemorrhage induced by chronic suppurative otitis media, and discuss the possible mechanism here. Chronic suppurnlive otitis media is a common suppurative inflammation of middle ear, which can cause sorts of extracranial and intracranial complications in the situation of lower resistance or higher virulence. However, the condition of subarachnoid heamorrhage casued by chronic suppurative otitis media is quite rare. According to this case and previously published articles, we consider that meningitis may be the main reason of subarachnoid hemorrhage induced by chronic suppurative otitis media.

  5. Sensorineural hearing loss in patients with unilateral safe chronic suppurative otitis media

    Directory of Open Access Journals (Sweden)

    Manpreet Singh Nanda

    2015-06-01

    Full Text Available Background: Chronic Suppurative Otitis Media (CSOM is the major cause of hearing impairment, mainly conductive type of hearing loss. The occurrence of sensorineural hearing loss (SNHL in CSOM is controversial and the controversy is more for safe mucosal type. This study aims to assess the association between SNHL and safe mucosal CSOM and its relation to patient's age, sex, duration of disease, active or inactive disease and speech frequencies. Methods: 100 patients with unilateral mucosal type of CSOM with normal contralateral ear were included in the study. The infected ear was taken as study ear and normal ear as control ear in all patients. All patients underwent hearing assessment by pure tone audiometry for both ears. In case of active disease, ear discharge was first cleared and then audiometric assessment done. Results were statistically compared in all patients for both study and control ears using parameters of patient's age, sex, duration of disease, speech frequency and active or inactive disease. Results: There was significant higher number of study ears with CSOM having average bone conduction threshold of all frequencies above 25 decibels which implies SNHL (21% compared to control contralateral ears without infection (5%. There was higher incidence of SNHL at higher speech frequencies. The incidence also increased with age of patient and duration of disease. The incidence was higher in active stage than inactive or quiescent stage. There was no difference among males and females. Conclusion: Safe mucosal CSOM can cause significant SNHL and risk increases with increasing age, duration of disease, higher speech frequencies and presence of active disease. [Int J Res Med Sci 2015; 3(3.000: 551-555

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

    Directory of Open Access Journals (Sweden)

    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 .

  7. 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.

  8. BACTERIOLOGICAL PROFILE OF CHRONIC SUPPURATIVE OTITIS MEDIA AND ITS CLINICAL SIGNIFICANCE IN RURAL AREA

    Directory of Open Access Journals (Sweden)

    Mohit

    2015-11-01

    Full Text Available BACKGROUND: Middle ear infection is one of the most common condition in ENT practice, particularly in our country. Its significance lies in its chronicity and its dreaded complications like hearing loss and cholesteatoma. Chronic suppurative Otitis media and its complications are among the most common conditions seen by both the otologist and pediatrician. Both gram positive and negative organisms are responsible for infection of the middle ear. AIMS: The study was primarily carried out in 200 cases of C.S.O.M. to determine the bacteriological flora and to study the antibiotic sensitivity pattern of the organisms isolated on culture from discharging ears. RESULTS: In our study Pseudomonas aeruginosa was found to be the most common isolated bacteria (40.65% [100/246], followed by Staphylococcus aureus (14.63%[36/246], Klebsiella aerogenes (11.78%[29/246] and Proteus Mirabilis (10.56%[26/246]. Among the anerobic organisms Peptostreptococcus (5.69% was the most common followed by Propionibacterium (4.06% and Bacteroids spp. (3.65%. Amikacin was the most effective antibiotic in the present study. It was effective against maximum number of strains 97(95.48% followed by Gentamycin 95(92.36% and Ciprofloxacin 93(91.30%. Cefoperazone 88(86.42%, Cefotaxime 78(74.54% and Ofloxacin 64(62.68%. CONCLUSION: Efficient and effective treatment of CSOM is based on the knowledge of causative micro-organisms and thus their antimicrobial sensitivity ensures proper clinical recovery and avoidance of the possible dreaded complications. It has been observed that human negligence is one of the main factor responsible for the development of antibiotic resistance. Along with the indiscriminate use of antibiotics by the treating physician the lack of compliance on part of the patient also results in emergence of resistance and thus in treatment failure. It has been frequently encountered that as soon as the symptoms subside and improvement in condition occurs, many

  9. BACTERIOLOGICAL PROFILE OF CHRONIC SUPPURATIVE OTITIS MEDIA AND ITS CLINICAL SIGNIFICANCE IN RURAL AREA

    Directory of Open Access Journals (Sweden)

    Mohit Srivatsava

    2015-12-01

    Full Text Available Background: Middle ear infection is one of the most common condition in ENT practice, particularly in our country. Its significance lies in its chronicity and its dreaded complications like hearing loss and cholesteatoma. Chronic suppurative Otitis media and its complications are among the most common conditions seen by both the otologist and pediatrician. Both gram positive and negative organisms are responsible for infection of the middle ear. Aims: The study was primarily carried out in 200 cases of C.S.O.M. to determine the bacteriological flora and to study the antibiotic sensitivity pattern of the organisms isolated on culture from discharging ears. Results: In our study Pseudomonas aeruginosa was found to be the most common isolated bacteria (40.65% [100/246], followed by Staphylococcus aureus (14.63% [36/246], Klebsiella aerogenes (11.78% [29/246] and Proteus Mirabilis (10.56% [26/246]. Among the anerobic organisms Peptostreptococcus (5.69% was the most common followed by Propionibacterium (4.06% and Bacteroids spp. (3.65%. Amikacin was the most effective antibiotic in the present study. It was effective against maximum number of strains 97 (95.48% followed by Gentamycin 95 (92.36% and Ciprofloxacin 93 (91.30%. Cefoperazone 88 (86.42%, Cefotaxime 78 (74.54% and Ofloxacin 64 (62.68%. Conclusion: Efficient and effective treatment of CSOM is based on the knowledge of causative micro-organisms and thus their antimicrobial sensitivity ensures proper clinical recovery and avoidance of the possible dreaded complications. It has been observed that human negligence is one of the main factor responsible for the development of antibiotic resistance. Along with the indiscriminate use of antibiotics by the treating physician the lack of compliance on part of the patient also results in emergence of resistance and thus in treatment failure. It has been frequently encountered that as soon as the symptoms subside and improvement in condition occurs

  10. Medical Recapitulate%Application of High Resolution Computed Tomography in Patients with Chronic Suppurative Otitis Media in Preoperative Assessment

    Institute of Scientific and Technical Information of China (English)

    张建鹏

    2016-01-01

    Objective To discuss the value of high resolution computed tomography(HRCT) in preop-erative evaluation of in patients with chronic suppurative otitis media ( CSOM) .Methods Total of 210 patients with CSOM in Shangluo Central Hospital from May 2012 to May 2015 were included in the study,including 105 cases of bone ulcer otitis and 105 cases of cholesteatoma otitis.HRCT was used to check the extent of damage of bone ulcer otitis media and cholesteatoma otitis media in incus body ,crus longum incudis,crus breve incudis,lenticular process, stirrup,malleus head and malleus handle,and compare the results with intraoperative observation.Results The extent of damage in patients with bone ulcer otitis media in the pre-operative HRCT examination compared with intraoperative results showed no statistically significant difference (P>0.05).The extent of damage in patients with cholesteatoma otitis media in the preoperative HRCT examination compared with intraoperative results showed:there were statistically significant differences in the extent of damage in crus breve incudis, lenticular process and stirrup(P 0.05 ) .Conclusion HRCT plays an important role not only in the diagnosis of CSOM,but also in the preoperative evaluation and the choice of surgical methods.%目的:探讨高分辨率 CT( HRCT)在慢性化脓性中耳炎( CSOM)患者术前评估中的作用。方法选泽2012年5月至2015年5月商洛市中心医院就诊且诊断为CSOM的骨疡型患者105例,胆脂瘤型患者105例,术前通过HRCT来评估两型中耳炎在砧骨体、砧骨长脚、砧骨短脚、豆状突、镫骨、锤骨头和锤骨柄这7个部位的破坏情况,并与术中所观察到的两型中耳炎7个部位的破坏程度进行比较。结果骨疡型中耳炎患者在术前进行的 HRCT检查显示的破坏程度与术中观察到的结果进行比较发现,7个部位部位的听骨破坏程度差异无统计学意义( P >0.05)。胆脂瘤型中耳炎患者

  11. Antihistamines for children with otitis media

    OpenAIRE

    Bonney, Asha G.; Goldman, Ran D.

    2014-01-01

    Question Otitis media is a very common condition in pediatrics and can be quite distressing for children and their parents. Is there a role for antihistamines and decongestants in the management of acute otitis media or otitis media with effusion in children?

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

    NARCIS (Netherlands)

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

    2015-01-01

    IMPORTANCE: 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). OBJECTIVE: To identify the influence of preoperative OCD on he

  13. Nursing Observation of Chronic Suppurative Otitis Media%慢性化脓性中耳炎护理观察

    Institute of Scientific and Technical Information of China (English)

    刘晓萍

    2015-01-01

    目的:探讨慢性化脓性中耳炎患者的临床护理要点。方法选择慢性化脓性中耳炎患者94例,随机分为观察组和对照组两组,每组47例,对照组采用常规护理,观察组实施临床护理路径,比较两组患者的临床效果及护理满意度。结果观察组治疗有效率为95.74%,优于对照组的76.60%,差异有统计学意义(P<0.05);观察组护理满意度97.87%,优于对照组的80.85%,差异有统计学意义(P<0.05)。结论临床护理路径可以提高慢性化脓性中耳炎的临床效果及护理满意度。%Objective To explore the clinical nursing of chronic suppurative otitis media.Methods94 cases of chronic suppurative otitis media were randomly divided into two groups, the observation group and the control group, 47 cases in each group. The control group received routine nursing care, the observation group implemented clinical nursing path,and compared two groups of patients with clinical effect and nursing satisfaction.Results In the observation group, the effective rate was 95.74%, significantly higher than that of the control group 76.60%,and the difference was statisticaly significant (P< 0.05).Observation group satisfaction was 97.87%, significantly higher than that of the control group 80.85%, and the diference was statisticaly significant (P< 0.05).Conclusion Clinical nursing pathway can significantly improve the clinical efect of chronic suppurative otitis media and nursing satisfaction.

  14. Otitis Media, Learning and Community.

    Science.gov (United States)

    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,…

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  17. General and disease-specific quality of life in patients with chronic suppurative otitis media - a prospective study

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    Plinkert Peter K

    2011-06-01

    Full Text Available Abstract Background Chronic suppurative otitis media (CSOM is frequently associated with symptoms of inflammation like discharge from the ear or pain. In many cases, patients suffer from hearing loss causing communication problems and social withdrawal. The objective of this work was to collect prospective audiological data and data on general and disease-specific quality of life with validated quality of life measurement instruments to assess the impact of the disease on health-related quality of life (HR-QOL. Methods 121 patients were included in the study. Patients were clinically examined in the hospital before and 6 months after surgery including audiological testing. They filled in the quality of life questionnaires SF-36 and Chronic Otitis Media Outcome Test 15 (COMOT-15 pre-operatively and 6 and 12 months post-operatively, respectively. Results Complete data records from 90 patients were available for statistical analysis. Disease-specific HR-QOL in patients with CSOM improved after tympanoplasty in all the scales of the COMOT-15. There was no difference in HR-QOL assessment between patients with mesotympanic respectively epitympanic CSOM. However, we did find the outcome to be worse in patients who received revision surgery compared with those receiving primary surgery. Audiometric findings correlated very well with the subscale hearing function from the COMOT-15 questionnaire. General HR-QOL measured with the SF-36 was not significantly changed by tympanoplasty. Conclusions Tympanoplasty did lead to a significant improvement of disease-specific HR-QOL in patients with CSOM while general HR-QOL did not change. Very well correlations were found between the subscale hearing function from the COMOT-15 questionnaire and audiological findings. Revision surgery seems to be a predictor for a worse outcome.

  18. Quality of life measures in otitis media.

    Science.gov (United States)

    Maile, E J; Youngs, R

    2013-05-01

    Disabling hearing impairment is the world's most common disability. Traditionally, hearing levels measured by pure tone audiometry have been used to define and quantify hearing loss. The effects of disabling hearing loss on patients' quality of life can be profound, and audiometric data alone may not correlate with quality of life measures. Generic measures of quality of life can be used to compare different diseases, and as such are useful in resource allocation and burden of disease studies. Their disadvantage is that they are not disease-specific and can therefore under-estimate the effects of a disease on patients' quality of life. Disease-specific measures are more sensitive. In chronic otitis media, additional factors such as discharge augment the effect of hearing loss alone on quality of life. Many of the quality of life measures developed for chronic otitis media have been used to assess improvement following reconstructive surgery. Quality of life measures have also been used to assess the effect of paediatric otitis media. Quality of life measures also have utility in the developing world, where hearing impairment is a huge burden.

  19. TUBERCULOUS OTITIS MEDIA – REVISITED WITH 3 INTERESTING CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Akanksha A.

    2013-12-01

    Full Text Available ABSTRACT: Tuberculous otitis media is a ra re disease that is clinically variable and nonspecific. Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. The signs and symptoms are variable and nonspecific and ofte n differ from classic descriptions. Furthermore, no two cases may not necessarily present itself clinically in the same manner. Cases of chronic otitis media that are unresponsive to the usual therapy or show unexpected postoperative evolution should be in vestigated for tuberculosis. Tuberculous otitis media should be suspected after failure of current antibiotics or persistent effusion after tympanoplasty or mastoidectomy. Because of these factors, the diagnosis is often made during surgery or postoperati vely. Late diagnosis delays the start of treatment, thereby increasing the risk of complications

  20. Genetic mouse models for otitis media

    Institute of Scientific and Technical Information of China (English)

    Qingyin Zheng; Ken R Johnson

    2003-01-01

    @@ Genetics of Otitis Media (OM): OM is affected by multiple factors including eustachian tube (ET) structure and function, immune status, innate mucosal defense, genetic susceptibility, and pathogens.

  1. Inflammation in the middle ear of children with recurrent or chronic otitis media is associated with bacterial load

    NARCIS (Netherlands)

    Stol, K.; Diavatopoulos, D.A.; Graamans, K.; Engel, J.A.; Melchers, W.J.G.; Savelkoul, H.F.J.; Hays, J.P.; Warris, A.; Hermans, P.W.M.

    2012-01-01

    Background: Viral upper respiratory tract infections have been described as an important factor in the development of otitis media (OM), although it is unclear whether they facilitate bacterial OM or can directly cause OM. To clarify the role of viral infections in OM, we compared the relative contr

  2. 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...... in young children in Sisimiut, the second biggest town of Greenland (population 5400), where living conditions are relatively western and approximately 90% are Inuits....

  3. 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.)

  4. Acute otitis media in adults: many unknowns.

    Science.gov (United States)

    2003-06-01

    (1) Acute otitis media is likely in adults with recent-onset otalgia, fever, and a bulging eardrum on otoscopy. Management is similar to that in children: no antibiotics in the first instance, then amoxicillin later if antibiotic therapy is needed. (2) Otitis media with a perforated eardrum, and evidence of pus must be distinguished from external otitis. In patients with otitis media and a perforated eardrum, the commonest bacterial isolates are staphylococci, pseudomonas and pneumococci. (3) If antibiotics are prescribed the choice of agent is based on individual clinical findings and underlying health status.

  5. Clinical Treatment Observation of chronic suppurative otitis media by San otitis media%用复方中耳炎散治疗慢性化脓性中耳炎的效果探析

    Institute of Scientific and Technical Information of China (English)

    徐玉婷; 吴丹慧

    2016-01-01

    目的:探讨用复方中耳炎散治疗慢性化脓性中耳炎的临床效果。方法:对2011年~2014年期间我院收治的186例慢性化脓性中耳炎患者的临床资料进行回顾性研究。将这186例患者随机分为对照组和治疗组,每组各有93例患者。为对照组患者使用氧氟沙星滴耳液进行治疗,为治疗组患者使用我院自制的复方中耳炎散进行治疗。然后,比较对两组患者流脓、鼓膜穿孔、头痛和头晕等症状进行治疗的效果及其不良反应的发生率。结果:经过治疗,治疗组患者流脓、鼓膜穿孔、头痛和头晕等症状进行治疗的总有效率与对照组患者相比均无明显差异(P>0.05)。治疗组患者不良反应的发生率明显低于对照组患者,二者相比差异具有显著性(P<0.05)。结论:用复方中耳炎散治疗慢性化脓性中耳炎的效果显著,此药的治疗效果与氧氟沙星滴耳液的治疗效果相当,且安全性高。此疗法值得在临床上推广应用。%Objective: To observe the clinical effects of chronic suppurative otitis media by San otitis media.Methods: March the year of 2011-2013 ,selecte 186 patients admitted with chronic suppurative otitis media were divided into 2 groups, treatment group 93 cases, treatment with San otitis media; control group 93 cases, treatment with ofloxacin otic solution.compare two treatment groups.Result: The volume of ear pus, healing of tympanic membrane and hearing recovery between the treatment group and control group has not significant difference(P<0.05). Conclusions: Compound otitis media scattered on the efficacy and ofloxacin ear drops considerably,and it has high safety,which is worthy of clinical promotion.

  6. 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 prompt

  7. Otitis media: viruses, bacteria, biofilms and vaccines.

    Science.gov (United States)

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

    2009-11-01

    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.

  8. 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.

  9. Chronic suppurative otitis media and its association with socio-econonic factors among rural primary school children of bangladesh.

    Science.gov (United States)

    Shaheen, Md Mazharul; Raquib, Ahmed; Ahmad, Shaikh Muniruddin

    2012-03-01

    Chronic Suppurative Otitis Media (CSOM) is a common community health disorder of children in all developing countries like Bangladesh which causes significant impact in speech, cognitive, educational and psychological development. The aim of the study was to determine the prevalence of CSOM and its association with certain socio-economic factors and health related practice and believes among rural primary school children of Bangladesh. The study was done among 1468 rural school going children (Boys:Girls, 1:1.23) aged between 4 and 12 years (mean 8.8 ± 1.66) in five randomly selected rural primary school of Palash Upazilla of Narsingdi district, Bangladesh. They had underwent ENT check up by the doctors trained in ENT and their guardians were interviewed regarding their socioeconomic status, health related practices and beliefs and other related issues using a pre tested protocol. Total 77 (5.2%) cases of CSOM were detected with girl's predominance (5.7 vs. 4.7%). Our study revealed statistically significant association of CSOM with yearly income of guardian (P ear cleaning habit (P problem of CSOM can be resolved by collective effort by incorporating primary ear care program with primary health care system among the vulnerable children of rural area along with their socio-economic development. Thus, future citizens can be safeguarded from developing CSOM, hearing impairment and its resultant complications.

  10. A comparative study of outcome of ossiculoplasty using cartilage graft, bone and different alloplasts in chronic otitis media

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    Sougata Mahanty

    2015-01-01

    Full Text Available Objective: The objective was to determine which material, among autologous cartilage, autologous incus and partial ossicular replacement prosthesis (PORP, gives better postoperative hearing result in ossiculoplasty. Study Design: Nonrandomized prospective cohort (longitudinal study. Settings: Tertiary referral center. Materials and Methods: Patients were selected from outpatients department with the clinical diagnosis of chronic suppurative otitis media with cholesteatoma or granulation tissue. Patients underwent necessary preoperative investigations including pure tone audiometry (PTA. Total 67 patients were selected for this study, among them 12 patients did not fit the selection criteria and 5 patients lost during follow-up. Hence, total 50 patients were taken in the study group. Intervention: Ossiculoplasty with cartilage, incus and PORP after modified radical mastoidectomy. Main Outcome Measure: Hearing results were measured by PTA-air bone gap (PTA-ABG after 6 months of operation. Results: Selecting the criteria <20 dB ABG as success when stapes superstructure is present, cartilage has 60% success rate, incus has 73.68%, and PORP has 56.25% success. Extrusion rate of different prosthesis shows, PORP has 25%, cartilage has 20% extrusion. Incus has the lowest (5.26% extrusion rate. Conclusion: Among the ossiculoplasty materials, autologous incus gives best postoperative hearing gain and lowest extrusion rate.

  11. [Acute otitis media in children].

    Science.gov (United States)

    Grzegorowski, Michał; Szydłowski, Jarosław

    2005-09-01

    Acute otitis media (A.O.M.) occurs mainly in children. The first peak of this disease appears between 6-18 month of life, and the second between 4-7 year of age. The younger age at which the first A.O.M. incidence is noted, the higher probability of its recurrence. In Poland 65% of children up to the 2 year of age suffer from otitis media once, and 30% more than three times. The portal of infection in a.o.m. comprises: (1) Eustachian tube (2) Blood vessels (3) External auditory meatus with perforated tympanic membrane. In ca. 30% of a.o.m. the causative agents are viruses, while in 70% the disease is due to bacteria (Streptococcus pneumoniae in 30-40%, Haemophilus influenzae ca. 20%, Moraxella catarrhalis 10-15%). A.O.M. is diagnosed basing on history, but mainly using otoscopic examination. Regarding different ear anatomy in infants, otoscopic examination may cause many difficulties. In A.O.M. due to possible dehiscence in tegmen tympani or antri may occur meningismus, and dehiscence in the facial nerve canal can occur facial nerve paresis. The treatment of choice is tympanocentesis and administration of amoxycillin in the dose of 40 mg/kg b.w. daily. After recovery, the examination of upper respiratory tract patency should be performed and following that the evaluation of the ear should be continued.

  12. PRIMARY TUBERCULOSIS OTITIS MEDIA: CASE PRESENTATION AND REVIEW OF LITERATURE

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    Shankar

    2014-12-01

    Full Text Available : INTRODUCTION: Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. The incidence of tuberculosis in the middle ear is very low and accounts for only 0.04% of all cases of chronic Suppurative otitis media. Its diagnosis is often delayed because it can easily be confused with other acute or chronic middle ear conditions, still the treatment of tuberculous otitis media is medical treatment with anti -tuberculous drugs and mastoid exploration if the temporal bone is involved and also to clear the disease from the middle ear cavity to avoid further complications. CASE PRESENTATION: A 21 year male patient presented with ear discharge, deafness and headache, diagnosed as primary tuberculous otitis media, treated with mastoidectomy and anti-tuberculous treatment. DISCUSSION: Primary tuberculous otitis media is very rare condition in adults, it is commonly seen in children which is also secondary to pulmonary tuberculosis / extra pulmonary tuberculosis the treatment of choice is anti tuberculous treatment for 06 months, surgery indicated to clear the disease from middle ear, temporal bone and to avoid further complications. CONCLUSION: Even though primary tuberculosis in middle ear and mastoid is very rare, the diagnosis is possible only with histological findings. In our case there was no signs of pulmonary / extra pulmonary tuberculosis, treated with mastoidectomy followed by anti - tuberculous treatment.

  13. Prospects for a vaccine against otitis media.

    Science.gov (United States)

    Cripps, Allan W; Otczyk, Diana C

    2006-08-01

    Otitis media is a major cause of morbidity in 80% of all children less than 3 years of age and often goes undiagnosed in the general population. There is evidence to suggest that the incidence of otitis media is increasing. The major cause of otitis media is infection of the middle ear with microbes from the nasopharynx. The anatomical orientation of the eustachian tube, in association with a number of risk factors, predisposes infants and young children to the infection. Bacteria are responsible for approximately 70% of cases of acute otitis media, with Streptococcus pneumoniae, nontypeable Haemophilus influenzae and Moraxella catarrhalis predominating as the causative agents. The respiratory viruses, respiratory syncytial virus, rhinovirus, parainfluenza and influenza, account for 30% of acute otitis media cases. Over the past decade, there has been a profound increase in the reported resistance to antibiotics, which, with increased disease burden, has focussed attention on vaccine development for otitis media. A polymicrobial formulation containing antigens from all major pathogens would have the greatest potential to deliver a sustained reduction in the disease burden globally. The disappointing outcomes for otitis media seen with the polysaccharide pneumococcal conjugate vaccine have raised major challenges for the vaccination strategy. Clearly, more knowledge is required concerning immune mechanisms in the middle ear, as well as vaccine formulations containing antigens that are more representative of the polymicrobial nature of the disease. Antigens that have been extensively tested in animal models are now available for testing in human subjects.

  14. Demography, types, outcome and relationship of surgically treated intracranial suppuration complicating chronic suppurative otitis media and bacterial rhinosinusitis

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    Olufemi Emmanuel Idowu

    2014-01-01

    Full Text Available Introduction: Surgically treated intracranial suppurations (ICS are uncommon, life-threatening neurosurgical emergencies. They can result from complication of chronic suppurative otitis media (CSOM and bacterial rhinosinusitis (BRS. The objective of this study was to know the frequency of BRS and CSOM and relate it to its rare complication of surgically treated ICS while also describing the demography, type and outcome of ICS that resulted from BRS and CSOM. Materials and Methods: All patients that presented to the Otorhinolaryngological department and Neurosurgical unit of the same institution with clinical and radiological features of CSOM, BRS, and ICS were prospectively studied over a 5-year period. Patients were followed up for a minimum of 3 months. Results: Two thousand, two hundred and seventy-nine patients presented during the 5-year study period. Of all these patients, 1511 had CSOM (66.3% and 768 (33.7% presented with features of BRS. Eleven (0.73% had ICS complicating their CSOM while 8 (1.04% cases of surgically treated ICS followed BRS. Bacterial rhinosinusitis was not more likely to lead to ICS (P = 0.4348. The Odds ratio (OR of a child ≤ 18 years of age with CSOM developing ICS was 5.24 (95% Confidence interval 1.13-24.34; P = 0.0345, while it was 7.60 (95% Confidence interval 1.52-37.97; P = 0.0134 for children with BRS. Conclusions: The most common type of ICS complicating CSOM and BRS was brain abscess and subdural empyema, respectively. Children are more prone to develop surgical ICS following CSOM and BRS. The proportion of males that had ICS was higher in both CSOM and BRS patients. Optimal outcome is achieved in patients that presented with GCS of 13 and above.

  15. CHANGING TRENDS OF ANTIBIOGRAM PROFILE IN PATIENTS WITH COMMUNITY ACQUIRED CHRONIC OTITIS MEDIA IN A TERTIARY CARE HOSPITAL

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    Bipasa

    2014-09-01

    Full Text Available : INTRODUCTION: Chronic otitis media (COM is one among the commonest otological diseases encountered in otorhinolaryngological practice and attending ENT OPD especially among the lower socio-economic strata of society. AIMS: This study was carried out to know about the aerobic bacterial flora causing COM and in-vitro antibiotic susceptibility pattern in order to scientifically guide patient management instead of relying on empirical therapy alone. MATERIALS AND METHODS: This study included 100 patients of community acquired COM attending ENT OPD of a tertiary care level hospital. After proper sample collection by sterile aural swabs, they were immediately sent to the microbiology laboratory for processing by aerobic culture, isolation and identification following standard recommended methods and antibiotic susceptibility tests were done by Kirby-Bauer disc diffusion methods as per Clinical and Laboratory Standards Institute (CLSI guidelines. RESULTS: Out of 100 cases of COM, microbiological culture yielded 101 bacterial isolates from 90 patients and 4 fungal isolates (3 isolates of Candida albicans and 1 isolate of Aspergillusfumigatus from 4 patients. Polymicrobial infections were seen in 11.11% patients. In this study Staphylococcus aureus (31.68% was the commonest isolate followed by Pseudomonas aeruginosa (23.76%. Other common bacterial isolates were E.coli, Klebsiellapneumoniae, coagulase negative Staphylococcus (CONS, Proteus mirabilis in descending order. Piperacillin-tazobactum was the most sensitive drug (85.45% among the gram-negative bacteria followed by meropenem (81.81%, amikacin (76.36% and levofloxacin (74.54%. Gram positive bacteria showed 100% sensitivity to vancomycin and 93.47% sensitivity to linezolid. For Methicillin resistant Staphylococcus aureus (MRSA isolates ciprofloxacin, cotrimoxazole, tetracycline, linezolid and vancomycin were found to have good activity. CONCLUSION: This study suggests that the common etiological

  16. Prevalence of Chronic Suppurative Otitis Media (CSOM and Associated Hearing Impairment Among School-aged Children in Yemen

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    Salem Muftah

    2015-09-01

    Full Text Available Background: Chronic suppurative otitis media (CSOM is one of the leading causes of preventable disabling hearing impairment (DHI in developing countries. Early detection and management complements advances made in other survival programs, improves work capacity, and enhances learning opportunities for school children. We aimed to determine the prevalence of CSOM and associated DHI among school children aged six to 16 years in Socotra Island, Yemen. Methods: We conducted a cross-sectional community-based survey, from 20 April 2011 to 20 June 2011. The study procedures involved completing a questionnaire, an otoscopic ear examination, an audiometric test of hearing, and tuning fork tests for the type of DHI. Results: A total of 686 children were interviewed and examined for CSOM and associated DHI of CSOM cases. The prevalence of CSOM was 7.4%, (95% CI 5.5–9.4. CSOM status was significantly associated with DHI (p=0.001, but no significant associations were found between demographic characteristics and CSOM status. Logistic regression identified four significant independent contributing factors: history of ear discharge in the last 12 months (odds ratio (OR 7.8, 95% CI 3.9–15.6; swimming in local pools (OR 6.0, 95% CI 1.4–25.4; recurrent respiratory tract infection more than three times per year (OR 5.3, 95% CI 2.5–11.0; and overcrowding with more than three families per house (OR 4.4, 95% CI 1.7–11.5. . Conclusion: The burden of CSOM in the children studied indicates a high level of DHI in these communities within Yemen. A history of ear discharge, swimming in local pools, recurrent respiratory infections, and overcrowded housing were the strongest predictors for CSOM. There is a need for better ear care and screening programs for early detection and management of this disease.

  17. Efficacy of nasopharyngeal culture in identification of pathogens in middle ear fluid in chronic otitis media with effusion

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    Eser O

    2009-01-01

    Full Text Available Purpose: Chronic otitis media with effusion (OME is the leading cause of hearing loss during childhood. In bacterial etiology of OME, the most frequent pathogens responsible are Haemophilus influenzae followed by Streptococcus pneumoniae and Moraxella catarrhalis . This study aimed at evaluating the accuracy of nasopharyngeal (NP specimens in the identification of pathogens in the middle ear fluid (MEF in patients with OME. Materials and Methods: In this cross sectional, case-control study, 95 MEFs and 53 NP secretion specimens were obtained from 53 children. As a control group, 102 NP specimens were taken from children having an operation other than an otological disease. Conventional culture methods and multiplex-PCR method have been used to determine the etiology of OME; NP carriage between cases and control groups were compared using conventional culture methods. Pearson Chi-Square and Fisher′s Exact tests were used in statistical analysis. Results : Bacteria were isolated by culture in 37.9% of MEF specimens, 14.7% of which belonged to the group H. influenzae , S. pneumoniae and M. catarrhalis. PCR was positive in 30.5% specimens targeting the same pathogens. There was a two-fold increase in carriage rate of S. pneumoniae and H. influenzae in patients than controls for each pathogen. Conclusion: PCR is a more reliable method to detect middle ear pathogens in MEF in comparison with the conventional culture methods. The NP colonization wasn′t found to be an indicator of the pathogen in MEF although middle ear pathogens colonize more in nasopharynx of diseased children.

  18. Innovative technologies in diagnosing acute otitis media.

    Science.gov (United States)

    Shand, Kate D; Campe, Kristin

    2016-01-01

    New guidelines for managing acute otitis media include stricter criteria for properly diagnosing the condition and ensuring an accurate diagnosis before clinicians make treatment decisions. This is key because of the increase in antibiotic-resistant pathogens. This article focuses on how clinicians can use ancillary techniques and technologies to improve diagnostic accuracy for acute otitis media. Techniques include proper cerumen removal, visualizing the tympanic membrane with the correct otoscope, pneumatic otoscopy, using a spectral gradient acoustic reflectometer, and tympanometry.

  19. 慢性化脓性中耳炎的治疗浅谈%The treatment of chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    赵守琴

    2009-01-01

    @@ 慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)是指中耳黏膜、骨膜或深达骨质的慢性化脓性炎症,临床上以耳内长期间歇或持续流脓、鼓膜穿孔或听力下降为特点.全世界范围内,不分国界及种族,许多人都不同程度地受着慢性化脓性中耳炎的折磨,严重影响了他们的生活质量.

  20. 慢性非胆脂瘤中耳炎并耳蜗瘘管%Cochlear fistula in chronic otitis media without cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    李树峰; 梁琴

    2011-01-01

    目的 探讨慢性非胆脂瘤中耳炎引起的耳蜗瘘管的病因、临床表现、诊断和手术处理.方法 结合文献复习,回顾性分析1例非胆脂瘤中耳炎引起的耳蜗瘘管.结果 非胆脂瘤中耳炎所致的耳蜗瘘管骨导下降不明显,无眩晕,瘘管实验为阴性.瘘口骨内膜完整,术后骨导均仅有轻度下降.结论 机械因素可能不是骨质破坏的必要因素,术前研究全系列高分辨率图像有利于避免漏诊耳蜗瘘管,应尽量清除瘘口的病变上皮或肉芽,通过仔细操作能够保存耳蜗功能.%Objective To investigate the etiology, clinical features, diagnosis and treatment of cochlear fistula due to noncholesteatomatous chronic otitis media. Method A retrospective investigation of a case of cochlear fistula due to noncholesteatomatous chronic otitis media and review of two cases (3 ears) previously reported in literatures were conducted. Results There was no obvious decrease of bone conduction in these cases with cochlear fistula due to noncholesteatomatous chronic otitis media. No vertigo was complained by these cases and the results of fistula test were all negative. The endosteums in fistula were found to be intact during surgery. The bone conductions were slightly decreased after surgery. Conclusions Mechanical pressure might not be essential to bone resorption, complete images of HRCT should be used to investigate the bone lesion in chronic otitis media to avoid missed diagnosis of cochlear fistula, complete removal of the lesion above the endosteum in cochlear fistula is necessary, and cochlear function is quite possible to be preserved by careful operation.

  1. Acute otitis media and respiratory virus infections.

    Science.gov (United States)

    Ruuskanen, O; Arola, M; Putto-Laurila, A; Mertsola, J; Meurman, O; Viljanen, M K; Halonen, P

    1989-02-01

    We studied the association of acute otitis media with different respiratory virus infections in a pediatric department on the basis of epidemics between 1980 and 1985. Altogether 4524 cases of acute otitis media were diagnosed. The diagnosis was confirmed by tympanocentesis in 3332 ears. Respiratory virus infection was diagnosed during the same period in 989 patients by detecting viral antigen in nasopharyngeal mucus. There was a significant correlation between acute otitis media and respiratory virus epidemics, especially respiratory syncytial virus epidemics. There was no significant correlation between outbreaks of other respiratory viruses and acute otitis media. Acute otitis media was diagnosed in 57% of respiratory syncytial virus, 35% of influenza A virus, 33% of parainfluenza type 3 virus, 30% of adenovirus, 28% of parainfluenza type 1 virus, 18% of influenza B virus and 10% of parainfluenza type 2 virus infections. These observations show a clear association of respiratory virus infections with acute otitis media. In this study on hospitalized children Haemophilus influenzae strains were the most common bacteriologic pathogens in middle ear fluid, occurring in 19% of cases. Streptococcus pneumoniae was present in 16% and Branhamella catarrhalis in 7% of cases. There was no association between specific viruses and bacteria observed in this study.

  2. 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.

  3. Prevalence and risk factors of chronic otitis media: the Korean National Health and Nutrition Examination Survey 2010-2012.

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    Mina Park

    Full Text Available The performance of nationwide studies of chronic otitis media (COM in adults has been insufficient in Korea. We evaluated the prevalence and risk factors of COM in Korea.This study was conducted using data from the fifth Korean National Health and Nutrition Examination Survey (n = 23,621. After excluding the subjects under 20 year old and suffered from cancers, 16,063 patients were evaluated for COM. Participants underwent a medical interview, physical examination, endoscopic examination, and blood and urine test. COM was diagnosed by trained residents in the Department of Otorhinolaryngology using an ear, nose, and throat questionnaire and otoendoscopy findings. Data on the presence and absence of COM were collected. Multivariate logistic regression analyses were performed to identify its risk factors.Of the 16,063 participants aged above 20 year old, the weighted prevalence of COM was 3.8%. In the multivariate analyses, the following factors showed high odds ratios (ORs for COM: pulmonary tuberculosis (adjusted OR, 1.78; 95% confidence interval [CI], 1.06-3.01, chronic rhinosinusitis (adjusted OR, 1.87; 95% CI, 1.17-2.98, mild hearing impairment (adjusted OR, 1.95; 95% CI, 1.34-2.85, moderate hearing impairment (adjusted OR, 4.00; 95% CI, 2.21-7.22, tinnitus (adjusted OR, 1.82; 95% CI, 1.34-2.49, increased hearing thresholds in pure tone audiometry in the right ear (adjusted OR, 1.02; 95% CI, 1.01-1.03, and left ear (adjusted OR, 1.03; 95% CI, 1.02-1.04. The following factors showed low odds ratios for COM: hepatitis B (adjusted OR, 0.28; 95% CI, 0.08-0.94 and rhinitis (adjusted OR, 0.60; 95% CI, 0.42-0.88. In addition, high levels of vitamin D, lead, and cadmium, EQ-5D index; and low red blood cell counts were associated with development of COM (Student's t-test, P < 0.01.Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and environmental factors. Further research on its

  4. Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

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    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.

  5. Prevalence and associated risk factors of otitis media and its subtypes in South Indian population

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    Manche Santoshi Kumari

    2016-07-01

    Full Text Available Background: Otitis media is a common inflammatory disorder caused by the effusion of fluids or pathological changes in the tympanic membrane of middle ear that leads to hearing loss in all age groups which may be either temporary or permanent. Objective: The present study aimed to identify the risk factors responsible for the onset and progression of otitis media and its subtypes as well as its associated co-morbidities in the South Indian population. Subjects and methods: The study constituted 2602 subjects including children and adults affected with OM and the diagnosis was confirmed by ENT specialists using all the required otorhinolaryngological tests. The study was carried out by the institutional ethical clearance. The data were coded and evaluations were performed using the Statistical Package for Social Sciences, PASW STATISTICS 18.0 software (SPSS Inc., Chicago, IL, USA. Results: squamous-chronic suppurative otitis media was highly prevalent (47.3% followed by mucosal-chronic suppurative otitis media (18.5%, acute suppurative otitis media (17.6%, and otitis media with effusion (16.6%. The multinomial logistic regression analysis showed significant association of tinnitus with squamous-chronic suppurative otitis media; bilaterality, tinnitus and vertigo with mucosal-chronic suppurative otitis media while bilaterality, adenoids, tinnitus and snoring with otitis media with effusion. Significant differences were observed in different forms of hearing loss at higher frequency within the subtypes of otitis media. Conclusions: The study has revealed that otitis media predominantly affects all age groups and has a serious health concern in cases affected with hearing loss and its associated co-morbidities.

  6. Fatal Lemierre’s syndrome as a complication of chronic otitis media with cholesteatoma

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    Tashneem Harris

    2016-12-01

    Full Text Available Background. Lemierre’s syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body to form septic infarctions and abscesses, with the most frequent site being pulmonary. Methods. We discuss the case of a 14-year-old male with Lemierre’s syndrome as a complication of chronic middle ear infection. Results. The patient developed septic shock and microemboli, and subsequently died. Conclusion. This case report illustrates that untreated chronic middle ear infection can lead to potentially fatal complications such as Lemierre’s syndrome, and emphasises the importance of timeous treatment of chronic middle ear pathology.

  7. Acute otitis externa.

    Science.gov (United States)

    Hui, Charles Ps

    2013-02-01

    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.

  8. Acute otitis externa

    OpenAIRE

    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.

  9. Comparison of Conventional Versus Spiral Computed Tomography with Three Dimensional Reconstruction in Chronic Otitis Media with Ossicular Chain Destruction

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    Naghibi

    2015-12-01

    Full Text Available Background Chronic otitis media (COM can be treated with tympanoplasty with or without mastoidectomy. In patients who have undergone middle ear surgery, three-dimensional spiral computed tomography (CT scan plays an important role in optimizing surgical planning. Objectives This study was performed to compare the findings of three-dimensional reconstructed spiral and conventional CT scan of ossicular chain study in patients with COM. Patients and Methods Fifty patients enrolled in the study underwent plane and three dimensional CT scan (PHILIPS-MX 8000. Ossicles changes, mastoid cavity, tympanic cavity, and presence of cholesteatoma were evaluated. Results of the two methods were then compared and interpreted by a radiologist, recorded in questionnaires, and analyzed. Logistic regression test and Kappa coefficient of agreement were used for statistical analyses. Results Sixty two ears with COM were found in physical examination. A significant difference was observed between the findings of the two methods in ossicle erosion (11.3% in conventional CT vs. 37.1% in spiral CT, P = 0.0001, decrease of mastoid air cells (82.3% in conventional CT vs. 93.5% in spiral CT, P = 0.001, and tympanic cavity opacity (12.9% in conventional CT vs. 40.3% in spiral CT, P=0.0001. No significant difference was observed between the findings of the two methods in ossicle destruction (6.5% conventional CT vs. 56.4% in spiral CT, P = 0.125, and presence of cholesteatoma (3.2% in conventional CT vs. 42% in spiral CT, P = 0.172. In this study, spiral CT scan demonstrated ossicle dislocation in 9.6%, decrease of mastoid air cells in 4.8%, and decrease of volume in the tympanic cavity in 1.6%; whereas, none of these findings were reported in the patients' conventional CT scans. Conclusion Spiral-CT scan is superior to conventional CT in the diagnosis of lesions in COM before operation. It can be used for detailed evaluation of ossicular chain in such patients.

  10. COMPARATIVE EVALUATION OF OUTCOME OF TYPE I TYMPANO PLASTY WITH AND WITHOUT CORTICAL MASTOIDECTOMY IN TREATMENT OF INACTIVE MUCOSAL TYPE OF CHRONIC OTITIS MEDIA

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    Chander

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the result of tympanoplasty type I in inactive mucosal type of chronic suppurative otitis media with and without cortical mastoidectomy. METHODS: This prospective study was carried out in the department of ENT & HNS in a tertiary care hospital of western U.P, where 80 patients with inactive mucosal type of chronic suppurative otitis media (CSOM were included. The period of study was from Aug . 2013 to J uly 2014. The age and sex matched patients were divided into two groups of 40 each. Half of the patients underwent tympanoplasty type I and rest tympanoplasty type I with cortical mastoidectomy. All the patients underwent underlay technique tympanoplasty with temporalis fascia graft. Patients were Followed - up after six weeks, six months and one year. RESULTS: Hearing improvement was comparable in both groups. There was no significant difference in graft uptake between group I and group II cases. CONCLUSION: Cortical Mastoidectomy performed in inactive mucosal type of CSOM shows no statistically significant difference over tympanoplasty type I done without mastoidectomy.

  11. 慢性化脓性中耳炎手术治疗的临床研究%Chronic suppurative otitis media of surgical treatment of clinical research

    Institute of Scientific and Technical Information of China (English)

    冯云

    2015-01-01

    目的:重点探索手术治疗慢性化脓性中耳炎的有效性及安全性。方法:挑选的研究对象是2011年02月01日至2014年02月01日在我院接受治疗的89例慢性化脓性中耳炎患者,根据疾病类型选择不同的手术方式,42例患者接受改良乳突根治术,47例患者接受开放式鼓室成形术,对比两种手术方法对慢性化脓性中耳炎患者的影响。结果:改良乳突根治术组的优良率达到95.24%。开放式鼓室成形术组的优良率达到97.87%。两组慢性化脓性中耳炎患者的手术效果没有明显差异(P>0.05)。改良乳突根治术组的并发症发生率为9.52%。开放式鼓室成形术组的并发症发生率为12.76%。两组慢性化脓性中耳炎患者的并发症发生率没有明显差异(P>0.05)。结论:开放式鼓室成形术或者改良乳突根治术治疗慢性化脓性中耳炎的疗效良好,根据患者的鼓膜穿孔部位采取合适的手术方法进行治疗的效果更为明显。%Objective The key to explore the effectiveness of surgical treatment for chronic suppurative otitis media and security.Methods The research object is 01, 02, 2011-01, 02, 2014 in our hospital treated 89 cases of patients with chronic suppurative otitis media, in 42 patients improved, 47 patients accepting open tympanoplasty.Results The improvement of mastoidotympanectomy group was 95.24%. The rate of good, open tympanoplasty group reached 97.87%. Two groups of patients with chronic suppurative otitis media operation effect was no significant difference (P > 0.05). Improved mastoidotympanectomy group the incidence of complications was 9.52%. The incidences of complications to open tympanoplasty was 12.76%. Two groups of patients with chronic suppurative otitis media the incidence of complications was no significant difference (P > 0.05).Conclusion Modified mastoidotympanectomy open tympanoplasty or treatment the curative effect of chronic suppurative

  12. KRITERIA DIAGNOSIS DAN PENATALAKSANAAN OTITIS MEDIA SUPURATIF KRONIS

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    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.

  13. Acute otitis media guidelines: review and update.

    Science.gov (United States)

    Lieberthal, Allan S

    2006-07-01

    In 2004, the Subcommittee on Management of Acute Otitis Media of the American Academy of Pediatrics and American Academy of Family Physicians published evidence-based clinical practice guidelines on the "Diagnosis and Management of Acute Otitis Media." The guidelines included a definition of acute otitis media (AOM) that included three components: 1) a history of acute onset of signs and symptoms; 2) the presence of middle-ear effusion; and 3) signs and symptoms of middle-ear inflammation. An option to observe selected children with AOM for 48 to 72 hours without initial antibiotic therapy was proposed. This option was based on age, severity of illness, and certainty of diagnosis. Despite the changing prevalence of bacterial pathogens and increasing resistance of Streptococcus pneumoniae, amoxicillin remains the first-line antibiotic for initial antibacterial treatment of AOM. The guideline also addresses the management of otalgia, choice of antibiotics after initial treatment failure, and methods for preventing AOM.

  14. Antibiotics for acute otitis media in children.

    Science.gov (United States)

    Nitsche, María Pía; Carreño, Monica

    2015-10-29

    Acute otitis media is one of the most common infectious diseases diagnosed in children. Antibiotic treatment use remains controversial. This summary aims to evaluate the effectiveness and safety of antibiotics in children with acute otitis media. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 18 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded antibiotics reduce pain at 48-72 hours and reduce the risk of tympanic perforations in children with acute otitis media, but they do not reduce late recurrences and increase the risk of side effects (rash, vomiting and diarrhea).

  15. [Bacterial flora in children with recurrent acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-02-01

    The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from middle ear in children with recurrent acute otitis media and acute otitis media. The study comprised 83 children--42 with recurrent acute otitis media and 41 with acute otitis emdia classified for paracentesis. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clinadamycin and trimethoprim/sulfamethoxazole. 217 organisms from middle ear in children with recurrent acute otitis media and 131 organisms from middle ear in children with acute otitis media were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--71.4% in recurrent acute otitis media and 47.3% in acute otitis media. We observed statistically significant (p acute otitis media older than 2 years. The best susceptibility was observed to amoxicillin/clavulanate (79.7% of bacteria in children with recurrent acute otitis media and 83.2% of bacteria in children with acute otitis media). The most of organisms presented resistance to trimethoprim/sulfamethoxazole--65.9% of bacteria in children with recurrent acute otitis media and 62.6% of bacteria in children with acute otitis media. Our investigation showed that resistance to bacteria increase in children with recurrent acute otitis media, most frequent appear in children older than 2 years and depend on number of episodes of acute otitis media and day care.

  16. Natural history, definitions, risk factors and burden of otitis media.

    Science.gov (United States)

    Kong, Kelvin; Coates, Harvey L C

    2009-11-02

    Otitis media remains a major health problem in Australia, with an unacceptably great dichotomy of incidence and severity of otitis media and its complications between Indigenous and non-Indigenous Australians. Among most children with acute otitis media, infection resolves rapidly with or without antibiotics, with ongoing middle ear effusion the only sequela. Overcrowding, poor living conditions, exposure to cigarette smoke, and lack of access to medical care are all major risk factors for otitis media. Estimates of the number of cases of otitis media in 2008 vary between 992,000 and 2,430,000 Australians, with a total estimated cost of $100 - $400 million.

  17. Production of cytokines by mononuclear cells of hypertrophic adenoids in children with otitis media with effusion.

    Science.gov (United States)

    Zelazowska-Rutkowska, Beata; Ilendo, Elzbieta; Skotnicka, Bozena; Wysocka, Jolanta; Kasprzycka, Edwina

    2012-01-01

    Hypertrophic adenoids with otitis media with effusion is a common infectious disease and present a serious otological problem in children. Cytokines, potent inflammatory mediators, play important role in the initiation of immunological response in otitis media. Adenoids excised due to hypertrophy with or without chronic otitis media with effusion were used to isolate mononuclear cells. Secretion of cytokines by non-stimulated and PHA-stimulated cells was determined by specific ELISAs. We found a significant increase in the production of IL-5 and TNF-α secreted by adenoidal cells of children with otitis media with effusion compared to group with hypertrophic adenoids. No differences were found in the secretion of IL-8, IL-6, and IL-10 between these two groups of patients. Our results suggest a difference between the immunological responses in the course of hypertrophic adenoids with otitis media as compared to hypertrophic adenoids.

  18. Treatment of chronic suppurative otitis media with ofloxacin in hydroxypropyl methylcellulose ear drops: a clinical/bacteriological study in a rural area of Malawi.

    Science.gov (United States)

    van Hasselt, Piet; van Kregten, Eric

    2002-03-15

    Chronic suppurative otitis media in young children is a major problem in Africa, with socio-economic consequences at a later age. Common treatment regimens with antibiotics are expensive and often not practically feasible. Therefore, a project was started to develop a low-cost and effective treatment in a rural area of Malawi by studying the clinical efficacy of an inexpensive application regimen of ofloxacin (0.075%) in hydroxypropyl methylcellulose (1.5%) ear drops. In earlier studies with this treatment regimen, it was possible to cure approximately 70% of ears. The aim of this study was to find out whether the bacteriological spectrum cultured from wet ears before and after treatment, and patterns of resistance to antibiotics, played a role in the percentage of cures. Patients with long-standing chronic suppurative otitis media were clinically assessed and treated with suction cleaning and instillation of ear drops on days 1, 3, 7 and 10. Bacterial swabs were taken for culture and sensitivity tests for ofloxacin were on days 1 and 10 from the ears that were still discharging. After 21 weeks, the ears were assessed again clinically. Clinical cure was considered to be complete cessation of otorrhea. Ninety of 104 tested patients (124 ears) completed the study. About 73% of the ears had become dry by day 10. This dropped to 42% after 21 weeks. Before treatment, most ears (91%) harbored fecal bacteria, Proteus mirabilis (74%) and enterococci (60%) being the most frequently isolated microbes. The second group of frequently cultured bacteria were water bacteria e.g. Pseudomonas species and other non-fermenters (69%), whereas the classical otitis media pathogens were detected only in 15% of ears. Before treatment, 9.7% of strains were resistant to ofloxacin, most (30/35) of which were cultured from ears that were eventually cured. After treatment, fecal and water bacteria were still the most frequently found, with 36% new strains and an overall sensitivity to

  19. 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

  20. 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 a

  1. EOSINOPHILIC OTITIS MEDIA A LITERATURE REVIEW

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    Balasubramanian Thiagarajan

    2013-01-01

    Full Text Available Eosinophilic otitis media is actually a recent introduction. These patients may manifest with sudden hearing loss. There may be associated bronchial asthma and allergic rhinitis. Diagnostic criteria of this condition are rather vague. A review of literature shows that demonstration of eosinophils in the middle ear secretion of these patients could be considered to be pathognomonic of this condition

  2. Analysis of 80 cases of surgical treatment of patients with chronic otitis media%慢性中耳炎80例手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    金铭鑫; 沈琳琳

    2014-01-01

    目的:探讨鼓室成形术治疗慢性中耳炎的临床疗效。方法对2011年1月~2013年10月在我院接受鼓室成形术治疗的80例慢性中耳炎患者的临床资料进行回顾性分析,并比较患者手术前后听力改善情况。结果80例患者术后气导听阈为(38.7±5.4)dB,气骨导差为(21.2±5.8)dB,与治疗前比较均明显降低,差异有统计学意义(P<0.05);80例患者手术治疗后,治愈34例,有效38例,总有效率为90.0%。结论慢性中耳炎患者实施鼓室成形术治疗可以显著缓解患者的临床症状,改善患者的听力,提高患者的生活质量,临床疗效显著,是临床治疗慢性中耳炎的有效手术方法,值得在临床工作中推广。%ObjectiveTo evaluate the clinical efficacy of tympanoplasty treatment of chronic otitis media. MethodsThe clinical data of 80 cases of chronic otitis media patients treated with tympanoplasty in our hospital from January 2011 to October 2013 were retrospectively analyzed, and hearing level of patients before and after surgical were compared.Results80 cases of patients after surgical, air conduction hearing threshold was (38.7±5.4) dB and air-bone gap was (21.2±5.8)dB, which were significantly lower compared with before treatment. The difference was statistically significant(P<0.05). 80 patients after surgical treatment, cured 34 cases, effective in 38 cases, total effective rate was 90.0%.ConclusionChronic otitis media patients with the implementation of tympanoplasty treatment can significantly relieve symptoms of patients, improve the patient's hearing level and the quality of life, which has significant clinical effect. It is an effective surgical method for the clinical treatment of chronic otitis media, which should be promoted in clinical practice.

  3. Volume equivalente: um estudo em indivíduos com otite média crônica Equivalent volume: study in subjects with chronic otitis media

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    Ana P. T. Alencar

    2005-10-01

    Full Text Available O Volume Equivalente do Meato Acústico Externo está na faixa de 0,3ml a 1,0ml em crianças e 0,65ml a 1,75ml em adultos. Em indivíduos com Otite Média Crônica estes valores podem sofrer alterações, de acordo com as condições da doença. OBJETIVO: Estudar o volume equivalente de 52 orelhas de pacientes com Otite Média Crônica com e sem infecção ativa. FORMA DE ESTUDO: clínico prospectivo com coorte transversal. MATERIAL E MÉTODO: O volume equivalente da orelha foi obtido em 52 orelhas com Otite Média Crônica, com e sem infecção ativa, e num grupo controle de mesma idade e sexo do grupo estudo. O grupo estudo com infecção foi avaliado antes e após tratamento clínico. RESULTADOS: A média do volume equivalente para os grupos estudos sem e com infecção e para o grupo controle foi, respectivamente, 2,86ml; 1,42ml e 0,80ml. A média do volume equivalente para o grupo estudo com infecção antes e após tratamento clínico foi, respectivamente, 1,42ml e 1,82ml. CONCLUSÕES: 1. O Volume Equivalente médio da Orelha é maior em pacientes com Otite Média Crônica. 2. Não foi observada variação no Volume Equivalente antes e após o tratamento clínico.The equivalent ear canal volume ranges from 0.3ml to 1.0ml in children and from 0.65 to 1.75ml in adults. In subjects with chronic otitis media these values can be different, according to the disease status. AIM: To study the equivalent ear canal volume in 52 ears of patients with chronic otitis media with and without active infection. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: The equivalent ear canal volume was obtained from 52 ears diagnosed with chronic otitis media with and without active infection and in age and gender matched control group. The study group with active infection was evaluated before and after clinical treatment. RESULTS: Equivalent ear canal volume mean for the studied groups with and without infection and for the

  4. OUTCOME OF TYPE I TYMPANOPLASTY IN TUBOTYMPANIC CHRONIC SUPPURATIVE OTITIS MEDIA IN RELATION TO SITE AND SIZE OF TYMPANIC MEMBRANE PERFORATION

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    Nitin V

    2015-11-01

    Full Text Available AIM: To find out the relation between hearing loss with site and size of perforation and assessment of improvement in hearing and graft uptake following type I tympanoplasty in dry Tubotympanic Chronic Suppurative Otitis Media. Study Design-Non-Randomized Experimental Study. MATERIAL AND METHOD: This study was done in ENT OPD at Tertiary Health Care Institute of Central India. It was conducted from November 2012 to October 2014 on 46 patients having dry Tubotympanic Chronic Suppurative Otitis Media. Type 1 Tympanoplasty was done in all patients using temporalis fascia graft. All patients were followed up for 12 weeks postoperatively and evaluated for graft uptake and hearing improvement with respect to size and site of perforation. Results were analyzed statistically. RESULTS: Complete graft uptake was seen in 86.46% patients. Graft uptake was more in small perforations than larger ones (p value=0.0008. Graft failure was more in subtotal perforation and perforations involving all four quadrants. Average Pure Tone hearing loss was more in Subtotal perforation (45.5dB and perforations occupying all four quadrants (41.27%. Hearing loss was more in Posteroinferior quadrant perforations as compared to Anteroinferior quadrant perforations and so also the hearing improvement after type I tympanoplasty. CONCLUSION: There was a relationship between size and site of perforation with hearing impairment in tubotympanic type of CSOM. Posterior quadrant perforations were having more hearing loss and greater hearing improvement after surgery as compared to those with anterior quadrant perforation. Rate of graft uptake was directly proportional to size of perforation.

  5. Role of IgE in Eosinophilic Otitis Media

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    Yukiko Iino

    2010-01-01

    Full Text Available Eosinophilic otitis media (EOM is an intractable otitis media characterized by the presence of a highly viscous yellow effusion containing eosinophils. It mainly occurs in patients with bronchial asthma and is resistant to conventional treatments for otitis media. Here we discuss the role of IgE in the pathogenesis of EOM. In middle ear effusion, a significantly higher IgE level was detected in EOM patients than in control patients with common otitis media with effusion. This IgE level was significantly higher (about 10 fold than the serum IgE level. In addition, many IgE-immunopositive cells were found in the middle ear mucosa. The IgE staining was mainly observed on mast cell surfaces, but also partially in the cytoplasm of cells that appeared to be plasma cells. These results suggested that IgE is produced locally in the middle ear mucosa. The existence of high-level IgE may exacerbate eosinophilic inflammation in the middle ear. One of the most distinct characteristics of EOM is the high incidence of sensory hearing loss independent of age. High-tone hearing loss is more frequently found and more severe in EOM patients than in control patients with common chronic otitis media. The concentration of IgE in middle ear effusion significantly and positively correlated with bone conduction hearing levels at 2 kHz and 4 kHz in EOM patients. Overproduction of IgE locally in the middle ear may be related to the pathological condition of EOM and eventually cause inner ear damage.

  6. 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.

  7. Craniofacial morphology and otitis media with effusion in children.

    Science.gov (United States)

    Di Francesco, Renata; Paulucci, Bruno; Nery, Claudio; Bento, Ricardo Ferreira

    2008-08-01

    Otitis media with effusion (OME) affects 28-38% of pre-school children, and it occurs due to the dysfunction of the auditory tube. Anatomical development of the auditory tube depends on the craniofacial growth and development. Deviations of normal craniofacial morphology and growth using cephalometric studies, may predict the evolution of otitis. Our goal in this paper is to determine if there are differences in craniofacial morphology between children with adenoid enlargement, with and without otitis media with effusion. This is a prospective study in which the sample consisted of 67 children (male and female) from 5 to 10 years old. All patients presented chronic upper airway obstruction due to tonsil and adenoid enlargement (>80% degree of obstruction). Thirty-three patients presented otitis media with effusion, for more than 3 months and 34 did not. The latter composed the control group. Standardized lateral head radiographs were obtained for all subjects. Radiographs were taken with patient positioned by a cephalostat and stayed with mandibles in centric occlusion and lips at rest. Radiographs were digitalized and specific landmarks were identified using a computer program Radiocef 2003, 5th edition. Measurements, angles and lines were taken of the basicranium, maxilla and mandible according to the modified Ricketts analysis. In addition, facial height and facial axis were determined. Children with otitis media with effusion present differences in the morphology of the face, regarding these measures: N-S (anterior cranial base length), N-ANS (upper facial height), ANS-PNS (size of the hard palate), Po-Or.N-Pog (facial depth), Ba-N.Ptm-Gn (facial axis), Go-Me (mandibular length) and Vaia--Vaip (inferior pharyngeal airway).

  8. Heterotopic ossification in chronic fibrosing otitis externa

    Science.gov (United States)

    Maughan, Elizabeth F.; Bhutta, Mahmood F.; Lavy, Jeremy

    2015-01-01

    Acquired external auditory canal atresia is a rare complication of chronic inflammatory otitis, and is generally fibrous or soft tissue in nature. Here, we present the first reported case of heterotopic ossification within chronic fibrosing otitis externa in a 25-year-old male patient with a childhood history of granular myringitis and failed tympanoplasty. A calcified mass was demonstrated adjacent to the tympanic membrane on CT imaging, and surgical exploration revealed a cohesive bar of bone traversing the medial external auditory canal. Drill canaloplasty and split-thickness skin graft coverage of the lateral tympanic membrane resulted in an improvement in the pure tone average from 79 to 55 dB. As the treatment for chronic fibrosing otitis externa involves the surgical widening of the external auditory canal, we alert surgeons to the possibility of cohesive bone formation as a potential cause of navigational confusion and inadvertent over- or under-drilling of the canal stenosis. PMID:26429555

  9. Suppurative labyrinthitis associated with otitis media: 26 years' experience

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    André Souza de Albuquerque Maranhão

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. OBJECTIVE: To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. METHODS: Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. RESULTS: We identified 14 patients, eight (57% of whom were females and six (43% males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%, acute suppurative otitis media in six (43%, and chronic otitis media without cholesteatoma was diagnosed in two patients (14%. Besides labyrinthitis, 24 concomitant complications were identified: six cases (25% of labyrinthine fistula, five cases (21% of meningitis, five cases (21% of facial paralysis, five cases (21% of mastoiditis, two cases (8% of cerebellar abscess, and one case (4% of temporal abscess. There was one death. Eight (57% individuals became deaf, while six (43% acquired mixed hearing loss. CONCLUSION: Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant.

  10. 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.

  11. A simplified approach to assess variations in Eustachian tubal ventilatory function by Bortnick-Miller apparatus in chronic otitis media cases (dry before surgery

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    Apoorva Kumar Pandey

    2011-01-01

    Full Text Available Aim: The aim of this study is to see the different functional gradings of Eustachian tube ventilatory function as assessed by Bortnick-Miller (B-M apparatus in chronically diseased middle ears (dry cases planned to undergo tympanoplasty and to correlate the results with the past experiences. Materials and Methods: This study consisted of 29 cases of chronic suppurative otitis media, inactive stage having central perforation. Tubal function was evaluated by B-M apparatus based on ability of tube assimilating the applied positive and negative pressure. Tubal opening pressure was noted after applying positive pressure while residual intratympanic pressure after 10 swallows was recorded after applying negative pressure. Results: This study revealed that results of tubal manometry in diseased ears cover a wide spectrum of normal function to partial/non-function. 51.72% of cases were able to equalize applied negative pressure, 41.39% partially equalizing, while 6.89% of cases were completely unable to equalize applied negative pressure. Conclusion: Our results of aspiration method with the help of BM apparatus explicitly suggest that tubal function in chronically diseased ears deviates from that of normal ears. It perpetually reflects that varied results of middle ear reconstructive surgeries could be anticipated in accordance with different tubal function gradings.

  12. 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.

  13. Intra cranial complications of tuberculous otitis media

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    M Prakash

    2015-01-01

    Full Text Available Tuberculosis is one of the most common infections in the world. It is seen that tuberculous otitis media (TOM is almost secondary to pulmonary tuberculosis. In this review we have tried to deal with all the aspects of the intra cranial complications of TOM such as tuberculoma, otitic hydrocephalus, brain abscess and tuberculous meningitis. The aspects covered in this review are the pathology, clinical features, and investigations of the intra cranial manifestations.

  14. New Insights into Eosinophilic Otitis Media.

    Science.gov (United States)

    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.

  15. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  16. Efficacy of high-resolution CT in differential diagnosis of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows%高分辨率CT对慢性化脓性中耳炎和胆脂瘤中耳炎软组织分型的诊断价值

    Institute of Scientific and Technical Information of China (English)

    孙晓卫; 张建基; 丁元萍; 窦芬芬; 张寒冰; 巩克波; 许安廷

    2011-01-01

    目的 探讨高分辨率CT(high-resolution CT,HRCT)检查在慢性化脓性中耳炎及胆脂瘤中耳炎软组织分型中的诊断价值.方法 对120例153耳慢性化脓性中耳炎和胆脂瘤中耳炎患者行HRCT检查,以原始轴位图像为基础,分别行轴位、冠状位多平面重建(multiplanar reconstructtion,MPR)及最大密度投影(maximum intensity projiection,MIP),观察软组织生长特点、窗宽窗位对软组织显影的影响、邻近主要解剖结构改变情况并与手术结果进行对比.结果 120例153耳中经HRCT诊断为胆脂瘤中耳炎109耳,其中27耳合并肉芽组织;慢性化脓性中耳炎44耳,其中合并肉芽组织形成33耳,仅有分泌物11耳.术后诊断为胆脂瘤中耳炎107耳,其中25耳合并肉芽组织;慢性化脓性中耳炎46耳,其中35耳合并肉芽组织,仅有分泌物11耳.HRCT诊断胆脂瘤中耳炎和慢性化脓性中耳炎的符合率为98.6%,对胆脂瘤、肉芽组织、分泌物诊断的约登指数分别为0.98、0.98、1.00.结论 HRCT轴位、冠状位MPR及MIP图像相结合对慢性化脓性中耳炎软组织诊断分型具有重要的价值,可常规应用于慢性化脓性中耳炎及胆脂瘤中耳炎的鉴别诊断,并制定相应手术计划.%Objective To evalute the efficacy of high-resolution CT(HRCT) in differential diagnosis and treatment of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows. Methods HRCT scanning was performed in 120 cases, 153 ears, with chronic otitis suppurative media and cholesteatoma otitis media, of which original data were processed with multi-planar reconstructtion (MPR) and maximum intensity projection ( MIP) , the characteristics of the soft-tissue shadows' growth, window width or window leveling and bony destruction were respectively observed, as well as compared with the surgery findings. Results In 120 patients (133 ears), 109 ears were diagnosed as cholesteatoma otitis media, and 44 ears were diagnosed

  17. Automated Diagnosis of Otitis Media: Vocabulary and Grammar

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    Anupama Kuruvilla

    2013-01-01

    Full Text Available 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.

  18. Analysis on the Hearing Test Results for Patients with Chronic Suppurative Otitis Media%慢性化脓性中耳炎患者听力检查临床分析

    Institute of Scientific and Technical Information of China (English)

    陶勇; 郑芸; 王恺; 胥科; 孟照莉

    2011-01-01

    目的 了解慢性化脓性中耳炎患者的听力学检查特点.方法 回顾性分析2005年8月-2008年12月间就诊的382例确诊为慢性化脓性中耳炎患者的听力学检查资料.结果 慢性化脓性中耳炎中男性和单耳患者居多,任何年龄均可发病,以中度传导性听力损失为主,鼓室图形态各异,耳道容积变大.结论 慢性化脓性中耳炎是常见的耳科疾病,需及时治疗,听力学检查对于指导治疗方案和评估预后意义重大.%Objective To learn the audiological characteristics of chronic suppurative otitis media patients. Methods We retrospectively analyzed the audiologic data of 382 patients diagnosed with chronic suppurative otitis media treated in our hospital from August 2005 to December 2008. Results The number of male chronic suppurative otitis media patients was more than female patients, and single ear infections are more than infections of both ears. The onset of the disease could be at any age. Most of the patients had a moderate conductive hearing loss. All kinds of tympanogram were found,and ear canal volume of the patients was enlarged. Conclusion Chronic suppurative otitis media is a common disease of the ear, which needs timely treatment, and audiological tests are important in guiding treatment plans and assessing prognosis.

  19. Diagnostic Performance of Endoscopic and Microscopic Procedures for Identifying Different Middle Ear Structures and Remaining Disease in Patients with Chronic Otitis Media: A Prospective Cohort Study.

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    Farhad Farahani

    Full Text Available The diagnostic performance of endoscopic and microscopic procedures for detecting diseases of the middle ear in patients with chronic otitis media (COM has rarely been investigated. This study was conducted to compare the performance of these procedures for identifying middle ear structures and their associated diseases in COM patients.In this prospective cohort study, 58 patients with chronic COM, who were candidates for tympanoplasty with or without a mastoidectomy, were enrolled. Before the surgical intervention, the middle ear was examined via an operating microscope and then through an endoscope to identify the middle ear structures as well as diseases associated with the middle ear.The patients were 15 years of age or older. The anatomical parts of the middle ear - the epitympanic, posterior mesotympanic, and hypotympanic structures - were more visible through an endoscope than through a microscope. In addition, the various segments of the mesotympanum, oval window, round window, and Eustachian tube were more visible via endoscopy. The post-operative endoscopic reevaluation of the middle ear revealed that a cholesteatoma had remained in four of 13 patients after surgery.According to the results of this study, in cases in which there is poor visibility with the operating microscope or the surgeon suspects remaining disease within the middle ear, endoscopy could be utilized to improve the evaluation of more hidden middle ear pits and structures, particularly if there is a potentially recrudescent pathology.

  20. An evidence-based approach to treating otitis media.

    Science.gov (United States)

    Rosenfeld, R M

    1996-12-01

    More than 20 years ago, a shrewd clinician remarked, "There is little evidence that those antimicrobial agents which hypothetically or in vitro are more effective ... are superior in the treatment of otitis when compared to penicillin alone." Several hundred clinical trials later, the advantages of broad spectrum drugs remain unproved, and questions remains as to whether antibiotics are required for most episodes of AOM. Further, antibiotics have been demoted to the status of optional therapy for OME. This situation is unlikely to change as new studies with new antibiotics proliferate. What is clear, however, is that accelerated patterns of bacterial resistance mandate an evidence-based approach to managing otitis media. Bacteria have an uncanny ability to learn new mechanisms of antibiotic resistance. A large part of bacterial "education" has undoubtedly been fueled by antibiotic prescriptions from well-intentioned physicians, with unrealistic expectations of drug efficacy. A judicious approach to antibiotic treatment of otitis media can result only from knowing the spontaneous course of the disorder and incremental effect of antibiotics on clinical outcomes. In this article, a series of unifying concepts are developed to help practicing clinicians with an evidence-based approach to managing otitis media. Critical review of the published evidence suggests that the most favorable outcomes from medical treatment will occur if practitioners: appreciate the favorable natural history of untreated otitis media realize that OME may take months to resolve following a single AOM episode modify risk factors to improve the odds of spontaneous resolution use pneumatic otoscopy and confirmatory tympanometry to diagnose OME recognize the limited impact of antibiotic therapy on treatment and prevention balance the benefits of antibiotics against the risk of accelerated bacterial resistance avoid repetitive, prolonged, or prophylactic antibiotic treatment of chronic OME avoid

  1. Acute otitis media: a simple diagnosis, a simple treatment.

    Science.gov (United States)

    Chhetri, S S

    2014-09-01

    To assess the symptoms and signs of acute otitis media and efficiency of simple antibiotics like amoxicillin in its treatment in the primary health care setup. This is a prospective longitudinal study including 204 patients from different institutions. Patients were diagnosed as suffering from acute otitis media when presented with earache, fever, fullness and or otorrhea. Patients were divided into two equal groups on basis of the treatment they received, Group A received only symptomatic treatment while Group B were given Amoxicillin (40 mg/kg/day) for 7 days. Acute otitis media was common in children under 15 years (64.7%). Patients presented with earache (100%), aural fullness (90.68%), fever (76.47%) associated with recent onset of upper respiratory tract infections (88.23%). In group A, improvement was noticed in 28.43% in 3 days while 35.29% in 7 days. In group B, improvement was noticed in 48.03% in day 3 while 86.27% in day 7. In countries where medical care is scarce, patients lost to follow up, it is wise to treat with simple antibiotics like amoxicillin in adequate dose than to treat only symptomatically. It prevents chronicity, early hearing impairments and reduces antibiotic resistance.

  2. Observation option toolkit for acute otitis media.

    Science.gov (United States)

    Rosenfeld, R M

    2001-04-01

    The observation option for acute otitis media (AOM) refers to deferring antibiotic treatment of selected children for up to 3 days, during which time management is limited to analgesics and symptomatic relief. With appropriate follow-up complications are not increased, and clinical outcomes compare favorably with routine initial antibiotic therapy. Although used commonly in the Netherlands and certain Scandinavian countries, this approach has not gained wide acceptance in Europe and the United States. This article describes an evidence-based toolkit developed by the New York Region Otitis Project for judicious use of the observation option. The toolkit is not intended to endorse the observation option as a preferred method of management, nor is it intended as a rigid practice guideline to supplant clinician judgement. Rather, it presents busy clinicians with the tools needed to implement the observation option in everyday patient care should they so desire.

  3. Racial and familial factors in otitis media. A point prevalence study on Easter Island.

    Science.gov (United States)

    Goycoolea, H G; Goycoolea, M V; Farfan, C R

    1988-02-01

    Of the 249 children aged 5 to 9 years who live on Easter Island, 220 underwent complete otolaryngological evaluation. Twenty children were found to have otitis media (acute, chronic, or both). Three of these children were genetically impure natives, nine were of mixed parentage, and eight were "continentals" (with a birth origin other than the island). None of the genetically pure natives had otitis media. Our data show that, in a population with all factors in common except for familial and racial background, the point prevalence of otitis media is higher in children of mixed or continental origin than in genetically pure native children. The high prevalence of otitis media in children of mixed parentage and in one particular family of European ancestry suggests the presence of intrinsic or pronicity factors that are seemingly transmissible.

  4. 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...

  5. COMPARATIVE STUDY OF RESULTS OF CARTILAGE-PERICHONDRIUM VS TEMPORALIS FASCIA GRAFTING IN ACTIVE TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA

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    Rajeev

    2014-06-01

    Full Text Available Temporalis fascia has long been regarded as the ideal graft material for tympanic membrane repair. However it often does not seem to withstand negative middle ear pressure in the post-operative period. Tragal cartilage with perichondrium would appear to be a better graft material with good hearing outcome. It can be obtained easily with cosmetically acceptable incision. In the present study, we have compared the graft properties of Temporalis fascia versus Tragal cartilage perichondrium with respect to healing, hearing and rate of postoperative retraction or re-perforation. 132 patients of chronic otitis media with pure conductive hearing loss were posted for tympanoplasty. Temporalis fascia graft was used in 71 patients and cartilage perichondrium (composite graft was used in 61 patients. Post-operative healing, hearing and rate of retraction or re-perforation were compared for both the graft materials. All the patients were followed up for 2 years. Patients where temporalis fascia graft was used, 60 (84.5% showed a good neotympanum, 7(9.85% had re-perforation and 5(7.04% had retraction pockets. Patients where tragal cartilage perichondrium was used, 60(98.36% showed a healed tympanic membrane and only 1(1.63% had re-perforation. None of the patients showed retraction pocket or cholestetoma. Postoperative hearing was accessed 6 months after surgery. Patients with temporalis fascia graft showed an air bone gap of less than 10 dB in 49 (82% patients and more than 10 dB in 11(18% patients. Air bone gap closure with tragal cartilage perichondrium was less than 10 dB in 45(78% patients and more than 10 dB in 13 patients (122%. Tragal cartilage perichondrium (<0.5 mm seems to be an ideal graft material for tympanic membrane in terms of postoperative healing and acoustic properties. It can easily withstand negative middle ear pressure which may have contributed to the development of otitis media and significantly affect healing outcomes in

  6. 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 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.

  7. Comparison of the effectiveness and safety of cefpodoxime and ciprofloxacin in acute exacerbation of chronic suppurative otitis media: A randomized, open-labeled, phase IV clinical trial

    Directory of Open Access Journals (Sweden)

    Arijit Ghosh

    2012-01-01

    Full Text Available Objective : To compare the effectiveness and safety of cefpodoxime and ciprofloxacin for the treatment of mild to moderate cases of acute exacerbation of chronic suppurative otitis media (AECSOM. Materials and Methods : Adult patients diagnosed with AECSOM were screened and patients fulfilling the inclusion criteria were randomized to receive either cefpodoxime 200 mg twice daily or ciprofloxacin 500 mg twice daily orally for 7 days. The primary outcome of this randomized, open-labeled, phase IV clinical trial (Registration Number - CTRI/2011/10/002079 was clinical success rate at day 14 visit and the secondary outcome was incidence of adverse events (AEs. Forty-six patients were enrolled: 23 in the cefpodoxime group and 23 in the ciprofloxacin group. Results : The clinical success rates were 95.6% in the cefpodoxime group versus 90.9% in the ciprofloxacin group. These rates are comparable, but no statistically significant difference was observed between the groups. Few mild and self-limiting AEs were observed and the tolerability of both the drugs was also good. Conclusion : The results of this randomized, open-labeled phase IV clinical trial showed that a 7-day course of cefpodoxime is therapeutically comparable to ciprofloxacin in terms of both clinical effectiveness and safety for the treatment of patients with AECSOM.

  8. 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.

  9. Perioperative Nursing of The Patients With Chronic Suppurative Otitis Media%慢性化脓性中耳炎患者围手术期的护理观察

    Institute of Scientific and Technical Information of China (English)

    曾传惠

    2016-01-01

    ObjectiveTo explore perioperative nursing of patients with chronic suppurative otitis media.MethodIn 94 cases of patients with chronic suppurative otitis mediaby preoperative preparation, intraoperative care and postoperative nursing perioperative nursing method,and summarize the nursing methods in treating effect.Result94 cases of patients with chronic suppurative otitis media after implement comprehensive perioperative nursing, 90 patients were cured, 4 cases were cured after second operation, the cure rate was 100%,and there were no serious complications occurred.ConclusionTo strengthen the perioperative nursing of patients with suppurative otitis media, to improve the surgical treatment effect has a vital role.%目的:对慢性化脓性中耳炎患者的围术期护理方法进行探讨。方法对94例慢性化脓性中耳炎患者采取术前准备、术中护理、术后护理等围手术期护理方法,并总结护理方法对治疗效果的影响。结果94例慢性化脓性中耳炎患者实施围手术期综合护理后,90例患者治愈,4例患者经二次手术后治愈,治愈率为100%,且均无严重并发症发生。结论加强对化脓性中耳炎患者的围术期护理,对提升手术治疗效果有至关重要的作用。

  10. Management of Otitis Media with Effusion

    Institute of Scientific and Technical Information of China (English)

    LIU Li-min; DONG Min-ming

    2008-01-01

    Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child with OME is not at risk for speech/language/or learning problems. Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate. Complementary or alternative medicine is not recommended as a treatment for OME. This paper provides a systematic review of management of OME, which we hope will be helpful for clinicians.

  11. [Impact of vaccination on acute otitis media].

    Science.gov (United States)

    Blanchard-Rohner, Geraldine; Gervaix, Alain

    2016-02-17

    Acute otitis media (AOM) is an important reason for medical visits and antibiotic use in children, with possible complications. Pneumococcal conjugate vaccines (PCV) have been developed from 2000, with first the apparition of the 7-valent PCV (PCV7), and from 2013, of the 13-valent PCV (PCV13). First developed to prevent invasive pneumococcal infections, they have been shown to reduce the number of AOM as well. PC13 has allowed to reduce the nasopharyngeal carriage of the majority of pneumococcal serotypes found in AOM, with a reduction of 77% of pneumococcal AOM, according to one study.

  12. Antibiotics for acute otitis media in children

    OpenAIRE

    María Pía Nitsche; Monica Carreño

    2015-01-01

    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 l...

  13. Importance of respiratory viruses in acute otitis media.

    Science.gov (United States)

    Heikkinen, Terho; Chonmaitree, Tasnee

    2003-04-01

    Acute otitis media is usually considered a simple bacterial infection that is treated with antibiotics. However, ample evidence derived from studies ranging from animal experiments to extensive clinical trials supports a crucial role for respiratory viruses in the etiology and pathogenesis of acute otitis media. Viral infection of the upper respiratory mucosa initiates the whole cascade of events that finally leads to the development of acute otitis media as a complication. The pathogenesis of acute otitis media involves a complex interplay between viruses, bacteria, and the host's inflammatory response. In a substantial number of children, viruses can be found in the middle-ear fluid either alone or together with bacteria, and recent studies indicate that at least some viruses actively invade the middle ear. Viruses appear to enhance the inflammatory process in the middle ear, and they may significantly impair the resolution of otitis media. Prevention of the predisposing viral infection by vaccination against the major viruses would probably be the most effective way to prevent acute otitis media. Alternatively, early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of acute otitis media.

  14. Nasal nitric oxide in children with recurrent acute otitis media.

    Science.gov (United States)

    Torretta, S; Marchisio, P; Capaccio, P; Pignataro, L

    2016-01-01

    Recently, reduced Nasal nitric oxide (nNO) nNO levels have been reported in children with adenoidal hypertrophy predisposing to chronic nasosinusal inflammation. Given the strict anatomic and physiopathologic link between the nasopharyngeal and middle ear compartments, and considering the high prevalence of otitis prone children among those affected with chronic adenoiditis, we designed a study aimed to test any possible difference in nNO levels between non-allergic children with and without recurrent acute otitis media (RAOM) associated with chronic adenoiditis. The study involved 54 children with RAOM (44.4% males; mean age= 7.5±3.5 years) and 51 children without RAOM (47.4% males; mean age= 7.0±3.8 years). nNO levels were significantly reduced in children with RAOM compared to children without RAOM (676.9±250.7 ppb vs 831.8±320.4 ppb, respectively; p= 0.02). Our results could be related to reduced NO production by the ciliated paranasal, nasopharyngeal and middle ear epithelium and the impaired sinusal ostial and Eustachian tube patency due to chronic inflammation, and seem to confirm the involvement of NO pathway in recurrent upper airway infections related to impaired ciliated respiratory mucosa.

  15. Otitis media with effusion in children younger than 1 year

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26559603

  16. Otitis media with effusion in children younger than 1 year

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. An evidence-based approach to managing acute otitis media.

    Science.gov (United States)

    Nesbit, Chadd E; Powers, Margaret C

    2013-04-01

    Acute otitis media is one of the most common pediatric illnesses; however, there is considerable controversy in its management. While most cases are treated with antibiotics, there is a growing concern regarding antibiotic overuse and subsequent drug resistance. Researchers in the Netherlands have developed a "watchful waiting" (ie, an observation approach) that has been successful in treating acute otitis media, although it has not gained widespread popularity in the United States. This review will summarize the latest research on diagnosing acute otitis media as well as different treatment regimens, including the efficacy of the watchful-waiting approach.

  19. ADULT ONSET ACUTE OTITIS MEDIA - A PRELIMINARY REPORT

    Directory of Open Access Journals (Sweden)

    Mukta

    2014-05-01

    Full Text Available Acute otitis media is a common disease of children with typical symptomatology & is not infrequent in adults. Literature available on adult acute otitis media is limited. This study has been carried out to assess the presentation, progression & outcome of disease in adults. 90 patients presenting with signs & symptoms consistent with acute otitis media were examined, evaluated & followed up. Earache was the commonest symptom present in 65 patients. Spontaneous perforation was present in 37 patients. Earache, ear discharge & hearing loss are the commonest symptoms in adults & rate of spontaneous perforation is higher compared to children.

  20. 完壁式乳突切开鼓室成形术%Intact canal wall mastoidectomy and tympanoplasty in the treatment of chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    余坤飞; 张松; 熊武; 袁佛良; 吴淑献; 潘松

    2015-01-01

    Objective To report outcomes in patients with active chronic suppurative otitis media treat-ed with intact canal wall mastoidectomy and tympanoplasty. Methods Data from 57 cases treated with intact canal wall mastoidectomy and tympanoplasty were retrospectively reviewed. Result Regarding the tympanic membrane, primary healing was achieved in 48 ears;residual perforation was seen with delayed (2-3 weeks) healing in 5 ears with transplanted fascia;and surgical sites was infected with no tympanic membrane healing in 4 ears. There were no recurrent cases found during the follow-up period of 10 to 34 months. Air-conductive average threshold over 0.5, 1.0, 2.0 and 4.0 kHz improved from 49.7±9.4 dB HL pre-operatively to 30.3±8.0 dB HL postoperatively, with the average air-bone gap reduced by 15 dB. Hearing improvement was reported by the patient in 48 cases. Conclusion Intact canal wall mastoidectomy can be used in active chronic suppura-tive otitis media to effectively remove middle ear lesions and reconstruct middle ear conduction structures, while retaining the normal morphology of ear, improving hearing and enhancing quality of life.%目的:介绍完壁式乳突切开鼓室成形术治疗活动期慢性化脓性中耳炎的临床效果。方法回顾分析我院采用完壁式乳突切开鼓室成形术治疗的57例(耳)活动期慢性化脓性中耳炎的临床资料。结果48耳术后鼓膜一期愈合,5耳移植筋膜边缘残留裂隙,2-3周后延期愈合,4耳术后感染鼓膜穿孔未愈合;随访10个月至34个月,无复发病例,57耳的0.5、1.0、2.0、4.0kHz气导听阈平均值由术前的49.7±9.4 dBHL恢复到30.3±8.0 dBHL,气骨导差平均缩小15 dBHL,其中48耳听力有改善。结论采用完壁式乳突切开鼓室成形术治疗活动期慢性化脓性中耳炎,亦可有效清除中耳乳突病灶,重建中耳传导结构,且能保留耳部正常形态,提升患者听力及生活质量。

  1. Role of dynamic slow motion video endoscopy in etiological correlation between eustachian dysfunction and chronic otitis media: A case-control study

    Directory of Open Access Journals (Sweden)

    Minal Gupta

    2015-01-01

    Full Text Available Objective: To assess the role of dynamic slow motion video endoscopy (DSVE for diagnosing eustachian tube (ET dysfunction in the cases of middle ear disorders and to classify eustachian dysfunction into mechanical and functional for the purpose of systematic management of middle ear disorders. Materials and Methods: A prospective, case-control study was carried out on total 84 patients (168 ears of whom 64 patients with ear complaints (total 95 ears having middle ear disease was taken as cases. Remaining 20 patients without any ear and nasal complaints (40 ears and the normal ears among the case group (33 ears were taken as controls (total 73 ears. DSVE was performed in cases and controls to compare the incidence of eustachian dysfunction in the two groups. Tubal movements were classified into four grades depending on: (1 Appearance of tubal mucosa, (2 movements of medial and lateral cartilaginous lamina, (3 lateral excursion and dilatory waves of the lateral pharyngeal wall, (4 whether tubal lumen opened well or not and (5 presence of patulous tubes (concavity in the superior third of tube. Results: On correlating the DSVE findings of ET in both case and control group, 4 times higher incidence of abnormal ET dysfunction was obtained in cases of middle ear disorders as compared to controls (P = 0.001, odds ratio of 4.0852. We found that 29 tubes had mechanical type of dysfunction (Grades 2A and 3A, whereas 30 tubes had functional type of dysfunction (Grades 2B and 3B and patulous. Conclusion: There is a positive etiological correlation between eustachian dysfunction and chronic otitis media by DSVE. It provides valuable information regarding the structural and functional status of the pharyngeal end of the ET and in classifying the type of eustachian dysfunction into mechanical or functional, which has management implications.

  2. Impacto da Haart na prevalência de otite média crônica em crianças brasileiras infectadas pelo HIV Haart impact on prevalence of chronic otitis media in Brazilian HIV-infected children

    Directory of Open Access Journals (Sweden)

    Raimar Weber

    2006-08-01

    Full Text Available O advento de novas drogas anti-retrovirais como os inibidores de protease provocou mudanças sensíveis na morbidade e mortalidade de pacientes infectados pelo HIV. OBJETIVOS: Avaliar o impacto das novas drogas anti-retrovirais (Highly Active Anti-retroviral Therapy - HAART na prevalência de otite média crônica em população pediátrica infectada pelo HIV. MÉTODOS: Analisamos os prontuários de 471 crianças com idade entre zero e 12 anos e 11 meses portadoras de HIV atendidas no ambulatório de AIDS de Clínica Otorrinolaringológica do HCFMUSP. As crianças foram divididas em dois grupos, de acordo com a faixa etária: 0 a 5 anos e 11 meses e 6 a 12 anos e 11 meses, e classificadas como portadoras de otite média crônica, baseadas em achados de anamnese, otoscopia, audiometria e imitanciometria. As prevalências de otite média crônica apresentadas e as contagens de linfócitos T CD4+ foram comparadas entre as crianças em uso ou não de HAART. RESULTADOS: Das 459 crianças atendidas, 65 (14,2% apresentavam otite média crônica. Observamos, nas crianças de 0 a 5 anos e 11 meses que o uso de HAART esteve associado a significante menor prevalência de otite média crônica (p = 0,02, e maior contagem de linfócitos T CD4+ (p The advent of new antiretroviral drugs such as protease inhibitors has generated sensible changes in morbity and mortality in HIV-infected patients. OBJECTIVES: To evaluate the impact of Highly Active Antiretroviral Therapy (HAART on the prevalence of chronic otitis media in HIV-infected pediatric population. METHODS: We analyzed medical charts of 471 children aged zero to 12 years and 11 months with HIV infection from an Ambulatory of ENT and AIDS. Children were divided according to the age: 0 to 5 years and 11 months and 6 to 12 years and 11 months and classified as having chronic otitis media based on history, physical examination, audiologic and tympanometric data. Prevalence of chronic otitis media, as well as

  3. Acute otitis media and respiratory viruses.

    Science.gov (United States)

    Bulut, Yunus; Güven, Mehmet; Otlu, Bariş; Yenişehirli, Gülgün; Aladağ, Ibrahim; Eyibilen, Ahmet; Doğru, Salim

    2007-03-01

    The present study was performed to elucidate the clinical outcome, and etiology of acute otitis media (AOM) in children based on virologic and bacteriologic tests. The study group consisted of 120 children aged 6 to 144 months with AOM. Middle ear fluid (MEF) was tested for viral pathogens by reverse transcriptase polymerase chain reaction (RT-PCR) and for bacteria by gram-staining and culture. Clinical response was assessed on day 2 to 4, 11 to 13, 26 to 28. Respiratory viruses were isolated in 39 patients (32.5%). Respiratory syncytial virus (RSV) (46.5%) was the most common virus identified in MEF samples, followed by human rhinovirus (HRV) (25.6%), human coronavirus (HCV) (11.6%), influenza (IV) type A (9.3%), adenovirus type sub type A (AV) (4%), and parainfluenza (PIV) type -3 (2%) by RT-PCR. In total 69 bacterial species were isolated from 65 (54.8%) of 120 patients. Streptococcus pneumoniae (S. pneumoniae) was the most frequently isolated bacteria. Viral RNA was detected in 31 (56.3%) of 55 bacteria-negative specimens and in 8 (12.3%) of 65 bacteria-positive MEF samples. No significant differences were found between children representing viral infection alone, combined viral and bacterial infection, bacterial infection alone, and neither viral nor bacterial infection, regarding clinical cure, relapse and reinfection rates. A significantly higher rate of secretory otitis media (SOM) was observed in alone or combined RSV infection with S. pneumonia or Haemophilus influenzae (H. influenzae) than in other viruses infection. Conclusion. This study provides information about etiologic agents and diagnosis of AOM in Turkish children. The findings highlight the importance of common respiratory viruses and bacterial pathogens, particularly RSV, HRV, S. pneumoniae and H. influenzae, in predisposing to and causing AOM in children.

  4. Gradenigo Syndrome: Unusual Consequence of Otitis Media

    Directory of Open Access Journals (Sweden)

    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.

  5. Study of simultaneous audition reconstruction to chronic suppurative otitis media in the period of infection%活动期慢性化脓性中耳炎Ⅰ期听力重建的研究

    Institute of Scientific and Technical Information of China (English)

    高雄辉; 谢景华; 吴晓钟; 黄顺德; 宋江顺; 孟庆翔; 李鹏

    2008-01-01

    目的 探讨活动期慢性化脓性中耳炎Ⅰ期鼓室成形术的可行性和疗效.方法 48例活动期(48耳)慢性化脓性中耳炎患者(胆脂瘤型31例,骨疡型17例)在彻底清除病变(经典或改良乳突根治术)同时进行Wullstein Ⅱ型和Ⅲ型鼓室成形术.结果 全部4~10周,平均7周干耳.术后1年纯音听力测试:气骨导差10 dB以内者11例,15~20 dB者25例,25~30 dB者9例,无变化甚至更差者3例.结论 慢性化脓性中耳炎活动期不是鼓室成形术的绝对禁忌证.术中彻底清除所有病变、重建乳突-鼓室-咽鼓管引流通气系统后,进行Wullstein Ⅲ型+乳突腔填充+耳甲腔成形术是可取的方法,同时咽鼓管是否通畅是手术成败的主要原因.%Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases (48 ears) with chronic suppurative otitis media in the period of infection (31 with cholesteatoma, 17 with caries) were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete elimination of the lesions (typical or modified mastoidectomy). Results All eases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 eases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 eases, no change or worse in 3 eases. Conclusions Infection is not the absolute eontraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and eonchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main eanse to failure of surgery.

  6. 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...

  7. The impact of otitis media on cognitive and educational outcomes.

    Science.gov (United States)

    Williams, Corinne J; Jacobs, Ann M

    2009-11-01

    Otitis media is a common disease in childhood that can adversely affect cognitive and educational outcomes. The literature in this area is equivocal, and findings may be influenced by research design. The impact of otitis media on individual children's development appears to depend on the inter-relationship between several factors. Children who have early-onset otitis media (under 12 months) are at high risk of developing long-term speech and language problems. Otitis media has been found to interact negatively with pre-existing cognitive or language problems. For biological or environmental reasons, some populations have a pattern of early onset, higher prevalence and episodes of longer duration; this pattern leads to a higher risk of long-term speech and language problems. These factors suggest that Indigenous children may be at higher risk of cognitive and educational sequelae than non-Indigenous children.

  8. Otitis media: diagnosis, management, and judicious use of antibiotics.

    Science.gov (United States)

    Stool, Sylvan; Carlson, Linda H; Johnson, Candice E

    2002-07-01

    Otitis media continues to present a major challenge to practitioners in the clinical setting. With the ever-increasing trend toward the use of a sound research-structured approach to health care and the use of evidence-based guidelines, it is important to have an understanding of these findings related to otitis media. A review of research-supported literature regarding the diagnosis and management of this disease, and suggestions for the judicious use of antibiotics, are presented in this paper.

  9. Observation of the Curative Effect of Chronic Suppurative Otitis Media in Treatment of Tympanoplasty%慢性化脓性中耳炎患者采用鼓室成形术的远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    张小安; 黄海; 蔡云香

    2013-01-01

    Objective:The hospital treated patients with chronic suppurative otitis media with tympanoplasty operation treatment,to observed in patients with long-term efficacy and study tympanoplasty treatment of otitis media clinical applications.Method:98 chronic suppurative otitis media patients underwent tympanoplasty therapy in our hospital from February 2006 to January 2011,the patient’s hearing were compared and analyzed.Result:The patients were followed up for a period of 12 months after treatment,for patients with speech frequency pure tone air conduction audiometry hearing threshold,all types of otitis media patients after tympanoplasty surgery,the patient’s hearing had been significantly improved sexual,compared with before treatment,significant difference,with statistical significance(P<0.05).98 patients were wound infection occurred in 2 cases,2 patients with facial paralysis.The recurrence of 4 ears after one year,accounting for 4%.Conclusion:The patients with chronic otitis media tympanoplasty surgery, can effectively improve the patient’s symptoms,significantly improve the patient’s hearing level,patients were followed up found that in the long run it also has a very good long-term efficacy,as clinical treatment of chronic suppurative otitis media scientifically valid method worthy of wider promotion and application.%目的:对本院收治的慢性化脓性中耳炎患者采用鼓室成形手术治疗,观察患者远期疗效,探讨鼓室成形手术治疗中耳炎的临床应用价值。方法:对本院在2006年2月-2011年1月期间收治98例慢性化脓性中耳炎患者均行鼓室成形术治疗,对患者的听力情况进行比较和分析。结果:经治疗,同时对患者进行为期12个月的随访,并进行纯音测听语言频率气导听阈,各种类型的中耳炎患者在经过鼓室成形手术治疗之后,听力都得到明显性的提高,与治疗前比较,差异有统计学意义(P<0.05)。在这98例

  10. 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

  11. Feasibility Analysis of Chronic Otitis Media Patients Using Endoscopic Tympanoplasty%慢性中耳炎患者应用内镜下鼓室成形术的可行性分析

    Institute of Scientific and Technical Information of China (English)

    陈志强

    2015-01-01

    Objective To study the effect of using endoscopic tympanoplasty were analyzed in patients with chronic otitis media. Methods Based on 56 cases of chronic otitis media patients of our hospital to carry on the discussion analysis, patients were grouped into control group and random group, control group adopted is otitis media operation treatment, the observation group adopted is endoscopic tympanoplasty, the two groups of patients with dry ear rate, the effect of treatment, relapse rate and so on comparative analysis. Results In the observation group, the dry ear rate should be higher than the control group, the cure rate is relatively outstanding in observation group, two patients were in the group after 500, 1 000, 2 000 Hz and 4 000 Hz frequency drum hearing mean were increased signiifcantly (P<0.05), the two groups of patients as the observation group with low recurrence rate (P<0.05). Conclusion Chronic otitis media using endoscopic tympanoplasty with good effect, low recurrence rate in patients with clinical treatment, the effect is more outstanding, have greater application value.%目的:研究分析慢性中耳炎患者使用内镜进行鼓室成形术的效果。方法根据我院的56例慢性中耳炎患者来进行探讨分析,将患者分组为对照组和随机组,对照组采取的是中耳炎手术治疗,观察组采取的是内镜下鼓室成形术,对两组患者的干耳率、治疗效果、复发率等进行比较分析。结果观察组患者的干耳率要比对照组高,治愈率也是观察组较为优秀;两组患者术后在500、1000、2000 Hz及4000 Hz频率的鼓导听均值均较术前显著提高(P<0.05);两组患者的复发率为观察组较低(P<0.05)。结论慢性中耳炎使用内镜鼓室成形术的效果比较好,临床复发率低,患者的治疗效果比较突出,具有比较大的应用价值。

  12. Pathogenesis of otitis externa and otitis media in dogs and cats

    Directory of Open Access Journals (Sweden)

    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

  13. Clinical Observation on Chronic Suppurative Otitis Media by the Treatmentof Traditional Chinese Medicine Combined with Western Medicine%中西医结合治疗慢性化脓性中耳炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    余莲桂; 武海玲

    2011-01-01

    Objective: To observe the clinical effective of chronic suppurative otitis media by the treatment of traditional Chinese medicine combined with western medicine. Methods: 120 patients with chronic suppurative otitis media were randomly divided into treatment group and control group. The control group was given common western medicine, the treatment group was given traditional Chinese medicine combined with western medicine. Results: The total effective rate of the treatment group was 90.00%, the control group was 78.33%. There are significant differences ( P>0.05 ). Conclusion: the treatment of traditional Chinese medicine combined with western medicine could treat chronic suppurative otitis mediaeffectively.%目的:观察中西医结合治疗慢性化脓性中耳炎的临床疗效.方法:将本院收治的120例慢性化脓性中耳炎患者随机分为两组,即对照组和治疗组,对照组给予常规西医治疗,口服交沙霉素和增效联磺片,治疗组采用中西医结合的方法治疗,即在对照组的基础上加用中药汤剂口服.结果:治疗组的总有效率为90.00%,对照组的总有效率为78.33%,两组比较差异有显著意义(P>0.05).结论:中西医结合的疗法治疗慢性化脓性中耳炎疗效显著.

  14. Observation Effect of Myringoplasty Treatment Chronic Otitis Media in Endoscope%内镜下鼓室成形术治疗慢性中耳炎的效果观察

    Institute of Scientific and Technical Information of China (English)

    李新伟

    2015-01-01

    Objective To exploer the effect of myringoplasty treatment chronic otitis media in endoscope. Methods Selected 86 cases with chronic otitis media in our hospital as the research object, randomly divided into the control group and observation group. The control group used conventional treatment method, and the observation group received endoscopic tympanic cavity forming operation. Compared with the cure effect of two groups. Results The observation group total effective rate was 97.92%,the control group the total effective rate was 52.63%, the observation group effective rate was higher than the control group, P<0.05, had difference statistically significance. Conclusion Endoscopic tympanoplasty can improve the treatment of patients with otitis media effectiveness, dry ear rate, improve listening comprehension, and reduce the recurrence rate of otitis media.%目的:探讨内镜下鼓室成形术治疗慢性中耳炎的效果。方法选取于我院接受治疗的86例慢性中耳炎患者为研究对象,随机分为对照组与观察组。对照组采用常规治疗方法,观察组接受内镜下鼓室成形手术。对比两组患者的治愈效果。结果观察组治疗总有效率为97.92%,对照组的治疗总有效率为52.63%,观察组治疗有效率高于对照组,P<0.05,差异具有统计学意义。结论内镜下鼓室成形术可提高中耳炎患者的治疗有效率、干耳率,可以改善患者听力,并降低中耳炎的复发率。

  15. Differential diagnosis between chronic otitis media with and without cholesteatoma by temporal bone CT: focus on bone change and mass effect

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Cheol Kyu; Park, Dong Woo; Seong, Jin Yong; Lee, Kak Soo; Park Choong Ki; Lee, Seung Ro; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2000-01-01

    In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media (COM) with and without cholesteatoma, focusing on bone change. Between 1997 and 1998, 82 patients (84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36 cases of COM with cholesteatoma (26 patients, M:F =3D 11:15; age range, 16-61 (mean, 36,2) years), and 58 cases without chlesteatoma (56 patients, M:F =3D 25:31, age range, 15-61 (mean, 36.2) years). The findings of temporal bone CT were analysed at the point of bony changes including erosion and medial displacement of ossicles (malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. Bone erosion or destruction was seen in 36.2% of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles including the malleus (81%, 24%), incus (88%, 14%), stapes (58%, 10%), scutum (88%, 10%), facial canal (8%, 0%), and lateral semicircular canal (8%, 0%), was more common in COM with cholesteatoma (p-value less than 0.05), with the exception of erosion of the tegmen (8%, 3%). Other bony changes including medial displacement of ossicles (27%, 3%), ballooning of tympanic cavity and mastoid antrum (96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space (58%, 14%) and perforation of the pars

  16. CT Diagnosis of Chronic Otitis Media with Cholesteatoma%胆脂瘤型慢性中耳炎的CT诊断

    Institute of Scientific and Technical Information of China (English)

    余红胜; 吉六舟

    2011-01-01

    目的:探讨胆脂瘤型慢性中耳炎(CMC)的CT影像表现特征,以提高对该病的诊断及鉴别诊断水平.方法:收集医院经手术病理证实的CMC病例34例,所有病例术前均行HRCT扫描,阅片时重点观察瘤体软组织形态及分布、邻近骨质改变等.结果:34例患者中,单侧31例,双侧3例,合计37耳;上鼓室28耳,中鼓室2耳,鼓窦及入口7耳,表现为软组织团块状影.骨质改变:鼓室盾板破坏27耳,合并上鼓室外侧壁破坏扩大14耳;听小骨移位31耳,伴有骨质破坏23耳;岩鳞板破坏5耳,乳突多呈硬化型及板障型.结论:鼓室、乳突窦及入口软组织影(占位征)、邻近骨质破坏是诊断中耳胆脂瘤的主要影像学依据.%Objective To explore the CT performance characteristics of chronic otitis media with cholestealoma(CMC) to raise the level of diagnosis and differential diagnosis. Methods 34 CMC cases proven by pathological examination underwent pre-operative HRCT scanning, and the soft tissue morphology, distribution and ambient bone change of the tumor body were paid attention to. Results Of the 34 cases, 31 ones had unilateral CMC, and the remained 3 ones had bilateral CMC. Of the 37 nodular shadows, there were 28 ones at the upper tympanum, 2 ones at the mesotympanum, and the remained 7 ones at the tympanic anlmm and aditus ad antrum. There were 27 ones of tympanic scute destruction, of which, 14 ones were accompanied by lateral wall destruction of the tympanum. 31 ones suffered from auditory ossicles transport, with 23 ones of bone destruction. There were 5 ones of petrosquamous lamina destruction. Conclusion The soft tissue shadows at the tympanum, mastoid sinuses and aditus ad antrum as well as ambient bone destruction can be the imaging diagnosis bases for the cholesteatoma.

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  18. Prevention of otitis media in children by pneumococcal vaccination.

    Science.gov (United States)

    Karma, P; Pukander, J; Sipilä, M; Timonen, M; Pöntynen, S; Herva, E; Grönroos, P; Mäkelä, H

    1985-01-01

    A total of 3,340 infants, 95 per cent of them 7 to 9 months old, were randomly vaccinated in a double-blind fashion with either the 14-valent pneumococcal (Pn) polysaccharide vaccine or a saline placebo in three urban areas in Finland. The second dose of the vaccine was given 5 months later. Age and sex distribution, recruitment of infants, and their otitis-related treatment and follow-up were similar in the study areas. Side effects after vaccination were mild and fewer than among older children. Antibody responses to vaccine polysaccharides varied from type to type, but were generally poor, especially to types most prevalent in otitis media. After the first dose of vaccine, the occurrence of otitis visits among the Pn-vaccinated, as compared with controls, showed inter-area differences, but ranged from not more than a 30 per cent reduction at its best to an increase in some areas and in some clinical categories. The respective figures for children with acute otitis media were similar between the vaccination groups and the study areas. The effect of the vaccine on acute otitis media caused by specific Pn types/groups represented in the vaccine was variable but generally poor. Group 6 attacks especially seemed to behave problematically. The second dose of the vaccine did not give additional benefit serologically or clinically. The efficacy of currently available pneumococcal vaccine against otitis media seemed poor in infants.

  19. Clinical Observation of Mastoidectomy With Tympanoplasty in Treatment of Chronic Otitis Media With Cholesteatoma%乳突根治鼓室成形术治疗胆脂瘤型中耳炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    杜卫峰

    2015-01-01

    Objective To investigate the clinical effect of radical mastoidectomy with tympanoplasty operation in patients with cholesteatoma otitis media. Methods 50 cases of otitis media with cholesteatoma in our hospital were treated with radical mastoidectomy and tympanoplasty operation, observed the treatment effect. Results 3 patients were ineffective, the recovery of hearing was greater than or equal to 24 cases of 35 dB patients, increased by 10~19 dB in 10 patients, 20~29 dB of patients and 13 cases improved, 10 cases had complications. Conclusion Patients with chronic otitis media treated with cholesteatoma of mastoidectomy and tympanoplasty can achieve remarkable effect.%目的:探讨乳突根治鼓室成形手术对胆脂瘤型中耳炎患者的临床效果。方法我院接收患胆脂瘤型中耳炎患者50例,对患者进行乳突根治鼓室成形手术,观察治疗效果。结果3例患者无效,听力恢复≥35 dB患者24例,提高10~19 dB患者10例,提高20~29 dB患者13例,出现并发症10例,经治疗均好转。结论胆脂瘤型中耳炎患者进行乳突根治鼓室成形术治疗,效果显著。

  20. Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection.

    Science.gov (United States)

    Hirano, Takashi; Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

    2016-01-01

    Nontypeable Haemophilus influenzae (NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (10(7) CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4(+) CD25(+) FoxP3(+) Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear.

  1. 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...

  2. Timing of Tympanoplasty in Treatment of Chronic Otitis Suppurative Media%慢性化脓性中耳炎鼓膜成形术的时机选择

    Institute of Scientific and Technical Information of China (English)

    敬峥; 李洪涛; 陈燕芯

    2012-01-01

    Objective To explore the timing oi tympanoplasty in treatment of chronir otitis suppurative media, in order to provide basis for the clinical treatment. Methods A retrospective analysis of 50 cases( 56 ears )with hronir otitis suppurative media in our hospital Jun. 2009 to Jun. 2011 were divided into 7 groups arrording to the time of dry ear,and 8 ears were selected in earh group to rondurt tympanoplasty,the healing level of each patient was recorded and follow-up was done for 3 months to analyze the correlation between healing level and operation dry ear time. Results The highest hearing improvement alter tympanoplasty as treatment oi rhronir otitis suppurative media was after 2-4 months for dry ear by the fitting equation:Y - 12. 5567 +0. 19671x - 0. 03221 x2. Conclusion The optimal time oi tympanoplasty as treatment oi chronic otitis suppurative media was after 2-4 months for dry ear,which can increase the surressful rate and maximize the healing threshholds,thus improve patients life quality.%目的 探讨慢性化脓性中耳炎鼓膜成形术的时机选择,为临床治疗提供依据.方法 选择2009年6月至2011年6月我院收治的慢性化脓性中耳炎患者50例(56耳),根据干耳时间,选择7个组段干耳时间,每组干耳时间选择8耳行鼓膜成形术,记录每例患者的听力水平,并随访观察3个月,分析治疗后听力水平与干耳时间的关系.结果 通过拟合最佳方程Y^=12.5567+0.19671x-0.03221x2,发现鼓膜成形术选择在干耳时间2 ~4个月,听力水平提高最高.结论 慢性化脓性中耳炎鼓膜成形术的最佳时机选择在干耳时间2 ~4个月能够提高手术成功率,使听力阈值最大,患者生活质量得到改善.

  3. Ear infection - chronic

    Science.gov (United States)

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... up. When this happens, infection can occur. A chronic ear infection develops when fluid or an infection ...

  4. 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.

  5. 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...... 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...... 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...

  6. Complications of otitis media - a potentially lethal problem still present

    Directory of Open Access Journals (Sweden)

    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.

  7. Analyze the clinical effect of endoscopic tympanoplasty in the treatment of chronic otitis media%内镜下鼓室成形术治疗慢性中耳炎临床效果分析

    Institute of Scientific and Technical Information of China (English)

    孙小龙; 翟建光; 李晓洋; 张永平

    2014-01-01

    目的:探讨内镜下鼓室成形术治疗慢性中耳炎的临床效果。方法:2012年3月-2013年6月收治慢性中耳炎患者50例,随机分为试验组和对照组,各25例。试验组患者接受内镜下鼓室成形术,对照组患者接受保守治疗。治疗结束后对比两组患者的临床治愈率、气导听值、干耳率及复发率。结果:治疗结束后,发现试验组患者的临床总治愈率及干耳率明显高于对照组患者,复发率低于对照组患者,P<0.05差异有统计学意义。结论:对于慢性中耳炎患者,内镜下鼓室成形术是一种治愈率高、复发率低的有效治疗手段。%Objective:To discuss the clinical effect of endoscopic tympanoplasty in the treatment of chronic otitis media.Methods:To admit 50 cases of patients with chronic otitis media form March 2012 to June 2013,they were randomly divided into the experimental group and the control group,25 cases in each group.The experimental group patients received endoscopic tympanoplasty,while the control group patients received conservative treatment.After treatment, compare clinical cure rate,drum guide to value,dry ear rate and recurrence rate of two groups.Results:After treatment,the clinical total cure rate and dry ear rate of patients in the experimental group were found significantly higher than that of patients in the control group.The recurrence rate was lower than the control group. The difference has statistical significance (P<0.05).Conclusion:In patients with chronic otitis media,endoscopic myringoplasty is a effective treatment method with high cure rate and low recurrence rate.

  8. Pathogenesis of otitis externa and otitis media in dogs and cats

    OpenAIRE

    Popović Nikola

    2005-01-01

    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 t...

  9. Cochlear implant challenges encountered in tuberculous otitis media

    Institute of Scientific and Technical Information of China (English)

    Cheng-Fang Chen; Zhao-Hui Liu; Jing Xie; Xiao-Bo Ma; Yi Li; Shu-Sheng Gong

    2012-01-01

    ABSTRACT Tuberculous otitis media (TOM) is rare inENT department, and is frequently misdiagnosed as otitis media. Thus early systemic treatment is very important forTOM. We reported a case report withTOM to highlight development of the disease and difficulties in clinical treatment in late stage ofTOM. Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming team. With thorough preparation and complete knowledge about characters of specific issues, implantation would be performed successfully, and patients with ossified cochlear could benefit from cochlear implantation.

  10. Trombose do seio sigmóide associada à otite média crônica Sigmoid Sinus thrombosis associated to chronic otitis media

    Directory of Open Access Journals (Sweden)

    Norma de Oliveira Penido

    2007-04-01

    Full Text Available A trombose séptica do seio sigmóide (TSSS é uma doença rara de tratamento controverso. OBJETIVO: Relatarmos nossa experiência, ressaltando os aspectos clínicos e terapêuticos. MATERIAL E MÉTODO: Estudo retrospectivo de seis casos de TSSS tratados nos últimos 10 anos. O diagnóstico foi confirmado através de angiorressonância com acompanhamento de seis meses a seis anos. RESULTADOS: O diagnóstico da TSSS só foi suspeitado durante a análise de imagem solicitada para avaliação de outras complicações de otite média crônica. Febre, cefaléia e paralisia facial foram as principais manifestações clínicas relacionadas aos diagnósticos de mastoidite, meningite e abscesso cerebelar. Não foi possível identificar nenhum sintoma específico de trombose do seio sigmóide. Em todos os pacientes foi realizado mastoidectomia com antibioticoterapia de largo espectro sendo mantido por três meses. Em três casos foi realizada anticoagulação e nos outros três não foi indicado este tipo de terapia. Todos os pacientes evoluíram bem sem seqüelas. CONCLUSÃO: O diagnóstico de TSSS tem sido realizado inesperadamente em pacientes com otites médias crônica com outras complicações associadas. Acreditamos que esta doença esteja sendo subdiagnosticada. Apesar de grave, o prognóstico clínico tem sido bom, apenas com mastoidectomia e antibioticoterapia.Otogenous lateral sinus thrombosis (OLST is a rare disease and presents a controversial treatment. AIM: Clinical aspects and treatment were reported based on our experience. METHODS: Retrospective study. Six cases of OLST were treated in our institution in the last ten years. Clinical and imaging data were analyzed. RESULTS: All six patients had the lateral sinus thrombosis detected during image evaluation for other symptoms related to chronic otitis media (COM complications. Fever, headache and facial paralysis were the main clinical manifestation related to mastoiditis, meningitis and

  11. Otitis media in a new mouse model for CHARGE syndrome with a deletion in the Chd7 gene.

    Directory of Open Access Journals (Sweden)

    Cong Tian

    Full Text Available 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.

  12. Otitis Media and Related Complications among Children with Autism Spectrum Disorders

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  14. Detection of human metapneumovirus from children with acute otitis media.

    Science.gov (United States)

    Suzuki, Akira; Watanabe, Oshi; Okamoto, Michiko; Endo, Hiroko; Yano, Hisakazu; Suetake, Mitsuko; Nishimura, Hidekazu

    2005-07-01

    Nasal and middle ear specimens collected from children with acute otitis media were subjected to viral isolation and bacteria culture. All virus-negative specimens underwent reverse transcription polymerase chain reaction to detect human metapneumovirus. Three of 126 middle ear specimens were positive by this assay.

  15. Economic evaluation of ventilation tubes in otitis media with effusion.

    NARCIS (Netherlands)

    Moret-Hartman, M.; Rovers, M.M.; Ingels, K.J.A.O.; Zielhuis, G.A.; Severens, J.L.; Wilt, G.J. van der

    2001-01-01

    OBJECTIVE: To determine the costs and effectiveness of treatment with ventilation tubes as compared with watchful waiting in children with persistent otitis media with effusion. DESIGN: Randomized controlled trial. SETTING: Institutional practice. PATIENTS: A total of 187 young children (19 months o

  16. Otitis media across nine countries : Disease burden and management

    NARCIS (Netherlands)

    Arguedas, A.; Kvaerner, K.; Liese, J.; Schilder, A. G. M.; Pelton, S. I.

    2010-01-01

    Objective: To assess the perceived disease burden and management of otitis media (OM) among an international cohort of experienced physicians. Methods: A cross-sectional survey conducted in France, Germany, Spain, Poland, Argentina, Mexico, South Korea, Thailand and Saudi Arabia. Face-to-face interv

  17. 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...

  18. Influenza virus induces bacterial and nonbacterial otitis media.

    NARCIS (Netherlands)

    Short, K.R.; Diavatopoulos, D.A.; Thornton, R.; Pedersen, J.; Strugnell, R.A.; Wise, A.K.; Reading, P.C.; Wijburg, O.L.

    2011-01-01

    Otitis media (OM) is one of the most common childhood diseases. OM can arise when a viral infection enables bacteria to disseminate from the nasopharynx to the middle ear. Here, we provide the first infant murine model for disease. Mice coinfected with Streptococcus pneumoniae and influenza virus ha

  19. Otitis media and its consequences : beyond the earache

    NARCIS (Netherlands)

    Vergison, Anne; Dagan, Ron; Arguedas, Adriano; Bonhoeffer, Jan; Cohen, Robert; DHooge, Ingeborg; Haberman, Alejandro; Liese, Johannes; Marchisio, Paola; Palmu, Arto A.; Ray, G. Thomas; Sanders, Elisabeth A. M.; Simoes, Eric A. F.; Uhari, Matti; van Eldere, Johan; Pelton, Stephen I.

    2010-01-01

    An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger

  20. Variation in Rates of Diagnosis of Acute Otitis Media.

    Science.gov (United States)

    Berwick, Donald M.; Thibodeau, Lawrence A.

    1980-01-01

    Over 13 weeks during two periods in 1978 the diagnostic rate for acute otitis media was monitored among febrile children in the emergency room of a large children's hospital. Temporal variation in diagnostic rates by physicians was largely attributable to differences among individual providers and independent of level of training. (Author/MLW)

  1. 慢性化脓性中耳炎鼓室成形术式选择及临床疗效分析%Surgical types selection of chronic suppurative otitis media tympanoplasty and its clinical curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    方敏; 李朝军; 杨莉; 邝韶景; 熊俊伟; 李必强; 黄羽; 赵彦

    2016-01-01

    目的:总结慢性化脓性中耳炎鼓室成形术式选择经验并评估术后疗效。方法收集慢性化脓性中耳炎患者病历,患者的手术方式主要依据其听力功能检查、残余鼓膜及鼓室表现、乳突CT表现进行选择,部分患者需通过术中鼓室探查后方能决定手术方式。最后收集到病历资料及随访内容完整者共161例(164耳),其中单纯鼓室成形Ⅰ型(40耳)、完桥式乳突切开+鼓室成形Ⅰ型(30耳)、开放式乳突切开+鼓室成形Ⅱ型(94耳),从听力、生存质量及手术满意度评分等方面评价不同手术方式治疗慢性化脓性中耳炎的疗效。结果3组患者术后气导听阈平均值均较术前降低(P<0.05),骨导听阈平均值皆无明显变化(P>0.05);比较3组患者术后气导改善值,差异无统计学意义( P>0.05);3种术式术后主观听力提高率分别为82.5%、70.0%和83.0%,差异无统计学意义( P>0.05)。术后整体生存质量提高率分别为80.0%、80.0%和79.8%,差异无统计学意义( P>0.05);对病情的担心程度降低率分别为90.0%、93.3%和95.7%,差异无统计学意义( P>0.05);基本满意以上所占比例分别为100.0%、100.0%和97.9%,差异无统计学意义( P>0.05)。结论对于适合行鼓室成形术的慢性化脓性中耳炎患者,手术方式主要根据其听力、耳镜、乳突CT及术中所见进行选择;从患者术后听力及生存质量等方面评价,3种鼓室成形术治疗慢性化脓性中耳炎均取得满意疗效。%Objective To summary the experience of surgical types selection of chronic suppurative otitis media tympano‐plasty and evaluate its clinical curative effect .Methods Chronic suppurative otitis media patient records were collected ,surgical types selection based on hearing ,otoscope and mastoid CT selection .Finally

  2. Distribution and drug susceptibility analysis of pathogens in the pus of children with chronic suppurative otitis media%慢性化脓性中耳炎患儿感染病原菌分布与药敏分析

    Institute of Scientific and Technical Information of China (English)

    李颖; 任红波; 韩富根; 杨建伟; 杨俊梅

    2016-01-01

    目的:探讨慢性化脓性中耳炎患者脓液中病原菌分布及其药敏分析结果,为临床用药提供参考依据。方法采集2012年1月-2013年12月就诊的110例慢性化脓性中耳炎患儿脓液进行病原菌分离培养和药敏试验,对检测结果进行描述性分析,数据采用SPSS 20.0软件进行统计分析。结果110份慢性化脓性中耳炎脓液样本中检测出92株病原菌,检出率为83.64%;以革兰阳性菌为主,共59株占64.13%;金黄色葡萄球菌、表皮葡萄球菌和凝固酶阴性葡萄球菌对利奈唑胺和呋喃妥因的敏感性最高,均达100.00%。结论慢性化脓性中耳炎患儿感染病原菌主要以金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和变形菌属为主,其对抗菌药物的敏感度不同,临床诊治应根据致病菌及其药敏分析结果选择适当药物。%OBJECTIVE To explore the distribution and drug susceptibility of pathogens in the pus of children with chronic suppurative otitis media ,so as to provide the basis for clinical use of drugs .METHODS Pus were collected from 110 cases of children with chronic suppurative otitis media from Jan .2012 to Dec .2013 ,and cultivation of pathogen separation and drug susceptibility analysis were conducted and analyzed .SPSS 20 .0 was explored to make statistical analysis .RESULTS Totally 95 strains of pathogens were detected from 110 pus samples and the total detection rate was 83 .64% .There had 59 (64 .13% ) gram‐positive bacteria strains .The top three pathogens in gram‐positive bacteria were Staphylococcus aureus ,Staphylococcus epidermis and coagulase negative Staphy‐lococci ,which were all 100 .00% sensitive to linezolid and nitrofurantoin .CONCLUSION S .aureus ,S .epider‐mis ,Pseudomonas aeruginosa and Mycetozoan were the predominant species of pathogens in the pus of children with chronic suppurative otitis media .Each pathogen had different sensitive to different

  3. Implementing guidelines for the treatment of acute otitis media.

    Science.gov (United States)

    Barenkamp, Stephen J

    2006-01-01

    The recently published Clinical Practice Guideline for the Diagnosis and Management of Acute Otitis Media represents a sincere effort by the AAP andthe AAFP to provide management guidelines for the practitioner based upon the best scientific evidence available. Despite many years of research and hundreds of clinical studies addressing various aspects of the epidemiology, clinical presentation, and treatment of acute otitis media, important questions remain unaddressed or have been addressed in a less than optimal fashion. These gaps in knowledge and deficiencies in several of the studies that formed the scientific basis for the proposed guidelines are the major reasons behind continued disagreement over certain recommendations. Until more comprehensive and careful analyses can be performed, disagreements are likely to persist. Even so, there is general agreement about most of the recommendations made in these guidelines, and these recommendations will provide a very valuable framework for the practicing physician as he or she cares for children with acute otitis media. To briefly review the major points, first is the critical importance of accurately diagnosing acute otitis media using a combination of clinical findings and observable abnormalities of the tympanic membrane and middle ear space. Particularly important is the differentiation of acute otitis media from otitis media with effusion. Second is the value of treating the pain associated with acute otitis media as a regular component of care, irrespective of any decision concerning antimicrobial treatment. Third is the option, for a select group of older patients with nonsevere disease, of withholding antimicrobial therapy for the first 48 to 72 hours, if close follow-up and active parental involvement can be guaranteed. Fourth is the recommendation that if an antimicrobial agent is used, high-dose amoxicillin (80 to 90 mg/kg/d) is the treatment of choice for most children at the time of initial presentation

  4. 内镜技术在儿童分泌性中耳炎的手术治疗中的应用%Endoscopy in surgical treatment for children with chronic non-suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    欧阳顺林; 褚玉敏; 郭明明; 汪博; 张建国

    2011-01-01

    [ Objectives ] To investigate the surgical treatment methods and effects on non-supparative otitis media in children. [Methods] 74 children (112 ears) suffering from chronic non-suppurative otitis media were conducted adenoidectomy and myringotomy or myringotomy with tube insertion under endoscopy,they were follow-up more than half year, and the results were evaluated. [ Results ] The hearing and middle ear function in children had significant improvement post-operative, the total effective rate was 93.8% (102/112); Air conduction hearing threshold of speech frequency average were (13.5±5.1) dB, air-bone gap were (7.5 ±4.9) dB, they also had significant difference compared with preoperative (P <0.05); the effective rate was 92.7% (51/55) in myringotomy group, and it was 94.7% (54/57) in myringotomy with tube insertion group,there was no significant difference between the two groups (P >0.05). [ Conclusion ] To practice effective surgical treatment on children with chronic non-suppurative otitis media is conducive to the protection of children's hearing and middle ear function, and to prevent the occurrence of otitis media sequelae.%目的 探讨儿童分泌性中耳炎手术治疗方法和效果.方法 对74例(112耳)患有分泌性中耳炎的儿童在内镜下行腺样体切除术和鼓膜切开或置管术,随访半年以上并评价其治疗效果.结果 术后患儿的听力和中耳功能明显好转,总有效率为93.8%(102/112);53耳语言频率气导平均听阈为(13.5±5.1)dB,气骨导差为(7.5±4.9)dB,两者和术前相比较差异有显著性(P<0.05);行鼓膜切开术组有效率为92.7%(51/55);加鼓膜置管组有效率为94.7%(54/57),两组之间相比较差异无显著性(P>0.05).结论 对患有分泌性中耳炎的儿童进行有效的手术治疗,有利于保护儿童的听力和中耳功能,防止中耳炎后遗症的发生.

  5. Surgical management of 43 cases of chronic otitis externa in the dog

    Directory of Open Access Journals (Sweden)

    Doyle Ronan S

    2004-01-01

    Full Text Available Over a seven-year period, chronic otitis externa was surgically managed in 43 dogs at the University Veterinary Hospital of University College Dublin. Lateral ear canal resection (LECR was undertaken in nine of the 43 dogs: results were unsatisfactory, with a failure of the surgery in five of eight dogs and one dog lost to follow-up. Once end-stage otitis externa, with or without otitis media, is diagnosed, total ear canal ablation and lateral bulla osteotomy (TECA/LBO is the best treatment option. In this series, 37 of 43 dogs underwent TECA/LBO and of the 29 dogs for which follow-up results were obtained 27 (93% had an excellent or improved outcome to surgery. Complications following all procedures were most common in cases with a concurrent dermatopathy; therefore, definitive diagnosis and medical treatment for skin and ear disease is essential.

  6. Corynebacterium pseudotuberculosis associated with otitis media-interna in goats

    Directory of Open Access Journals (Sweden)

    Rhoda Leask

    2013-02-01

    Full Text Available Corynebacterium pseudotuberculosis or caseous lymphadenitis is a common condition in sheep and goats. Two cases are described involving otitis media-interna and, in one case, cerebellar abscessation. The first case began with otitis externa and progressed to cerebellar abscessation, presumably as a result of C. pseudotuberculosis infection based on the macroscopic appearance of the abscess. The second case of otitis media-interna involved C. pseudotuberculosis with parasitic encephalitis or secondary meningo-encephalitis. Caseous lymphadenitis is a worldwide problem in livestock and also has zoonotic implications. Antimicrobial therapy of abscesses is often unrewarding due to the thick encapsulation of the abscesses and the extremely contagious nature of the organism. Alternative measures of treating this condition must be sought. In flocks or herds where caseous lymphadenitis has been diagnosed, it should be considered as a differential diagnosis for neurological conditions. The potential for spread must be kept in mind when it is suspected to be the cause of otitis in livestock.

  7. 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)

  8. Role of innate immunity in the pathogenesis of otitis media.

    Science.gov (United States)

    Mittal, Rahul; Kodiyan, Joyson; Gerring, Robert; Mathee, Kalai; Li, Jian-Dong; Grati, M'hamed; Liu, Xue Zhong

    2014-12-01

    Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.

  9. Role of innate immunity in the pathogenesis of otitis media

    Directory of Open Access Journals (Sweden)

    Rahul Mittal

    2014-12-01

    Full Text Available Otitis media (OM is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM, characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.

  10. Developing a vaccine to prevent otitis media caused by nontypeable Haemophilus influenzae.

    Science.gov (United States)

    Khan, M Nadeem; Ren, Dabin; Kaur, Ravinder; Basha, Saleem; Zagursky, Robert; Pichichero, Michael E

    2016-07-01

    Nontypeable Haemophilus influenzae (NTHi) is a predominant organism of the upper respiratory nasopharyngeal microbiota. Its disease spectrum includes otitis media, sinusitis, non-bacteremic pneumonia and invasive infections. Protein-based vaccines to prevent NTHi infections are needed to alleviate these infections in children and vulnerable populations such as the elderly and those with chronic obstructive pulmonary disease (COPD). One NTHi protein is included in a pneumococcal conjugate vaccine and has been shown to provide efficacy. Our lab has been interested in understanding the immunogenicity of NTHi vaccine candidates P6, protein D and OMP26 for preventing acute otitis media in young children. We expect that continued investigation and progress in the development of an efficacious protein based vaccine against NTHi infections is achievable in the near future.

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

    Science.gov (United States)

    Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn; Kvestad, Ellen; Casselbrant, Margaretha L; Homoe, Preben; Rovers, Maroeska M

    2010-03-01

    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 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 vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.

  12. Rare A2ML1 variants confer susceptibility to otitis media.

    Science.gov (United States)

    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

    2015-08-01

    A duplication variant within the middle ear-specific gene A2ML1 cosegregates 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 3 otitis-prone European-American and Hispanic-American children but is absent in non-otitis-prone children and >62,000 next-generation sequences. We identified seven additional A2ML1 variants in six otitis-prone children. Collectively, our studies support a role for A2ML1 in the pathophysiology of otitis media.

  13. Eya4-deficient mice are a model for heritable otitis media

    OpenAIRE

    2008-01-01

    Otitis media is an extremely common pediatric inflammation of the middle ear that often causes pain and diminishes hearing. Vulnerability to otitis media is due to eustachian tube dysfunction as well as other poorly understood factors, including genetic susceptibility. As EYA4 mutations cause sensorineural hearing loss in humans, we produced and characterized Eya4-deficient (Eya4–/–) mice, which had severe hearing deficits. In addition, all Eya4–/– mice developed otitis media with effusion. A...

  14. Tuberculous otitis media: findings on high-resolution CT

    Energy Technology Data Exchange (ETDEWEB)

    Lungenschmid, D. [Dept. of Radiodiagnostics, University Hospital Innsbruck (Austria)]|[Dept. of Magnetic Resonance and Spectroscopy, University Hospital of Innsbruck (Austria); Buchberger, W. [Dept. of Radiodiagnostics, University Hospital Innsbruck (Austria)]|[Dept. of Magnetic Resonance and Spectroscopy, University Hospital of Innsbruck (Austria); Schoen, G. [Dept. of Radiodiagnostics, University Hospital Innsbruck (Austria); Schoepf, R. [Radiologic Inst., Landeck (Austria); Mihatsch, T. [Dept. of Oto-Rhino-Laryngology, University Hospital of Innsbruck (Austria); Birbamer, G. [Dept. of Magnetic Resonance and Spectroscopy, University Hospital of Innsbruck (Austria); Wicke, K. [Inst. of Computed Tomography, University Hospital of Innsbruck (Austria)

    1993-12-01

    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.)

  15. Tuberculous otitis media with facial paralysis: microbiological and clinical study

    Directory of Open Access Journals (Sweden)

    Adriana Mosca

    2011-12-01

    Full Text Available Tuberculosis is a serious infectious disease affecting various organs and tissues even if the lung is the most commonly involved site.A case of tuberculous otitis media in a patient who had no history of tuberculosis is herewith presented with the aim of increasing the awareness of this disease whose diagnosis is often delayed because either of the rarity of this pathologic condition or of its usually indolent course.

  16. Unusual complication of otitis media with effusion: facial nerve paralysis.

    Science.gov (United States)

    Vayisoglu, Yusuf; Gorur, Kemal; Ozcan, Cengiz; Korlu, Savaş

    2011-07-01

    Facial nerve paralysis (FNP) is a very rare complication of otitis media with effusion (OME). There are few patients with OME and FNP in the literature. A 5-year-old girl was admitted to our department with right facial weakness. Right FNP and right OME were diagnosed on the examination. After medical treatment and ventilation tube insertion, FNP completely resolved. The symptoms, signs, and management of this patient are presented.

  17. (Central Auditory Processing: the impact of otitis media

    Directory of Open Access Journals (Sweden)

    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.

  18. The pus bacterial cultivation and drug sensitive test analysis of chronic suppurative otitis media in 81 cases%81例慢性化脓性中耳炎脓液细菌培养及药敏分析

    Institute of Scientific and Technical Information of China (English)

    胡春梅; 陈德珍; 何刚

    2015-01-01

    目的:分析入院拟手术的慢性化脓性中耳炎患者耳部感染的菌群分布及药敏结果,寻找敏感的抗生素,指导临床合理用药。方法81例诊断慢性化脓性中耳炎入院拟行手术的患者耳道分泌物进行细菌培养及药敏试验,对培养阳性菌株的种类以及药物敏感试验结果进行统计分析。结果81份标本中分离出致病菌43株,阳性率53%,革兰氏阳性球菌24株(55.8%),以金黄色葡萄球菌及星座链球菌为主;革兰氏阴性杆菌17株(39.5%),以铜绿假单胞菌,肺炎克雷伯菌,大肠埃希菌为主,真菌2株(4.6%)。革兰氏阳性菌普遍对碳青霉烯,万古霉素类抗生素敏感,革兰氏阴性菌普遍对莫西沙星,碳氢霉烯类,万古霉素等抗生素敏感,结论革兰氏阳性菌是本地区慢性化脓性中耳炎的主要致病菌,临床需根据药敏结果选择安全有效的药物治疗。%Objective Analysis of the distribution of pathogenic bacteria and its drug sensitivity of chronic suppurative otitis media in patients to be operated ,searching for sensitive antibiotics and guiding clinical rational drug use .Methods The bacterial culture and drug sensitivity test were carried out on the patient's ear canal secretion with chronic suppurative otitis media admitted to be treated with surgery ,and the type of positive strains and drug sensitivity test results were statistically analyzed .the results were statisticallyanalyzed.Results 43strainspathogenicbacteriaweredetectedin81samples,andthepositive rate was 53% .Gram positive bacteria were 24 (55 .8% ) ,mainly staphylococcus aureus and streptococcus constellation ;.gram negative bacilli were 17 (39 .5% ) ,mainly pseudomonas aeruginosa ,klebsiella pneumoniae ,escherichia coli;Fungi were 2 strains (4 .6% ) .Gram positive bacteria were sensitivated to carbapenems and vancomycin ,while gram negative bacteria generally to moxifloxacin ,carbapenems and

  19. Labyrinthine fistula caused by chronic otitis media with cholesteatoma%胆脂瘤型中耳炎并发迷路瘘管38例临床分析

    Institute of Scientific and Technical Information of China (English)

    周敬淳; 龚桃根; 柯朝阳; 刘明

    2011-01-01

    Objective To report clinical features and management experience of labyrinthine fistula in chronic otitis media with cholesteatoma. Methods Thirty-eight cases of labyrinthine fistula caused by chronic otitis media with choles-teatoma that underwent radical mastoidectomy from 2000 to 2010 were reviewed. After removal of cholesteatoma matrix and inflammatory tissue around the fistula, two layers of temporalis fascia were used to seal types Ⅰand Ⅱ semicircular canal fistula. The semicircular canal was obliterated for type of HI fistula. Results The prevalence of labyrinthine fistula in chronic otitis media with cholesteatoma was 8.2% (38/464). All fistulas were located in the horizontal semicircular canal during surgery. Otorrhea stopped in all cases postoperatively. There was no vertigo. Average bone conduction threshold did not significantly change postoperatively. Conclusion the most reliable way to identify a fistula is surgery. Careful manipulation and appropriate methods of fistula sealing in the first-stage can preserve cochlear function in addition to removal of abnormal tissue around fistula. Semicircular canal obliteration for type Ⅲ fistula is safe and effective.%目的 分析胆脂瘤型中耳炎并发迷路瘘管的临床特征,总结其诊治经验和体会.方法 回顾性分析我科2000年7月至2010年12月收治的38例经手术证实为胆脂瘤型中耳炎并发迷路瘘管患者的临床资料,38例患者均在全麻下行乳突根治术,术中一期清除瘘管处胆脂瘤及肉芽,Ⅰ型、Ⅱ型瘘管取双层颞肌筋膜覆盖封闭瘘口,Ⅲ型瘘管行半规管阻塞术.结果 胆脂瘤型中耳炎并发迷路瘘管的发生率为8.2%(38/464),术中发现瘘管全部位于水平半规管,术后所有患者均获干耳,眩晕未再发作,干耳后平均骨导听阈与术前相比无明显差异.结论 迷路瘘管的确诊有赖于手术中发现证实;只要术中精细操作并采用合适的方法修补瘘管,一期彻底清除

  20. 53例慢性化脓性中耳炎患者分泌物细菌培养及药敏学分析%Pathogenic bacteria and drug sensitivity in 53 patients with chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    李慎玲; 张孝田; 姜晓丹; 黄天桥; 郭鸽; 梁大鹏

    2015-01-01

    目的:分析53例慢性化脓性中耳炎患者分泌物细菌分布及药敏学的数据结果,探讨此类患者的临床用药方案。方法采用 VITEK-2 COMPACT 微生物分析系统对近3年住院的53例慢性化脓性中耳炎患者分泌物进行病原菌分离鉴定与药敏试验,进行总结统计。结果53份分泌物培养出微生物的有45份,检出率为84.9%,共培养出微生物49株,其中革兰阳性球菌21株,占42.9%;革兰阴性杆菌21株,占42.9%;真菌7株,占14.2%。检出主要病原菌为铜绿假单胞菌,占22.4%,其次为表皮葡萄球菌、金黄色葡萄球菌,分别占16.3%、14.3%。常见革兰阳性菌、革兰阴性菌对临床常用药物左氧氟沙星均有较高敏感性(分别为81.0%、90.9%)。结论铜绿假单胞菌、表皮葡萄球菌、金黄色葡萄球菌是常见慢性化脓性中耳炎感染细菌,对临床常用药物(如左氧氟沙星)有较高敏感性。而对常用药物治疗不敏感的病例要警惕细菌耐药可能,及时行细菌培养,真菌感染不容忽视。%Objective To investigate the pathogenic bacteria and drug sensitivity tests in patients with chronic suppura-tive otitis media for drug application.Methods Secretion were collected from 53 patients with chronic suppurtive otitis media who were admitted into our hospital from March 2011 to March 2014.Bacterial culture and drug susceptibility tests using VITEK-2 COMPACT microbiological analysis system were performed.Results There were 49 stains of mi-crobes isolated from 45 secretion specimens of middle ear.The first three most common pathogenic bacteria were Pseud-omonas aeruginosa,Staphylococcus epidermidis and Staphylococcus aureus accounted for 22.4%,16.3%,16.3%, respectively.The common gram-positive and gram-negative bacteria all showed highly sensitive to levofloxacin. (81%,90.9% correspondingly).Conclusion Pseudomonas aeruginosa

  1. 中耳炎合并迷路瘘管治疗方法的回顾分析%Retrospective analysis of surgical treatment of labyrinthine fistula in patients with chronic otitis media

    Institute of Scientific and Technical Information of China (English)

    刘振; 虞幼军; 郑立岗; 林枫; 谢雪颜

    2012-01-01

    目的 探讨治疗中耳炎合并迷路瘘管简单易行的处理方法.方法 回顾性分析我科在2004年6月~2010年6月间中耳炎手术1226例,其中54例55耳伴迷路瘘管,分析其临床特点、手术方式、效果.术后随访1~5年,观察病人有无复发及听力、平衡障碍的变化.结果 在1226例中耳炎患者中合并迷路瘘管的54例55耳(4.4%),54例患者均一期手术,根据情况选择筋膜覆盖或者筋膜填塞.术后3个月,所有病例均干耳,术腔上皮化(100%);手术后无眩晕发作9例(16.7%),眩晕持续1周以内缓解19例(35.2%),2周以内23例(42.6%),眩晕持续3月3例(5.6%).有术后半年纯音听阈记录的患者38例,与术前比较听力无变化的18耳(47.4%),较术前提高的有9耳(23.2%),术后随访1~5年胆脂瘤及瘘管均无复发.结论 单纯筋膜填塞迷路瘘管的方法,与文献中介绍的方法比较,简单易行,风险小,手术并发症少,对听力无明显干扰,值得推广应用.%Objective To present the authors' experience with surgical management of labyrinthine fistula caused by chronic otitis media. Methods Between June 2004 and June 2010,1226 patients affected by chronic otitis media were operated upon by the authors. Among these cases, 54 (55 ears) were complicated by labyrinthine fistula and retrospectively reviewed. In each patient, clinic features and type of surgery were evaluated. Results The rate of labyrinthine fistula in the 1226 patients with chronic otitis media was 4.4%(54 cases). In all of these cases, primary repair of the fistula was achieved through fascia sealing or fascia filling based upon the condition of the particular lesion. After 3 months, all patients showed dry ear and complete surgical cavity healing (100%). Post-operatively, vertigo was absent in 9 cases (16.7%), resolved within 1 week in 19 cases (35.2%) and within 2 weeks in 23 cases (42.6%), but persistent in 3 patients (5.6 %). Hearing records six months after

  2. 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.

  3. 开放式鼓室成形术在胆脂瘤型中耳炎治疗中的应用研究%Application Research of Open Tympanoplasty in the Treatment of Chronic Otitis Media with Cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    李卫平

    2012-01-01

    目的 探讨开放式鼓室成形术在胆脂瘤型中耳炎治疗中的应用效果.方法 选择我院2009年10月至2010年12月收治的胆脂瘤型中耳炎患者70例作为研究对象,均采用开放式鼓室成形术治疗,观察该治疗方法的疗效及安全性.结果术后3个月干耳70例,干耳率为100%;术后6个月鼓膜生长良好67例,愈合率为95.7%.术后3个月、9个月测得患者的听力与治疗前比较均明显提高,且差异具有统计学意义(P<0.05).术后患者出现眩晕1例,低调耳鸣2例,经对症处理后症状明显改善,无其他严重并发症发生.结论 开放式鼓室成形术在胆脂瘤型中耳炎治疗中的应用效果满意,经过治疗患者听力明显提高,且无严重并发症发生,是一种安全、有效的治疗方案.%Objective To explore the application effect oi open tympanoplasty in the treatment oi chronic otitis media with cholesteatoma. Methods 70 capes of rhronir otitis media with cholesteatoma from October 2009 to December 2010 in our hospital were selected as the objects of the study,they were treated with open tympanoplasty, and the treatment efficacy and safety were observed. Results Alter 3 months, dry ear in 70 cases,the dry ear rate was 100% ; after 6 months,the tympanic membrane grew well in 67 cases,the healing rate was 95.1% . Alter 3 months and 9 months,the patient's healing were significantly improved ,and the difference was statistically significant( P <0. 05 ). Postoperative dizziness in 1 case,low-key tinnitus in 2 cases, which after symptomatic treatment were significantly improved, no other serious complications. Conclusion Open tympanoplasty in the treatment oi chronic otitis media with cholesteatoma has satisfactory results, alter treatment patients' hearing are improved significantly, and no serious complications,thus is a sale and effective treatment.

  4. Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection.

    Science.gov (United States)

    Pettigrew, Melinda M; Gent, Janneane F; Pyles, Richard B; Miller, Aaron L; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2011-11-01

    Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute otitis media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute otitis media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute otitis media. In adjusted models controlling for the presence of key viruses, bacteria, and acute otitis media risk factors, acute otitis media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute otitis media risk differs by the specific viruses and bacteria involved. Acute otitis media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute otitis media bacterial pathogens.

  5. Facial Canal Dehiscence in Patients with Chronic Otitis Surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Uluat

    2016-04-01

    Full Text Available Aim: To examine facial canal status in patients with chronic otitis media (COM surgery and to detect the relation between facial canals dehiscence (FCD with middle ear pathology in these patients. Material and Method: The surgery data of patients who were subjected to tympanoplasty with or without mastoidectomy and radical mastoidectomy due to COM were analyzed retrospectively from January 2006 to December 2012. In addition to demonstrative data of the patients, status of facial canal and preoperative diagnoses of patients, type of the operation performed, status of middle ear, number of surgeries, existence of cholesteatoma, existence of ossicular chain defect, lateral canal defect and dura defect were assessed and the relation thereof with facial canal dehiscence (FCD was analyzed statistically. Results: Seven hundred ninety six patients were included in the study. FCD was detected in 10.05% of the patients. FCD was most frequently observed in the tympanic segment. It was found out that there was a statistically significant relationship of middle ear pathology, cholesteatoma, revision surgery, lateral semicircular canal and ossicular chain defect with FCD. Discussion: COM diagnosed patients may have defect in facial canal according to their preoperative diagnoses, middle ear pathologies, number of operations and ossicular chain defects. These patients should be applied a more careful surgery and closely followed up in postoperative periods.

  6. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yong, E-mail: guoyong27@hotmail.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Liu, Yang, E-mail: liuyangdoc@sina.com [Department of Otorhinolaryngology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Lu, Qiao-hui, E-mail: Luqiaohui465@126.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Zheng, Kui-hong, E-mail: zhengkuihong1971@sina.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Shi, Li-jing, E-mail: Shilijing2003@yahoo.com.cn [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Wang, Qing-jun, E-mail: wangqingjun77@163.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China)

    2013-09-15

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM.

  7. Birth characteristics and recurrent otitis media with effusion in young children.

    NARCIS (Netherlands)

    Engel, J.A.M.; Straetemans, M.; Zielhuis, G.A.

    2005-01-01

    OBJECTIVE: To study the association between birth characteristics and the recurrence of otitis media with effusion (OME). METHODS: Prospective cohort study on 136 children aged 2-7 years, who received tympanostomy tubes for bilateral otitis media with effusion. Checkups were planned 1 week after tub

  8. 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.

  9. 77 FR 60126 - Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment; Availability

    Science.gov (United States)

    2012-10-02

    ... HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0971; Formerly Docket FDA-2008-N-0041; Formerly 2008N-0004] Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment... the draft guidance for industry entitled ``Acute Otitis Media--Developing Antimicrobial Drugs...

  10. Acute otitis media | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available condition(s) being investigated Acute otitis media MedDRA Classification E.1.3Condition being studied is a ...mation not present in EudraCT E.3Principal inclusion criteria Acute Otitis Media ...jects incapable of giving consent Children age 12 months – 10 years clinically suspected Acute

  11. The Effects of Early Bilateral Otitis Media with Effusion on Language Ability: A Prospective Cohort Study.

    Science.gov (United States)

    Grievink, Eefje H.; And Others

    1993-01-01

    This follow-up study to the Nijmegen Otitis Media study evaluated 270 children (age 7). A history of otitis media with effusion (OME), even up to nine instances, did not have negative consequences for language performance at age seven. Intermittent, as opposed to more continuous, OME was not found to affect language ability negatively. (Author/JDD)

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

    Directory of Open Access Journals (Sweden)

    Hermanus C. Myburgh

    2016-03-01

    Interpretation: The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~64% to 80% using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.

  13. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Silberberg Peter

    2005-07-01

    Full Text Available Abstract Background Middle ear disease (otitis media is common and frequently severe in Australian Aboriginal children. There have not been any recent large-scale surveys using clear definitions and a standardised middle ear assessment. The aim of the study was to determine the prevalence of middle ear disease (otitis media in a high-risk population of young Aboriginal children from remote communities in Northern and Central Australia. Methods 709 Aboriginal children aged 6–30 months living in 29 communities from 4 health regions participated in the study between May and November 2001. Otitis media (OM and perforation of the tympanic membrane (TM were diagnosed by tympanometry, pneumatic otoscopy, and video-otoscopy. We used otoscopic criteria (bulging TM or recent perforation to diagnose acute otitis media. Results 914 children were eligible to participate in the study and 709 were assessed (78%. Otitis media affected nearly all children (91%, 95%CI 88, 94. Overall prevalence estimates adjusted for clustering by community were: 10% (95%CI 8, 12 for unilateral otitis media with effusion (OME; 31% (95%CI 27, 34 for bilateral OME; 26% (95%CI 23, 30 for acute otitis media without perforation (AOM/woP; 7% (95%CI 4, 9 for AOM with perforation (AOM/wiP; 2% (95%CI 1, 3 for dry perforation; and 15% (95%CI 11, 19 for chronic suppurative otitis media (CSOM. The perforation prevalence ranged from 0–60% between communities and from 19–33% between regions. Perforations of the tympanic membrane affected 40% of children in their first 18 months of life. These were not always persistent. Conclusion Overall, 1 in every 2 children examined had otoscopic signs consistent with suppurative ear disease and 1 in 4 children had a perforated tympanic membrane. Some of the children with intact tympanic membranes had experienced a perforation that healed before the survey. In this high-risk population, high rates of tympanic perforation were associated with high

  14. Karakteristik Penderita Otitis Media Supuratif Kronik Di RSUP Haji Adam Malik Medan Pada Tahun 2012

    OpenAIRE

    Batubara, Muhammad Akbar

    2014-01-01

    Chronic Suppurative Otitis Media (CSOM) is included in one of the major health problem which can be found in many population in the world and it is one of the cause of significant morbidity and motility. The prevalence rate of CSOM in the world states 1 to 46% in the middle to low class in developing countries . This research is conducted in order to recognize the char acteristic of patients with CSOM at RSUP Haji Adam Malik Medan in 201 2. The samples of this research are the patients of thi...

  15. Risk factors analysis for non dry ear after radical mastoidectomy for chronic suppurative oti-tis media%慢性化脓性中耳炎患者乳突根治术后出现不干耳的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    郑树国

    2015-01-01

    目的:探讨慢性化脓性中耳炎患者行乳突根治术后不干耳的危险因素。方法回顾性分析我院行乳突根治术的120例慢性中耳炎患者临床资料,应用Logistic回归模型分析年龄、性别、病程、吸烟史、药物过敏史、鼻咽部炎症状况、中耳炎类型以及致病菌等因素对术后不干耳的影响。结果干耳组与不干耳组患者年龄、性别、病程、药物过敏史、鼻咽部炎症状况等差异无统计学意义( P>0.05);不干耳组中吸烟者比例以及骨疡型中耳炎患者比例高于干耳组,胆脂瘤中耳炎比例低于干耳组,差异均有统计学意义( P<0.05);两组患者的常见致病菌构成差异亦有统计学意义( P<0.05)。 Logistic回归分析显示,吸烟史、中耳炎类型、致病菌与慢性化脓性中耳炎患者术后不干耳显著相关( OR值分别为8.201、10.801和7.273)。结论术前中耳炎类型、吸烟史以及真菌感染是慢性化脓性中耳炎患者行乳突根治术后不干耳的危险因素,针对这些因素,术前应积极做好充分准备。%Objective To investigate the risk factors of non dry ear after radical mastoidectomy for chronic suppurative otitis media.Methods Clinical data of 120 patients with chronic otitis media (COM),who were treated with radical mastoidectomy in our hospital,were retrospectively analyzed.The effects of age,gender,disease duration,smoking history,drug allergies history,nasopharynx inflammatory conditions ,otitis media types and pathogens in postoperative non dry ear were analyzed by using the Logistic regression a -nalysis.Results There was no significant difference in age ,gender,disease duration,drug allergies and nasopharynx inflammatory be-tween the dry ear and non dry ear groups .The proportions of smokers and COM with osteitis in the non dry ear groups were significantly higher than that in the dry ear group while the proportion of

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

    Directory of Open Access Journals (Sweden)

    Chinh C Ngo

    Full Text Available Otitis media (OM is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention.A systematic review of published reports of microbiology of acute otitis media (AOM and otitis media with effusion (OME from January, 1970 to August 2014, was performed using PubMed databases.This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine.Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of

  17. Societal costs and burden of otitis media in Portugal

    Directory of Open Access Journals (Sweden)

    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

  18. [Changing the therapeutic approach to acute otitis media in children].

    Science.gov (United States)

    Grossman, Zahi; Branski, David

    2004-04-01

    Acute Otitis Media (AOM) is the most common reason for pediatrician's visits and for antibiotic prescription in childhood. A significant rise in bacterial resistance to antibiotic treatment has been detected in recent years. Accordingly, the attitude towards antibiotic treatment for AOM has been re-evaluated. Due to various difficulties in ear examination, physicians overdiagnosis Otitis Media with Effusion (OME) as AOM, leading to unnecessary prescription of antibiotics. The natural history of AOM shows spontaneous improvement without complications. Studies that have examined antibiotic treatment versus placebo in AOM have shown only minimal advantage for the antibiotic therapy in symptom reduction. Critical appraisal of the literature according to Evidence-based Medicine (EBM) criteria has led to several meta-analyses that showed only a minor advantage for antibiotics over placebo in AOM. In the Netherlands, the approach to AOM is that of delayed prescribing: symptomatic therapy is given for the first 24-72 hours and an antibiotic drug is prescribed only if symptoms persist after this initial period. This review examines the difficulties in reaching an accurate diagnosis of AOM and describes the natural history of AOM and evaluates the studies and meta-analyses comparing antibiotics to placebo. The Dutch approach to AOM will be discussed as an option and a recommended basis for reduction in antibiotic prescriptions for AOM.

  19. 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.

  20. 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

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

    NARCIS (Netherlands)

    Emonts, M.; Veenhoven, R.H.; Wiertsema, S.P.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.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

  2. Changes of the Ultrastructure of Chorda Tympani Nerve in Chronic Otitis Media%慢性中耳炎患者鼓索神经超微结构的变化

    Institute of Scientific and Technical Information of China (English)

    胡正清; 王正敏

    2001-01-01

    Purpose To investigate the ultrastructure of the chorda tympani nerves in chronic otitis media. Methods The tympanic segments of chorda tympani nerves were collected for ultrastructural investigaions in 35 cases who underwent canal-wall-down tympanoplasty. All patients received a spatial (regional) taste test preoperatively and postoperatively. The extended Cochran-Mantel-Haenszel statistics was applied. Results There were obvious damages in all the chorda tympani nerves, such as swelling( 100 % ), disarrangement (100%), vacuoles formation (83%)of myelin, the edema of Schwann cell (91%), intracytoplasmic vacuoles in Schwann cell (89 % ) and the proliferation of the collagen tissue ( 97 % ). Five patients complained of taste change postoperatively. The gustation test showed that the taste intensities ipsilateral to the side of tympanoplasty were not statistically significant for each stimulus to all the loci( P > 0.05)comparing preoperative tests with postoperative tests. Conclusions This research implied that the chorda tympani nerves had pathological changes in ultrastructue in chronic otitis media who underwent canal wall-down tympanoplasty. The transection of chorda tympani nerve would not affect the function of taste in these patients.%目的研究慢性中耳炎患者鼓索神经的超微结构。方法取35例开放式鼓室成形术中所取的鼓室段 鼓索神经作透射电镜观察并进行区域性化学味阈的测定,统计方法为扩展Cochran-Mantel-Haenszel法。结果 35例慢性中耳炎患者鼓索神经的超微结构均有不同程度的变化,如有髓神经纤维髓鞘肿胀(100%)、排列紊乱 (100%)、空泡形成(83%)、Schwann细胞肿胀(91%)、细胞内空泡形成(89%)、髓鞘间胶原组织增生(97%)。35 例患者中5例术后发生味觉障碍,手术前后每一溶液于术侧舌部和软腭引起的味觉反应的差异在统计学上无显 著意义(P>0.05)。结论行开放式鼓室成形术患者鼓

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

    Science.gov (United States)

    Chen, Jing; Ingham, Neil; Clare, Simon; Raisen, Claire; Vancollie, Valerie E; Ismail, Ozama; McIntyre, Rebecca E; Tsang, Stephen H; Mahajan, Vinit B; Dougan, Gordon; Adams, David J; White, Jacqueline K; Steel, Karen P

    2013-01-01

    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.

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

    DEFF Research Database (Denmark)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse;

    2015-01-01

    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. RESULTS: Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis...

  5. 鼓室成形术治疗慢性化脓性中耳炎的疗效分析%The clinical observations of tympanoplasty in treatment of chronic otitis suppurative media

    Institute of Scientific and Technical Information of China (English)

    秦江波; 侯世东

    2009-01-01

    Objective To discuss the feasibility and curative effect of tympanoplasty for chronic suppurative otitis media. Methods Thirty-three cases of chronic suppurative otitis media in the period of infection had infected tissue removed and the Eustachian tube restored during tympanoplasty. The short-and long-term curative effects were observed by follow-up visit. Results Among the 33 cases, 3 cases are found tinnitus during tamponading the cavity during operation and normal state resumeed after the tampons were taken out. 2 weeks after operation, tampons were taken out of the acoustic duct and the transplants in 27cases showed normal color and growth. 4 cases had low Blood-supply. 2 cases showed bottom margin crevices. All the transplants were maintained after therapy. The follow-up showed that the tympanums in 28 cases grew well(85% ). Perforation of ear drum recurred in 2 cases 6 months after-wards. 1 case with the transplanted tympanum perforated and suppurated again. The transplant invaginated in 1 case but get better after inflating the eustachian tube. 1 case had relative severe tympanum invaginating and didn't show acoustic sensibility recovery. 1 year after operation, the tympanic membranes of 28 ears were normal. Among 33 ca-ses, the air bone gap in 9 patients was improved 10dB HL. 14 ears were improved from 15 to 20 dB HL, 6 ears were improved from 25 to 30 dB HL. 4 cases showed no change. Conclusion Tympanoplasty can be performed in pa-tients with chronic suppurative otitis media in the period of infection. The complete removal of diseased tissue, pla-cing the transplant precisely, preventing formation of cholesteatoma and restoring the eustachian tube function are key factors to successful operation%目的 探讨慢性化脓性中耳炎鼓室成形术的可行性和疗效.方法 对33例单侧慢性化脓性中耳炎患者在恢复咽鼓管功能、清除病变的同时行鼓室成形术,随访观察近期及远期疗效.结果 33例患者中,3例术腔填

  6. Rare but numerous serious complications of acute otitis media in a young child.

    Science.gov (United States)

    Van Munster, Mariëtte P E; Brus, Frank; Mul, Dick

    2013-03-12

    Acute otitis media is a very common disease in children. Most children recover with symptomatic therapy like potent analgesics, but occasionally serious complications occur. We present a 3-year-old girl who suffered from acute otitis media for already 2 weeks and presented with fever, abducens nerve palsy of her left eye and vomiting. She was finally diagnosed with an acute otitis media complicated by a mastoiditis, sinus thrombosis, meningitis and cerebellar empyema. Fusobacterium necrophorum was cultured from cerebrospinal fluid. The girl recovered following appropriate antibiotic and anticoagulation treatment.

  7. 乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效观察%Clinical Efficacy Mastoidectomy Plus Tympanoplasty in Treating Chronic Suppurative Otitis Media and Cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    王珏

    2016-01-01

    Objective To investigate the clinical eficacy tympanoplasty plus mastoidectomy in the treatment of chronic suppurative otitis media and cholesteatoma.Methods 72 patients with chronic suppurative otitis media and cholesteatoma patients randomized to the treatment group(n=36)taken tympanoplasty mastoidectomy plus the control group(n=36)a simple line of mastoidectomy,compared to group 2 patient surgery.Results The air-bone gap,air conduction hearing threshold and relapse rates were lower than the control group(P<0.05). ConclusionClinical eficacy of tympanoplasty plus mastoidectomy in the treatment of chronic suppurative otitis media and cholesteatoma certainly worth learning.%目的:探讨乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效。方法将72例慢性化脓性及胆脂瘤中耳炎患者随机分组,治疗组(n=36)采取乳突根治加鼓室成形术,对照组(n=36)单纯行乳突根治术,对比2组患者手术疗效。结果治疗组气骨导差、气导听阈以及复发率均低于对照组(均P<0.05)。结论乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效肯定。

  8. A Retrospective Study on Cholesteatoma Otitis Media Coexisting with Cholesterol Granuloma

    Institute of Scientific and Technical Information of China (English)

    罗凌惠; 龚树生; 白广平; 汪吉宝

    2002-01-01

    Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cas-es of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cas-es of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and blood-y otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Tem poral bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases,enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplas-ty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological e-tiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location,extension and severity of the lesion, The purpose of surgery is to remove the lesion and create an

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 咽鼓管功能障碍对慢性化脓性中耳炎患者疗效观察%Effect of eustachian tube dysfunction on clinical efficacy in patients with chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    喻继康

    2016-01-01

    Objective :To investigate the effect of eustachian tube dysfunction on clinical efficacy in patients with chronic suppurative otitis media .Methods :55 cases (65 ears)of chronic suppurative otitis media were selected from April 2014 to October 2015 in our hospital ,according to the eustachian tube function examination results were divided into the normal and abnormal of the eustachian tube function groups ,the difference of the pure tone hearing and the biggest difference of tympanic cavity pressure before and after treatment were compared in the two groups ,a‐nalysis of the relationship between eustachian tube function and curative effect ,anti acoustic instrument pressure test ,the growth of the tympanic membrane .Results :The ABG in normal eustachian tube function group after oper‐ation (18 .65 + 11 .39) dBHL was lower than the abnormal eustachian tube group (25 .62 + 10 .38) dBHL ,and the difference has statistical significance (P<0 .05);The biggest difference of tympanic cavity pressure in normal eusta‐chian tube function group after operation (18 .97 + 4 .69) daPa was lower than the abnormal eustachian tube group (22 .19 5 .91) daPa ,and the difference has statistical significance (P<0 .05);The hearing improvement degree ≥10 dB in patients with normal eustachian tube group (29 cases ,69 .05% ) was higher than that of the abnormal eusta‐chian tube group (9 cases ,39 .13% ) ,and the difference has statistical significance (P<0 .05) .The normal ratio of sound guide instrument pressure resistance test result in patients with normal eustachian tube group was higher than that of abnormal eustachian tube ,and the difference has statistical significance (P<0 .05);The normal tympanum growth rate in patients with normal eustachian tube group was higher than the abnormal eustachian tube ,and the difference was statistically significant (P<0 .05) .Conclusion:The clinical curative effect of otitis media purulenta‐chronica patients with abnormal eustachian tube

  11. Influence of Comfort Care on Comfort Degree of Patients With Chronic Suppurative Otitis Media%舒适护理对慢性化脓性中耳炎乳突根治术患者舒适度的影响研究

    Institute of Scientific and Technical Information of China (English)

    索明云

    2016-01-01

    目的:研究舒适护理对慢性化脓性中耳炎乳突根治术患者舒适度的影响。方法选取2015年7月~2016年7月我院接收并行乳突根治术的慢性化脓性中耳炎患者62例,分为两组,对照组行常规护理,研究组则实施舒适护理,分析两组护理效果。结果研究组护理后中耳积液消失时间、穿孔鼓膜愈合时间优于对照组,P<0.05;且研究组护理后总舒适度高于对照组,P<0.05。结论舒适护理对慢性化脓性中耳炎乳突根治术患者舒适度较为显著。%Objective To study the influence of comfort nursing on the comfort degree of patients with chronic suppurative otitis media in patients with chronic suppurative otitis media.Methods 62 cases of chronic suppurative otitis media were divided into two groups from July 2015 to July 2016, and the control group received routine nursing, while the study group received comfortable nursing care. The effect of the two groups was analyzed. ResultsIn the study group, the disappearance time of middle ear effusion and the healing time of perforated ear drum were better than that of the control group,P<0.05. And the total comfort of the study group was higher than that of the control group,P<0.05.Conclusion Comfort care for patients with chronic suppurative otitis media in patients with a more comfortable degree of comfort.

  12. Dilemmas in primary care: antibiotic treatment of acute otitis media.

    Science.gov (United States)

    True, B L; Helling, D K

    1986-09-01

    Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.

  13. Pediatric acute otitis media: the case for delayed antibiotic treatment.

    Science.gov (United States)

    Johnson, Nicholas C; Holger, Joel S

    2007-04-01

    Acute otitis media (AOM) is both a commonly diagnosed condition and a frequent indication for antibiotic use in children. Recent literature suggests that antibiotics are not needed in many children with AOM, as most cases resolve spontaneously without complication. However, a majority of AOM infections in children are still treated with antibiotics. The American Academy of Pediatrics and American Academy of Family Physicians released a guideline for treatment of AOM in children. We review the guideline as well as scientific evidence related to AOM treatment options. We support a set of evidence-based guidelines employing a delayed prescription option for antibiotic therapy in selected children. If used appropriately, these cost-effective guidelines will reduce the amount of antibiotics prescribed, increase parental satisfaction, and may lower rates of antibiotic resistance while producing similar rates of resolution of AOM.

  14. Influenza virus induces bacterial and nonbacterial otitis media.

    Science.gov (United States)

    Short, Kirsty R; Diavatopoulos, Dimitri A; Thornton, Ruth; Pedersen, John; Strugnell, Richard A; Wise, Andrew K; Reading, Patrick C; Wijburg, Odilia L

    2011-12-15

    Otitis media (OM) is one of the most common childhood diseases. OM can arise when a viral infection enables bacteria to disseminate from the nasopharynx to the middle ear. Here, we provide the first infant murine model for disease. Mice coinfected with Streptococcus pneumoniae and influenza virus had high bacterial load in the middle ear, middle ear inflammation, and hearing loss. In contrast, mice colonized with S. pneumoniae alone had significantly less bacteria in the ear, minimal hearing loss, and no inflammation. Of interest, infection with influenza virus alone also caused some middle ear inflammation and hearing loss. Overall, this study provides a clinically relevant and easily accessible animal model to study the pathogenesis and prevention of OM. Moreover, we provide, to our knowledge, the first evidence that influenza virus alone causes middle ear inflammation in infant mice. This inflammation may then play an important role in the development of bacterial OM.

  15. Viral-bacterial interactions in acute otitis media.

    Science.gov (United States)

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

    2012-12-01

    Acute otitis media (AOM) is a polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (URI). While respiratory viruses alone may cause viral AOM, they increase the risk of bacterial middle ear infection and worsen clinical outcomes of bacterial AOM. URI viruses alter Eustachian tube (ET) function via decreased mucociliary action, altered mucus secretion and increased expression of inflammatory mediators among other mechanisms. Transient reduction in protective functions of the ET allows colonizing bacteria of the nasopharynx to ascend into the middle ear and cause AOM. Advances in research help us to better understand the host responses to viral URI, the mechanisms of viral-bacterial interactions in the nasopharynx and the development of AOM. In this review, we present current knowledge regarding viral-bacterial interactions in the pathogenesis and clinical course of AOM. We focus on the common respiratory viruses and their established role in AOM.

  16. Efficacy and safety of cefpodoxime in the treatment of acute otitis media in children

    Directory of Open Access Journals (Sweden)

    Mortada H. El-Shabrawi

    2016-06-01

    Conclusion: Cefpodoxime proxetil is an effective, safe, well-tolerated antimicrobial agent for treatment of acute otitis media in children. It can be considered as an excellent choice for the empirical treatment of bacterial AOM.

  17. [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

    INTRODUCCIÓN: la otitis media aguda es la enfermedad bacteriana más frecuente en los niños menores de cinco años, por lo que constituye una de las causas más comunes de consulta médica pediátrica. El objetivo de esta investigación fue conocer el panorama epidemiológico de la otitis media aguda, con la finalidad de determinar la factibilidad de considerarla un indicador centinela de la atención médica. MÉTODOS: se recolectaron y analizaron todos los casos nuevos de otitis media aguda que se presentaron entre 2008 y 2011. Se determinaron proporciones, razones y tasas de incidencia, y se calcularon los límites para proporciones por prueba exacta de P-media. Resultados: en los niños menores de cinco años de edad se observó 20 % de los casos de otitis media no supurativa y 17 % de los casos de otitis media supurativa. En ese grupo de edad, aumentó la razón de casos de infecciones respiratorias agudas en relación con los de otitis media: 87:1 en 2008 a 53:1 en 2011.

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

    Directory of Open Access Journals (Sweden)

    Francesco Martines

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: 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. OBJECTIVE: To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. METHODS: 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. RESULTS: Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p < 0.05; children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p < 0.05. Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p < 0.05; the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. CONCLUSIONS

  19. 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...... is associated with an increased risk of otitis media and VT insertions in the offspring. Antibiotics late in pregnancy mainly contributed to these effects, pointing toward potential transmission of an unfavorable microbiome from mother to child....

  20. Adenotonsiller Hipertrofinin Effüzyonlu Otitis Media Üzerine Etkileri

    OpenAIRE

    Bayındır, Tuba; Toplu, Yüksel; Kızılay, Ahmet

    2013-01-01

    Obstructive hypertrophy with adenoid and/or tonsil inflammation is one of the most common problems in pediatric group patients. Especially adenoid tissue, which is a component of Waldeyer's ring, may play an important role in the pathogenesis of otitis media, according to its anatomic position, when inflamed and/or enlarged. Therefore, adenoid surgery is thought to have a role in the management of otitis media with effusion. According to the relationship between the adenoid tissue and eustach...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-07-01

    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.

  2. 完壁式鼓室成形术治疗慢性化脓性中耳炎%Intact Canal Wall Tympanoplasty in Treating Patients with Chronic Suppurative Otitis Media

    Institute of Scientific and Technical Information of China (English)

    王凯; 俞杰; 李幼珍; 张建

    2013-01-01

    目的:介绍完壁式鼓室成形术治疗慢性化脓性中耳炎的的手术体会。方法回顾性分析96完壁式鼓室成形术治疗慢性化脓性中耳炎的临床资料,术中注意上鼓室外侧壁盾板的完整,清除病灶保护粘膜,建立咽鼓管、鼓室、鼓窦、乳突的通气引流系统。结果术前纯音听力测试0.5、1.0、2.0、4.0kHz语言频率区听阈气骨导差的平均值0-10dB为0耳(0%),11-20 dB为4耳(4.17%),21-30 dB为29耳(30.2%),31-40 dB为46耳(47.9%),大于40 dB为17耳(17.7%),平均气导为(54.1±6.5)dB,平均骨导为(13.6±7.6)dB;术后3月纯音听力测试,0.5、1.0、2.0、4.0kHz语言频率区听阈气骨导差的平均值0-10dB为25耳(26.0%),11-20 dB为46耳(47.9%),21-30 dB为19耳(19.8%),31-40 dB为6耳(6.3%),大于40 dB为0耳0%),平均气导为(38.1.±7.9)dB,平均骨导为(12.5±6.3)dB。术后8月以上(平均间隔时间为11个月)纯音听力测试的情况是0-10dB为22耳(22.9%),11-20 dB为41耳(42.7%),21-30 dB为24耳(25%),31-40 dB为9耳(9.3%),大于40 dB为0耳0%),平均气导为(41.2±8.4)dB,平均骨导为(12.6±7.6)dB。术后8个月~3年随访中行颞骨CT扫描(平均间隔时间为11个月),96耳中75耳乳突鼓窦保持气化(78.1%),21耳乳突鼓窦软组织影充填(21.9%)。结论完壁式鼓室成形术治疗慢性化脓性中耳炎可取得满意疗效,遵循个体化原则建立合理的中耳通气引流系统是手术的关键。%Objective To introduce the experience of the intact canal wall tympanoplasty in chronic suppurative otitis media. Methods Clinical data of 96 cases of the intact canal wall tympanoplasty for treating chronic suppurative otitis media was retrospectively reviewed. During the operation, the outside wall of attic should be keeped intact, lesions should be re-moved, mucosa

  3. The role of respiratory syncytial virus and other viral pathogens in acute otitis media.

    Science.gov (United States)

    Klein, B S; Dollete, F R; Yolken, R H

    1982-07-01

    We utilized recently developed enzyme immunoassay techniques to examine the role of selected viruses in the etiology of acute otitis media. Viral pathogens were found in middle ear fluids obtained from 13 (24%) of 53 children with acute otitis media; respiratory syncytial virus accounted for ten of the 13 viral agents identified. In addition, respiratory syncytial viral antigen was found in nasopharyngeal washings obtained from 15 of the 53 children. Seven of these children had RSV identified as the sole middle ear pathogen, whereas six children had otitis caused by Streptococcus pneumoniae as either the sole middle ear pathogen or in combination with RSV. Similarly, all three children with respiratory infections caused by influenza virus had ear infections caused by bacterial pathogens, either alone or in combination with influenza virus. These findings suggest that, in patients with viral respiratory infection, coexisting acute otitis media may be associated with the recovery of either viruses or bacteria from the middle ear exudates.

  4. 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.

  5. Clinico-audio-radiological and operative evaluation of otitis media with effusion

    Directory of Open Access Journals (Sweden)

    Karan Sharma

    2015-01-01

    Full Text Available Aims: Otitis media with effusion (OME is a common cause of hearing and speech impairment in children. The correlation of the clinical, audiological, radiological, and intraoperative findings was carried out so as to make a protocol for early diagnosis and management of OME. It will help prevent the more serious sequelae of OME such as tympanosclerosis, chronic adhesive otitis media, and even chronic suppurative otitis media. Methods: 300 clinically diagnosed patients of OME were studied prospectively. Thereafter, patients underwent impedance audiometry, pure tone audiometry, and X-ray soft tissue nasopharynx for adenoids. The patients were given adequate medical treatment for 3 to 6 months, and the patients who did not respond to the treatment were subjected to adenoidectomy with ear examination under magnification and myringotomy with or without grommet insertion. Results: The mean age at presentation was 5.96 years. Only 32% patients gave a history of hearing loss. About 90% patients had mouth breathing, followed by snoring (84%. About 79% ears had abnormal tympanic membrane appearance and mobility; 65.5% had an abnormality on impedance audiometry; and 69.75% had an air condition threshold level of >20 dB. About 78% patients had either Grade III or Grade IV Adenoid hypertrophy. Adenoidectomy was done in all 300 patients with myringotomy in 472 ears. Grommets were inserted in 365 ears. There was a significant reduction in mean air conduction threshold with an improvement of 8.0 dB and 7.5 dB in right and left ears, respectively at 2 months postoperatively. At 6 th month postoperative, the average improvement from baseline dropped to 6.0 dB in right ear and 5.5 dB in the left ear. Conclusion: OME is the most frequent causes of silent hearing impairment in young children which needs a close vigil. All suspected children (on clinical and otoscopic findings must be subjected to impedance audiometry and X-ray soft tissue nasopharynx for adenoids

  6. Otitis media with effusion: benefits and harms of strategies in use for treatment and prevention.

    Science.gov (United States)

    Principi, Nicola; Marchisio, Paola; Esposito, Susanna

    2016-01-01

    Otitis media with effusion (OME) is a common clinical condition that is associated with hearing loss. It can be diagnosed at least once in approximately 80% of preschool children: 30-40% of them have recurrent episodes, and 5-10% have chronic disease. OME, in recurrent and persistent cases, might significantly delay or impair communication skills, resulting in behavioral and educational difficulties. Several therapeutic approaches have been used to avoid these problems. Most, however, have not been adequately studied, and no definitive conclusions can be drawn. Official guidelines do not recommend the use of decongestants, antihistamines, steroids, or antibiotics. The data are too scanty to assess other interventions, although autoinflation, because it incurs neither cost nor adverse events, deserves attention. Surgical procedures (i.e., tympanostomy tube insertion and adenoidectomy as an adjuvant) can be useful in some cases. This review evaluates all the current OME treatments and preventive measures, including their possible adverse events.

  7. Nasal Mucociliary Clearance in Adenoid Hypertrophy and Otitis Media with Effusion.

    Science.gov (United States)

    Yazıcı, Hasmet

    2015-12-01

    Mucociliary clearance (MCC), which exists in many systems, is the first defensive mechanism of the human body. Nasal MCC has an important role in transporting the secretions of the nasal cavity and paranasal sinuses along with the trapped inhaled pathogens to the nasopharynx. Physiologic or pathologic situations that effect nasal MCC, such as temperature, humidity, nasal obstruction, allergic rhinitis, chronic infections, etc., lead to impaired MCC and related local or circumjacent system disorders. With this perspective, when a unified airway with a multiple disease principle is considered, investigating the relationship between adenoid hypertrophy (AH), otitis media with effusion (OME) and nasal MCC is logical. In this review, histological and physiologic properties of nasal MCC and its possible role involving pathologic situations such as AH and OME is discussed together with recent literature findings.

  8. Serum antibody response to three non-typeable Haemophilus influenzae outer membrane proteins during acute otitis media and nasopharyngeal colonization in otitis prone and non-otitis prone children.

    Science.gov (United States)

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

    2011-01-29

    Non-typeable Haemophilus influenzae (NTHi) is the most common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (rAOM; otitis prone) and AOM treatment failure (AOMTF) in children. In this 3.5 years of prospective study, we measured the serum antibody response to outer membrane proteins D, P6 and OMP26 of NTHi in children with AOM (n=26), rAOM (n=32), AOMTF (n=27). The geometric mean titers (GMTs) of IgG at their acute AOM visit against Protein D in otitis prone children were significantly lower compared to AOMTF (p value4 fold increases in the non-otitis prone children (p value<0.001). We conclude that otitis prone children mount less of an IgG serum antibody response toward Protein D, P6 and OMP26 after AOM which may account for recurrent infections. The data on acute sera of otitis prone vs non-otitis prone children and the acute-to-convalescence response in non-otitis prone children point to a possible link of anti-PD to protection. Moreover, the data suggest that otitis prone children should be evaluated for their responses to Protein D, P6 and OMP26 vaccine antigens of NTHi.

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

    Science.gov (United States)

    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.

  10. ModM DNA methyltransferase methylome analysis reveals a potential role for Moraxella catarrhalis phasevarions in otitis media.

    Science.gov (United States)

    Blakeway, Luke V; Power, Peter M; Jen, Freda E-C; Worboys, Sam R; Boitano, Matthew; Clark, Tyson A; Korlach, Jonas; Bakaletz, Lauren O; Jennings, Michael P; Peak, Ian R; Seib, Kate L

    2014-12-01

    Moraxella catarrhalis is a significant cause of otitis media and exacerbations of chronic obstructive pulmonary disease. Here, we characterize a phase-variable DNA methyltransferase (ModM), which contains 5'-CAAC-3' repeats in its open reading frame that mediate high-frequency mutation resulting in reversible on/off switching of ModM expression. Three modM alleles have been identified (modM1-3), with modM2 being the most commonly found allele. Using single-molecule, real-time (SMRT) genome sequencing and methylome analysis, we have determined that the ModM2 methylation target is 5'-GAR(m6)AC-3', and 100% of these sites are methylated in the genome of the M. catarrhalis 25239 ModM2 on strain. Proteomic analysis of ModM2 on and off variants revealed that ModM2 regulates expression of multiple genes that have potential roles in colonization, infection, and protection against host defenses. Investigation of the distribution of modM alleles in a panel of M. catarrhalis strains, isolated from the nasopharynx of healthy children or middle ear effusions from patients with otitis media, revealed a statistically significant association of modM3 with otitis media isolates. The modulation of gene expression via the ModM phase-variable regulon (phasevarion), and the significant association of the modM3 allele with otitis media, suggests a key role for ModM phasevarions in the pathogenesis of this organism.

  11. Optical coherence tomography for the diagnosis of human otitis media

    Science.gov (United States)

    Cho, Nam Hyun; Jung, Unsang; Jang, Jeong Hun; Jung, Woonggyu; Kim, Jeehyun; Lee, Sang Heun; Boppart, Stephen A.

    2013-05-01

    We report the application of Optical Coherence Tomography (OCT) to various types of human cases of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface information of the tympanic membrane (TM), OCT is able to effectively reveal the depth-resolved microstructural below the TM with a very high spatial resolution. With the potential advantage of using OCT for diagnosing different types of OM, we examined in-vivo the use of 840 nm wavelength, and OCT spectral domain OCT (SDOCT) techniques, in several human cases including normal ears, and ears with adhesive and effusion types of OM. Peculiar positions were identified in two-dimensional OCT images of abnormal TMs compared to images of a normal TM. Analysis of A-scan (axial depth-scans) data from these positions could successfully identify unique patterns for different constituents within effusions. These OCT images may not only be used for constructing a database for the diagnosis and classification of OM, but they may also demonstrate the feasibility and advantages for upgrading the current otoscopy techniques.

  12. [Acute otitis media: do not change the Dutch practice guideline].

    Science.gov (United States)

    Damoiseaux, Roger A M J

    2012-01-01

    Two recent clinical trials have again shown that antibiotics are effective in the management of young children with acute otitis media (AOM). Should this change our reserved attitude towards the use of antibiotics? According to the rules for evidence-based medicine, we cannot ignore the vast body of evidence already existing unless new trials are methodologically better and their results differ from previous trials. This does not seem to be the case. The patient characteristics of these trials are similar to those of a previously published individual patient data meta-analysis. The primary outcome 'symptom scores' reported by Hoberman et al. is also comparable, but Tähtinen et al. may have overestimated the effect of antibiotics. Their primary outcome 'time to treatment failure' does not take later improvement or recovery into account. In both trials, the greatest benefit is related to otoscopic recovery of AOM, which is clinically not the most relevant outcome. For now, there is no reason to adapt the current AOM practice guideline of the Dutch College of General Practitioners.

  13. Prevention of acute otitis media using currently available vaccines.

    Science.gov (United States)

    Principi, Nicola; Baggi, Elena; Esposito, Susanna

    2012-04-01

    Acute otitis media (AOM) is common in infants and children. Although approximately two-thirds of cases are due to bacteria, almost all of the episodes are preceded by upper respiratory viral infection. Several viruses, among which respiratory syncytial virus is the most common, are involved in the determination of AOM. However, a significant number of AOM cases are associated with influenza infection, and influenza viruses are among the most frequently found respiratory viruses in the middle ear fluid during an acute episode of AOM. Consequently, influenza vaccination may have a favorable impact on the incidence and course of AOM. Moreover, as Streptococcus pneumoniae is one of the leading AOM bacterial pathogens and it is well known that influenza virus infection predisposes to pneumococcal infection, there is a further reason to suggest the use of influenza vaccine to reduce the risk of AOM. On the other hand, the administration of pneumococcal conjugate vaccine is considered per se a possible means of reducing the incidence of the disease. However, although a number of studies have measured the impact of both vaccines on AOM, it is still not known whether (and to what extent) they are really effective, nor what impact the more recently licensed vaccines may have. The aim of this review is to examine the clinical impact of vaccinations on AOM.

  14. Correlation between CT and tympanogram in secretory otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Toshimitsu; Sakurai, Tokio; Taniguchi, Kazuhiko; Takahashi, Kuniaki (Iwaki-Kyoritsu General Hospital, Iwaki, Fukushima (Japan)); Ikeda, Katsuhisa; Kawamoto, Kazutomo

    1984-11-01

    In an attempt to evaluate the feasibility of the tympanometry in detecting the middle ear effusion (MEE) in secretory otitis media (SOM) in childhood, the findings of the computed tomography (CT) were evaluated whether they were compatible with that of tympanometry in 27 cases (51 ears) of SOM. Tympanometry (tympanogram, static compliance measurement and stapedial reflex test), pure tone audiometry and high resolution CT were performed sequentially, and the CT findings were compared with the results of the other tests. The conclusions obtained were summarized as follows. 1. Among the tests performed, tympanogram appeared to be the most reliable measure in detection of MEE. 2. Fifteen ears out of 16 with type B tympanograms and 6 ears out of 15 with type C/sub 2/ tympanograms, were diagnosed by CT as having MEE. MEE occupied the entire middile ear space in most ears with type B tympanograms. By contrast, in the ears with type C/sub 2/ tympanograms, air containing space of varying size were always observed even in the ears with MEE.

  15. Failure of antibiotic therapy in acute otitis media.

    Science.gov (United States)

    Babin, Emmanuel; Lemarchand, Vincent; Moreau, Sylvain; Goullet de Rugy, Marc; Valdazo, André; Bequignon, Arnaud

    2003-03-01

    The aim of this retrospective study was to determine the possible causes of failure of antibiotic therapy in children with acute otitis media (AOM). Thirty-nine samples of middle-ear fluid were obtained by myringotomy from 31 children suffering from AOM, unrelieved by antibiotic therapy administered for over 48 hours. The samples were analysed by the usual microbiological techniques, including cultures, tests for beta-lactamase producing strains and the determination of the minimal inhibitory concentration of penicillin for Streptococcus pneumoniae. In 14 samples, no bacterial strains were detected in the cultures of middle-ear fluid; and in two samples the cultures revealed two strains of bacteria. The bacteria most frequently identified were Haemophilus influenzae, found in 11 samples, and Streptococcus pneumoniae, found in seven samples, of which four produced strains with reduced susceptibility to penicillin. The failure of antibiotic therapy in AOM appears to be related to the increased resistance of Haemophilus influenzae and to the reduced susceptibility of Streptococcus pneumoniae to penicillin. Other factors contributing to the failure of antibiotic therapy in AOM may be the viruses or the bacteria that produce multiple pathogens in the middle ear.

  16. 乳突根治鼓室成形术在胆脂瘤型中耳炎治疗中的临床价值探究%The Clinical Value of Mastoidectomy and Tympanoplasty in the Treatment of Chronic Otitis Media With Cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    张春林

    2016-01-01

    Objective To analyze the clinical value of mastoidectomy and tympanoplasty in the treatment of chronic otitis media with cholesteatoma. Methods Randomly selected in our hospital accepted treatment of 36 cases of cholesteatoma otitis media patients, the patients take mastoid radical tympanoplasty therapy. Results The total effective rate of the patients was 97.2%, and the indexes were improved after the operation, P<0.05. Conclusion Mastoidectomy and tympanoplasty for cholesteatoma achieved remarkable effect, can improve patient listening.%目的:分析乳突根治鼓室成形术在胆脂瘤型中耳炎治疗中的临床价值。方法随机抽取在我院接受治疗的36例胆脂瘤型中耳炎患者,对患者采取乳突根治鼓室成形术治疗。结果患者治疗总有效率为97.2%,术后各指标较术前改善,P <0.05。结论乳突根治鼓室成形术治疗胆脂瘤型中耳炎取得显著效果,能够提高患者听力。

  17. Har forhold under svangerskapet betydning for utviklingen av otitis media?

    Directory of Open Access Journals (Sweden)

    Kari J. Kværner

    2009-10-01

    Full Text Available  SAMMENDRAGMed utgangspunkt i data fra et populasjonsbasert utvalg av 7 992 norske tvillinger ble sammenhengenmellom gjentatte ørebetennelser og forhold under svangerskapet studert. Som parametre på intrauterinevekstforhold ble informasjon om fødselsvekt og gestasjonsalder fra Medisinsk Fødselsregister benyttet.Informasjon om rapporterte øreinfeksjoner ble basert på spørreskjemaer som ble besvart av tvillingene ialderen 18–25 år. Først studerte vi individuelle effekter av fødselsvekt og gestasjonsalder på forekomsten avotitis media (OM. Rapportert fødselsvekt hos individer med OM var signifikant lavere enn hos kontrollene,med en gjennomsnittsforskjell på 86 gram. Hos de som rapporterte OM var gjennomsnittlig gestasjonsalder3 dager kortere enn i kontrollmaterialet. Deretter beregnet vi effekten av fødselsvekt ved bruk av co-twinkontroll metoden. Blant monozygote (MZ tvillingpar gjenspeiler fødselsvektforskjeller innenfor tvillingparetintra-uterine miljøforskjeller. Blant dizygote (DZ par kan vektforskjellen være både genetiske ogmiljøbetinget. Ved sammenligning av fødselsvektforskjeller innenfor tvillingparene er tvillingen som ikkehar gjentatte øreinfeksjoner en matchet kontroll blant OM diskordante par. Resultatene antyder at lavfødselsvekt er en risikofaktor for otitis media. Gjennomsnittlig vektforskjell blant par diskordante for OMvar 48 gram, og den av tvillingen som ikke rapporterte OM hadde signifikant høyere fødselsvekt.Kværner KJ, Tambs K, Harris J, Magnus P. Do pregnancy-related factors influence the development ofotitis media? Nor J Epidemiol 1997; 7 (1: 55-58.  ENGLISH SUMMARYThe association between intrauterine growth, as measured by weight and gestational age, and the occurrenceof recurrent ear infections was studied using data from a population based sample of 7992 Norwegian twins.Perinatal measures were collected from the Medical Birth Registry, and reports of recurrent ear infectionswere based on

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. Transiently Evoked Otoacoustic Emissions in Children with Otitis Media with Effusion

    Directory of Open Access Journals (Sweden)

    Dimitris G. Balatsouras

    2012-01-01

    Full Text Available Introduction. Otitis media with effusion is a common pediatric disease whose diagnosis is based on pneumatic otoscopy, pure-tone audiometry, and tympanometry. The aim of this study was to evaluate transiently evoked otoacoustic emissions in the diagnosis of otitis media with effusion as compared to tympanometry. Patients and Methods. 38 children with bilateral otitis media with effusion were studied. 40 normal children of similar age and sex were used as controls. All subjects underwent pneumatic otoscopy, standard pure-tone audiometry, tympanometry, and transiently evoked otoacoustic emissions. Results. In the group of children with bilateral otitis media, transiently evoked otoacoustic emissions were absent in 51 ears (67%. In the remaining 25 ears (33% the mean emission amplitude was reduced, as compared to the mean value of the control group. Conclusions. Transiently evoked otoacoustic emissions should be included in the diagnostic workup of otitis media with effusion because it is a fast, reliable, and objective test. Transiently evoked otoacoustic emissions should always be used in conjunction with tympanometry, because a more meaningful interpretation of transiently evoked otoacoustic emissions measures is possible.

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

    OpenAIRE

    Silva N.

    2001-01-01

    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. ...

  2. Multi-species bacterial biofilm and intracellular infection in otitis media

    Directory of Open Access Journals (Sweden)

    Thornton Ruth B

    2011-10-01

    Full Text Available Abstract Background Bacteria which are metabolically active yet unable to be cultured and eradicated by antibiotic treatment are present in the middle ear effusion of children with chronic otitis media with effusion (COME and recurrent acute otitis media (rAOM. These observations are suggestive of biofilm presence or intracellular sequestration of bacteria and may play a role in OM pathogenesis. The aim of this project is to provide evidence for the presence of otopathogenic bacteria intracellularly or within biofilm in the middle ear mucosa of children with COME or rAOM. Methods Middle ear mucosal biopsies from 20 children with COME or rAOM were examined for otopathogenic bacteria (either in biofilm or located intracellularly using transmission electron microscopy (TEM or species specific fluorescent in situ hybridisation (FISH and confocal laser scanning microscopy (CLSM. One healthy control biopsy from a child undergoing cochlear implant surgery was also examined. Results No bacteria were observed in the healthy control sample. In 2 of the 3 biopsies imaged using TEM, bacteria were observed in mucus containing vacuoles within epithelial cells. Bacterial species within these could not be identified and biofilm was not observed. Using FISH with CLSM, bacteria were seen in 15 of the 17 otitis media mucosal specimens. In this group, 11 (65% of the 17 middle ear mucosal biopsies showed evidence of bacterial biofilm and 12 demonstrated intracellular bacteria. 52% of biopsies were positive for both biofilm and intracellular bacteria. At least one otopathogen was identified in 13 of the 15 samples where bacteria were present. No differences were observed between biopsies from children with COME and those with rAOM. Conclusion Using FISH and CLSM, bacterial biofilm and intracellular infection with known otopathogens are demonstrated on/in the middle ear mucosa of children with COME and/or rAOM. While their role in disease pathogenesis remains to be

  3. 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

    2006-01-01

    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. MET

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

    Science.gov (United States)

    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…

  5. 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…

  6. Cholesterol granuloma associated with otitis media and leptomeningitis in a cat due to a Streptococcus canis infection.

    Science.gov (United States)

    Van der Heyden, Sara; Butaye, Patrick; Roels, Stefan

    2013-01-01

    Cholesterol granuloma in the middle ear is a pathological condition often associated with otitis media in humans. Cholesterol granulomas in cats are rarely described. To our knowledge, this is the first report of middle ear cholesterol granuloma in a cat, associated with otitis media and leptomeningitis due to a Streptococcus canis septicemia.

  7. Cholesterol granuloma associated with otitis media and leptomeningitis in a cat due to a Streptococcus canis infection

    OpenAIRE

    Van der Heyden, Sara; Butaye, Patrick; Roels, Stefan

    2013-01-01

    Cholesterol granuloma in the middle ear is a pathological condition often associated with otitis media in humans. Cholesterol granulomas in cats are rarely described. To our knowledge, this is the first report of middle ear cholesterol granuloma in a cat, associated with otitis media and leptomeningitis due to a Streptococcus canis septicemia.

  8. 开放式鼓室成形术与乳突根治术治疗慢性化脓性中耳炎的临床分析%Clinical Analysis of the Treatment of Chronic Suppurative Otitis Media by Open Tympanoplasty and Radical Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    岳显

    2015-01-01

    Objective To investigate the clinical result of treatment of chronic suppurative otitis media by open tympanoplasty and radical mastoidectomy. Methods The clinical data of 58 patients with chronic suppurative otitis media admitted in the Department of Otorhinolaryngology of our hospital duing October 2010 and January 2015 was analyzed and divided into the combined treat-ment group (n=29,open tympanoplasty and radical mastoidectomy) and radical mastoidectomy group (n=29) according to different treatment methods . Results The recovery rate of external auditory canal and clinical effect of the combined treatment group were 93.1%and 100%, which were superior to 10.3%and 89.7%of the radical mastoidectomy group, and the differences were statisti-cally significant, P<0.05. Conclusion The clinical result of treatment of chronic suppurative otitis media by open tympanoplasty and radical mastoidectomy is obvious, therefore it is worthy of promotion in clinic.%目的:探讨开放式鼓室成形术与乳突根治术治疗慢性化脓性中耳炎的临床效果情况。方法分析该院耳鼻喉科2010年10月-2015年1月收治的慢性化脓性中耳炎患者58例临床资料,依据治疗方式的不同进行临床分组,联合治疗组(乳突根治术+开放式鼓室成形术)29例和乳突根治术组29例。结果联合治疗组慢性化脓性中耳炎患者术后外耳道形状变化和临床疗效100%均优于乳突根治术组89.7%,差异有统计学意义(P<0.05)。结论开放式鼓室成形术联合乳突根治术治疗慢性化脓性中耳炎的临床效果明显,值得临床推广应用。

  9. 慢性化脓性及胆脂瘤中耳炎患者行乳突根治加鼓室成形术治疗的临床疗效观察%Observation of Chronic Suppurative Otitis Media With Cholesteatoma and Underwent Radical Mastoidectomy and Tympanoplasty in Clinical Treatment

    Institute of Scientific and Technical Information of China (English)

    许亮

    2016-01-01

    目的:探讨乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效。方法选择2013年3月~2014年3月我院收治的80例慢性化脓性及胆脂瘤中耳炎患者,均行乳突根治加鼓室成形术治疗,并术后随访6个月,观察患者术后干耳率、听力的情况。结果80例患者治疗后平均气骨导差及平均气导听阈与治疗前相比均有显著改善,差异有统计学意义(P<0.05);治疗后49例纯音听阈(500,1000,2000 Hz)平均气骨导差缩小达到15 dB及以上,听力提高总有效率为61.25%。患者干耳率为96.25%。结论乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎可提高患者听力及术后干耳率,临床疗效确切。%Objective To investigate the clinical curative effect of radical mastoidectomy and tympanoplasty in chronic suppurative otitis media and cholesteatoma. Methods 80 cases of chronic suppurative and cholesteatoma otitis media patients were chosen from March 2013 to March 2014 in our hospital, underwent radical mastoidectomy and tympanoplasty in the treatment, and postoperative follow-up of 6 months were observed after surgery in patients with dry ear rate, listening. Results 80 cases of patients after treatment, the average air bone guide difference and the average air conduction threshold and treatment before have a significant decrease compared, the difference is statistically signiifcant (P<0.05). After the treatment of 49 speech frequency (500, 1 000, 2 000 Hz) average air bone conduction gap reached more than 15 dB and, hearing provided high total effective rate was 61.25%. The dry ear rate was 96.25%. Conclusion Radical mastoidectomy and tympanoplasty in the treatment of chronic suppurative and cholesteatoma otitis media can improve the hearing of patients and postoperative dry ear rate and clinical effcacy precise.

  10. 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

  11. Gustatory alteration evaluation in patients with chronic otitis media Avaliação de alteração gustatória em pacientes com otite média crônica

    Directory of Open Access Journals (Sweden)

    Felippe Felix

    2009-08-01

    Full Text Available Many studies have shown the consequent gustatory alteration caused by ear surgeries. However, few have reported this alteration in patients with chronic otitis media (COM, prior to surgical treatment. AIM: to identify gustatory alterations due to chorda tympani nerve involvement in patients with COM without prior surgery. METHODS: Clinical essay, with tests based on "taste strips" with different concentrations of salt, sweet, bitter, and sour, was performed in 45 patients with unilateral cholesteatomatous or suppurated COM not previously submitted to otological surgery, using the disease-free ear on the contralateral side as control. The score ranged between 0 and 16. RESULTS: A total of 25 patients presented cholesteatoma and 20 had non-cholesteatomatous disease. The mean score was 6.65 for the affected side and 9.93 for the half of the tongue on the side of the healthy ear (pMuitos estudos mostraram a consequente alteração do paladar após cirurgia otológica. Entretanto, poucos reportaram essa alteração como uma queixa de pacientes com otite média crônica (OMC previamente à cirurgia. OBJETIVO: Avaliar alterações na função gustatória na área inervada pelo nervo corda do tímpano em pacientes com OMC ainda não submetidos à cirurgia. MATERIAL E MÉTODOS: O ensaio clínico, com teste gustatório baseado em "tiras gustativas" com diferentes concentrações de sal, doce, amargo e azedo, foi realizado em 45 pacientes com OMC colesteatomatosa e não-colesteatomatosa unilateral, nunca antes submetidos à cirurgia otológica, utilizando a metade da língua do lado livre de doença otológica como controle. As notas variavam de 0 a 16. RESULTADOS: 25 pacientes apresentavam colesteatoma e o restante OMC não-colesteatomatosa. A pontuação média foi de 6,65 para o lado afetado e 9,93 para a metade da língua do lado sadio (p<0,001. Nenhum paciente se queixava de alteração do paladar antes do exame. Encontramos 24 casos de hipogeusia do

  12. 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

    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...... 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......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...

  13. Parents' beliefs and knowledge about the management of acute otitis media

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Howlett, Janine; Del Mar, Chris

    2015-01-01

    BACKGROUND: Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients' (or parents') expectations of antibiotics often influence general practitioners' (GPs) decision to prescribe...... antibiotics, but few have explored parents' expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents' knowledge and beliefs about the management of acute otitis media in children. METHODS: Individual semi...... experience and the advice of the GP. Pain relief medications, such as paracetamol and non-steroidal anti-inflammatory drugs, were not considered by parents to be sufficient treatment on their own. CONCLUSION: There is discrepancy between parents' beliefs and expectations of management of acute otitis media...

  14. [Acute otitis media and antibiotics. Evidence-based guidelines for antibiotic therapy?].

    Science.gov (United States)

    Thorøe, J; Lous, J

    1999-09-27

    Antibiotic treatment of acute otitis media is controversial. The questions are when to treat, with which antibiotic, and for how long? Within the last years three reviews attempting to discuss these questions have been published. All three found only a marginal effect of antibiotic treatment. The effect was less earache after the first day. The meta-analyses showed that between eight and 22 children had to be treated before one had any benefit of the treatment. The randomized studies did not find a greater effect of amoxicillin than of penicillin. The marginal effect of antibiotics on acute otitis media supports watchful waiting and individualized care and follow-up. There is a need for well-organized, randomized, placebo-controlled trials including the youngest children and the more severe cases of acute otitis media where the effect of antibiotic treatment may turn out to be most beneficial.

  15. Presence of human herpesviruses in young children with acute otitis media.

    Science.gov (United States)

    Shinogami, Masanobu; Ishibashi, Toshio

    2004-02-01

    Some herpesviruses have been detected in middle ear fluid (MEF) of patients with acute otitis media (AOM), but their role in middle ear disease is unknown. We examined 73 middle ear fluid samples from 73 children with acute otitis media for the presence of four major herpesviral DNA, respiratory viral genomes, and bacterial DNA by multiplex polymerase chain reaction (PCR). Herpesviruses were detected in 16 specimens (22%), with 18 viral infections were identified overall. Respiratory viruses were detected in 35 specimens (48%), 39 viral infections overall. Bacterial DNA was detected in 51 specimens (70%), 60 bacterial infections overall. Clinical outcome was compared in patients with and without herpesvirus DNA, respiratory viral genomes, or bacterial DNA. Progression to otitis media with effusion (OME) was more common when herpesviral DNA was present. Presence of herpesvirus DNA may reflect an immunocompromised state that may make it difficult to eliminate bacteria from the middle ear after infection.

  16. Analysis of Quality of Life and its Influence Factors in Patients with Chronic Suppurative Otitis Media Before and After Operation%慢性化脓性中耳炎患者手术前后生活质量调查及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陈美珍; 曾薇; 林志敏; 李研

    2016-01-01

    【目的】探讨慢性化脓性中耳炎(Chronic suppurative otitis media ,CSOM )患者手术前后生活质量及其影响因素。【方法】选取2010年5月至2015年5月于本院行手术治疗的CSOM患者216例,采用慢性化脓性中耳炎生活质量量表(CSOM‐QOL)及视觉模拟量表(VAS)评价其手术前后生活质量及分析其影响因素。【结果】与手术前相比,患者手术后生活质量总评分、躯体表现、情感异常、医学资源利用、日常活动受限制评分明显较高;患者手术后平均VAS评分显著低于手术前;手术前患者中,年轻、生活在城市、累及双耳、鼓膜穿孔的患者生活质量总评分较低( P <00.5);手术后患者中,累及双耳、鼓膜穿孔的患者生活质量总评分较高(P <00.5)。患者手术前年龄、生活环境、累及耳别、中耳炎类型与生活质量有相关性(P <00.5);手术后累及耳别、中耳炎类型与生活质量有相关性( P <00.5)。【结论】CSOM 患者经手术治疗后生活质量明显改善,累及双耳及病情较严重的患者术后生活质量改善更加明显,可根据生活质量评价选择合适的治疗手段。%[Objective]To explore the quality of life and its influence factors in patients with chronic sup‐purative otitis media before and after operation .[Methods]Two hundred and sixteen patients with chronic sup‐purative otitis media underwent operation in our hospital from May 2010 to May 2015 were selected .Quality of life and its influence factors of patients before and after operation were evaluated by the scale of quality of life for chronic suppurative otitis media (CSOM‐QOL)and the visual analog scale(VAS) .[Results]Compared with the situation before operation ,patients had significantly higher scores in total quality of life ,somatic manifes‐tations ,affective disorders ,medical resource utilization and restricted daily activities

  17. The diagnosis and management of acute otitis media.

    Science.gov (United States)

    Lieberthal, Allan S; Carroll, Aaron E; Chonmaitree, Tasnee; Ganiats, Theodore G; Hoberman, Alejandro; Jackson, Mary Anne; Joffe, Mark D; Miller, Donald T; Rosenfeld, Richard M; Sevilla, Xavier D; Schwartz, Richard H; Thomas, Pauline A; Tunkel, David E

    2013-03-01

    This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this

  18. Mycological investigation in patients with acute otitis media

    Directory of Open Access Journals (Sweden)

    O. J. Akinjogunla

    2012-07-01

    Full Text Available Middle ear swabbed samples from 272 patients with acute otitis media (AOM attending Ear, Nose and Throat clinics were collected and cultured using standard mycological technique. Deoxyribonuclease and In-vitro susceptibility of the fungal isolates to Flucytosine (Flu, Nystatin (Nys, Voriconazole (Vor and Ketoconazole (Ket were evaluated using DNase agar and disc diffusion techniques, respectively. The results showed the highest prevalence of AOM in age group ≤ 10 years with 84 (30.9% cases and lowest prevalence in age group ≥ 61 having 12 (4.4% cases. Only 124 (45.6% samples showed positive growth, while 148 (54.4% showed no growth. Of the 124 samples with growth, 9(36.4% samples showed growth of single fungal isolate, while 18 (6.6% and 7 (2.6% showed growth of two and three fungal isolates, respectively. Aspergillus niger was the predominant fungal isolate, followed by Candida albicans with 38 (24.4%, Cryptococcus neoformans 32 (20.5%, Candida spp 21 (13.5% and Aspergillus flavus 14 (9.0%. Only 46 (29.5% of fungal isolates were deoxyribonuclease producers, with 30/38 (78.9% being C. albicans and 16/21 (76.2% being Candida spp. The results of antifungal susceptibility showed that between 65.8 to 71.1% C. albicans, 64.3 to 85.7% A. flavus, 64.7 to 78.4% A. niger, 53.1 to 75.0% C. neoformans, and 52.4 to 57.1% Candida spp. were sensitive to Ket, Vor and Flu, while between 81.6-84.4% of C. albicans and C. neoformans were sensitive to Nys. In overall, 72.4%, 76.3%, 67.9% and 62.2% of the fungal isolates were sensitive to Flu, Nys, Vor and Ket, respectively. Consequently, Nystatin will be highly effective in treating AOM caused by fungi.

  19. Gradenigo’s syndrome and thrombosis of the cavernous sinus secundary to acute otitis media

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    Hellín-Meseguer D

    2012-05-01

    Full Text Available Gradenigo’s syndrome is characterized by facial pain in the area supplied by the trigeminal nerve and a unilateral external ophthalmoplegia (paralysis of VI cranial nerve secondary to acute apical petrositis for evolutionary complication of otitis media. This is a serious complication that requires immediate treatment to prevent permanent damage and may be associated with other intracranial complications such as thrombosis of the cavernous sinus. We report a 4 year old male who complains of fever, headache and external ocular paralysis in the course of acute otitis media.

  20. 鼻镜指导下吸切器切除腺样体对儿童慢性鼻窦炎和分泌性中耳炎临床转归的影响分析%Effect of nasal endoscopic guidance on the clinical outcome in children with chronic sinusitis and secretory otitis media

    Institute of Scientific and Technical Information of China (English)

    刘栋; 管强

    2016-01-01

    目的 分析鼻镜指导下吸切器切除腺样体对儿童慢性鼻窦炎和分泌性中耳炎临床转归的影响.方法 选取2013年2月至2014年2月行手术治疗的腺样体肥大并发慢性鼻窦炎或分泌性中耳炎患儿36例作为研究对象,均在鼻镜指导下行腺样体切除术,并辅以药物治疗,术后随访3~6个月,观察所有患者的转归情况.结果 本研究患儿术后均无睡眠打鼾、张口呼吸症状及术后出血等;经鼻镜检查无咽鼓管损伤、腺样体残留、瘢痕形成及其他并发症发生;术后随访3~6个月,本研究患儿中有32例睡眠打鼾、鼻塞、张口呼吸消失,其余4例仍有轻度睡眠打鼾,但无张口呼吸症状;经纯音测试:显效28例,有效8例.结论 对并发慢性鼻窦炎和分泌性中耳炎的腺样体肥大患儿采取鼻镜指导下吸切器切除术可取得较好效果,属于一种安全、有效的手术方式,值得临床推广应用.%Objective To analyze the outcome of chronic sinusitis and secretory otitis media from nasal endoscopy guided resection of adenoid body in children.Methods Thirty-six children with chronic sinusitis or secretory otitis media were treated by surgical treatment of adenoid hypertrophy complicated with chronic sinusitis or secretory otitis media from February 2013 to February 2014.The children were treated by endoscopic resection with drug therapy,and the children were followed up for 3 to 6 months after surgery.Results In this group of children after operation,there was no sleep snoring,mouth breathing symptoms and postoperative bleeding or other normal;nasal endoscopy without injury of eustachian tube,residual adenoids,scar formation and other complications.Patients were followed up for 3 to 6 months,snoring,stuffy nose,mouth breathing disappeared in 32 children,the remaining 4 cases still had mild sleep snoring,but no respiratory symptoms of tension;the pure tone audiometry:markedlyeffective in 28 cases,effective in 8 cases

  1. Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion

    Science.gov (United States)

    2017-01-01

    Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy. PMID:28244296

  2. Increased percentage of T cells with the expression of CD127 and CD132 in hypertrophic adenoid in children with otitis media with effusion.

    Science.gov (United States)

    Żelazowska-Rutkowska, Beata; Wysocka, Jolanta; Ratomski, Karol; Kasprzycka, Edwina; Skotnicka, Bożena

    2012-07-01

    The hypertrophic adenoid may promote chronic suppurative otitis media in children as it fulfills its immune function. The number of lymphocytes in the adenoid and their cooperation in the immune response depend of on their proliferation and migration to the effector sites. Interleukin 7 (IL-7) is essential for the normal development and function lymphocytes. IL-7 plays pivotal role for activation and proliferation of T and B cells. The heterodimeric interleukin-7 receptor (IL-7R) is composed of the IL-7Rα (127) and the common cytokine receptor γc (CD132). The aim of this study was to evaluate the percentage of lymphocytes T (CD4(+) and CD8(+)) with IL-7R (CD127 and CD132) expression in hypertrophic adenoid in children suffering with otitis media with effusion for a duration of 3 months. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. CD4(+) CD127(+), CD4(+)132(+), CD8(+)CD127(+) and CD8(+)CD132(+) cell subpopulations were identified using monoclonal antibodies and flow cytometry. The percentage of CD4(+) and CD8(+) T cells with CD127 receptor expression in hypertrophic adenoid of children with otitis media with effusion was statistically significantly higher than in hypertrophic adenoid group. The percentage of CD4(+) T cells with CD132 expression in the study group was statistically significantly higher than in the reference group. The percentage of CD8(+) T cells with CD132(+) expression was not statistically different in both groups. The increased percentage of T lymphocytes with IL-7R expression (CD127 and CD132) in hypertrophic adenoid seems to influence the quantity of lymphocytes and upset the immunological function of tonsils which can influence the course of otitis media with effusion.

  3. 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…

  4. 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.

  5. The Effects of Otitis Media on Speech and Language. Final Report for 1983-1984.

    Science.gov (United States)

    Roberts, Joanne Erwick; Henderson, Frederick W.

    This study, part of a 4-year longitudinal project, examined the possible relationship between persistent otitis media (middle ear disease) in early childhood and speech and language functioning. Subjects were 38 black preschool children between 3 and 7 years of age who, although normal in intellectual and verbal functioning, were identified as at…

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

    Science.gov (United States)

    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…

  7. A Whole Community Approach to Otitis Media--Reducing Its Incidence and Effects. Report.

    Science.gov (United States)

    McSwan, David

    Otitis media (OM) is an inflammation of the middle ear that is prevalent in childhood. OM can result in hearing loss, which interferes with learning. In Australia, indigenous children experience OM more often than other populations. Because teachers lack knowledge of OM and its effects on learning, affected children are often mislabeled as problem…

  8. Microbiology of acute otitis media in children with tympanostomy tubes : prevalences of bacteria and viruses

    NARCIS (Netherlands)

    Ruohola, Aino; Meurman, Olli; Nikkari, Simo; Skottman, Tuukka; Salmi, Aimo; Waris, Matti; Osterback, Riikka; Eerola, Erkki; Allander, Tobias; Niesters, Hubert; Heikkinen, Terho; Ruuskanen, Olli

    2006-01-01

    BACKGROUND: Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute midd

  9. The role of vascular endothelial growth factors and fibroblast growth factors in angiogenesis during otitis media.

    Science.gov (United States)

    Husseman, Jacob; Palacios, Sean D; Rivkin, Alexander Z; Oehl, Heinz; Ryan, Allen F

    2012-01-01

    The middle ear response to otitis media includes transformation and hyperplasia of the mucosal epithelium and subepithelial connective tissue. Significant neovascularization is also noted, which occurs both to support the hypertrophied mucosa and to mediate the increased trafficking of leukocytes. We investigated the role of two known potent angiogenic growth factor families, the fibroblast growth factors (FGFs) and vascular endothelial growth factors (VEGFs), in middle ear mucosal angiogenesis. DNA microarrays were used to evaluate the expression of FGFs and VEGFs, as well as their receptors and unique signaling proteins, in the middle ears of mice undergoing a complete course of acute bacterial otitis media. In addition, a member of each family was introduced to the middle ear submucosal compartment of the normal middle ears of guinea pigs, by a continuous-release osmotic minipump system over 1 week. During the course of bacterial otitis media, a significant regulation of a number of genes important for angiogenesis was identified. Histologic evaluation of middle ear mucosa following micropump infusion of both FGF1 and VEGF-A showed significant angiogenesis at the site of infusion in comparison to control saline infusion. These results support a role for FGFs and VEGFs in the neovascularization of the middle ear mucosa during otitis media, and offer a potential avenue for therapeutic intervention.

  10. Hospitalisation with otitis media in early childhood and cognitive function in young adult life

    DEFF Research Database (Denmark)

    Mortensen, Nanna Marie; Nielsen, Rikke Beck; Fisker, Niels;

    2013-01-01

    BACKGROUND: Otitis media (OM) is a very common condition in children and occurs during years that are critical to the development of learning, literacy, and math skills. Therefore, among a large cohort of Danish conscripts, we aimed to examine the association between hospitalisation with OM in ea...

  11. Sonotubometry in children with otitis media with effusion before and after insertion of ventilation tubes.

    NARCIS (Netherlands)

    Avoort, S.J.C.; Heerbeek, N. van; Zielhuis, G.A.; Cremers, C.W.R.J.

    2009-01-01

    OBJECTIVES: To test the outcome of sonotubometric measurement in children with otitis media with effusion (OME) before and after insertion of ventilation tubes. DESIGN: Eustachian tube ventilatory function was tested in children with OME. To test validity, sonotubometric testing took place before in

  12. Intratemporal and intracranial complications of acute suppurative otitis media in children : renewed interest

    NARCIS (Netherlands)

    Dhooge, IJM; Albers, FWJ; Van Cauwenberge, PB

    1999-01-01

    In recent years, a rise in the incidence of intratemporal and intracranial complications of acute otitis media (AOM) has been mentioned in the literature. Lack of a well-developed immune system and difficulties in diagnosing AOM, can account for part of the rise in the incidence of complications of

  13. Grommets in otitis media with effusion: an individual patient data meta-analysis.

    NARCIS (Netherlands)

    Rovers, M.M.; Black, N.; Browning, G.G.; Maw, R.; Zielhuis, G.A.; Haggard, M.P.

    2005-01-01

    AIMS: To identify subgroups of children with otitis media with effusion (OME) that might benefit more than others from treatment with ventilation tubes. METHODS: An individual patient data (IPD) meta-analysis on seven randomised controlled trials (n = 1234 children in all), focusing on interactions

  14. Viral-bacterial co-infection in Australian Indigenous children with acute otitis media

    Directory of Open Access Journals (Sweden)

    Whiley David

    2011-06-01

    Full Text Available Abstract Background Acute otitis media with perforation (AOMwiP affects 40% of remote Indigenous children during the first 18 months of life. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the primary bacterial pathogens of otitis media and their loads predict clinical ear state. Our hypothesis is that antecedent respiratory viral infection increases bacterial density and progression to perforation. Methods A total of 366 nasopharyngeal swabs from 114 Indigenous children were retrospectively examined. A panel of 17 respiratory viruses was screened by PCR, and densities of S. pneumoniae, H. influenzae and M. catarrhalis were estimated by quantitative real time PCR. Data are reported by clinical ear state. Results M. catarrhalis (96%, H. influenzae (91%, S. pneumoniae (89% and respiratory viruses (59% were common; including rhinovirus (HRV (38%, polyomavirus (HPyV (14%, adenovirus (HAdV (13%, bocavirus (HBoV (8% and coronavirus (HCoV (4%. Geometric mean bacterial loads were significantly higher in children with acute otitis media (AOM compared to children without evidence of otitis media. Children infected with HAdV were 3 times more likely (p Conclusion This study confirms a positive association between nasopharyngeal bacterial load and clinical ear state, exacerbated by respiratory viruses, in Indigenous children. HAdV was independently associated with acute ear states.

  15. 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 a q...

  16. Toward an Improved Scale for Assessing Symptom Severity in Children With Acute Otitis Media.

    Science.gov (United States)

    Shaikh, Nader; Hoberman, Alejandro; Rockette, Howard E; Kurs-Lasky, Marcia; Paradise, Jack L

    2015-12-01

    The objective of the present study was to determine whether changes in the previously developed 7-item Acute Otitis Media Severity of Symptoms scale could improve its responsiveness and its longitudinal construct validity. The items "diminished activity" and "diminished appetite" had low or borderline levels of responsiveness and longitudinal construct validity. Dropping these items seems to be potentially advantageous.

  17. 中西医结合治疗慢性化脓性中耳炎体会%Clinical experience of treating chronic suppurative otitis media in the integrative medicine

    Institute of Scientific and Technical Information of China (English)

    袁静

    2014-01-01

    Objective: To observe clinical effects of the integrative medicine on treating chronic suppurative otitis. Methods:Cleaning the ear canal and tympanic pus with 3%hydrogen peroxide, then drop Lincomycin 0.6 g+dexamethasone 5 mg into external auditory canal for 5 days. Results: The total efficacy in 75 patients was 72.9%. Conclusion:Drops of western medicines plus oral TCM medicine achieved good effects.%目的:观察中西医结合治疗慢性化脓性中耳炎的临床效果。方法:采用3%双氧水清洗外耳道及鼓室内的脓液,然后向外耳道内滴入林可霉素0.6 g+地塞米松5 mg,并配以中药托里消毒散口服治疗,疗程5d。结果:75例(96耳)慢性化脓性中耳炎患者治疗全部有效,治愈率72.9%。结论:西药局部点耳配以中药口服是治疗慢性化脓性中耳炎的有效方法。

  18. Incidence survey of acute otitis media in children in Sado Island, Japan--Sado Otitis Media Study (SADOMS.

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    Taketo Otsuka

    Full Text Available BACKGROUND: Acute otitis media (AOM is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9-1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1 evaluate the latest AOM incidence in pediatric outpatients and 2 identify the bacterial pathogens from these patients and ascertain their serotypes and resistance. METHODS: The study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as "surveillance week", and all outpatients with acute illness aged 0-18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae. RESULTS: In total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9-4.7% among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44-0.64. Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3-47.3 and 62.8% (95% CI: 53.6-71.4, respectively. Of 122 H.influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46% showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance. CONCLUSIONS: Approximately 4-5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians

  19. [The evolution of otitis media with effusion treated by transtympanic drainage].

    Science.gov (United States)

    Lacosta, J L; Zabaleta, M; Erdozain, I

    1996-01-01

    One hundred sixty children with effusive otitis media who did not improve with medical treatment were reviewed. The evolution and complications observed in 294 ears treated by myringotomy and ventilation tubes (grommets) over a three-year period were analyzed. Otorrhea occurred during grommet placement in 11.6%. The disease remitted in 84%. Recurrences occurred in 15.3%: 4.8% had different degrees of tympanic atelectasia and 0.7% had perforation. Three per cent of the children were reoperated for bilateral recurrence of otitis. Younger children and those whose had delayed surgery had a worse outcome. Insertion of ear grommets improved hearing.

  20. [Nasopharyngeal and middle ear flora in children with acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-01-01

    Nasopharyngeal flora can be a reservoir of bacteria caused acute otitis media in children. The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from the nasopharynx and middle ear of children with acute otitis media. The study comprised 128 children ages 1 year to 14 years with diagnosed of acute otitis media with purulent discharge. The nasopharyngeal and middle ear samples were collected at the same time. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clindamycin and trimethoprim/sulfamethoxazole. 196 organisms from nasopharynx and 325 organisms from middle ear were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--75.6% in nasopharynx and 77.8% in middle ear. We observed statistically significant (p bacteria from nasopharynx and 81.8% of bacteria from middle ear. Most organisms were resistant to trimethoprim/sulfamethoxazole--60.7% of bacteria from nasopharynx and 62.6% of bacteria from middle ear. Penicillin resistance was observed in 25.0% of bacteria from nasopharynx and 25.6% of bacteria from middle ear. The correlation in resistance of bacteria between trimethoprim/sulfamethoxazole and erythromycin (r = 0.4886) and between trimethoprim/sulfamethoxazole and penicillin (r = 0.5027) was observed. Nasopharyngeal and middle ear flora in children with acute otitis media is similar. In that case susceptibility of bacteria from the nasopharynx can be useful for empirical treatment of acute otitis media in children.

  1. Analysis of Disdiagnosis of Tuberculosis Otitis Media and Mastoiditis%结核性中耳乳突炎误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    朱立新; 刘世英

    2001-01-01

    Objective To investigate the disdiagnosed cause of tubercular otitis media and mastoiditis.Methods The clinical data of 12 cases (14 ears) with tubercular otitis media and mastoiditis were analyzed retrospectly.Results Tubercular otitis media and mastoiditis was mainly characterized by otorrhea,big perforation of tympanic membrane,abundant pale or red granulation,heavy deafness.Conclusions The clinical manifestation of tubercular otitis media and mastoiditis was not characteristic and it was usually considered as chronic suppurative otitis media.The doctors should attach importance to this kind of diseases.The correct diagnosis was made malinly by the combination of case history,physical ckeck-up,image and pathological examination or other special examination.%目的探讨结核性中耳乳突炎误诊原因。方法对12例(14耳)结核性中耳乳突炎的临床资料进行回顾性分析。结果结核性中耳乳突炎多以耳漏、鼓膜大穿孔、鼓室内大量苍白色或红色肉芽组织、听力损失较重为特征。结论结核性中耳乳突炎临床表现不典型,易与慢性化脓性中耳乳突炎相混淆;临床医生应重视此病,结合病史、体检、影像学检查、病理学检查以及其他特殊检查,以明确诊断。

  2. [Comparative characteristic of the local application of anti-inflammatory agents for the treatment of otitis externa and otitis media].

    Science.gov (United States)

    Magomedov, M M; Starostina, A E; Magomedov, M G

    2012-01-01

    The objective of the present work was the clinical study of candibiotic exhibitic antibacterial, antimycotic, anti-inflammatory, and anesthetic properties when applied for the treatment of otitis externa and otitis media. This agent was included together with traditionally used systemic medications in the combined treatment of 26 patients. It was applied in the form of endoaural drops, transtubal administration through a catheter, and transtympanic pumping by the Politzer balloon technique (in case of perforation). In the patients with otomycosys, the preparation was used for the treatment of the external acoustic canal after the removal of fungal masses thrice daily for 1 month. Good clinical effect achieved in all the patients was manifest as the normal otoscopic picture and less frequent complaints on days 8-10 after the onset of therapy. Its maximum duration was 21 days. Positive dynamics (pain relief) was apparent within the first 2 days of the treatment. Fungal mycelium was absent after 14-16 days of the treatment in 100% of the patients initially presenting with yeast-like fungi.

  3. 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

  4. Genome-wide association study to identify the genetic determinants of otitis media susceptibility in childhood.

    Directory of Open Access Journals (Sweden)

    Marie S Rye

    Full Text Available BACKGROUND: Otitis media (OM is a common childhood disease characterised by middle ear inflammation and effusion. Susceptibility to recurrent acute OM (rAOM; ≥ 3 episodes of AOM in 6 months and chronic OM with effusion (COME; MEE ≥ 3 months is 40-70% heritable. Few underlying genes have been identified to date, and no genome-wide association study (GWAS of OM has been reported. METHODS AND FINDINGS: Data for 2,524,817 single nucleotide polymorphisms (SNPs; 535,544 quality-controlled SNPs genotyped by Illumina 660W-Quad; 1,989,273 by imputation were analysed for association with OM in 416 cases and 1,075 controls from the Western Australian Pregnancy Cohort (Raine Study. Logistic regression analyses under an additive model undertaken in GenABEL/ProbABEL adjusting for population substructure using principal components identified SNPs at CAPN14 (rs6755194: OR = 1.90; 95%CI 1.47-2.45; P(adj-PCA = 8.3 × 10(-7 on chromosome 2p23.1 as the top hit, with independent effects (rs1862981: OR = 1.60; 95%CI 1.29-1.99; P(adj-PCA = 2.2 × 10(-5 observed at the adjacent GALNT14 gene. In a gene-based analysis in VEGAS, BPIFA3 (P(Gene = 2 × 10(-5 and BPIFA1 (P(Gene = 1.07 × 10(-4 in the BPIFA gene cluster on chromosome 20q11.21 were the top hits. In all, 32 genomic regions show evidence of association (P(adj-PCA<10(-5 in this GWAS, with pathway analysis showing a connection between top candidates and the TGFβ pathway. However, top and tag-SNP analysis for seven selected candidate genes in this pathway did not replicate in 645 families (793 affected individuals from the Western Australian Family Study of Otitis Media (WAFSOM. Lack of replication may be explained by sample size, difference in OM disease severity between primary and replication cohorts or due to type I error in the primary GWAS. CONCLUSIONS: This first discovery GWAS for an OM phenotype has identified CAPN14 and GALNT14 on chromosome 2p23.1 and the BPIFA gene cluster on chromosome 20q11.21 as

  5. Mutation at the Evi1 locus in Junbo mice causes susceptibility to otitis media.

    Science.gov (United States)

    Parkinson, Nicholas; Hardisty-Hughes, Rachel E; Tateossian, Hilda; Tsai, Hsun-Tien; Brooker, Debra; Morse, Sue; Lalane, Zuzanna; MacKenzie, Francesca; Fray, Martin; Glenister, Pete; Woodward, Anne-Marie; Polley, Sian; Barbaric, Ivana; Dear, Neil; Hough, Tertius A; Hunter, A Jackie; Cheeseman, Michael T; Brown, Steve D M

    2006-10-06

    Otitis media (OM), inflammation of the middle ear, remains the most common cause of hearing impairment in children. It is also the most common cause of surgery in children in the developed world. There is evidence from studies of the human population and mouse models that there is a significant genetic component predisposing to OM, yet nothing is known about the underlying genetic pathways involved in humans. We identified an N-ethyl-N-nitrosourea-induced dominant mouse mutant Junbo with hearing loss due to chronic suppurative OM and otorrhea. This develops from acute OM that arises spontaneously in the postnatal period, with the age of onset and early severity dependent on the microbiological status of the mice and their air quality. We have identified the causal mutation, a missense change in the C-terminal zinc finger region of the transcription factor Evi1. This protein is expressed in middle ear basal epithelial cells, fibroblasts, and neutrophil leukocytes at postnatal day 13 and 21 when inflammatory changes are underway. The identification and characterization of the Junbo mutant elaborates a novel role for Evi1 in mammalian disease and implicates a new pathway in genetic predisposition to OM.

  6. Cytokine responses in relation to age, gender, body mass index, Mycobacterium tuberculosis infection, and otitis media among inuit in greenland

    DEFF Research Database (Denmark)

    Nielsen, Nina Odgaard; Soborg, Bolette; Børresen, Malene

    2013-01-01

    To evaluate the cytokine response pattern in Inuit in Greenland in relation to age, gender, body mass index (BMI), Mycobacterium tuberculosis infection (MTI), and otitis media (OM) to assess whether Inuit may have signs of impaired immune responsiveness to infection.......To evaluate the cytokine response pattern in Inuit in Greenland in relation to age, gender, body mass index (BMI), Mycobacterium tuberculosis infection (MTI), and otitis media (OM) to assess whether Inuit may have signs of impaired immune responsiveness to infection....

  7. Experimental otitis media in gerbils and chinchillas with Streptococcus pneumoniae, Haemophilus influenzae, and other aerobic and anaerobic bacteria.

    Science.gov (United States)

    Fulghum, R S; Brinn, J E; Smith, A M; Daniel, H J; Loesche, P J

    1982-05-01

    To ascertain the usefulness of Mongolian gerbils as an inbred model for otitis media, 52 Mongolian gerbils (Meriones unguiculatus, strain MONT/Tum) were compared with 26 chinchillas (Chinchilla laniger) for susceptibility to Streptococcus pneumoniae type 3. Haemophilus influenzae type b, and a polymicrobic culture including anaerobes (Streptococcus intermedius, Propionibacterium acnes, Staphylococcus epidermidis, and Corynebacterium sp.). Organisms were inoculated percutaneously into the superior chamber of the middle ear bulla. The gerbils and chinchillas shared similar susceptibilities and responses to the inoculated organisms as determined by X-ray, otoscopic, histopathological, and microbiological determinations at 5 to 7 days. Koch's postulate studies proved the role of S. pneumoniae and H. influenzae in the pathology found in both animal models. The animals were also susceptible to the polymicrobic culture, although the relative virulence of the individual members of this mixture was low, suggesting that these species potentiated as a polymicrobic mixture. The Corynebacterium sp. appeared to elicit the greatest histopathological response in chronic (8-week) studies in gerbils. The gerbils were found to be useful as an alternative animal model for the study of otitis media of bacterial etiology.

  8. SUSCEPTIBILITY AND DETECTION OF EXTENDED SPECTRUM β-LACTAMASE ENZYMES FROM OTITIS MEDIA PATHOGENS

    Directory of Open Access Journals (Sweden)

    Ejikeugwu Chika

    2013-01-01

    Full Text Available Otitis media is the bacterial infection of the middle ear usually accompanied with inflammation, effusions and pain. It can present clinically in two major forms: Acute Otitis Media (AOM and Otitis Media with Effusion (OME and it is one of the leading cause of hospital visits and antibiotic prescriptions amongst children and even adults. Antibiotic resistance is a global public health problem and Extended Spectrum β-Lactamase (ESBL enzymes is one of the new mechanisms of resistance in especially Gram negative bacteria including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. ESBLs are plasmid-mediated β-lactamase enzymes that hydrolyze extended-spectrum oxyimino 3rd generation cephalosporins and monobactams. Organisms producing ESBLs have remained important nosocomial and community-acquired pathogens over the years. Ear swab specimens of children (aged 0-7 with suspected Otitis media infections and who attended a tertiary hospital in Enugu, Nigeria were cultured on growth media. E. coli, K. pneumoniae and P. aeruginosa were isolated and identified by standard microbiological techniques. Antibiogram was conducted on all isolated ear pathogens by Kirby-Bauer disk diffusion method and ESBL production was evaluated by the Double Disk Synergy Test (DDST method. Imipenem and meropenem were the most active antibiotics against the E. coli, K. pneumoniae and P. aeruginosa ear pathogens. Sulphamethoxazole-trimethoprim was the least active agent against the tested ear pathogens and this was followed by ofloxacin, ciprofloxacin, gentamicin, cefotaxime and ceftazidime. None of the E. coli, K. pneumoniae and P. aeruginosa ear pathogens produced ESBLs by the method used. ESBL production by pathogenic bacteria confers on organisms the ability to be multidrug resistant. Their prompt and accurate detection from clinical specimens, together with reporting them along with hospitals routine antibiogram results is vital as this will help to

  9. 改良完壁式乳突切除术及鼓室成形术治疗慢性中耳乳突炎的疗效分析%Efficacy of the treatment of chronic otitis media improved finished wall mastoidectomy and tympanoplasty

    Institute of Scientific and Technical Information of China (English)

    孙海燕; 李翔宇; 王东海; 曾祥悦; 李玉环

    2014-01-01

    目的:分析改良完壁式乳突切除术及鼓室成形术治疗慢性中耳乳突炎的疗效.方法:从2011-05/2013-05,于我院共有110例病患被诊断为慢性中耳乳突炎并需进行手术.以数字法随机分成观察组(55例)和对照组(55例).观察组患者行改良完壁式乳突切除术及鼓室成形术进行治疗,对照组患者行常规完壁式乳突切除术及鼓室成形术治疗.结果:观察组疗效为优者占比58.18%(32/55),优良率为90.25%(50/55),均显著高于对照组.差异均有统计学意义(P <0.05).观察组的气导平均听阈为(30.03±3.56)dB HL,骨导平均听阈(22.67±0.45)dB HL,均显著少于对照组的(38.85±4.57)dB HL,(28.85±2.47)dB HL.差异均有统计学意义(P<0.05).结论:改良完壁式乳突切除术及鼓室成形术对于治疗慢性中耳乳突炎效果更加显著,对于患处病灶清除更加彻底,患者听力得到很大程度提高,耳内更加干燥,值得临床广泛推荐。%AIM:To analyze the effects of the improvement fin-ished wall mastoidectomy in tympanoplasty treatment of chronic o-titis media.METHODS:From May 2011 to May 2013,there were 1 10 cases in our hospital diagnosed with chronic otitis media and needing surgery.All cases were digitally randomly divided in-to observation group (55 cases)and control group (55 cases). The patients in observation group underwent modified finished wall mastoidectomy and tympanoplasty for treatment,the control group underwent routine finished wall mastoidectomy and tympanoplas-ty.RESULTS:In the observation group,excellently treated pa-tients accounting for 58.18% (32/55 ),good and excellent rate at 90.25% (50/55 ),were significantly higher than control groups.Differences were statistically significant (P<0.05).The average air conduction hearing threshold observation group was (30.03 ±3.56)dB HL,while bone conduction hearing threshold was (22.67 ±0.45)dB HL,were significantly less than the con-trol group [(38.85 ±4.57)dB HL

  10. The effect of tympanoplasty on tinnitus and analysis of possible influencing factors in patients with chronic otitis media%慢性中耳炎患者鼓室成形术后耳鸣变化及影响因素

    Institute of Scientific and Technical Information of China (English)

    郭平; 王武庆

    2014-01-01

    目的:了解慢性中耳炎患者鼓室成形术后耳鸣改变情况,分析慢性中耳炎患者术后听力提高程度、中耳炎分型与术后耳鸣改变的关系。方法记录106例慢性中耳炎病人术前及术后6个月的耳鸣严重程度的变化及听力改变情况,分析耳鸣改变与中耳炎分型以及听力提高的关系。使用配对t检验、独立样本t检验、卡方检验和确切概率法进行统计分析。结果慢性中耳炎患者的耳鸣发生率为46%。术前伴有耳鸣的40例病人,术后有15例病人的耳鸣治愈;18例病人耳鸣治疗有效;7例耳鸣治疗无效,鼓室成形术对耳鸣治疗有效率为82%;术后有1例新发耳鸣。术后耳鸣改善明显组的气导听力提高较耳鸣改善不良组的明显(p0.05)。结论对慢性中耳炎伴耳鸣的患者,手术可使多数患者耳鸣缓解。其中低频气导听力的提高对其耳鸣的缓解作用较显著,鼓室成形术诱发新的耳鸣不常见。%Objective The purpose of this paper is to investigate the effect of tympanoplasty on tinnitus in patients with chronic otitis media(COM), and to determine the effect of audiologic outcome, different types of chronic otitis media influenc-ing on tinnitus changes. Methods Our study consisted of 106 patients who were operated between March 2012 and January 2013. Audiologic evaluation by pure tone audiometry and assessment of tinnitus scores were conducted 3 months before and after surgery. We analysed the data with Paired t test, Student’s t test and Fisher's exact test by stata software. Results The pre-operative incidence of tinnitus in patients with chronic otitis media was 46%. After tympanoplasty, tinnitus reduced in 82%of patients. There was a very significant difference between audiological gain and reduced tinnitus scores (p0.05). There was one patient having new tinnitus after surgery. Conclusions Following tympanoplasty, most patients experienced a reduction in

  11. 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;…

  12. Mutation at the Evi1 locus in Junbo mice causes susceptibility to otitis media

    OpenAIRE

    Parkinson, N.; Hardisty-Hughes, R.E.; Tateossian, H.; Tsai, H. T.; Brooker, D.; Morse, S.; Lalane, Z.; Mackenzie, F.; Fray, M.; Glenister, P.; Woodward, A. M.; Polley, S.; Barbaric, I.; Dear, N.; Hough, T.A.

    2006-01-01

    Otitis media ( OM), inflammation of the middle ear, remains the most common cause of hearing impairment in children. It is also the most common cause of surgery in children in the developed world. There is evidence from studies of the human population and mouse models that there is a significant genetic component predisposing to OM, yet nothing is known about the underlying genetic pathways involved in humans. We identified an N-ethyl-N-nitrosourea-induced dominant mouse mutant Junbo with hea...

  13. Mutation at the Evi1 Locus in Junbo Mice Causes Susceptibility to Otitis Media

    OpenAIRE

    Parkinson, N.; Hardisty-Hughes, R.E.; Tateossian, H.; Tsai, H. T.; Brooker, D.; Morse, S.; Lalane, Z.; Mackenzie, F.; Fray, M.; Glenister, P.; Woodward, A. M.; Polley, S.; Barbaric, I.; Dear, N.; Hough, T.A.

    2006-01-01

    Otitis media ( OM), inflammation of the middle ear, remains the most common cause of hearing impairment in children. It is also the most common cause of surgery in children in the developed world. There is evidence from studies of the human population and mouse models that there is a significant genetic component predisposing to OM, yet nothing is known about the underlying genetic pathways involved in humans. We identified an N-ethyl-N-nitrosourea-induced dominant mouse mutant Junbo with hea...

  14. Otitis media and a neck lump--current diagnostic challenges for Paragonimus-like trematode infections.

    Science.gov (United States)

    Schuster, H; Agada, F O; Anderson, A R; Jackson, R S; Blair, D; McGann, H; Kelly, G

    2007-02-01

    A 29 year-old Nigerian studying in the UK presented with a neck lump and otitis media. Paragonimus-like trematode eggs were found in the neck lump aspirate. Morphologically these eggs resembled Paragonimus uterobilateralis or Achillurbainia congolensis. We favoured the diagnosis of achillurbainiasis over extrapulmonary paragonimiasis on the basis of clinical features and because we could not amplify DNA sequences using PCR primers specific for Paragonimus species. We discuss current diagnostic challenges for this rare parasitic infection.

  15. Impact of Plant Extracts and Antibiotics on Biofilm Formation of Clinical Isolates From Otitis Media

    Science.gov (United States)

    Rehman, Saba; Mujtaba Ghauri, Shahbaz; Sabri, Anjum Nasim

    2016-01-01

    Background: Otitis media can lead to severe health consequences, and is the most common reason for antibiotic prescriptions and biofilm-mediated infections. However, the increased pattern of drug resistance in biofilm forming bacteria complicates the treatment of such infections. Objectives: This study was aimed to estimate the biofilm formation potential of the clinical isolates of otitis media, and to evaluate the efficacy of antibiotics and plant extracts as alternative therapeutic agents in biofilm eradication. Materials and Methods: The ear swab samples collected from the otitis media patients visiting the Mayo Hospital in Lahore were processed to isolate the bacteria, which were characterized using morphological, biochemical, and molecular (16S rRNA ribotyping) techniques. Then, the minimum inhibitory concentrations (MICs) of the antibiotics and crude plant extracts were measured against the isolates. The cell surface hydrophobicity and biofilm formation potential were determined, both qualitatively and quantitatively, with and without antibiotics. Finally, the molecular characterization of the biofilm forming proteins was done by amplifying the ica operon. Results: Pseudomonas aeruginosa (KC417303-05), Staphylococcus hemolyticus (KC417306), and Staphylococcus hominis (KC417307) were isolated from the otitis media specimens. Among the crude plant extracts, Acacia arabica showed significant antibacterial characteristics (MIC up to 13 mg/ml), while these isolates exhibited sensitivity towards ciprofloxacin (MIC 0.2 µg/mL). All of the bacterial strains had hydrophobic cellular surfaces that helped in their adherence to abiotic surfaces, leading to strong biofilm formation potential (up to 7 days). Furthermore, the icaC gene encoding polysaccharide intercellular adhesion protein was amplified from S. hemolyticus. Conclusions: The bacterial isolates exhibited strong biofilm formation potential, while the extracts of Acacia arabica significantly inhibited biofilm

  16. Dual presentation of tuberculosis: Otitis media with retropharyngeal abscess - The first case report

    Directory of Open Access Journals (Sweden)

    Priyanka Gairola

    2016-01-01

    Full Text Available Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rarer. We have not come across any such case in the English literature of the dual presentation of tuberculosis to the best of our knowledge so far. Early diagnosis and prompt management are the key to reduce the disease burden and also to avoid life-threatening complications.

  17. 开放式乳突根治伴鼓室成型术治疗胆脂瘤型和骨疡型中耳炎的疗效观察%Evaluation of the curative effect of open mastoidectomy combined with tympanoplasty in the treatment of chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    胡春梅; 陈德珍

    2013-01-01

    Objective The evaluate the therapeutic effects of open mastoidectomy combined with tympanoplasty in the treatment of chronic suppurative otitis media with cholesteatoma and/or granulation tissue. Methods Sixty patients suffered from chronic o-titis media with cholesteatoma and/or granulation tissue were treated with combination of tympanoplasty and open mastoidectomy. The patients were followed-up for 1 to 2 years. Results After operation,56 of 60 cases had dry ears. The pure tone test showed that 19 ears have been improved more than 20 db,20 ears improved from 10 to 19 db and 17 ears improved less than 10 db. Five cases had perforation , and 4 cases had cholesteatoma. Conclusions The open mastoidectomy can completely remove the lesion and control the infection. The autologous residual auditory ossicles can be used in reconstruction of ossieular chain. The open mastoidectomy combined with tympanoplasty may improve the hearing level and life quality.%目的 观察开放式乳突根治术并同期鼓室成型术治疗胆脂瘤型和骨疡型中耳炎的疗效,探讨自体残余听小骨在彻底清除中耳病变后重建听力的效果.方法 60例患者行开放式乳突根治术并同期鼓室成型术,随访1~2年,判定疗效.结果 术后干耳56例,纯音测听平均听阈提高20 db以上有19耳,提高10~19 dB有20耳,提高10 dB以内有17例;术后鼓膜穿孔5例,耳流脓4例,1例出现术后眩晕.干耳率93%,治愈率65%.结论 乳突根治术能彻底清除病灶,控制感染,自体残余听骨是很好的鼓室成型材料;同期鼓室成形能有效提高听阈,改善生活质量.

  18. [The clinical manifestations and diagnostics of otitis media caused by tuberculosis].

    Science.gov (United States)

    Kriukov, A I; Garov, E V; Ivoĭlov, A Y U; Shadrin, G B; Sidorina, N G; Lavrova, A S

    2015-01-01

    The objective of the present study was to clarify the characteristic pathognomonic features of middle ear lesions associated with tuberculosis and the approaches to their diagnostics under the present-day conditions. The study included 11 cases (18 ears) of tuberculosis otitis media and the related lesions of the mastoid process diagnosed with the use of clinical, roentgenological, cytological, bacteriological, pathomorphological, and molecular-genetic methods (including PCR diagnostics). The primary localization of tuberculosis in the middle ear was documented in 6 patients; in 5 patients, it was associated with pulmonary involvement. Five patients presented with smoldering exudative otitis media and the remaining six ones with suppurative perforating otitis media. The tuberculous process was diagnosed with the use of various methods including clinical examination, bacteriological (9%), cytological (27.3%), pathomorphological (18%) studies, and PCR diagnostics (55%). Diagnosis was made within a period from 1 month to 1.5 years after the application of the patients for medical assistance which suggests the difficulty of verification of tuberculous etiology of the disease of the middle ear. It is concluded that the high index of suspicion in the case of smoldering middle ear pathology facilitates its early diagnostics and successful treatment.

  19. Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children.

    Science.gov (United States)

    Sillanpää, Saara; Oikarinen, Sami; Sipilä, Markku; Kramna, Lenka; Rautiainen, Markus; Huhtala, Heini; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej

    2016-09-01

    According to studies based on bacterial cultures of middle ear fluids, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis have been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence of S. pneumoniae, H. influenzae, M. catarrhalis, Alloiococcus otitidis, Staphylococcus aureus, and Pseudomonas aeruginosa One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis, M. catarrhalis results were positive in 42 (47%) samples, H. influenzae in 30 (33%), S. pneumoniae in 27 (30%), A. otitidis in 6 (6.7%), S. aureus in 5 (5.6%), and P. aeruginosa in 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, and M. catarrhalis was detected in most (85%) of those cases. Fifteen signals for M. catarrhalis were strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even though M. catarrhalis is often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen.

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

    Science.gov (United States)

    Kryukov, A I; Kunel'skaya, N L; Gurov, A B; Elchueva, Z G; Sokolov, S S

    2015-01-01

    The objective of the present work was to study the spectrum of bacterial pathogenic agents responsible for the development of acute otitis media under present conditions and to elucidate the relationship between the pathogen species and the clinical course of the inflammatory process in the middle ear. A total of 60 patients of either sex at the age varying from 18 to 64 patients were available for the examination. All of them complained of ear pain, purulent discharge from the ears, hearing impairment, and general weakness. The following methods were employed: the analysis of the patients' complaints and their medical histories, visualexamination of the ENT organs, tonal threshold audiometry, tympanometry, and the analysis of secretion from the tympanic cavity using the real-time PCR technique. The study has demonstrated some regular patterns of the clinical manifestations of the disease depending on its causative agent. Specifically, it turned out that acute otitis media associated with the infection by Streptоcoccus pneumoniae is characterized by the more reactive clinical symptoms and the greater amount of complications compared with acute otitis media caused by Haemophilus influenzae that is largely a subclinical pathology. However, the latter condition more frequently leads to chronization of the pathological process.

  1. Respiratory virus infection as a cause of prolonged symptoms in acute otitis media.

    Science.gov (United States)

    Arola, M; Ziegler, T; Ruuskanen, O

    1990-05-01

    We studied respiratory viruses in 22 children with acute otitis media who had failed to improve after at least 48 hours of antimicrobial therapy. The mean duration of preenrollment antimicrobial therapy was 4.8 days. For comparison we studied 66 children with newly diagnosed acute otitis media. Respiratory viruses were isolated from middle ear fluid or from the nasopharynx, or both, significantly more often in the patients unresponsive to initial antimicrobial therapy than in the comparison patients (68% vs 41%, p less than 0.05). Viruses were recovered from the middle ear fluid in 32% of the study patients and from 15% of the comparison group. Bacteria were isolated from the middle ear fluid of four (18%) children in the study group; one child had an isolate resistant to initial antimicrobial therapy. All four children with bacteria in the middle ear fluid had evidence of concomitant respiratory virus infection. Our results indicate that respiratory virus infection is often present in patients with acute otitis media unresponsive to initial antimicrobial therapy, and may explain the prolongation of symptoms of infection. Resistant bacteria seem to be a less common cause of failure of the initial treatment.

  2. Role of interleukin-10 and transforming growth factor beta 1 in otitis media with effusion

    Institute of Scientific and Technical Information of China (English)

    ZHAO Shou-qin; LI Jie; LIU Hua; ZHANG Quan-geng; WANG Yang; HAN De-min

    2009-01-01

    Background Otitis media with effusion (OME) is a disease with complicated pathogeneses which are not clearly known. Increasing interest has been focused on immunological cells, cytokines and their roles in chronic inflammatory states. This study was designed to disclose the existence and roles of interleukin-10 (IL-10) and transforming growth factor beta1 (TGF-β1) in the cause of OME in adults, and to investigate the probable role of Foxp3+CD4+CD25+ T cells in OME.Methods The concentrations of IL-10 and TGF-β1 in the middle ear effusions (MEEs) and plasmas of 36 adults (45 ears) with OME were measured by means of enzyme linked immunosorbent assay (ELISA). As contrast, the concentrations of IL-10 and TGF-β1 in the plasma of 30 normal volunteers were measured using the same method. Furthermore, the proportion of Foxp3+CD4+CD25+ T cells in CD4+ T cells of blood was tested by flow cytometry. Results (1) The concentrations of IL-10 in all MEEs and plasmas of the chronic OME patients were higher than those in patients with acute OME (both P 0.05). The concentration of IL-10 in MEEs had a strong correlation with the duration of the illness (r=0.547, P<0.01). The same correlation was also found between the concentration of TGF-β1 in MEEs and the times patients being treated (r=0.579, P <0.01). (3) The proportion of Foxp3+CD4+CD25+T/CD4+ T cells in the blood of chronic OME was not only significantly higher than that in the acute OME (P<0.01), but also higher than that in normal volunteers (P <0.01). In chronic OME, there was a correlation between the proportion of Foxp3+CD4+CD25+ T/CD4+ T cells in the blood and the concentration of IL-10 in the plasmas (r=0.602, P <0.05). Conclusions IL-10 and TGF-β1, as two important immunoregulatory mediators, participate in middle ear inflammatory response, especially in chronic course of OME in adults. Foxp3+CD4+CD25+ T cells may play some immunoregulatory roles in the course of this disease.

  3. 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 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 (pmedia 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.

  4. Virus and bacteria enhance histamine production in middle ear fluids of children with acute otitis media.

    Science.gov (United States)

    Chonmaitree, T; Patel, J A; Lett-Brown, M A; Uchida, T; Garofalo, R; Owen, M J; Howie, V M

    1994-06-01

    Histamine levels were measured in 677 middle ear fluid (MEF) samples from 248 children (aged 2 months to 7 years) with acute otitis media (AOM); of these, 116 (47%) had documented viral infection. Histamine content was higher in bacteria-positive than in bacteria-negative MEF samples (P = .007) and higher in samples from patients with viral infection than in those from patients with no viral infection (P = .002). Bacteria and viruses together had an additive effect on histamine content in MEF. Histamine concentration in the initial MEF sample tended to be higher in patients with persistent otitis than in those with good response to treatment (P = .14). Results suggest that viruses, bacteria, or both induce histamine production, which leads to increased inflammation in the middle ear. Antihistaminic drugs may be beneficial. Large, prospective, controlled trials of the effects of antihistamine as an adjunct therapy in bacterial and viral AOM are required before recommendations can be made.

  5. Clinical efficacy of open tympanoplasty combined radical mastoidectomy in treatment of chronic otitis media with cholesteatoma%开放式鼓室成形术联合乳突根治术治疗胆脂瘤型中耳炎的临床疗效

    Institute of Scientific and Technical Information of China (English)

    章洺; 黄秋红

    2014-01-01

    Objective To explore clinical efficacy of open tympanoplasty combined radical mastoidectomy in treatment of chronic otitis media with cholesteatoma. Methods Retrospectively analyzed the clinical data of 68 cases of cholesteatoma otitis media patients in our hospital from 2011 June to 2012 December ,and they were divided into con-trol group and observation group,each group 34 cases, the control group received simple mastoidectomy, the observa-tion group received the open-ended tympanoplasty with mastoidectomy treatment,follow-up of 1.5 years,the operation efficiency and improve the postoperative hearing, complications were compared. Results The observation group, the clinical total effective rate (94.12%) was significantly higher than that of the control group (73.53%), with statistical significance (P<0.05);The control group tympanic membrane healing rate of live,dry ear rate (73.53%, 76.47%) was signif-icantly lower than the observation group (91.18%,94.12%),the differences were statistically significant (P<0.05). Conclusion The radical mastoidectomy with tympanoplasty for cholesteatoma otitis media with the exact effect ,can effectively improve the patient's hearing,it is worthy of clinical application.%目的:探讨胆脂瘤型中耳炎治疗中开放式鼓室成形术联合乳突根治术治疗的应用效果。方法采用回顾性方法,选取我院2011年6月~2012年12月收治的68例胆脂瘤型中耳炎患者的临床资料,分为对照组及观察组各34例。对照组予单纯乳突根治术治疗,观察组予开放式鼓室成形术辅以乳突根治术治疗,随访1.5年,观察两组手术有效率及其术后听力提高、并发症情况。结果观察组临床总有效率(94.12%)明显高于对照组(73.53%),差异有统计学意义(P<0.05);对照组鼓膜愈合成活率、干耳率(73.53%、76.47%)明显低于观察组(91.18%、94.12%),差异有统计学意义(P<0.05)。结论采用乳突根治术联

  6. Prevalence and characteristics of gastroesophageal reflux in children with otitis media in Isfahan, Iran

    Science.gov (United States)

    Abtahi, Seyed Hamidreza; Kazerooni, Azadeh; Brejis, Nezamodin; Abdeyazdan, Zahra; Saneian, Hossein

    2016-01-01

    Background: Otitis media (OM) is the most common cause of childhood hearing loss and reason to visit the pediatrician. Furthermore, gastroesophageal reflux (GER) has been associated with a variety of upper aerodigestive tract symptoms or diseases, such as sinusitis, laryngitis, and otits. The objective of the present study was to determine the frequency of GER in children, aged 3 months to 7 years, with OM. Materials and Methods: This retrospective case-control study was conducted on 50 children with OM and 50 healthy children. Presence of GER as the main variables was diagnosed by clinical examination in all studied children using the questionnaires with 2 age-stratified versions of the pediatric GER disease symptoms for children 2 years old and younger, and children 3–7 years old. Results: The prevalence of GER in children with OM and controls was 58% and 22% respectively (P = 0.0005). The frequency of irritability, congestion, and feeding complex in children with OM were significantly more than in control groups. Among children with recurrent acute OM (AOM), and chronic serous OM (CSOM) the prevalence of GER was significantly more than controls (61.1%, vs. 22% for AOM, P = 0.004, and 72.7% vs. 22%, P= 0.003). In children with AOM, regurgitation, vomiting, irritability and congestion were significantly higher than controls included. In children with CSOM, regurgitation, vomiting, and congestion were significantly higher than controls. Conclusion: Results show a significant association between GER and OM, AOM and CSOM in children with OM compares to healthy children. This shows that looking for GER in children with OM may help improving treatments outcomes. PMID:27274496

  7. Clinical therapeutic effect analysis on children's secretory otitis media%儿童分泌性中耳炎临床治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    吴锋; 胡兵; 孟彬彬

    2015-01-01

    目的:探讨儿童分泌性中耳炎的临床特点及其不同治疗方案治疗效果的分析。方法回顾性分析60例儿童患者的临床资料,收集整理其完整的听力学检查资料,做治疗前后的对比分析。结果儿童分泌性中耳炎多出现在急性上呼吸道感染后,容易反复发作,本组患儿每年发作2次以上者21例。分别经过药物保守、外科手术治疗后,均得到了满意的治疗效果。结论药物对急性分泌性中耳炎治疗有效,但单纯药物对慢性分泌性中耳炎治疗效果差,慢性分泌性中耳炎患儿应该常规腺样体切除,鼓室冲洗或是置管术,置管应该保留6个月以上。%Objective To explore the clinical characteristic of pediatric secretory otitis media, and the effect of different treatments.Methods Sixty cases were analyzed retrospectively.To summarize the sixty clinical cases with complete audiology manifestations for contrasting between prior and post treatment.Results Children secretory otitis media after appearing in acute upper respiratory tract infection, easy to repeated attacks. This group of children 21 cases occurred more than 2 times each year.Respectively after drug conservative treatment, surgical operation, obtained satisfactory curative effect.Conclusions Drugs for acute otitis media with effusion treatment effective, but simple drug treatment of chronic otitis media with effusion effect.Chronic bran-secretory otitis media in children should be routine adenoid resection, tympanic membrane puncture rinse or eardrum catheterization technique, catheterization should be retained for longer than 6 months.

  8. How often do general practitioners prescribe antibiotics for otitis media and the most common respiratory tract infections?

    Directory of Open Access Journals (Sweden)

    Jørund Straand

    2009-11-01

    Full Text Available  ABSTRACTObjective:  Design:  Setting:  Material:  Results:  Conclusion:  Key words:  Antibiotics, general practice, diagnoses, respiratory tract infections, otitis media, pharmacoepidemiologyExcept for upper respiratory tract infection, antibiotic treatment is the rule not an exception, forall the diagnoses studied. In general practice, improved communication- and prescribing-skills are probablyessentials for implementing a more evidence based treatment of otitis media, and the common respiratorytract infections. The significance of patient related factors for seeing a GP (or not and for (not expectingantibiotics for otitis media and the common respiratory tract infections should be explored in future research.Antibiotics were issued during 57% of all contacts for the included diagnoses, ranging from 22%(upper respiratory tract infection to 91% (tonsillitis. All patients who had first time office consultations fortonsillitis, acute bronchitis and pneumonia, were prescribed antibiotics. One out of three patients who consultedthe doctor on the telephone for these diagnoses, were also prescribed an antibiotic.8610 physician-patient contacts, and 4909 antibiotic prescriptions for otitis media, upper respiratorytract infection, tonsillitis, sinusitis, acute bronchitis, and pneumonia.Cross sectional, multipractice study.GPs in the Norwegian county of Møre & Romsdal. Data were recorded during two months.To examine how frequently general practitioners actually prescribe antibiotics for patientscontacting them for otitis media, and the most common respiratory tract infection diagnoses, – by the type ofdoctor-patient contact during prescribing, and patients' age and sex.

  9. Compared to placebo, long-term antibiotics resolve otitis media with effusion (OME and prevent acute otitis media with perforation (AOMwiP in a high-risk population: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Morris Peter S

    2008-06-01

    Full Text Available Abstract Background For children at high risk of chronic suppurative otitis media (CSOM, strategies to prevent acute otitis media with perforation (AOMwiP may reduce progression to CSOM. Methods In a double blind study in northern Australia, 103 Aboriginal infants with first detection of OME were randomised to receive either amoxicillin (50 mg/kg/d BD or placebo for 24 weeks, or until bilateral aerated middle ears were diagnosed at two successive monthly examinations (success. Standardised clinical assessments and international standards for microbiology were used. Results Five of 52 infants in the amoxicillin group and none of 51 infants in the placebo group achieved success at the end of therapy (Risk Difference = 9.6% [95% confidence interval 1.6,17.6]. Amoxicillin significantly reduced the proportion of children with i perforation at the end of therapy (27% to 12% RD = -16% [-31,-1], ii recurrent perforation during therapy (18% to 4% RD = -14% [-25,-2], and iii reduced the proportion of examinations with a diagnosis of perforation during therapy (20% to 8% adjusted risk ratio 0.36 [0.15,0.83] p = 0.017. During therapy, the proportion of examinations with penicillin non-susceptible (MIC > 0.1 microg/ml pneumococci was not significantly different between the amoxicillin group (34% and the placebo group (40%. Beta-lactamase positive non-capsular H. influenzae (NCHi were uncommon during therapy but more frequent in the amoxicillin group (10% than placebo (5%. Conclusion Aboriginal infants receiving continuous amoxicillin had more normal ears, fewer perforations, and less pneumococcal carriage. There was no statistically significant increase in resistant pneumococci or NCHi in amoxicillin children compared to placebo children who received regular paediatric care and antibiotic treatment for symptomatic illnesses.

  10. NEUMATOSCOPIA E IMPEDANCIOMETRÍA EN EL DIAGNÓSTICO DE LA OTITIS MEDIA CON EFUSIÓN Neumatoscoopy and impedanciometry in otitis media with effusion diagnosis

    Directory of Open Access Journals (Sweden)

    Gilberto Eduardo Marrugo Pardo

    2005-10-01

    Full Text Available Antecedentes: las consecuencias de la otitis media con efusión crónica en la audición, en el desarrollo cognitivo, lingüístico y de habilidades comunicativas son las principales razones a considerar para la búsqueda, diagnóstico y tratamiento adecuado de esta patología en los niños. Objetivo: comparar el rendimiento operativo de la neumatoscopia e impedanciometria como métodos diagnósticos de la efusión del oído medio. Material y métodos: estudio de pruebas diagnósticas, recolección prospectiva de pacientes llevados a miringocentesis y tubos de ventilación en la Fundación Hospital de la Misericordia de enero de 2002 a diciembre de 2003. Neumatoscopia en la consulta preoperatoria e impedanciometria cercana al procedimiento quirúrgico. Resultados. Sesenta pacientes, edad promedio 39.6 meses, 55.5% hombres, 18.3% con antecedente de labio y paladar hendido. La sensibilidad de la neumatoscopia fue 90%, con especificidad de 78.6%; para la impedanciometría 75.8% y 71.4% respectivamente. El valor predictivo positivo de la neumatoscopia fue 93%, el valor predictivo negativo de 71%; 90% y 48% respectivamente para la impedanciometría. La razón de probabilidades positiva para la neumatoscopia fue de 4.2 y la razón de probabilidades negativa fue 0.12, para la impedanciometría fueron 2.65 y 0.34 respectivamente. El DOR para la neumatoscopia fue 35 y 7.7 para la impedanciometría. Conclusión. Los indicadores calculados mostraron un desempeño superior de la neumatoscopia para el diagnóstico de la efusión del oído medio.Background: the consequences of otitis media with effusion in audition, cognitive and linguistic development are very strong sense for an accuracy diagnosis and effective treatment of this disease in children. Objective: to compare the operative performance of pneumatic otoscopy and tympanometry as diagnostic tools in otitis media with effusion. Materials and methods: diagnostic test study, prospective registry of

  11. Otitis media con efusión: estudio de casos y controles Otitis media with effusion: study of cases and controls

    Directory of Open Access Journals (Sweden)

    Sonia Grisales

    1992-01-01

    Full Text Available Se realizó un estudio en 66 niños y 34 niñas de 2 a 12 años. Cincuenta fueron casos de otitis media con efusión (OME y 50 controles. El grupo etario más numeroso fue el de dos años. Los síntomas y signos más frecuentes fueron otalgia y fiebre (70% e hipoacusia (40%. Veintinueve casos (58% y sólo 12 controles (24% presentaron adenoides hipertróficas (p < 0.01 . La pérdida auditiva fue significativamente mayor en el grupo de casos y las curvas timpanométricas se relacionaron directamente con ella. No se demostró que la alergia fuera un elemento importante en la génesis de la OME, a diferencia de la hipertrofia de adenoides que constituyó nuestro hallazgo más importante.

    Between July 1988 and May 1989 we studied 100 children aged2-14 years; there were fifty cases of otitis media with effusion (OME and fifty controls. Each group Included 33 boys and 17 girls. The predominant age group was 2 years. The most frequent clinical manifestations of OME were earache and fever (70% each and reduced hearing (40%. In 29 cases (58% and in only 12 controls (24% enlarged adenoids were found (p < 0.01 . impaired hearing was significantly most frequent In the cases and the tympanometric curves had direct relationship with reduced hearing. Despite Its high prevalence allergy was not found to be of importance In the etiology of OME; by contrast, enlarged adenoids were the most relevant determinant of this disease In our series.

  12. Corynebacterium spp. in dogs and cats with otitis externa and/or media: a retrospective study.

    Science.gov (United States)

    Henneveld, Kerstin; Rosychuk, Rodney A W; Olea-Popelka, Francisco J; Hyatt, Doreene R; Zabel, Sonja

    2012-01-01

    The role of Corynebacterium spp. in the pathogenesis of canine and feline otitis externa/media and their appropriate antimicrobial therapy are unclear. The objectives of this study were to (1) better establish the pathogenicity of Corynebacterium spp. in otitis utilizing reported criteria and by assessing clinical response to antibiotic therapy and (2) to determine the antimicrobial susceptibility patterns of Corynebacterium spp. associated with otitis. The study was retrospective, targeting cultures positive for Corynebacterium spp. Corynebacterium spp. were part of mixed microbial populations in 79/81 cultures. Corynebacterium spp. pathogenicity was highly questionable because of their almost invariable presence with other microbes and the observation that Corynebacterium spp. usually disappear from the ear with resolution of other infections, even when the Corynebacterium spp. are resistant to the prescribed antibiotic(s). However, 2/81 cultures came from two canine ears wherein Corynebacterium spp. may have been pathogenic. Antimicrobial sensitivities for Corynebacterium spp. were available for 54 isolates. Most isolates were susceptible to chloramphenicol (53/54), amikacin (50/54), tetracycline (50/54), gentamicin (46/54), and enrofloxacin (32/54). Among those antibiotics available in otic products, gentamicin and enrofloxacin would be rational choices for the empirical, topical therapy of Corynebacterium spp.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Evaluation of concordance between the microorganisms detected in the nasopharynx and middle ear of children with otitis media.

    Science.gov (United States)

    van Dongen, Thijs M A; van der Heijden, Geert J M G; van Zon, Alice; Bogaert, Debby; Sanders, Elisabeth A M; Schilder, Anne G M

    2013-05-01

    Studies of microorganisms involved in otitis media in children often use a nasopharyngeal sample as a proxy for the middle ear fluid to test for bacteria and viruses. The question is whether such studies provide an accurate estimate of the prevalence of microorganisms involved in otitis media. We performed a systematic review of the literature reporting on the concordance between test results of nasopharyngeal and middle ear fluid samples for the most prevalent microorganisms in children with otitis media. Our findings show that the concordances vary from 68% to 97% per microorganism. For the most prevalent microbes, positive predictive values are around 50%. Most negative predictive values are moderate to high, with a range from 68% up to 97%. These results indicate that test results from nasopharyngeal samples do not always provide an accurate proxy for those of the middle ear fluid. It is important to interpret and use results of such studies carefully.

  15. Photodynamic therapy of otitis media in-vitro and in-vivo using gerbil

    Science.gov (United States)

    Rhee, Chung-Ku; Kwon, Pil Seung; Ahn, Jin Chul; Chung, Phil Sang; Ge, Ruifeng

    2008-02-01

    The aim of this study was to evaluate antibacterial effects of PDT on common bacteria causing otitis media with effusion (OME). In vitro study was carried out using a hematoporphyrin derivative sensitizer (photogem) and 632 nm diode laser on H. influenzae, M. catarrhalis, and S. pneumoniae. One ml of each bacterial suspension was incubated for 3 hours and various concentrations of photogem were administered into the suspension. The suspensions were irradiated with 632 diode laser (15 J/cm2). The presence of colony forming units of the bacteria was examined, microscopic structures of bacteria were examined by TEM, and cytometry of bacteria was performed. The PDT was effective in killing all 3 kinds of bacteria. TEM showed damaged bacterial cell membrane and cytoplasmic structures and the flow cytometry showed lower number of viable bacteria in PDT group comparing to the control group. In vivo PDT study was performed using gerbil. S. pneumoniae or H. influenzae was injected into bullae. Photogem was injected into bullae in 2 days by when OME was developed and transcanal irradiation of 632 nm diode laser (90 J) was performed with a fiber perforated through an ear drum into a middle ear cavity and bulla. Four days after PDT, middle ear and bulla were washed with DPBS and the washed DPBS was cultured. The presence of bacterial colonies was examined. PDT was effective in killing S. pneumoniae in 87 % of the infected bullae with OME while it was effective to eradicate H. influenzae in 50 % of the infected bullae with OME. The results of these studies demonstrated that PDT may be effective to treat otitis media. It may have clinical implication to treat otitis media that is resistant to antibiotic therapy.

  16. Effects of amoxicillin treatment on the salivary microbiota in children with acute otitis media.

    Science.gov (United States)

    Lazarevic, V; Manzano, S; Gaïa, N; Girard, M; Whiteson, K; Hibbs, J; François, P; Gervaix, A; Schrenzel, J

    2013-08-01

    Amoxicillin is a first-line antibiotic treatment for acute otitis media in children and one of the most commonly used antibiotics for human bacterial infections. We investigated changes in salivary bacterial communities among children treated with amoxicillin for acute otitis media (n = 18), using a culture-independent approach based on pyrosequencing of the V3 region of the bacterial 16S rRNA gene. The control group consisted of children with acute otitis media who were not given antibiotics (n = 15). One species-level phylotype assigned to the genus Streptococcus was identified across all (n = 99) saliva samples. Two additional species-level phylotypes from the genera Gemella and Granulicatella were shared by all (n = 45) samples of control subjects. Amoxicillin treatment resulted in reduced species richness and diversity, and a significant shift in the relative abundance of 35 taxa at different ranks from phylum to species-level phylotype. At the phylum level, prevalence of TM7 and Actinobacteria decreased at the end of treatment, whereas Proteobacteria had a higher relative abundance post-treatment. Multivariate analysis showed that samples from the same control subject taken over time intervals tended to cluster together. Among antibiotic-treated subjects, samples taken before and at the end of amoxicillin treatment formed two relatively well-separated clusters both of which greatly overlapped with samples taken about 3 weeks post-treatment. Our results point to a substantial but incomplete recovery of the salivary bacterial community from the antibiotic about 3 weeks after the end of treatment.

  17. Trombosis del seno lateral. Complicación de una otitis media subaguda

    OpenAIRE

    Fuente Cañibano, Rebeca de la

    2011-01-01

    [ES] La otitis media es una entidad de gran prevalencia mundial, afectando especialmente a niños menores de 3 años cuando se trata de la forma aguda. La mayor parte de sus complicaciones son de origen infeccioso y para su desarrollo influirán factores como la existencia de bacteriemia, la agresividad del germen causal, la resistencia bacteriana al tratamiento, la correcta instauración del mismo y factores dependientes del individuo como su estado inmunológico. Las complicaciones deben sospech...

  18. Tuberculous otitis media in an adult in a primary care setting:A case report

    Institute of Scientific and Technical Information of China (English)

    Paul O Dienye; Geraldine U Ndukwu

    2010-01-01

    Tuberculous otitis media is a rare disease, hence not often considered in the differential diagnosis of otorrhea. This results in late diagnosis with resulting complications such as irreversible hearing loss. A case report with review of the literature is presented, emphasizing that tuberculosis should be considered in the differential diagnosis of otorrhea not responding to commonly prescribed antibiotics. We also emphasize the importance of awareness creation in the management of such a disease, involving family members to oversee treatment and also research on ways of shortening duration of treatment to avoid default in treatment.

  19. Lateral sinus thrombosis in setting of Acute otitis media: An atypical presentation

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-01-01

    Full Text Available Lateral sinus thrombosis (LST is a rare complication of Acute Otitis Media and associated mastoiditis. Although, in the era of antibiotics, the presentation may be variable and diagnosis is difficult. High index of suspicion is required to diagnose the atypical presentation. We report an atypical presentation of LST wherein a 12-year-old female presented with sudden onset severe occipital headache following ear syringing. Contrast enhanced computed tomography of temporal bone revealed LST without coalescent mastoiditis. Patient was managed conservatively with intravenous antibiotics and low-dose heparin. The management protocols in such cases are discussed and relevant literature reviewed.

  20. Síndrome de Gradenigo y trombosis de seno cavernoso secundaria a otitis media aguda

    OpenAIRE

    Pelegrín Hernández, Juan Pablo; Díaz Manzano, José A.; Menasalvas Ruíz, Ana I.; Hellín Meseguer, Diego

    2012-01-01

    [ES] El síndrome de Gradenigo se caracteriza por dolor facial en la zona inervada por el trigémino y una oftalmoplejía externa unilateral (parálisis del VI par craneal) secundaria a petrositis apical aguda, por complicación evolutiva de una otitis media. Se trata de una complicación grave que requiere de un tratamiento inmediato para evitar secuelas permanentes y puede asociarse a otras complicaciones intracraneales como la trombosis del seno cavernoso. Presentamos el caso de un varón de 4 añ...

  1. [Acute otitis media in children: an evidence-based practice guideline].

    Science.gov (United States)

    Koneczny, N; Schmidt-Troschke, S; Berger, T; Isfort, J; Floer, B; Vollmar, H C; Butzlaff, M

    2004-01-01

    Acute Otitis media is one of the most common acute respiratory infections managed in primary care and the most common infection among in children. Diagnostic criteria, however, do not always correspond to scientific evidence. They often differ depending on individual preferences and competences. Treatment, also, is controversial. In Germany, most children attending their pediatrician or primary care physician will be prescribed antibiotics. Evidence from several randomized studies and systematic reviews suggests that routine usage of antibiotics provides only modest benefit. The benefit of prescribing antibiotics should not only be balanced against the increased likelihood of side effects such as diarrhoea but also against the potential to contribute to longterm antibiotic resistance.

  2. Early childhood otitis media and later school performance e A prospective cohort study of associations

    DEFF Research Database (Denmark)

    Fougner, Vincent; Kørvel-Hanquist, Asbjørn; Koch, Anders

    2017-01-01

    Introduction: Otitis media (OM) is a common disease in childhood and hearing loss (HL) is the most common complication. Prolonged HL may lead to language delay and cognitive difficulties. However, the consequences of HL due to OM are not fully understood. The aim of this study was to determine...... National Birth Cohort, involving >100,000 individual pregnancies and their offspring. We defined four exposure groups (0, 1e3, 4e6 and !7 OM episodes) and assessed general school performance, mathematics and literacy. Possible con- founders were recognized a priori and associations were determined using...

  3. Early childhood otitis media and later school performance - A prospective cohort study of associations

    DEFF Research Database (Denmark)

    Fougner, Vincent; Kørvel-Hanquist, Asbjørn; Koch, Anders

    2017-01-01

    INTRODUCTION: Otitis media (OM) is a common disease in childhood and hearing loss (HL) is the most common complication. Prolonged HL may lead to language delay and cognitive difficulties. However, the consequences of HL due to OM are not fully understood. The aim of this study was to determine...... National Birth Cohort, involving >100,000 individual pregnancies and their offspring. We defined four exposure groups (0, 1-3, 4-6 and ≥7 OM episodes) and assessed general school performance, mathematics and literacy. Possible confounders were recognized à priori and associations were determined using...

  4. Pott's puffy tumor: a rare complication of acute otitis media in child: a case report.

    Science.gov (United States)

    Urík, Milan; Machač, Josef; Šlapák, Ivo; Hošnová, Dagmar

    2015-09-01

    To describe a rare case of Potts' puffy tumor (PPT) in the zygomatic area, which developed as a complication of acute otitis media in a 6-year-old child. To date, only one case of PPT has been described in the literature as a complication of latent mastoiditis in an adult, and one case of PPT as a complication of acute mastoiditis in a 10-year-old child. Urgent surgical intervention, including evacuation of the purulent lesion, removal of inflamed soft tissue and osteolysis of the involved bone, and antromastoidectomy, intravenous treatment with broad-spectrum antibiotics, including G+, G-, anaerobes and fungi, and local therapy.

  5. Otitis externa.

    Science.gov (United States)

    Wipperman, Jennifer

    2014-03-01

    Acute otitis externa (AOE) is most often infectious in origin, and can be easily treated with a combination of topical antibiotic and steroid preparations. Systemic antibiotics are rarely needed for AOE. Chronic otitis externa (COE) can be more difficult to treat, but if an underlying cause can be identified this condition can often be successfully managed. In both AOE and COE, prevention is fundamental. If patients are able to avoid precipitating factors, future episodes can often be averted.

  6. Unilateral otitis media with effusion caused by retained surgical gauze as an unintended iatrogenic complication of orthognathic surgery: case report.

    Science.gov (United States)

    Park, Chang Mook; Choi, Kang Young; Heo, Sung Jae; Kim, Jung-Soo

    2014-09-01

    Inadvertent retention of surgical gauze during an operation can have disastrous consequences for both the patient and the surgeon. Several cases have been reported, particularly after abdominal surgery. However, it has never to our knowledge been reported as a leading cause of dysfunction of the Eustachian tube after orthognathic surgery. We recently encountered a patient in whom it presented with unilateral otitis media with an effusion after orthognathic surgery. All surgeons involved with orthognathic surgery should be aware that remnants of surgical gauze after orthognathic surgery can compromise the Eustachian tube and cause otitis media with an effusion.

  7. 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....... 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...

  8. Efficacy observation of auditory reconstruction using three different materials in ossiculoplasty and mastoidectomy to treat chronic otitis media%三种不同材料应用于慢性中耳炎听力重建的疗效观察

    Institute of Scientific and Technical Information of China (English)

    顾兴华; 朱敬; 苏跃

    2013-01-01

    目的:探讨不同类型听骨赝复体应用于慢性中耳炎听力重建的疗效.方法:143例(143耳)慢性中耳炎患者分别用钛合金人工听骨(A组,52例)、羟基磷灰石人工听骨(B组,47例)和自体骨(C组,44例)在开放式鼓室成形术中重建听力.随访24个月以上,比较3组术后并发症及0.5、1.0、2.0、4.0 kHz纯音平均听阈、平均气骨导差和听力重建成功率.结果:术后12个月,3组气导平均听阈、平均气骨导差均较术前缩小(均P<0.05),A组重建成功率(78.7%)略优于B、C组(68.1%、70.4%),差异无统计学意义.术后24个月,B、C组气导平均听阈、平均气骨导差与术后12个月比较,均差异有统计学意义(均P<0.05);B、C组重建成功率(48.9%、45.5%)均低于A组(76.9%),差异有统计学意义(P<0.05).结论:应用钛合金人工听骨在开放式鼓室成形术中行Ⅰ期听力重建,对提高听力更有效,稳定性强,并发症少.%Objective:To study the effects of different types of prosthesis used in ossiculoplasty on mastoidectomy of treating chronic otitis media.Method:One hundred and forty three patients with chronic otitis media were treated by canal wall-down tympanoplasty with ossiculoplasty in a single stage.According to material of prosthesis,they were classified as titanium group(group A,52 cases),hydroxypatite group(group B,47 cases) and autogenous bone group(group C,44 cases).The postoperative complication and hearing thresholds were analyzed in the 24 months follow-up.Average postoperative air-conduction gain and air-bone gap were measured at four frequencies:0.5,1.0,2,and 4.0 kHz.Result:12-month after operation,the average air threshold and air-bone gaps of the three groups were reduced(P<0.05).The reconstruction successful rate(78.7%) of group A was slightly better than that of B,C (68.1%,70.4 %).there was no statistically significant difference.The difference of the average air threshold and air-bone gaps of group B

  9. [Acute otitis media in children. Comparison between conventional and homeopathic therapy].

    Science.gov (United States)

    Friese, K H; Kruse, S; Moeller, H

    1996-08-01

    Within a prospective group study of five practicing otorhinolaryngologists, conventional therapy of acute otitis media in children was compared with homeopathic treatments. Group A (103 children) was primarily treated with homeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea). Group B (28 children) was treated by decongestant nose-drops, antibiotics, secretolytics and/or antipyretics. Comparisons were done by symptoms, physical findings, duration of therapy and number of relapses. The children of the study were between 1 and 11 years of age. The difference in numbers was explained by the children with otitis media being primarily treated by pediatricians using conventional methods. The median duration of pain in group A was 2 days and in group B 3 days. Median therapy in group A lasted 4 days and in group B 10 days. Antibiotics were given over a period of 8-10 days, while homeopathic treatments were stopped after healing. In group A 70.7% of the patients were free of relapses within 1 years and 29.3% had a maximum of three relapses. Group B had 56.5% without relapses and 43.5% a maximum of six relapses. Five children in group A were given antibiotics and 98 responded solely to homeopathic treatments. No side effects of treatment were found in either group.

  10. Diagnosis and management of acute otitis media in the urgent care setting.

    Science.gov (United States)

    McCracken, George H

    2002-04-01

    The prevalence of otitis media is increasing, which affects health care resource utilization across all segments, including the urgent care setting. One of the greatest challenges in the management of acute otitis media (AOM) is the effective treatment of cases caused by pathogens that are resistant to commonly used antibiotics. Whereas the production of beta-lactamases among strains of Haemophilus influenzae and Moraxella catarrhalis is an important consideration for antimicrobial therapy, the high prevalence of resistance to penicillin and other classes of antibiotics among strains of Streptococcus pneumoniae represents a greater clinical concern. The Centers for Disease Control and Prevention (CDC) recently convened the Drug Resistant S. pneumoniae Therapeutic Working Group to develop evidence-based recommendations for the treatment of AOM in an era of prevalent resistance. The recommendations from this group included amoxicillin as the preferred first-line drug because of the demonstrated activity against penicillin-intermediate and -resistant strains of S. pneumoniae, using higher dosages of up to 90 mg/kg per day in certain settings. For patients in whom initial treatment is unsuccessful after 3 days, the recommended agents included high-dose amoxicillin-clavulanate (for activity against beta-lactamase-producing pathogens), clindamycin, cefuroxime axetil, or 1 to 3 doses of intramuscular ceftriaxone. The principles set forth in these guidelines can assist the therapeutic decisionmaking process for practitioners in the urgent care setting.

  11. Capsular switching as a strategy to increase pneumococcal virulence in experimental otitis media model.

    Science.gov (United States)

    Sabharwal, Vishakha; Stevenson, Abbie; Figueira, Marisol; Orthopoulos, George; Trzciński, Krzysztof; Pelton, Stephen I

    2014-04-01

    We hypothesized that capsular switch event, in which pneumococcus acquires a new capsule operon by horizontal gene transfer, may result in emergence of strains with increased virulence in acute otitis media. Using serotype 6A strain from a patient with invasive pneumococcal disease and clonally distant serotype 6C strain isolated from asymptomatic carrier we created 6A:6C (6A background with 6C capsule) capsular transformants and applied whole genome macro-restriction analysis to assess conservation of the 6A chassis. Next, we assessed complement (C3) and antibodies deposition on surface of pneumococcal cells and tested capsule recipient, capsule donor and two 6A:6C transformants for virulence in chinchilla experimental otitis media model. Both 6A:6C(1 or 2) transformants bound less C3 compared to 6C capsule-donor strain but more compared to serotype 6A capsule-recipient strain. Pneumococci were present in significantly higher proportion of ears among animals challenged with either of two 6A:6C(1 or 2) transformants compared to chinchillas infected with 6C capsule-donor strain [p < 0.001] whereas a significantly decreased proportion of ears were infected with 6A:6C(1 or 2) transformants as compared to 6A capsule-recipient strain. Our observations though limited to two serotypes demonstrate that capsular switch events can result in Streptococcus pneumoniae strains of enhanced virulence for respiratory tract infection.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Defective serum opsonization activity in children aged 6-48 months having acute purulent otitis media.

    Science.gov (United States)

    Tezcan, I; Yilmaz, Y; Oner, F; Yel, L; Sanal, O; Ersoy, F; Onerci, M; Berkel, A I

    1997-01-01

    Serum opsonization of yeast (Saccharomyces) was investigated in 51 patients whose ages were between six and 48 months (median 15 months) with acute purulent otitis media and in an age-matched control group (median 13 months). Opsonization was assessed by measuring yeast particle uptake in an assay based on an electronic count of the unphagocytosed particles in serum by polymorphonuclear leukocytes. Despite normal levels of CH50 and serum immunoglobulins, a defective opsonization was determined in 13.7 percent of the patients (7 in 51). The corresponding figure was 2.9 percent in 103 healthy controls (p < 0.001). On the other hand, 218 percent (5 in 23) of the children having a history of recurrent purulent otitis media showed defective opsonization (p < 0.001). Previously, the presence of an opsonization defect has been linked to low levels of mannan binding lectin (MBL), a calcium dependent serum lectin that acts as an opsonin. Therefore, our findings indirectly support the idea that MBL has an important role as host defense, particularly in the earlier period of life when the antibody repertoire is restricted.

  14. ROLE OF ADENOIDECTOMY IN THE MANAGEMENT OF OTITIS MEDIA WITH EFFUSION

    Directory of Open Access Journals (Sweden)

    Avinash

    2014-06-01

    Full Text Available OBJECTIVE: To study the role of adenoidectomy in the management of otitis media with effusion. TYPE OF STUDY: A prospective clinical study. MATERIALS AND METHODS: 20cases studied in department of ENT, GMCH. The duration of study was from February 2011 to December 2011. Hearing loss assessment in the form of PTA & TYMPANOMETRY before and after adenoidectomy was done. OBSERVATIONS AND RESULTS: Children <14 years were included in the study. Sex wise distribution was observed. Patients categorized according to the symptoms, gender and degree of hearing loss. Satisfactory results observed after adenoidectomy in relation to the improvement in hearing loss. There can be some complications after adenoidectomy but in our studies proper precautions were taken and no complications seen. CONCLUSION: Adenoidectomy is a very effective surgical modality of treatment in patients who are having otitis media with effusion due to adenoid hypertrophy. Conservative management has no role and grommet insertion is not of much value. Adenoidectomy alone has been shown to produce otoscopic clearance of middle ear effusion, alteration of tympanometric status and improvement of hearing loss.

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

    Science.gov (United States)

    Labout, Joost A M; Duijts, Liesbeth; Lebon, Ankie; de Groot, Ronald; Hofman, Albert; Jaddoe, Vincent V W; Verbrugh, Henri A; Hermans, Peter W M; Moll, Henriëtte 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 prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24-2.71 and aOR 2.72, 95% CI 2.18-3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13-1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life.

  16. HRCT常规重建与后处理对CSOM及中耳胆脂瘤诊断价值%The Diagnostic Value of HRCT Image Reconstruction and Post-processing Technology in Chronic Suppurative Otitis Media and Middle Ear Cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    李必强; 王小铭; 黄显龙; 李朝军; 杨超; 唐茁月; 唐永存

    2015-01-01

    目的:探讨高分辨率CT扫描常规轴位、冠状位重建图像及图像后处理技术对慢性化脓性中耳炎及中耳胆脂瘤的诊断价值。方法对经手术病理证实并行64排螺旋CT容积扫描慢性化脓性中耳炎及中耳胆脂瘤共105例(107耳)进行回顾性分析。在常规轴位及冠状位重建图像基础上,综合运用图像后处理技术,根据主要CT表现:1、鼓室、鼓窦腔软组织密度影;2、听骨链骨质破坏情况;3、鼓室、鼓窦壁骨质破坏情况;进行术前分型,并将手术阳性结果与CT表现进行比较分析。结果慢性化脓性中耳炎59耳,其中单纯型8耳,肉芽型36耳,硬化灶肉芽型15耳;中耳胆脂瘤48耳,术前CT分型准确率为89%。对主要CT征象,常规轴位+冠状位显示率为88%,结合图像后处理技术,显示率为95%。对于所有可CT显示的术中阳性发现,均可以用多平面重组进行显示;容积再现及多平面容积再现对锤骨、砧骨破坏能较好显示,对镫骨破坏显示受到一定限制;曲面重组对面神经骨管破坏显示较满意,对听骨链骨质破坏也有一定的价值。结论 HRCT能对CSOM及中耳胆脂瘤进行较准确的术前分类、分型,常规轴位、冠状位重建图像能较全面、准确地对解剖和病变进行显示,各种图像后处理技术特别是MPR能提高CSOM及中耳胆脂瘤细微病变显示率和诊断准确率,具有很高的临床应用价值。%Objective To investigate the high resolution CT(HRCT) conventional axial scanning, coronal reconstruction images and image post-processing technology in the diagnosis of chronic suppurative otitis media(CSOM ) and middle ear choles⁃teatoma. Methods 107 ears(105 patients) were included who had been diagnosed CSOM or middle ear cholesteatoma by surgi⁃cal pathology, and been checked by 64 slices spiral CT volume scanning before surgery. The retrospectively analysis was applied to

  17. [Analysis of the Cochrane Review: Antibiotics for acute otitis media in children. Cochrane Database Syst Rev. 2013;1:CD000219].

    Science.gov (United States)

    Pinto, Sara; Costa, João; Vaz Carneiro, António; Fernandes, Ricardo

    2013-01-01

    Acute otitis media is one of the most common infections in children and one of the leading causes for antibiotic prescription. In this paper, we assess and comment the Cochrane systematic review 'Antibiotics for acute otitis media in children', which aimed at assessing the efficacy and safety of antibiotics for acute otitis media in children and identifying subgroups of children who might benefit more than others from antibiotic treatment. This review showed spontaneous resolution of acute otitis media in most children (82%) and a favorable but modest effect of antibiotics, namely in pain control (number needed to treat to benefit: 20), reduction of tympanic membrane perforations and reduction of contralateral acute otitis media. Adverse effects such as vomiting, diarrhea or rash were more common in the antibiotic group (number needed to treat to harm: 14). Thus, for most children, an expectant observational approach during 48-72h without immediate antibiotic prescription seems justified. An additional meta-analysis found that antibiotics appear to be most useful in children with both acute otitis media and otorrhoea and children under two years of age with bilateral acute otitis media.

  18. Will Parents Participate in and Comply with Programs and Regimens Using Xylitol for Preventing Acute Otitis Media in Their Children?

    Science.gov (United States)

    Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.

    2015-01-01

    Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…

  19. Quality of Childcare and Otitis Media: Relationship to Children's Language during Naturalistic Interactions at 18, 24, and 36 Months

    Science.gov (United States)

    Vernon-Feagans, Lynne; Hurley, Megan M.; Yont, Kristine M.; Wamboldt, Patricia M.; Kolak, Amy

    2007-01-01

    The purpose of this study was to examine the relationship between the quality of childcare and experience with otitis media (middle ear disease) as they relate to children's early naturalistic language development. Sixty children were followed longitudinally from childcare entry in the first year of life until three years of age. Half the children…

  20. Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis

    NARCIS (Netherlands)

    Boonacker, C.W.; Rovers, M.M.; Browning, G.G.; Hoes, A.W.; Schilder, A.G.M; Burton, M.J.

    2014-01-01

    BACKGROUND: Otitis media (OM) is a leading cause of medical consultations, antibiotic prescription and surgery in children. The surgical procedures offered to children with recurrent or persistent OM are insertion of grommets, adenoidectomy or a combination of the two. There is clear National Instit

  1. Molecular epidemiology of pneumococcal colonization in response to pneumococcal conjugate vaccination in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    Bogaert, D.; Veenhoven, R.H.; Sluijter, M.; Wannet, W.J.B.; Rijkers, G.T.; Mitchell, T.J.; Clarke, S.C.; Goessens, W.H.F.; Schilder, A.G.M.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.

    2005-01-01

    A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotyp

  2. Pneumococcal conjugate vaccination does not induce a persisting mucosal IgA response in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    Bogaert, D.; Veenhoven, R.H.; Ramdin, R.; Luijendijk, I.H.; Rijkers, G.T.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.

    2005-01-01

    AIM: In a prospective controlled study in young children with a history of recurrent acute otitis media, we analyzed the salivary IgA and IgG antibody titers upon vaccination with a 7-valent pneumococcal conjugate vaccine (PCV) given once or twice, followed by a 23-valent polysaccharide booster vacc

  3. Molecular epidemiology of pneumococcal colonization in response to pneumococcal conjugate vaccination in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    D. Bogaert (Debby); R.H. Veenhoven (Reinier); M. Sluijter (Marcel); W.J. Wannet; G.T. Rijkers; T.J. Mitchell; S.C. Clarke; W.H.F. Goessens (Wil); A.G. Schilder (Anne); E.A. Sanders (Elisabeth); R. de Groot (Ronald); P.W.M. Hermans (Peter)

    2005-01-01

    textabstractA randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shif

  4. Restricted Consonant Inventories of 2-Year-Old Finnish Children with a History of Recurrent Acute Otitis Media

    Science.gov (United States)

    Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Kujala, Teija; Jansson-Verkasalo, Eira

    2015-01-01

    Many children experience recurrent acute otitis media (RAOM) in early childhood. In a previous study, 2-year-old children with RAOM were shown to have immature neural patterns for speech sound discrimination. The present study further investigated the consonant inventories of these same children using natural speech samples. The results showed…

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media

    NARCIS (Netherlands)

    Short, K.R.; Kockritz-Blickwede, M. von; Langereis, J.D.; Chew, K.Y.; Job, E.R.; Armitage, C.W.; Hatcher, B.; Fujihashi, K.; Reading, P.C.; Hermans, P.W.M.; Wijburg, O.L.; Diavatopoulos, D.A.

    2014-01-01

    Otitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss. OM can arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the pneumococc

  7. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media

    NARCIS (Netherlands)

    K.R. Short (Kirsty); M. von Köckritz-Blickwede (Maren); J.D. Langereis (Jeroen); K.Y. Chew (Keng Yih); E.R. Job (Emma); S. Armitage (Shane); P. Hatcher (Pascale); K. Fujihashi (Kohtaro); C.L. Reading (Chris ); P.W.M. Hermans (Peter); O.L. Wijburg (Odilia); D.A. Diavatopoulos (Dimitri)

    2014-01-01

    textabstractOtitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss.OMcan arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the

  8. Experimental otitis media in gerbils and chinchillas with Streptococcus pneumoniae, Haemophilus influenzae, and other aerobic and anaerobic bacteria.

    OpenAIRE

    Fulghum, R S; Brinn, J E; Smith, A M; Daniel, H J; Loesche, P J

    1982-01-01

    To ascertain the usefulness of Mongolian gerbils as an inbred model for otitis media, 52 Mongolian gerbils (Meriones unguiculatus, strain MONT/Tum) were compared with 26 chinchillas (Chinchilla laniger) for susceptibility to Streptococcus pneumoniae type 3. Haemophilus influenzae type b, and a polymicrobic culture including anaerobes (Streptococcus intermedius, Propionibacterium acnes, Staphylococcus epidermidis, and Corynebacterium sp.). Organisms were inoculated percutaneously into the supe...

  9. Myringotomy versus ventilation tubes in secretory otitis media: eardrum pathology, hearing, and eustachian tube function 25 years after treatment

    DEFF Research Database (Denmark)

    Caye-Thomasen, P.; Stangerup, S.E.; Jorgensen, G.;

    2008-01-01

    . MATERIALS AND METHODS: Two hundred twenty-four children with bilateral secretory otitis media were treated by bilateral myringotomy and insertion of a ventilation tube on the right side only. The children were reexamined by otomicroscopy, tympanometry, and pure tone audiometry after 3, 7, and 25 years...

  10. Some Audiological, Psychological, Educational and Behavioral Characteristics of Children with Bilateral Otitis Media with Effusion: A Longitudinal Study.

    Science.gov (United States)

    Silva, Phil A.; And Others

    1986-01-01

    A longitudinal study of 47 children with bilateral otitis media with effusion (OME) at age five compared with a group of non-OME children revealed that OME Ss continued to have significant hearing loss at subsequent ages, as well as language, speech, behavior, and reading difficulties. (Author/CL)

  11. Genetic relatedness between pneumococcal populations originating from the nasopharynx, adenoid, and tympanic cavity of children with otitis media.

    NARCIS (Netherlands)

    Tonnaer, E.L.G.M.; Rijkers, G.T.; Meis, J.F.G.M.; Klaassen, C.H.W.; Bogaert, D.; Hermans, P.W.M.; Curfs, J.H.A.J.

    2005-01-01

    Previous studies have shown that Streptococcus pneumoniae exists in both middle ear effusions and the upper respiratory region from children with otitis media with effusion (OME), but it remains unclear whether these strains represent genetically identical clones. Therefore, it cannot be determined

  12. The health care burden and societal impact of acute otitis media in seven European countries: results of an Internet survey

    NARCIS (Netherlands)

    J.H. Wolleswinkel-van den Bosch (Judith); E.A. Stolk (Elly); M. Francois (Martine); R. Gasparini (Roberto); M. Brosa (Max)

    2010-01-01

    textabstractThis paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherl

  13. The 4G/4G plasminogen activator inhibitor-1 genotype is associated with frequent recurrence of acute otitis media.

    NARCIS (Netherlands)

    Emonts, M.; Wiertsema, S.P.; Veenhoven, R.H.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.A.M.

    2007-01-01

    OBJECTIVES: Plasminogen activator inhibitor-1 counterregulates cell migration, adhesion, and tissue repair. The PAI1 4G/5G promoter polymorphism has an effect on expression levels of PAI1. After a first acute otitis media episode, children are at increased risk for a next episode. Because the PAI1 4

  14. Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study

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    Di Pierro F

    2015-09-01

    Full Text Available Francesco Di Pierro,1 Daniele Di Pasquale,2 Maurizio Di Cicco2 1Velleja Research, Milan, Italy; 2ORL Department, Ospedale Maggiore Policlinico Ca’ Grande IRCCS, Milan, Italy Abstract: Secretory otitis media (SOM remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM, is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®. After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. Keywords: BLIS K12, Bactoblis®, acute otitis media, exudative otitis media

  15. [Treatment of acute otitis media in paediatrics: a meta-analysis].

    Science.gov (United States)

    Esposito, Silvano; Novelli, Andrea; Noviello, Silvana

    2005-06-01

    Otitis represents the second most common infection of the upper respiratory tract, its treatment being the most common cause for prescribing antibiotics in the United States. A large number of antimicrobials, especially beta-lactams and macrolides, are generally used for treating acute otitis media (AOM) in paediatric patients, owing to their antibacterial spectrum including the main aetiological pathogens. Efficacy, safety and compliance of Cefaclor were compared with those of other antibiotics in the treatment of paediatric AOM in a meta-analysis of randomized controlled trials published between 1981 and 2004. Overall, evaluations were performed on 24 studies (Medline/PubMed, keywords "Cefaclor and otitis") which proved eligible (jadad score > or = 1); sixteen out of the 24 studies were multicentre, seven were double-blind. Mostly, the comparator agent was a beta-lactam, in four and three cases it was a macrolide or the association trimethoprim-sulfamethoxazole, respectively. Efficacy and safety were end-points of all studies whereas only 9 studies evaluated compliance. For the majority of studies (16/24) Cefaclor was administered for 10-day course. The analysis was based on a 2 x 2 contingency table with classification by treatment and number of improvements/cures, side-effects, and compliance of individual studies. The global estimate of the effective treatments was obtained with the weighted mean of the log OR (Odd Ratio) according to Mantel-Haenszel and associated confidence intervals (CI) at 95%. All the calculations were performed using SAS v.8. Chi-square test was performed. Clinical efficacy evaluation, number of improvements/cures, did not evidence a statistically significant difference among Cefaclor and comparators (86.8% vs 88.7%; Odds Ratio 0.77, IC 0.61/0.94). In the Cefaclor-treated patients, adverse events were observed in a statistically significant lower percentage compared to other antibiotics: 13.3% vs 19.4% (P antibiotics usually employed in

  16. Neutrophil extracellular traps and bacterial biofilms in middle ear effusion of children with recurrent acute otitis media--a potential treatment target.

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    Ruth B Thornton

    Full Text Available BACKGROUND: Bacteria persist within biofilms on the middle ear mucosa of children with recurrent and chronic otitis media however the mechanisms by which these develop remain to be elucidated. Biopsies can be difficult to obtain from children and their small size limits analysis. METHODS: In this study we aimed to investigate biofilm presence in middle ear effusion (MEE from children with recurrent acute otitis media (rAOM and to determine if these may represent infectious reservoirs similarly to those on the mucosa. We examined this through culture, viability staining and fluorescent in situ hybridisation (FISH to determine bacterial species present. Most MEEs had live bacteria present using viability staining (32/36 and all effusions had bacteria present using the universal FISH probe (26/26. Of these, 70% contained 2 or more otopathogenic species. Extensive DNA stranding was also present. This DNA was largely host derived, representing neutrophil extracellular traps (NETs within which live bacteria in biofilm formations were present. When treated with the recombinant human deoxyribonuclease 1, Dornase alfa, these strands were observed to fragment. CONCLUSIONS: Bacterial biofilms, composed of multiple live otopathogenic species can be demonstrated in the MEEs of children with rAOM and that these contain extensive DNA stranding from NETs. The NETs contribute to the viscosity of the effusion, potentially contributing to its failure to clear as well as biofilm development. Our data indicates that Dornase alfa can fragment these strands and may play a role in future chronic OM treatment.

  17. 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.

  18. Effectiveness of a propolis and zinc solution in preventing acute otitis media in children with a history of recurrent acute otitis media.

    Science.gov (United States)

    Marchisio, P; Esposito, S; Bianchini, S; Desantis, C; Galeone, C; Nazzari, E; Pignataro, L; Principi, N

    2010-01-01

    Recurrent acute otitis media (rAOM) is frequently encountered in infants and children and the lack of any definitive treatment has led parents and physicians to try complementary and alternative therapies. We evaluated the efficacy of a propolis and zinc suspension in preventing AOM in 122 children aged 1-5 years with a documented history of rAOM, who were prospectively, blindly, randomized 1:1 to receive the suspension plus elimination of environmental risk factors or elimination of environmental risk factors only. AOM- and respiratory-related morbidity were assessed at study entry and every four weeks. In the 3-month treatment period AOM was diagnosed in 31 (50.8%) children given the propolis and zinc suspension and in 43 (70.5%) controls (p=0.04). The mean number of episodes of AOM per child/month was 0.23+/-0.26 in the propolis and zinc group and 0.34+/-0.29 in controls (reduction 32.0%, p=0.03). The administration of a propolis and zinc suspension to children with a history of rAOM can significantly reduce the risk of new AOM episodes and AOM-related antibiotic courses, with no problem of safety or tolerability, and with a very good degree of parental satisfaction. No effect can be expected on respiratory infections other than AOM.

  19. The Importance of Integration of Stakeholder Views in Core Outcome Set Development: Otitis Media with Effusion in Children with Cleft Palate.

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    Nicola L Harman

    Full Text Available Approximately 75% of children with cleft palate (CP have Otitis Media with Effusion (OME histories. Evidence for the effective management of OME in these children is lacking. The inconsistency in outcome measurement in previous studies has led to a call for the development of a Core Outcome Set (COS. Despite the increase in the number of published COS, involvement of patients in the COS development process, and methods to integrate the views of patients and health professionals, to date have been limited.A list of outcomes measured in previous research was identified through reviewing the literature. Opinion on the importance of each of these outcomes was then sought from key stakeholders: Ear, Nose and Throat (ENT surgeons, audiologists, cleft surgeons, speech and language therapists, specialist cleft nurses, psychologists, parents and children. The opinion of health professionals was sought in a three round Delphi survey where participants were asked to score each outcome using a bespoke online system. Parents and children were also asked to score outcomes in a survey and provided an in-depth insight into having OME through semi-structured interviews. The results of the Delphi survey, interviews and parent/patient survey were brought together in a final consensus meeting with representation from all stakeholders. A final set of eleven outcomes reached the definition of "consensus in" to form the recommended COS: hearing; chronic otitis media (COM; OME; receptive language skills; speech development; psycho social development; acute otitis media (AOM; cholesteatoma; side effects of treatment; listening skills; otalgia.We have produced a recommendation about the outcomes that should be measured, as a minimum, in studies of the management of OME in children with CP. The development process included input from key stakeholders and used novel methodology to integrate the opinion of healthcare professionals, parents and children.

  20. Genetic characteristics of Haemophilus influenzae and Streptococcus pneumoniae isolated from children with conjunctivitis-otitis media syndrome.

    Science.gov (United States)

    Sugita, Gen; Hotomi, Muneki; Sugita, Rinya; Kono, Masamitsu; Togawa, Akihisa; Yamauchi, Kazuma; Funaki, Toshinari; Yamanaka, Noboru

    2014-08-01

    Acute conjunctivitis is the most common ocular disorders among children and frequently concomitant with acute otitis media (AOM) as conjunctivitis-otitis syndrome. In this study, we evaluated prevalence of causative pathogens and PCR-based genotypes of Haemophilus influenzae and Streptococcus pneumoniae among children with conjunctivitis-otitis media syndrome. Nontypeable H. influenzae (NTHi) is identified most often at 61.8% in conjunctiva exudates followed by S. pneumoniae at 28.2% and Moraxella catarrhalis at 19.1%. Genetic β-lactamase nonproducing ampicillin resistant (gBLNAR) strains of NTHi and genetic penicillin resistant S. pneumoniae (gPRSP) were identified at 72.1% and at 74.2% among conjunctiva isolates by polymerase chain reaction (PCR), respectively. Pneumococcal strains having either ermB or mefE genes were identified at 93.5% among conjunctiva isolates. The restriction fragment of patterns of 89.7% pairs of H. influenzae isolates and 100% pairs of pneumococcal isolates from conjunctiva exudates, middle ear fluids (MEFs) and nasopharyngeal swabs were identical. In contrast to the previous reports, most prevalent strains from conjunctivitis-otitis media syndrome was BLNAR H. influenzae in this study. The causative pathogen responsible for acute conjunctivitis will be originated from the nasopharynx. In the absence of MEFs one can possibly rely on the nasopharyngeal culture to guide an appropriate treatment.

  1. A longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion.

    Science.gov (United States)

    Henderson, F W; Collier, A M; Sanyal, M A; Watkins, J M; Fairclough, D L; Clyde, W A; Denny, F W

    1982-06-10

    We analyzed data from a 14-year longitudinal study of respiratory infections in young children to determine the relative importance of viral respiratory infection and nasopharyngeal colonization with Streptococcus pneumoniae and Haemophilus influenzae as factors influencing the occurrence of acute otitis media with effusion. The incidence of this disorder was increased in children with viral respiratory infections (average relative risk, 3.2; P less than 0.0001). Infection with respiratory syncytial virus, influenza virus (type A or B), and adenovirus conferred a greater risk of otitis media than did infection with parainfluenza virus, enterovirus, or rhinovirus. Colonization of the nasopharynx with Str. pneumoniae or H. influenzae had a lesser effect on the incidence of the disease (average relative risk; 1.5; P less than 0.01). Infections with the viruses more closely associated with acute otitis media (respiratory syncytial virus, adenovirus, and influenza A or B) were correlated with an increased risk of recurrent disease. Prevention of selected otitis-associated viral infections should reduce the incidence of this disease.

  2. TRANSFORMATION OF EFFUSION AND FORMATION OF GRANULATION TISSUE IN PATHOLOGIC PROCESS OF OTITIS MEDIA WITH EFFUSION

    Institute of Scientific and Technical Information of China (English)

    韦俊荣; 张青; 张全安

    2003-01-01

    Objective To explore the diversity of stagnant effusions and the pathologic processes leading to granulation tissue formation in otitis media with effusion(OME). Methods Temporal bone slides from 306 ears with OME were studied histopathologically under the light microscope. Results Results of this study revealed a pathologic process in witch the type and the condition of stagnant effusion in the middle ear cleft was a variable in the dynamics of OME progression from an early stage to an advanced stage. The location of granulation tissue and retentive effusion were found to be closely related. Conclusion Early stage granulation tissue formation exhibited a pathologic process in which granulation tissue formation occurred only in areas where effusion had stagnated or was absorbed. The incidence of the retentive effusion and formation of granulation tissue was much higher and the pathologic changes most extensive in the area around the ossicular chain.

  3. Modeling Analysis of Biomechanical Changes of Middle Ear and Cochlea in Otitis Media

    Science.gov (United States)

    Gan, Rong Z.; Zhang, Xiangming; Guan, Xiying

    2011-11-01

    A comprehensive finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was developed using histological sections of human temporal bone. The cochlea was modeled with three chambers separated by the basilar membrane and Reissner's membrane and filled with perilymphatic fluid. The viscoelastic material behavior was applied to middle ear soft tissues based on dynamic measurements of tissues in our lab. The model was validated using the experimental data obtained in human temporal bones and then used to simulate various stages of otitis media (OM) including the changes of morphology, mechanical properties, pressure, and fluid level in the middle ear. Function alterations of the middle ear and cochlea in OM were derived from the model and compared with the measurements from temporal bones. This study indicates that OM can be simulated in the FE model to predict the hearing loss induced by biomechanical changes of the middle ear and cochlea.

  4. Risk Factors of Early Otitis Media in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Kørvel-Hanquist, Asbjørn; Koch, Anders; Niclasen, Janni;

    2016-01-01

    OBJECTIVE: To assess risk factors of otitis media (OM) in six-months-old children. METHOD: The sample consisted of 69,105 mothers and their children from the Danish National Birth Cohort. The women were interviewed twice during pregnancy and again 6 months after birth. The outcome "one or more...... associated with a risk of OM. When a Bonferroni correction was introduced, gender, prematurity, parity, maternal age, maternal self-estimated health, taking penicillin during pregnancy, and terminating breastfeeding before age six months, was associated with a risk of early OM. The adjusted ORs of OM...... less than 6 months, had an increased OR of 1.42 (95% CI 1.28-1.58) compared to children being breastfeed beyond 6 months. CONCLUSION: These findings indicate that prenatal factors are of less importance regarding early OM before the age of six months. Postnatal risk factors seem to pose the main risk...

  5. Watchful Waiting for Cases of Pediatric Otitis Media: Modeling Parental Response to Physician Advice.

    Science.gov (United States)

    MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M

    2016-08-01

    Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice.

  6. Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media.

    Science.gov (United States)

    Taylor, James A; Jacobs, Jennifer

    2014-01-01

    Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM). Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032). Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.

  7. MICROBIOLOGICAL STUDY OF ACUTE OTITIS MEDIA IN CHILDREN AGED 2 MONTHS TO 18 YEARS

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    Ramakrishna Pai

    2014-01-01

    Full Text Available Acute Suppurative Otitis media (ASOM is one of the diseases that causedeath in children below the age of 5 years. The pathogens causing otitis media (OM vary from region to region. Both Gram positive and Gram negative bacteria are responsible f or OM. So this study was conducted to know the aerobic bacterial pathogens causing OM and their susceptibility pattern in children below 18 years attending a rural tertiary health care center in north Kerala . MATERIALS AND METHODS : A total of 75 patients in pediatric age group 2 months to 18 years clinically havingASOM , were included in the study . Ear discharge was collected using sterile cotton swabs and processed accordingly. RESULTS : A total of 75 patients aged 2 months to 18 years with discharging ears wer e included in the study. Among them , forty one (54.7% were males and thirty four (45.3% were females. Forty five children were below years. Sixty five (86.6% had unilateral ear discharge. Among the 75 ear swabs cultured , 66 (88% had aerobic bacteria is olated. S.aureus was themost common isolate accounting to 32(47% followed by P.aeruoginosa 19(27.9%. It was observed that most of the Staphylococcus aureusisolates were resistant to p en i cillins and first generation cephalosporins while Pseudomonas aerugi nosa to fluoroquinolones. CONCLUSION : Since there is reduced susceptibility of the pathogens isolated to first and second line antibacterials it is necessary to use these antibacterials judiciously and in the right dosage

  8. Vitamin D Levels in Children with Adenotonsillar Hypertrophy and Otitis Media with Effusion

    Science.gov (United States)

    Asghari, Alimohamad; Bagheri, Zohreh; Jalessi, Maryam; Salem, Mohammad Mahdi; Amini, Elahe; GhalehBaghi, Sahand; Bakhti, Sepideh

    2017-01-01

    Introduction: Vitamin D has been suggested to play a considerable role in the function of the immune system in various infectious, inflammatory, and autoimmune conditions. Otitis media with effusion (OME), defined as the presence of non-purulent fluid within the middle ear without signs or symptoms of suppurative otitis media, has a number of inflammatory predisposing factors. This study was designed to explore the association between vitamin D deficiency and OME. Materials and Methods: In this cross-sectional study, 74 children aged 2–7 years with an obstructive indication for adenotonsillectomy were included. Patients were divided into two groups based on the need for ventilation tube insertion for OME. Thirty-two children were enrolled in the OME group and 42 in the control group. The mean vitamin D level was compared between the two groups. Results: Mean vitamin D concentration in all patients was 11.96±5.85 ng/ml (9.79±4.36 ng/ml in the OME group and 13.61±6.33 ng/ml in the control group; P=0.003). There was also a significant difference in levels of vitamin D in patients referred in winter (9.0±2.94 ng/ml) compared with the summer (19.85±4.21 ng/ml; P=0.001). Data analyzed based on the season in which the patients were referred showed no significant difference between the OME and the control group. Conclusion: Although our results showed lower serum levels of vitamin D in OME patients, the difference was not significant when seasons were taken into consideration. Therefore, the season is an important confounding factor in any research related to vitamin D due to the effect of sun-induced vitamin D.

  9. Cost and Utilization of Retail Clinics vs. Other Providers for Treatment of Pediatric Acute Otitis Media.

    Science.gov (United States)

    Duncan, Ian; Clark, Kara; Wang, Stacy

    2016-10-01

    A common acute condition seen by providers in retails clinics is the evaluation and treatment of acute otitis media (AOM) in children younger than age 20. Annual direct treatment costs for AOM were US $5.3 billion in 1998 dollars. Based on the experience of a large retail pharmacy employer, the authors compared AOM episodes in covered dependents younger than age 20 in retail clinic states to those in states without retail clinic access. Relative costs as well as frequency of visits and antibiotic prescriptions were analyzed for both retail clinic-based, and non-retail clinic-based episodes. Rates of AOM episodes were lower in retail clinic than in non-retail clinic states (62.5 vs. 76.9 per 1000 members per year; P retail clinic and non-retail clinic states (1.417 vs. 1.430, respectively; P = 0.657), suggesting that retail clinics do not result in an increase in overall utilization. On a risk-adjusted basis, retail clinic episodes cost approximately $30-$130 less than community episodes, depending on year. In retail clinic states, the antibiotic prescription fill rate was 95.4% for retail clinic episodes and 82.8% for community episodes, consistent with rates in the literature. This study confirms results of earlier studies that retail clinics are a less costly setting than the community for the treatment of episodes of otitis media There also is little evidence that retail clinics lead to duplication of services (patients receiving follow-up care in other settings).

  10. Hubungan Antara Nilai Indeks Pertumbuhan Vertikal Wajah dan Kejadian Otitis Media Kronik pada Subras Deutero Melayu Dewasa

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    Henny Widyastuti

    2014-09-01

    Full Text Available Vertical growth index (VERT describes craniofacial growth. This value affects the eustachian tube growth. Differences in craniofacial morphology correlates with eustachian tube anatomy function and tensor veli palatini muscles that play a role in the pathogenesis of chronic otitis media (COM. This study aimed to determine the effect of vertical growth index (VERT and cephalometry on COM incident. The design was case-control with subjects from the outpatient clinic of otolaryngology head and neck surgery, Dr. Hasan Sadikin General Hospital during the period of September to November 2013. Subjects were divided into two groups: COM group and control group. Cephalometric measurements were performed and the mean values difference of both groups were calculated using t test or Mann-Whitney test. The mean index VERT was then calculated for each groups and relationship between risk factors and effects were analyzed using Odds Ratio. Four of 7 subjects in the COM group have a short round face/brachifacial type with greater facial depth angle (t=3.408, p=0.005 with smaller mandibular plane angle are (t = - 4.055, p=0.002. Subjects with VERT index > +0.5 (brachyfacial type have eight times higher risk to be COM (OR: 8; 95% CI: 0.41 to 309.1. In conclusion, the VERT index has an association with COM incident in adult Deutero Malays.

  11. Clinical Study of Aero-otitis Media%航空性中耳炎的临床探讨

    Institute of Scientific and Technical Information of China (English)

    郭庭梅

    2015-01-01

    Objective To study the clinical symptoms analysis of aviation otitis media.Methods Between January 2010 and January 2015 in our hospital 12 crew and passengers 8 diagnostic data were retrospectively analyzed, through to summarize the clinical data and the knowledge of aviation otitis media of the pathogenic factors and clinical symptoms.Results 20 cases, 2 cases diagnosed by aviation sex otitis media caused by eustachian tube dysfunction, 6 cases caused by upper respiratory tract infection aviation otitis media, 12 cases were caused by nasal and nasopharyngeal lesions aviation otitis media.Conclusion Through summary analysis of the diagnostic data, aviation otitis media of the upper respiratory tract infection were the major pathogenic factors, nasopharyngeal lesions and the decrease of the aircraft speed, etc.%目的 探讨分析航空性中耳炎的临床症状.方法 对2010年1月~ 2015年1月来我院就诊的12名空勤人员和8名旅客的诊断资料进行回顾性分析,通过对临床资料总结研究,了解航空性中耳炎的致病因素及临床症状.结果 20个病例中,初步诊断为2例因咽鼓管功能障碍导致航空性中耳炎,6例因上呼吸道感染导致航空性中耳炎,12例因鼻腔与鼻咽部病变导致航空性中耳炎.结论 通过对诊断资料的总结分析,航空性中耳炎的致病因素主要有上呼吸道感染、鼻咽部病变、飞机下降速度等.

  12. The impact of ventilation tubes in otitis media on the risk of cholesteatoma on a national level

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Christensen, Kaare; Skytthe, Axel

    2015-01-01

    OBJECTIVE: To estimate the impact of treatment with middle ear ventilation tube insertion (VTI) in children with otitis media (OM) on the risk of cholesteatoma on a national level. METHODS: Data were obtained from the Danish National Patient Register, the National Health Service Register and Stat......OBJECTIVE: To estimate the impact of treatment with middle ear ventilation tube insertion (VTI) in children with otitis media (OM) on the risk of cholesteatoma on a national level. METHODS: Data were obtained from the Danish National Patient Register, the National Health Service Register...... was associated with a lower risk of STMEC1. This may be the result of reduced time with negative middle ear pressure and OM. However, these findings may be susceptible to selection bias, as age at first VTI and time between VTIs, as well as the outcome variable, STMEC1, may all depend on the underlying...

  13. THE PRESENCE OF ADENOID VEGETATIONS AND NASAL SPEECH, AND HEARING LOSS IN RELATION TO SECRETORY OTITIS MEDIA

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    Gabriela KOPACHEVA

    2004-12-01

    Full Text Available This study presents the treatment of 68 children with secretory otitis media. Children underwent adenoid vegetations, nasal speech, conductive hearing loss, ventilation disturbance in Eustachian tube. In all children adenoidectomy was indicated.38 boys and 30 girls at the age of 3-17 were divided in two main groups: * 29 children without hypertrophic (enlarged adenoids, * 39 children with enlarged (hypertrophic adenoids.The surgical treatment included insertion of ventilation tubes and adenoidectomy where there where hypertrophic adenoids.Clinical material was analyzed according to hearing threshold, hearing level, middle ear condition estimated by pure tone audiometry and tympanometry before and after treatment. Data concerning both groups were compared.The results indicated that adenoidectomy combined with the ventilation tubes facilitates secretory otitis media heeling as well as decrease of hearing impairments. That enables prompt restoration of the hearing function as an important precondition for development of the language, social, emotional and academic development of children.

  14. Is a positive family history predictive for recurrent acute otitis media in children? An evidence-based case report.

    Science.gov (United States)

    Albersen, Monique; Bulatović, Maja; Lindner, Sanneke H; van Stiphout, Feikje; van der Heijden, Geert J M G; Schilder, Anne G M; Rovers, Maroeska M

    2010-01-01

    In this evidence-based case report, we studied the clinical question: Is a positive family history of acute otitis media (AOM) predictive for recurrent acute otitis media (rAOM) in children between zero and two years of age? The search yielded 3178 articles, of which only two were relevant and had a high validity regarding our clinical question. Neither of these two studies provided the final answer to our clinical question because they did not report stratified absolute risks for a positive family history. Fortunately, we were able to study the absolute risks in one of the two studies. The absolute risk of rAOM without distinguishing family history was 33 percent; the risk was 27 percent for children without a family history and 45 percent for children with a positive family history. Family history increases the absolute risk, but not in a way that it will help to predict rAOM accurately.

  15. A Case of Severe Asthma with Eosinophilic Otitis Media Successfully Treated with Anti-IgE Monoclonal Antibody Omalizumab

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    Azusa Okude

    2012-01-01

    Full Text Available A 51-year-old woman had been receiving medical treatment for asthma since she was 21 years old. However, her asthma was poorly controlled despite treatment involving combination inhalation of high-dose corticosteroid and long-acting β2-aderenergic agonist (LABA and regularly taking oral steroids. Hearing loss and otorrhea appeared at the age of 44, and she was given a diagnosis of eosinophilic otitis media (EOM and received medical treatment. In 2007, symptoms of asthma and otitis media deteriorated. In December 2009, omalizumab therapy was started for refractory asthma. After 2 months of omalizumab treatment, not only asthma, but also hearing loss improved. It is suggested that early initiation of omalizumab therapy may inhibit the progression of progressive EOM.

  16. [Evaluation of safety and efficacy of tebipenem pivoxil granules for pediatric in pneumonia, otitis media and sinusitis].

    Science.gov (United States)

    Kataoka, Hiroshi; Kasahara, Hiroshi; Sasagawa, Yuji; Matsumoto, Masato; Shimada, Seiya

    2016-02-01

    We conducted a postmarketing surveillance of tebipenem pivoxil granules (Orapenem® fine granules 10% for pediatric), an oral carbapenem antibacterial agent, between April 2010 and March 2013 to evaluate the safety and efficacy in patients with pneumonia or otitis media, or sinusitis Of 3,547 patients enrolled, 3,540 from whom survey forms were collected were analyzed. Of these 3,540 patients, there were a total of 3,331 patients included in the safety analysis, 2,844 in the efficacy analysis, 2,769 in the clinical efficacy analysis, and 461 in the bacteriological efficacy analysis. The incidence of adverse drug reactions (ADRs) was 9.97% (332/3,331 patients), and the major ADRs were gastrointestinal disorders including diarrhoea in 317 patients (9.52%). Diarrhoea was reported in 313 patients (316 events), which were not clinically significant and 94.9% (297/313 patients) were recovery and/or remission. The overall clinical efficacy rate was 94.0% (2,604/2,769 patients). The clinical efficacy rate by the type of infection was 95.6% (415/434 patients) for pneumonia, 93.7% (1,389/1,482 patients) for otitis media and 93.6% (659/704 patients) for sinusitis. The eradication rate of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella (Branhamella) catarrhalis which are major causative organisms in pediatric infection of pneumonia, otitis media and sinusitis were 94.4% (134/142 strains), 92.2% (130/141 strains) and 97.8% (45/46 strains), respectively. The compliance was good in 83.1% of the patients (2,767/3,331 patients). Overall, Orapenem® fine granules 10% for pediatric showed good safety, efficacy, and compliance. These results indicate that Orapenem® fine granules 10% for pediatric is a useful agent in pediatrics with pneumonia or otitis media, or sinusitis.

  17. Otitis media with effusion (OME in primary care: follow-up protocol.

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    José Ignacio BENITO-OREJAS

    2016-07-01

    Full Text Available Introduction and objective: With the intention of improving the quality of care of children with otitis media with effusion (OME, the pediatricians of primary care (PAP have been provided procedures diagnostic and training media, establishing a rule of consensus action. In this paper we present the Protocol developed for the monitoring of OME in children.Material and methods: A team of pediatricians and otolaryngologists from the same Healthcare Area, who have worked to achieve this consensus. Through the published guides and review of the literature on OME, we find his best adaptation to our environment.Results: We expose the necessary steps for the diagnosis, follow-up, referral and documentation of OME in children.Discussion: A correct therapeutic intervention for OME in children involves documenting patient characteristics and clinical findings of the pneumatic otoscopy and tympanometry, perform periodic and vigilant monitoring of potential disruptions, know and apply the reasons for referral to specialized care and maintaining good communication between pediatricians and ENT.Conclusions: The agreement between pediatricians and ENT has helped establish a joint guide of action in children for OME, which together with the improvement of diagnosis, will result in a greater degree of efficiency in the childhood care of OME.

  18. Next-Generation Sequencing Combined with Specific PCR Assays To Determine the Bacterial 16S rRNA Gene Profiles of Middle Ear Fluid Collected from Children with Acute Otitis Media

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    Kramna, Lenka; Oikarinen, Sami; Sipilä, Markku; Rautiainen, Markus; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej

    2017-01-01

    and possible roles of other bacteria is incomplete. The advent of unbiased bacteriome 16S rRNA gene profiling has allowed the detection of nearly all bacteria present in the sample, and it helps in depicting their mutual quantitative ratios. Due to the difficulties in performing mass sequencing in low-volume samples, only a few bacteriome-profiling studies of otitis media have been published, all limited to cases of chronic otitis media. Here, we present a study on samples obtained from young children with acute otitis media, successfully using a strategy of nested PCR coupled with mass sequencing, and demonstrate that the method can confer quantitative information hardly obtainable by other methods. PMID:28357413

  19. Change of serum, ear effusion inflammatory mediators and blood immune indexes of patients with secretory otitis media

    Institute of Scientific and Technical Information of China (English)

    Bo Liu; Chang-Hua Zhou; Hong-Quan Xiong; Si-Guo Qi

    2016-01-01

    Objective:To study the change state of serum, ear effusion inflammatory mediators and blood immune indexes of patients with secretory otitis media.Methods:A total of 70 patients with secretory otitis media in our hospital from January 2014 to August 2015 were selected as the observation group and 70 healthy persons in the same period were selected as the control group. Then, the serum, ear effusion inflammatory mediators and blood immune indexes of observation group and the blood indexes of control group were detected, and the serum inflammatory mediators and blood immune indexes of two groups were compared and the detection results of observation group with different classification and effusion property patients were compared too.Results: The serum inflammatory mediators of observation group were all higher than those of control group and the blood immune indexes were all worse than those of control group. While the serum and ear effusion inflammatory mediators and blood immune indexes of observation group with different classification and effusion property patients all had significant differences.Conclusions: The serum, ear effusion inflammatory mediators and blood immune indexes of patients with secretory otitis media show abnormal state, and the differences of those indexes of patients with different classification and effusion property have significant differences. So the detection values of those indexes in the patients are higher.

  20. [Balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media].

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    Burova, O V; Bogomil'sky, M R; Polunin, M M; Soldatsky, Yu L

    2016-01-01

    The objective of the present study was to evaluate the effectiveness and the safety of balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media. A total of 15 children (22 ears) at the age from 3 to 16 years suffering from relapsing exudative otitis media over 18 months in duration were available for the examination. Neither conservative nor surgical treatment produced any stable beneficial effect in these patients. Acoustic impedancometry yielded type B tympanograms. All the children were treated with the use of balloon dilatation of the cartilaginous portion of the Eustachian tube under endotracheal anesthesia. The follow-up examination carried out within 6--8 weeks after the treatment revealed the complete recovery of the function of the middle ear (type A tympanograms) in 11 (73.3%) children. Partial restoration of this function (as evidenced by type C tympanogram) was documented in 4 children. These patients underwent the second course of conservative therapy that resulted in the complete restoration of the function of the middle ear. It is concluded that balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media provides the efficient and safe approach to the management of this condition. Being a minimally invasive method, it has good prospects for the practical application and is worth further investigation.

  1. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    The use of cochlear implants is increasingly common, particularly in children younger than 3 years. Bacterial meningitis, often with associated acute otitis media, is more common in children with cochlear implants than in groups of control children. Children with profound deafness who are candidates for cochlear implants should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza. In addition, starting at 24 months of age, a single dose of 23-valent pneumococcal polysaccharide vaccine should be administered. Before implant surgery, primary care providers and cochlear implant teams should ensure that immunizations are up-to-date, preferably with completion of indicated vaccines at least 2 weeks before implant surgery. Imaging of the temporal bone/inner ear should be performed before cochlear implantation in all children with congenital deafness and all patients with profound hearing impairment and a history of bacterial meningitis to identify those with inner-ear malformations/cerebrospinal fluid fistulas or ossification of the cochlea. During the initial months after cochlear implantation, the risk of complications of acute otitis media may be higher than during subsequent time periods. Therefore, it is recommended that acute otitis media diagnosed during the first 2 months after implantation be initially treated with a parenteral antibiotic (eg, ceftriaxone or cefotaxime). Episodes occurring 2 months or longer after implantation can be treated with a trial of an oral antimicrobial agent (eg, amoxicillin or amoxicillin/clavulanate at a dose of approximately 90 mg/kg per day of amoxicillin component), provided the child does not appear toxic and the implant does not have a spacer/positioner, a wedge that rests in the cochlea next to the electrodes present in certain implant models available between 1999 and 2002. "Watchful waiting" without antimicrobial

  2. 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.

  3. [Clinical importance of tympanometry in the diagnosis of chronic secretory otitis].

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    Spremo, S; Markić, Z; Kurbalija

    1998-01-01

    Secretory otitis media is defined as a fluid in the middle ear without signs or symptoms of infection. As the aetiology and pathogenesis of the disease are unknown, and as it affects children aged from 3 to 12 years, treatment procedures proposed for management of secretory otitis media, are not uniform. Some authors [1, 4, 6] consider that functional or mechanical obstructions of the Eustachian tube could provoke secretory otitis. The purpose of the treatment is to remove exudate from the middle ear and appropriately ventilate it for a longer period. That could instantly normalize the hearing and exclude the appearance of late complications of secretory otitis. Although the disease could heal spontaneously, the treatment should be performed immediately for preventing sequelae of secretory otitis. The aim of the study was to evaluate possible aetiologic factors of secretory otitis in our population, and to evaluate results of lympanometry in children with exudate in the middle ear. There were 65 children, aged from 3 to 12 years (Table 1), who complained of deafness and were examined at the ORL Department in Banja Luka. The clinical examination revealed the integrity and color of tympanic membrane, scars, adhesions and atrophic areas. Audiometry and tympanometry had been performed in addition. Patients who proved to have exudate in the middle ear received nasal decongestants and mucolitics during three months, and were evaluated every three weeks by audiometry and tympanometry. Pathologic findings in the nose and epipharynx were the most common findings: enlarged adenoids in 38 (58%) patients, hypetrophic rhinitis in 15 (23%) and allergic rhinitis in 5 (8%) patients. Frequent relapses of middle ear infection in the first three years of life were found in 26 (40%) patients and early first attacks in the first year of life in 15 (23%) patients (Table 2). Premature onset (15%) and allergy (21%) had also been frequently found. Results of tympanometry and audiometry are

  4. Clinical evaluation of an antiinflammatory and antioxidant diet effect in 30 dogs affected by chronic otitis externa: preliminary results.

    Science.gov (United States)

    Di Cerbo, Alessandro; Centenaro, Sara; Beribè, Francesca; Laus, Fulvio; Cerquetella, Matteo; Spaterna, Andrea; Guidetti, Gianandrea; Canello, Sergio; Terrazzano, Giuseppe

    2016-03-01

    The aim of this evaluation study was to assess the possible role of a specific nutraceutical diet in relieving main clinical symptoms of chronic bilateral otitis externa (occlusion of ear canal, erythema, discharge quantity, and odor) in 30 adult dogs. Thirty dogs of different breeds (mean age ± SEM; 6.03 ± 0.15 years and mean weight ± SEM; 32.01 ± 1.17 Kg; 53.3% males, 46.6% females) with evident chronic clinical otitis symptoms were equally divided and randomly assigned to receive either the nutraceutical diet (ND group) or a standard diet (SD group) over a period of 90 days. In all cases a topical pharmacological treatment was given. The nutraceutical diet, also endowed with anti-inflammatory and antioxidant activities, significantly decreased the mean score intensity of all symptoms after 90 days of intervention (P otitis externa-related symptoms. This study opens new insights into otitis externa clinical management providing evidence of efficacy of a combined therapy with drugs and a specific nutraceutical diet.

  5. Otitis Media: To Treat, To Refer, To Do Nothing: A Review for the Practitioner.

    Science.gov (United States)

    Rosa-Olivares, Jose; Porro, Amanda; Rodriguez-Varela, Marielys; Riefkohl, Gloria; Niroomand-Rad, Iran

    2015-11-01

    .On the basis of research evidence, a recommended strategy for improving the care of middle ear infections is to identify the subset of patients least likely to benefit from antibiotic therapy. They include children ages 6 months to 23 months with unilateral disease without severe signs and symptoms (moderate or severe otalgia, otalgia lasting more than 48 hours,or temperature of 39°C [102.2°F]), and those older than 2 years ofage with unilateral or bilateral disease who have mild signs andsymptoms.(9) On the basis of research evidence, the initial treatment of otitis media with effusion is watchful observation. There is little harm in observing a child who is not at risk for speech, language, or learning difficulties compared to medical or surgical intervention.(4) On the basis of research evidence, administration of the annual influenza vaccine and the conjugated pneumococcal vaccination has been shown to have a small but statistically significant impact on the frequency of middle ear disease. (7)(8) On the basis of expert opinion, optimal outcomes depend oncommunication between clinicians and parents. At a minimum , primary care clinicians should state their reasons for their own clinical judgment about appropriate management and for referral to otolaryngology if necessary.

  6. Helicobacterpylori in middle ear of children with otitis media with effusion

    Institute of Scientific and Technical Information of China (English)

    PARK Chul-won; CHUNG Jae-ho; MIN Hyun-jung; KIM Kyung-rae; TAE Kyung; CHO Seok-hyun; LEE Seung-hwan

    2011-01-01

    Background Otitis media with effusion (OME) is a common pediatric disease,but its pathogenesis remains uncertain.The relationship between OME and Helicobacter pylori (HP) is currently being studied,and a relationship has not yet been confirmed.The purpose of this study was to show that a relationship does exist between HP and OME.Methods The study consisted of 60 patients who were diagnosed with OME and had ventilation tube insertions with or without an adenoidectomy.This study included an additional 30 patients who had only received an adenoidectomy without being diagnosed with OME.The effusion samples were analyzed with polymerase chain reaction (PCR) and the campylobacter-like organism (CLO) test.The adenoid tissue samples were analyzed with the CLO test.Results Eighteen patients among the 60 patients (30%) tested positive for HP.In the cases with adenoids,15.6% of the OME patients and 13.3% of the adenoidectomy only patients were positive for HP.There were no differences between the prevalence of HP in the adenoids of OME patients and the patients without OME.Conclusion HP can be considered one of the causes of OME.

  7. Polymorphisms of immunity genes and susceptibility to otitis media in children.

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    Johanna Nokso-Koivisto

    Full Text Available BACKGROUND: Acute otitis media (OM is a common disease which often develops through complex interactions between the host, the pathogen and environmental factors. We studied single nucleotide polymorphisms (SNPs of genes involved in innate and adaptive immunity, and other host and environmental factors for their role in OM. METHODS: Using Sequenom Massarray platform, 21 SNPs were studied in 653 children from prospective (n = 202 and retrospective (n = 451 cohorts. Data were analyzed for the relationship between SNPs and upper respiratory infection (URI frequency, risk of acute OM during URI episodes, and proneness to recurrent OM. RESULTS: Increased risk for OM proneness was associated with CX3CR1 (Thr280Met SNP and with a jointly interactive group of IL-10 (-1082 SNP, IL-1β (-511 wild type genotype and white race. Family history of OM proneness independently increased the risk for frequent URIs, OM occurrence during URI, and OM proneness. Additionally, IL-1β (-31 SNP was associated with increased risk for frequent URIs, but IL-10 (-592, IL-1β (-511, IL-5 (-746 and IL-8 (-251 SNPs were associated with decreased risk of URI. CONCLUSION: IL-1β (-31, CX3CR1 (Thr280Met, IL-10 (-1082 and IL-1β (-511 SNPs were associated with increased risk for frequent URIs or OM proneness.

  8. Evolving microbiology and molecular epidemiology of acute otitis media in the pneumococcal conjugate vaccine era.

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    Pichichero, Michael E; Casey, Janet R

    2007-10-01

    The addition of the 7-valent pneumococcal conjugate vaccine (PCV7) to the routine immunization schedule in the United States for infants has produced a much more favorable impact on the incidence of acute otitis media (AOM) than anticipated. Because the serotypes included in PCV7 were those most frequently expressing antibiotic resistance in 2001, predictions were made that up to 98% of pneumococcal AOM episodes would be caused by penicillin susceptible strains. However, recent studies have shown that the benefits of PCV7 are becoming eroded. Replacement serotypes of pneumococci have emerged, expressing polysaccharide capsules different from those included in PCV7, with increasing frequency. These replacement strains are coming to dominate in the nasopharynx and in AOM isolates (and in invasive disease). Expansion in the isolation of serotypes 3, 7F, 15B/C/F, 19A, 22F, 33F, and 38 has been described in various surveillance systems. Pneumococcal strains expressing non-PCV7 capsular serotypes also appear to be rapidly acquiring resistance to penicillin and other antibiotics. Emergence of strains of pneumococci expressing non-PCV7 capsular serotypes is occurring by multiple mechanisms including capsular switching as suggested by molecular epidemiology studies. Expansion of the number of serotypes included in pneumococcal conjugate vaccines is needed to sustain a long-term benefit from immunization against these bacteria.

  9. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

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    Hatice Hilal Doğan

    2016-01-01

    Full Text Available Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48±0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics.

  10. Transcriptome signature in young children with acute otitis media due to non-typeable Haemophilus influenzae.

    Science.gov (United States)

    Liu, Keyi; Chen, Linlin; Kaur, Ravinder; Pichichero, Michael E

    2013-06-01

    Non-typeable Haemophilus influenzae (NTHi) causes acute otitis media (AOM) in young children. In our recent paper in Microbes and Infection we described the transcriptome signature elicited from PBMCs at onset of AOM caused by Streptococcus pneumoniae. In the current study we found very different results with NTHi AOM infections; 5.1% of 29 187 genes were differentially regulated by more than 2-fold at the onset of AOM compared with the pre-infection healthy state in the same children. Among the 1487 transcripts, 100 genes associated with the immune defense response were specifically analyzed. About half of the differentially regulated genes associated with antibacterial activity and the cell-mediated immune response were activated and half were suppressed. The important signatures for NTHi in children suggested that the balance of the immune response was toward suppression. Moreover, 90% of the genes associated with a pro-inflammatory cytokine response were down-regulated. The genes associated with the classic complement pathway were down-regulated, although the alternative complement pathway genes were up-regulated. These results provide the first human transcriptome data identifying gene expression in the immune response to be predominantly down-regulated at the onset of AOM due to NTHi.

  11. Educational intervention for parents and healthcare providers leads to reduced antibiotic use in acute otitis media.

    Science.gov (United States)

    Småbrekke, Lars; Berild, Dag; Giaever, Anton; Myrbakk, Torni; Fuskevåg, Airin; Ericson, Johanna U; Flaegstad, Trond; Olsvik, Orjan; Ringertz, Signe H

    2002-01-01

    We used a controlled before-and-after design with the aims of reducing both the total consumption of antibiotics and the use of broad-spectrum antibiotics against acute otitis media (AOM), and to study to what extent prescriptions for antibiotics against AOM were dispensed. Information on evidence-based treatment of uncomplicated AOM was provided to doctors and nurses, and written guidelines were implemented. Pamphlets and oral information concerning symptomatic treatment and the limited effect of antibiotic use in AOM were given to parents. Eligible patients were 819 children aged 1-15 y. The proportion of patients receiving a prescription for antibiotics was reduced from 90% at baseline to 74% during the study period. The proportion of prescriptions for penicillin V increased from 72% at baseline to 85% during the study period. There were no significant changes at the control site. The proportion of dispensed prescriptions was 70% both at baseline and during the study period. Educational efforts reduced the total consumption of antibiotics and the use of broad-spectrum antibiotics for AOM in children aged 1-15 y at an emergency call service. Data on antibiotic use in AOM based only on prescribing overestimates the use of antibiotics.

  12. Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

    Science.gov (United States)

    Bernkopf, Edoardo; Bernkopf, Giulia; Giacomelli, Luciano; De Vincentis, Giovanni Carlo; Macrì, Francesco; de Filippis, Cosimo

    2016-01-01

    Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction. PMID:27965974

  13. Management of acute otitis media in children six months of age and older.

    Science.gov (United States)

    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

    Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be bacterial in origin and is a major diagnostic criterion for AOM. Perforation of the tympanic membrane with purulent discharge similarly indicates a bacterial cause. Immediate antibiotic treatment is recommended for children who are highly febrile (≥39°C), moderately to severely systemically ill or who have very severe otalgia, or have already been significantly ill for 48 h. For all other cases, parents can be provided with a prescription for antibiotics to fill if the child does not improve in 48 h or the child can be reassessed if this occurs. Amoxicillin remains the clear drug of choice. Ten days of therapy is appropriate for children <2 years of age, whereas older children can be treated for five days.

  14. Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander?

    Science.gov (United States)

    Chonmaitree, Tasnee; Ruohola, Aino; Hendley, J Owen

    2012-04-01

    Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens. Because viral culture is not sensitive and does not detect the comprehensive spectrum of respiratory viruses, polymerase chain reaction assays are commonly used to detect viral nucleic acids in the middle ear fluid. Although polymerase chain reaction assays have greatly increased the viral detection rate, new questions arise on the significance of viral nucleic acids detected in the middle ear because nucleic acids of multiple viruses are detected simultaneously, and nucleic acids of specific viruses are detected repeatedly and in a high proportion of asymptomatic children. This article first reviews the role of live viruses in AOM and presents the point-counterpoint arguments on whether viral nucleic acids in the middle ear represent an AOM pathogen or a bystander status. Although there is evidence to support both directions, helpful information for interpretation of the data and future research direction is outlined.

  15. High cytokine levels in perforated acute otitis media exudates containing live bacteria.

    Science.gov (United States)

    Skovbjerg, S; Roos, K; Nowrouzian, F; Lindh, M; Holm, S E; Adlerberth, I; Olofsson, S; Wold, A E

    2010-09-01

    Acute otitis media (AOM) is an inflammatory response to microbes in the middle ear, sometimes associated with rupture of the tympanic membrane. Human leukocytes produce different patterns of inflammatory mediators in vitro when stimulated with Gram-positive and Gram-negative bacteria, respectively. Here, we investigated the cytokine and prostaglandin E2 (PGE2) responses in middle ear fluids (MEFs) from children with spontaneously perforated AOM, and related the mediator levels to the presence of pathogens detected by culture (live) or PCR (live or dead). Furthermore, the in vivo cytokine pattern was compared with that induced in leukocytes stimulated by dead bacteria in vitro. MEFs with culturable pathogenic bacteria contained more interleukin (IL)-1β (median: 110 μg/L vs. bacteria. Cytokine levels were unrelated to bacterial species and to the presence or absence of virus. Similar levels of TNF and IL-6 as found in the MEFs were obtained by in vitro stimulation of leukocytes, whereas 11 times more IL-1β and 3.5 times more IL-8 were produced in vivo, and 22 times more IL-10 was produced in vitro. Vigorous production of proinflammatory cytokines accompanies AOM with membrane rupture, regardless of the causative agent, but the production seems to cease rapidly once the bacteria are killed and fragmented. IL-6 and PGE2, however, remain after bacterial disintegration, and may play a role in the resolution phase.

  16. Management of acute otitis media in children six months of age and older

    Science.gov (United States)

    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

    Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be bacterial in origin and is a major diagnostic criterion for AOM. Perforation of the tympanic membrane with purulent discharge similarly indicates a bacterial cause. Immediate antibiotic treatment is recommended for children who are highly febrile (≥39°C), moderately to severely systemically ill or who have very severe otalgia, or have already been significantly ill for 48 h. For all other cases, parents can be provided with a prescription for antibiotics to fill if the child does not improve in 48 h or the child can be reassessed if this occurs. Amoxicillin remains the clear drug of choice. Ten days of therapy is appropriate for children <2 years of age, whereas older children can be treated for five days. PMID:26941560

  17. Literacy skills of Australian Indigenous school children with and without otitis media and hearing loss.

    Science.gov (United States)

    Timms, Lydia; Williams, Cori; Stokes, Stephanie F; Kane, Robert

    2014-06-01

    This study examined the relationship between reading, spelling, and the presence of otitis media (OM) and co-occurring hearing loss (HL) in metropolitan Indigenous Australian children, and compared their reading and spelling outcomes with those of their non-Indigenous peers. OM and HL may hinder language development and phonological awareness skills, but there is little empirical evidence to link OM/HL and literacy in this population. Eighty-six Indigenous and non-Indigenous children attending pre-primary, year one and year two at primary schools in the Perth metropolitan area participated in the study. The ear health of the participants was screened by Telethon Speech and Hearing Centre EarBus in 2011/2012. Participants' reading and spelling skills were tested with culturally modified sub-tests of the Queensland University Inventory of Literacy. Of the 46 Indigenous children, 18 presented with at least one episode of OM and one episode of HL. Results indicated that Indigenous participants had significantly poorer non-word and real word reading and spelling skills than their non-Indigenous peers. There was no significant difference between the groups of Indigenous participants with OM and HL and those with normal ear health on either measure. This research provides evidence to suggest that Indigenous children have ongoing literacy development difficulties and discusses the possibility of OM as one of many impacting factors.

  18. Speech reception in noise: an indicator of benefit from otitis media with effusion surgery.

    Science.gov (United States)

    2004-10-01

    To determine possible selection criteria for ventilation tubes (VTs - grommets), in otitis media with effusion (OME), a randomized trial on 68 children was undertaken. To provide both a baseline predictor and outcome measure in auditory disability, speech-in-noise thresholds were obtained with the IHR-McCormick Automated Toy Test (SiN ATT). Children allocated to surgery (n = 32) and control (n = 36) were followed-up at 3 and 12 months postintervention. Baseline SiN ATT score provided a significant by-treatment interaction in predicting the performance at +3 months, establishing it as an evidence-based indicator. Although average benefits on hearing level score (HL) were also shown, baseline HL was not a valid indicator (no significant interaction). The 40% of the sample with worst baseline SiN experienced high benefit from VTs. In children over 3 years of age, baseline SiN performance can indicate those with OME most likely to benefit from VTs.

  19. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

    Science.gov (United States)

    Doğan, Hatice Hilal; Kırkgöz, Tarık; Bozaykut, Abdulkadir

    2016-01-01

    Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48 ± 0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics. PMID:27648079

  20. Evaluating Children with Otitis Media for Bacteremia or Urinary Tract Infection

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    Daniel Yawman

    2010-01-01

    Full Text Available Background. It is unclear if clinicians evaluate for concurrent bacteremia or UTI in young patients diagnosed with acute otitis media (AOM. Objectives. To describe how often, and under which circumstances, emergency providers investigate for bacteremia or UTI in 2–36 month olds with AOM. Methods. Cases of AOM were analyzed from the 2001–2004 National Hospital Ambulatory Medical Care Survey (NHAMCS-Emergency Department dataset. Results. AOM was diagnosed in 17% of the 10,847 recorded visits of 2–36 month olds. Of these visits, laboratory testing included: CBC: 7%, Blood culture: 4%, urinalysis or urine culture: 5%, and any of these tests: 9%. Rates of testing for 2–6 month olds with temperature ≥ 38.0 (CBC: 13%, blood culture: 9%, urinalysis or urine culture: 7%, any of the tests: 14% were not significantly different from testing of patients aged 6–12 months, or 12–36 months (all P>.1. Patients with temperature of ≥39.0 were more likely to have all tests, with the exception of urine investigation, than patients with temperature between 38.0 and 38.9. Conclusions. 17% of 2–36 month old patients seen in the emergency department are diagnosed with AOM. Investigating for bacteremia or UTI in these patients is not routine, even in febrile infants.

  1. Molecular epidemiology of nonencapsulated Streptococcus pneumoniae among Japanese children with acute otitis media.

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    Hotomi, Muneki; Nakajima, Kouji; Hiraoka, Masanobu; Nahm, Moon H; Yamanaka, Noboru

    2016-02-01

    The introduction of pneumococcal conjugate vaccine may change the epidemiology of Streptococcus pneumoniae. The increased prevalence of non-vaccine serotypes as the cause of pneumococcal diseases has already reported in the United States and Europe. However, little attention has been focused on the S. pneumoniae. In this study, nonencapsulated S. pneumoniae were identified in 15 isolates (6.4%) out of 236 pneumococcal strains obtained from the nasopharynges of children with acute otitis media (AOM), in 3 isolates (14.3%) out of 21 strains from acute rhinosinusitis, and in 2 isolates (12.5%) out of 16 nasopharyngeal carriage strains obtained from normal healthy children. Among the 20 nonencapsulated S. pneumoniae isolates, 15 (75.0%) isolates had the pspK gene. Seven sequence types (STs) were identified: ST7502 (5 strains), ST1106 (2 strains), ST7803 (2 strains), ST7786 (1 strain), ST6741 (1 strain), ST7496 (1 strain), and ST8642 (1 strain). Because nonencapsulated S. pneumoniae strains are not targeted by the current available pneumococcal vaccines, these strains will gradually become more common in nasopharyngeal carriage. The increase in colonization and dissemination of these strains would increase the risk of AOM and other systemic pneumococcal diseases against which current vaccines cannot provide protection. Nonencapsulated S. pneumoniae may thus become more prevalent as human pathogen.

  2. Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media

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    James A. Taylor MD

    2014-11-01

    Full Text Available Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM. Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032. Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.

  3. Divergent mucosal and systemic responses in children in response to acute otitis media.

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    Verhoeven, D; Pichichero, M E

    2014-10-01

    Acute otitis media (AOM), induced by respiratory bacteria, is a significant cause of children seeking medical attention worldwide. Some children are highly prone to AOMs, suffering three to four recurrent infections per year (prone). We previously determined that this population of children could have diminished anti-bacterial immune responses in peripheral blood that could fail to limit bacterial colonization in the nasopharynx (NP). Here, we examined local NP and middle ear (ME) responses and compared them to peripheral blood to examine whether the mucosa responses were similar to the peripheral blood responses. Moreover, we examined differences in effector cytokine responses between these two populations in the NP, ME and blood compartments at the onset of an AOM caused by either Streptococcus pneumoniae or non-typeable Haemophilus influenzae. We found that plasma effector cytokines patterned antigen-recall responses of CD4 T cells, with lower responses detected in prone children. ME cytokine levels did not mirror blood, but were more similar to the NP. Interferon (IFN)-γ and interleukin (IL)-17 in the NP were similar in prone and non-prone children, while IL-2 production was higher in prone children. The immune responses diverged in the mucosal and blood compartments at the onset of a bacterial ME infection, thus highlighting differences between local and systemic immune responses that could co-ordinate anti-bacterial immune responses in young children.

  4. Payment analysis of two diagnosis and management approaches of acute otitis media.

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    Casey, Janet R; Pichichero, Michael E

    2014-08-01

    We determined the cost of care for 2 diagnosis and management approaches for acute otitis media (AOM) among children 6 to 30 months old. A case-control design was used. Cases included 208 children diagnosed with AOM based on a bulging tympanic membrane (TM) and treated with amoxicillin/clavulanate. Controls (5:1 ratio) included 1020 children with AOM diagnosed not requiring bulging of the TM and treated with amoxicillin. Fewer cases (49%) than controls (69%) were diagnosed with AOM (P < .001), fewer were diagnosed with recurrent AOM or AOM treatment failure (0.34 vs 1.6/child; P < .0001), and fewer had insertion of tympanostomy tubes (6.3% vs 14.8%) due to recurrent AOM (P < .0001). The combined direct payments and indirect costs for management of AOM were $539/case versus $1,023/control. Using Rochester NY payments generalized to the US birth cohort, this case diagnosis and treatment strategy could save $1.008 billion per year.

  5. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis.

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    Kim, Chang-Hee; Yang, Young Soo; Im, Donghyuk; Shin, Jung Eun

    2016-06-01

    Conclusion The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. Objective This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. Methods From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. Results The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment.

  6. Incidence and recurrence of acute otitis media in Taiwan's pediatric population

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    Pa-Chun Wang

    2011-01-01

    Full Text Available OBJECTIVE: To report the incidence and recurrence of acute otitis media (AOM in Taiwan's pediatric population. METHODS: Information from children (aged <= 12 years with a diagnosis of AOM was retrieved from the 2006 National Healthcare Insurance claims database. We calculated the cumulative incidence rate and the incidence density rate of recurrent AOM within one year after the initial diagnosis in 2006. We used a multivariate logistic regression model to assess the predictors for recurrence of AOM. RESULTS: The annual incidence rate of AOM was estimated to be 64.5 cases per 1,000 children. The overall one-year cumulative incidence rate of recurrence was 33.1%, and the incidence density rate was 33.5 cases per 100 personyears, with the highest figure (41.2 cases per 100 person-years noted for children aged 0-2 years. Recurrence was significantly associated with age, gender, place of treatment, and physician specialty. CONCLUSION: AOM remains a major threat to children's health in Taiwan. Male children and very young children require more aggressive preventive strategies to reduce the risk of recurrence.

  7. Human parechovirus as a minor cause of acute otitis media in children.

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    Sillanpää, Saara; Oikarinen, Sami; Sipilä, Markku; Seppälä, Elina; Nurminen, Noora; Rautiainen, Markus; Laranne, Jussi; Hyöty, Heikki

    2015-01-01

    Human parechoviruses (HPeVs) cause mild upper respiratory infections, gastrointestinal symptoms, central nervous system infections and some studies have linked them with acute otitis media (AOM). The aim of the present study was to study further the role of HPeV infections in AOM by detecting these viruses directly from middle ear fluid (MEF), respiratory and stool samples collected from children during AOM episodes. A total of 91 MEF samples, 98 nasal swab (NS) samples and 92 stool samples were collected during 100 AOM episodes in a total of 87 children aged between five to 42 months. All specimens were analyzed by real time RT-PCR for the presence of HPeV RNA. HPeV infection was diagnosed in 12 (14%) patients. HPeV RNA was detected in altogether 13 samples, including four MEF samples, three NS samples and six stool samples. One patient was positive in both stool and MEF samples. The results suggest that HPeV may play a role in some AOM cases, but it is not a major cause of AOM in children.

  8. Clinical implications of antibiotic resistance for management of acute otitis media.

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    Klein, J O

    1998-11-01

    Antibiotic resistance to available antimicrobial agents has been constant since the introduction of the sulfonamides in the 1930s. Multidrug-resistant Streptococcus pneumoniae and beta-lactamase-producing Haemophilus influenzae are a concern now because of the importance of these pathogens in infections of the respiratory tract in infants and children. Amoxicillin remains the drug of choice for initial episodes of acute otitis media (AOM) although increase of the dosage schedule to 80 mg/kg/day has been recommended by some investigators. There are 15 additional antimicrobial agents approved by the Food and Drug Administration for the indication of AOM. All approved drugs are clinically effective but some have been suggested to have priority for patients who fail amoxicillin: amoxicillin-clavulanate; an oral cephalosporin such as cefuroxime axetil; and intramuscular ceftriaxone. Management of the child with severe and recurrent disease should include antibiotic prophylaxis but the increased incidence of resistance requires selective use. Prevention of infection may be achieved by innovative techniques for interference with attachment of bacteria to the nasal mucosa such as administration of oligosaccharides in a nasal spray. The currently available polysaccharide pneumococcal vaccines have limited immunogenicity in infants, but the vaccine is useful in children 2 years of age and older who still have recurrent AOM. Children with frequent AOM during the prior respiratory season are candidates also for influenza virus vaccine. If medical management fails to prevent new episodes of AOM in children with severe and recurrent disease, placement of tympanostomy tubes and possible adenoidectomy should be considered.

  9. Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

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    Edoardo Bernkopf

    2016-01-01

    Full Text Available Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM. Materials and Methods. The clinical outcome (number of acute recurrences in 12 months of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B. The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p<0.0001 and multivariate analysis (p=0.001. Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.

  10. Immunization Str.pneumonia vaccine reduces the incidence orphanage children’s acute otitis media (preliminary results

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    A. A. Dzhumagaziev

    2012-01-01

    Full Text Available In order to assess the impact of pneumococcal vaccine on the incidence of ear infections in children in the first four years of life, the comparative analysis of monthly incidence of the disease in 18 months in previously vaccinated children, and for the first six months after the catch-up immunization of 7- (PCV7 or 23 – valent (PPV23 pneumococcal vaccine . Traced threefold reduction in the incidence of hospitalization 114 children being raised in orphanages for acute otitis after a single use of pneumococcal vaccine. Early immunization of 101 children against pneumococcus contributes monthly prevent 1 case of hospitalization for acute otitis media.

  11. Effect of triamcinolone acetonide ammonia bromine joint hydrochloric acid on patients with secretory otitis media and on body's inflammatory factor and cellular immunologic parameters

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    Quan-Fu Hu; Shao-Ji Ouyang; Rong-Wei Yao; Xue-Jiang Xu; Jin-Hua He; Li-Li Zhang

    2016-01-01

    Objective:To explore the clinical effect of triamcinolone acetonide ammonia bromine joint hydrochloric acid on patients with secretory otitis media and the influences on the body's inflammatory factors and cellular immunologic parameters.Methods:A total of 40 cases of single ear secretory otitis media patients of the same period in our hospital were randomly selected as experimental group, using triamcinolone acetonide ammonia bromine joint hydrochloric acid treatment; And 40 cases of single ear secretory otitis media patients of the same period were randomly selected as control group, using dexamethasone treatment. To observe the clinical efficacy of two groups of patients and detect the inflammatory factors and cellular immune index level of the two groups of patients before and after treatment.Results:The total effective rate(90%) of treatment group is significantly higher than that (80%) of control group (P0.05). After treatment, the serum and ear effusion inflammatory cytokines levels of the two groups were significantly lower than that before treatment (P0.05); The CD4+/CD8+ levels of experimental group were significantly higher than the control group (P0.05). Conclusions: The triamcinolone acetonide ammonia bromine joint hydrochloric acid treatment is more conducive to improve the immune function of the secretory otitis media patients and treatment effect, which has important clinical significance on the treatment of secretory otitis media patients.

  12. Virulence phenotypes of low-passage clinical isolates of Nontypeable Haemophilus influenzae assessed using the chinchilla laniger model of otitis media

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    Hogg Justin

    2007-06-01

    Full Text Available Abstract Background The nontypeable Haemophilus influenzae (NTHi are associated with a spectrum of respiratory mucosal infections including: acute otitis media (AOM; chronic otitis media with effusion (COME; otorrhea; locally invasive diseases such as mastoiditis; as well as a range of systemic disease states, suggesting a wide range of virulence phenotypes. Genomic studies have demonstrated that each clinical strain contains a unique genic distribution from a population-based supragenome, the distributed genome hypothesis. These diverse clinical and genotypic findings suggest that each NTHi strain possesses a unique set of virulence factors that contributes to the course of the disease. Results The local and systemic virulence patterns of ten genomically characterized low-passage clinical NTHi strains (PittAA – PittJJ obtained from children with COME or otorrhea were stratified using the chinchilla model of otitis media (OM. Each isolate was used to bilaterally inoculate six animals and thereafter clinical assessments were carried out daily for 8 days by blinded observers. There was no statistical difference in the time it took for any of the 10 NTHi strains to induce otologic (local disease with respect to any or all of the other strains, however the differences in time to maximal local disease and the severity of local disease were both significant between the strains. Parameters of systemic disease indicated that the strains were not all equivalent: time to development of the systemic disease, maximal systemic scores and mortality were all statistically different among the strains. PittGG induced 100% mortality while PittBB, PittCC, and PittEE produced no mortality. Overall Pitt GG, PittII, and Pitt FF produced the most rapid and most severe local and systemic disease. A post hoc determination of the clinical origins of the 10 NTHi strains revealed that these three strains were of otorrheic origin, whereas the other 7 were from patients

  13. Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen

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    Marsh Robyn L

    2012-10-01

    abundance it may be contributing to the associated inflammation. Further studies to better understand A. otitidis as a secondary otopathogen are warranted, particularly in populations at high-risk of progression to chronic suppurative otitis media and where macrolide therapies are being used.

  14. The homoeopathic treatment of otitis media in children--comparisons with conventional therapy.

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    Friese, K H; Kruse, S; Lüdtke, R; Moeller, H

    1997-07-01

    In a prospective observational study carried out by 1 homoeopathic and 4 conventional ENT practitioners, the 2 methods of treating acute pediatric otitis media were compared. Group A received treatment with homoeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea), whereas group B received nasal drops, antibiotics, secretolytics and/or antipyretics. The main outcome measures were duration of pain, duration of fever, and the number of recurrences after 1 year, whereby alpha < 0.05 was taken as significance level. The secondary measures were improvement after 3 hours, results of audiometry and tympanometry, and necessity for additional therapy. These parameters were only considered descriptively. The study involved 103 children in group A and 28 children in group B, aged between 6 months and 11 years in both groups. For duration of pain, the median was 2 days in group A and 3 days in group B. For duration of therapy, the median was 4 days in group A and 10 days in group B: this is due to the fact that antibiotics are usually administered over a period of 8-10 days, whereas homoeopathics can be discontinued at an earlier stage once healing has started. Of the children treated, 70.7% were free of recurrence within a year in group A and 29.3% were found to have a maximum of 3 recurrences. In group B, 56.5% were free of recurrence, and 43.5% had a maximum of 6 recurrences. Out of the 103 children in group A, 5 subsequently received antibiotics, though homoeopathic treatment was carried through to the healing stage in the remaining 98. No permanent sequels were observed in either group.

  15. The Toll-Like receptor adaptor TRIF contributes to otitis media pathogenesis and recovery

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    Pak Kwang

    2009-08-01

    Full Text Available Abstract Background Toll-like receptor (TLR signalling is crucial for innate immune responses to infection. The involvement of TLRs in otitis media (OM, the most prevalent childhood disease in developed countries, has been implicated by studies in middle ear cell lines, by association studies of TLR-related gene polymorphisms, and by altered OM in mice bearing mutations in TLR genes. Activated TLRs signal via two alternative intracellular signaling molecules with differing effects; MyD88 (Myeloid differentiation primary response gene 88 inducing primarily interleukin expression and TRIF (Tir-domain-containing adaptor inducing interferon β mediating type I interferon (IFN expression. We tested the hypothesis that TRIF and type I IFN signaling play a role in OM, using a murine model of OM induced by non-typeable Haemophilus influenzae (NTHi. The ME inflammatory response to NTHi was examined in wild-type (WT and TRIF-/- mice by qPCR, gene microarray, histopathology and bacterial culture. Results Expression of TRIF mRNA was only modesty enhanced during OM, but both type I IFN signalling genes and type I IFN-inducible genes were significantly up-regulated in WT mice. TRIF-deficient mice showed reduced but more persistent mucosal hyperplasia and less leukocyte infiltration into the ME in response to NTHi infection than did WT animals. Viable bacteria could be cultured from MEs of TRIF-/- mice for much longer in the course of disease than was the case for middle ears of WT mice. Conclusion Our results demonstrate that activation of TRIF/type I IFN responses is important in both the pathogenesis and resolution of NTHi-induced OM.

  16. Feeding pattern a dual risk? otitis media (OM and early childhood caries (ECC

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    P. Sangeetha

    2014-04-01

    Full Text Available Purpose: To determine the prevalence of Otitis media (OM and Early childhood caries (ECC and their coexistence in children with a history of faulty feeding patterns. Method: Children aged 5 years and below were recruited at random from dental and medical hospitals. Parents of these children were posed with questions about the feeding methods, feeding patterns such as duration, frequency, position, burping, specific childhood illness etc. Children (120 were examined for ECC by a Paedodontist and OM by an Otolaryngologist and were segregated into three groups i.e. Control group, ECC group and OM group respectively. The ECC group was sub grouped into ECC only and ECC&OM group. The OM group was also similarly sub grouped into OM group and OM&ECC group. Collected data were tabulated and subjected for statistical analysis using Pearson Chi – square test. Results: Prevalence of ECC, OM, and their coexistence increased with age P < 0.001, whereas gender difference was not statistically significant. Overall Prevalence of their coexistence in children was 51.25%. Significant percentages (25% of children in the OM group were fed in supine position. Children fed on demand (47.5% experienced ECC. overall 85% (p=.017 of children had coexistence of ECC&OM fed on demand and during bed time. Significant numbers of children who were burped occasionally after feeding (35% or were not burped at all (12.5% were affected with both ECC and OM. Conclusion: Prevalence of their coexistence was higher in children with OM. Significant association existed between on demand feeding and ECC; supine feeding position and OM. Risk factors in common for both the disease were combined feeding position, on demand, bed time feeding and occasionally burping.

  17. Clinical and microbiological impact of human bocavirus on children with acute otitis media.

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    Beder, Levent Bekir; Hotomi, Muneki; Ogami, Masashi; Yamauchi, Kazuma; Shimada, Jun; Billal, Dewan Sakhawat; Ishiguro, Nobuhisa; Yamanaka, Noboru

    2009-11-01

    Human Bocavirus (HBoV) as a newly discovered parvovirus has been commonly detected in respiratory tract infections. However, its role in acute otitis media (AOM) has not been well studied. We examined HBoV in Japanese children with AOM and evaluated the virus prevalence together with clinical manifestations and bacterial findings. Overall, 222 nasopharyngeal swabs and 176 middle ear fluids (MEF) samples were collected from 222 children with AOM (median age, 19 months) between May 2006 and April 2007. HBoV detection was performed by PCR and bacterial isolation by standard culture methods. HBoV was found in the nasopharyngeal aspirates of 14 children (6.3%) and in the MEF of six children (2.7%). When HBoV detection results were evaluated with clinical characteristics of children, resolution time of AOM was significantly longer (p=0.04), and rate of fever symptom was also higher in HBoV-positive group (p=0.04). Furthermore, we found positive correlation between detection of HBoV and Streptococcus pneumoniae in the MEF (p=0.004). Nevertheless, nasopharyngeal proportion of S. pneumoniae was similar between virus positive and negative groups. Furthermore, S. pneumoniae was detected as a single pathogen in all MEF of HBoV-positive cases but one, while it presents mixed with other pathogenic bacteria in nasopharynx. In conclusion, HBoV may worsen the clinical symptoms and prolong the clinical outcome of AOM in pediatric population. Finally, HBoV may prime the secondary bacterial infection in the middle ear in favor of S. pneumoniae.

  18. Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.

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    Leah J McGrath

    Full Text Available OBJECTIVES: Guidelines to treat acute otitis media (AOM were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure. STUDY DESIGN: Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year. RESULTS: We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%. CONCLUSIONS: In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.

  19. Otitis media in sperm-associated antigen 6 (Spag6-deficient mice.

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    Xiaofei Li

    Full Text Available Mammalian SPAG6 protein is localized to the axoneme central apparatus, and it is required for normal flagella and cilia motility. Recent studies demonstrated that the protein also regulates ciliogenesis and cilia polarity in the epithelial cells of brain ventricles and trachea. Motile cilia are also present in the epithelial cells of the middle ear and Eustachian tubes, where the ciliary system participates in the movement of serous fluid and mucus in the middle ear. Cilia defects are associated with otitis media (OM, presumably due to an inability to efficiently transport fluid, mucus and particles including microorganisms. We investigated the potential role of SPAG6 in the middle ear and Eustachian tubes by studying mice with a targeted mutation in the Spag6 gene. SPAG6 is expressed in the ciliated cells of middle ear epithelial cells. The orientation of the ciliary basal feet was random in the middle ear epithelial cells of Spag6-deficient mice, and there was an associated disrupted localization of the planar cell polarity (PCP protein, FZD6. These features are associated with disordered cilia orientation, confirmed by scanning electron microscopy, which leads to uncoordinated cilia beating. The Spag6 mutant mice were also prone to develop OM. However, there were no significant differences in bacterial populations, epithelial goblet cell density, mucin expression and Eustachian tube angle between the mutant and wild-type mice, suggesting that OM was due to accumulation of fluid and mucus secondary to the ciliary dysfunction. Our studies demonstrate a role for Spag6 in the pathogenesis of OM in mice, possibly through its role in the regulation of cilia/basal body polarity through the PCP-dependent mechanisms in the middle ear and Eustachian tubes.

  20. Antibiotic Treatment for First Episode of Acute Otitis Media Is Not Associated with Future Recurrences

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    te Molder, Marthe; de Hoog, Marieke L. A.; Uiterwaal, Cuno S. P. M.; van der Ent, Cornelis K.; Smit, Henriette A.; Schilder, Anne G. M.; Damoiseaux, Roger A. M. J.; Venekamp, Roderick P.

    2016-01-01

    Objective Antibiotic treatment of acute otitis media (AOM) has been suggested to increase the risk of future AOM episodes by causing unfavorable shifts in microbial flora. Because current evidence on this topic is inconclusive and long-term follow-up data are scarce, we wanted to estimate the effect of antibiotic treatment for a first AOM episode occurring during infancy on AOM recurrences and AOM-related health care utilization later in life. Methods We obtained demographic information and risk factors from data of the Wheezing Illnesses Study Leidsche Rijn, a prospective birth cohort study in which all healthy newborns born in Leidsche Rijn (between 2001 and 2012), The Netherlands, were enrolled. These data were linked to children’s primary care electronic health records up to the age of four. Children with at least one family physician-diagnosed AOM episode before the age of two were included in analyses. The exposure of interest was the prescription of oral antibiotics (yes vs no) for a child’s first AOM episode before the age of two years. Results 848 children were included in analyses and 512 (60%) children were prescribed antibiotics for their first AOM episode. Antibiotic treatment was not associated with an increased risk of total AOM recurrences (adjusted rate ratio: 0.94, 95% CI: 0.78–1.13), recurrent AOM (≥3 episodes in 6 months or ≥4 in one year; adjusted risk ratio: 0.79, 95% CI: 0.57–1.11), or with increased AOM-related health care utilization during children’s first four years of life. Conclusions Oral antibiotic treatment of a first AOM episode occurring during infancy does not affect the number of AOM recurrences and AOM-related health care utilization later in life. This information can be used when weighing the pros and cons of various AOM treatment options. PMID:27632355

  1. In vitro antifungal susceptibility of Malassezia pachydermatis strains isolated from dogs with chronic and acute otitis externa.

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    Chiavassa, E; Tizzani, P; Peano, A

    2014-10-01

    Malassezia pachydermatis is a yeast that is frequently involved as a secondary/perpetuating factor in canine otitis externa. Topical therapies with different antifungal agents, mainly azole compounds, are generally successful in controlling the yeast overgrowth, but treatment failure and rapid recurrences are common. This study compared the in vitro antifungal susceptibility of M. pachydermatis isolates obtained from chronic and acute cases of otitis externa. The aim was to assess the possible onset of resistance mechanisms in isolates involved in long-lasting episodes with poor response to treatment. We evaluated the in vitro susceptibility to miconazole (MCZ) and clotrimazole (CTZ) of 42 isolates of M. pachydermatis obtained from dogs with chronic (group A, n = 25) and acute otitis (group B, n = 17), using a modified CLSI M27-A3 microdilution method. All isolates were inhibited by the antifungal agents employed, but Malassezia isolates from group A were significantly associated with higher minimum inhibitory concentration (MIC) values for both agents (Median MIC values: MCZ group A 2 µg/ml, group B 1 µg/ml; CTZ group A 8 µg/ml, group B 4 µg/ml). These findings prove that these isolates had a reduced in vitro susceptibility to the antifungal agents tested. However, it is unlikely that this could have any influence on the outcome of a topical treatment. Indeed, marketed products include concentrations of the tested agents that largely exceed even the highest MICs found in this study (in most cases at least 1,000 × the MIC, or greater). In conclusion, this study suggests that isolates of M. pachydermatis involved in chronic cases of canine external otitis and exposed to repeated antifungal treatments are unlikely to develop mechanisms of resistance of clinical relevance.

  2. Clinical study of secretory otitis media complicated by rhinosinusitife%分泌性中耳炎合并鼻-鼻窦炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    牟珊; 张勤修; 周立; 谢慧

    2011-01-01

    Objective To investigate the clinical features, diagnosis and surgical treatment of the secretory otitis media complicated by rhinosinusitis. Methods Ear endoscopy, pure tone audiometry, acoustic impedance and nasal endoscopy, sinus CT were used to examine fullness, hearing loss, more than 3 months in patients with secretory otitis media. 42 cases (65 ears)were diagnosed as secretory otitis media complicated by rhinosinusitis. Surgical and drug treatment were performed on all cases and the effects were analyzed. Results Apart from 1 patient (2 ears) with unknown cause recurrent secretory otitis media, the symptom such as ear fullness, hearing loss of the rest patients were improved. The results of acoustic impedance and pure tone audiometry were basically back to normal. Conclusion Rhinosinusitis were related to secretory otitis media closely. For this reason, we should keep a watchful eye on rhinosinusitis and estimate it when we treat secretory otitis media to prevent misdiagnosis of nose focus complicated by secretory otitis media, resulting in delayed healing of secretory otitis media.%目的 探讨分泌性中耳炎合并鼻-鼻窦炎的临床特征、诊断要点及手术治疗方法.方法 利用耳内镜、纯音测听、声阻抗及鼻内镜、鼻窦CT,对耳闷、听力下降3个月以上的分泌性中耳炎患者进行检查,确诊为分泌性中耳炎合并鼻-鼻窦炎42例(65耳),并对所有患者进行了手术及药物治疗,分析其疗效.结果 除1例(2耳)患者不明原因反复发作分泌性中耳炎外,其余所有患者耳闷、听力下降等症状均有改善,声阻抗、纯音听力测试结果基本恢复正常.结论 鼻-鼻窦炎与分泌性中耳炎发病有密切相关性,因此治疗分泌性中耳炎时应关注、评估鼻-鼻窦炎,以防漏诊与分泌性中耳炎共同存在的鼻部病灶,导致分泌性中耳炎迁延不愈.

  3. Lower nasopharyngeal epithelial cell repair and diminished innate inflammation responses contribute to the onset of acute otitis media in otitis-prone children.

    Science.gov (United States)

    Verhoeven, David; Nesselbush, Monica; Pichichero, Michael E

    2013-08-01

    About 30 % of young children experience excessive, frequent episodes of middle ear infection and are classified as acute otitis media prone (OP). Streptococcus pneumoniae (Spn) is a predominant otopathogen in OP and non-OP (NOP) children. The pathogenesis of middle ear infection involves otopathogen nasopharyngeal (NP) colonization followed by an upper respiratory viral infection that modifies the NP environment to allow a sufficient inoculum of bacteria to reflux via the Eustachian tube into the middle ear space. Here, we analyzed the NP mucosal repair response between age-matched stringently defined OP (sOP) and NOP children who progressed to middle ear infection caused by Spn. We found lower epidermal growth factor, epidermal growth factor receptor, and angiogenin cytokine concentrations in nasal washes of sOP compared with NOP children. Despite higher expression of TLR2/4 transcript expression in nasal epithelium and in polymorphonuclear cells present in nasal secretions in sOP children, sOP children had lower expression of proinflammatory cytokines such as IL-6 and IL-8 in the NP. Chemotaxis-associated cytokine expression at onset of AOM in sOP children was also lower compared with NOP children, possibly indicating a lower capacity to signal the innate immune system. We conclude that lower epithelial cell repair responses during viral infection in the NP combined with diminished innate inflammatory responses potentiate Spn pathogenesis in the sOP child.

  4. Analysis of Adenoid Vegetation Children with Different Types of Tympanograms and Secretory Otitis Media%腺样体肥大患儿鼓室导抗图与分泌性中耳炎的关系探讨

    Institute of Scientific and Technical Information of China (English)

    高永平; 田从哲; 刘会清; 孟胜环; 刘海燕

    2013-01-01

    目的:探讨腺样体肥大患儿的不同鼓室导抗图与分泌性中耳炎的关系。方法回顾性分析2009年1月~2011年6月收治的328例腺样体肥大患儿的临床资料,分析统计分泌性中耳炎的发病例(耳)数及声导抗测试诊断分泌性中耳炎的阳性率。结果328例腺样体肥大患儿中有104例(169耳)最终经鼓膜穿刺或鼓膜置管确诊为分泌性中耳炎(31.71%,104/328),其中鼓室导抗图为B型者89例152耳,最终确诊为分泌性中耳炎者为86例147耳,阳性率为96.71%(147/152);鼓室导抗图为C型(负压在-150 daPa以上)者33例49耳,最终确诊为分泌性中耳炎者为16例20耳,阳性率为40.82%(20/49);鼓室导抗图为A s型者2例2耳最终均确诊为分泌性中耳炎。结论腺样体肥大患儿无论有无听力下降主诉,均应行声导抗测试,B型鼓室导抗图对鼓室积液判断的准确率最高,C型次之,As型也有鼓室积液的可能。%Objective To explore the relationship between adenoid vegetation children with different types of tympanograms and secretory otitis media in children and diagnosis of secretory otitis media .Methods A retrospec-tive study was carried out among 328 cases with adenoid vegetation in children ,including simple adenoid vegetation and associated with chronic tonsillitis and tonsillar hypertrophy ,from August 2010 to May 2012 .The incidence of secretory otitis media and outcomes of tympanometry for the diagnosis were analyzed .Results 104 cases were diag-nosed with secretory otitis media by tympanic membrane puncture or tympanostomy tube in 328 cases with adenoid vegetation (32 .31% );86 cases (147 ears) were finally diagnosed as secretory otitis media among 89 cases (152 ears) with type B tympanogram (147/152 ,96 .63% );16 cases (20 ears) were finally diagnosed secretory otitis media among 33 cases (49 ears) with type C tympanogram (20/49 ,40 .82% );2 cases (2 ears) with

  5. Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study

    Science.gov (United States)

    Di Pierro, Francesco; Di Pasquale, Daniele; Di Cicco, Maurizio

    2015-01-01

    Secretory otitis media (SOM) remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM), is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®). After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. PMID:26396541

  6. [Investigation of viral nucleic acids in middle-ear effusion specimens from children with acute otitis media].

    Science.gov (United States)

    Abu Sitteh, Muhammed H; Sener, Kenan; Yapar, Mehmet; Kiliç, Abdullah; Güney, Cakir; Kubar, Ayhan

    2008-07-01

    Acute otitis media with effusion (OME) is one of the major causes of antibiotic use, indication for operation and hearing loss in children. In two third of the cases the etiologic agents are bacteria. Nonetheless, increasing numbers of reports have implicated viruses as etiologic agents that may have some effect on prognosis of OME. The aim of this study was to investigate the presence of nucleic acids of respiratory syncytial virus (RSV) type A and B, influenza type A virus, adenovirus, cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1), and enteroviruses in the middle ear effusion specimens from children with otitis media by TaqMan real-time PCR. As a result, 18 of 30 (60%) OME samples were found positive in terms of viral nucleic acids by real-time PCR. RSV-A was detected in nine samples (30%), CMV in 3 (10%) samples and HSV-1 in 1 (3.3%) sample. In five of the samples two viruses were detected in the same sample (three were positive for adenovirus and RSV-A, and two were positive for CMV and RSV-A). Our data have supported the importance of viruses as etiologic agents of OME. Additionally, it was thought that TaqMan real-time PCR may be used as a reliable and rapid method for the detection of viruses in the middle ear effusion samples.

  7. Role of group 3 innate lymphoid cells during experimental otitis media in a rat model.

    Science.gov (United States)

    Cho, Chang Gun; Gong, Sung Ho; Kim, Hee-Bok; Song, Jae-Jun; Park, Joo Hyun; Lim, Yun-Sung; Park, Seok-Won

    2016-09-01

    The objective of this study was to evaluate the role of group 3 innate lymphoid cells (ILC3) in the middle ear (ME) mucosal response to bacterial infection in a rat model. To confirm the role of ILC3 in bacterially induced otitis media (OM), the serum concentrations of IL-17 and IL-22 were determined by ELISA, and the tissue expression of IL-17 and IL-22 in infected ME mucosa was assessed by immunohistochemical staining. Immunohistochemical staining of specific cell surface markers was also assessed to confirm the origin of the cells expressing IL-17 and IL-22. Twenty Sprague-Dawley rats were used in the surgically-induced animal model of OM. OM was induced by inoculation of non-typeable Haemophilus influenzae into the ME cavity of the rats. The rats were divided into four experimental groups: three infected groups and one control group. Infected groups were subdivided into sets of 5 rats, one for each of the three time points (1, 4 and 7 days post-inoculation). For determination of rat IL-17 and IL-22 levels in infected rats and control rats, infected or control ME mucosa sections were analyzed by immunohistochemistry with specific antibodies directed against IL-17 and IL-22. Immunohistochemical staining for CD3, RORγt, and NKp46 were also conducted on the samples to confirm the origin of cells expressing IL-17 and IL-22. IL-17 and IL-22 serum concentrations were significantly increased in the infected rats compared to control rats. Immunohistochemical staining revealed increased IL-17 and IL-22 expressions in all infected ME mucosae from the first day after inoculation. In addition, the results of tissue staining for the specific surface markers were negative for CD3 and NKp46, but were highly positive for RORγt. IL-17 and IL-22 revealed their association with the bacterially induced proliferative and hyperplastic responses of ME mucosa, which are characteristic features in pathogenesis of OM. Surface marker examination showed that the source cells for IL-17

  8. Incidence of otitis media in a contemporary Danish National Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Tanja Todberg

    Full Text Available 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 was ability to understand and speak Danish. METHODS: Information of OM and ventilation tubes (VT was collected through three maternal interviews at 6-month, 18-month and 7-years of age and based on this age-specific and cumulative incidence of OM was calculated. As different numbers of the total population answered the different interviews, the calculations are done with different denominators. The information in DNBC was validated against two population based registries containing information of VT insertions. RESULTS: Cumulative incidence of OM at 7 years was 60.6% (31,982/52,755. For children with OM, 16.2% (7143/44194 had their first OM episodes between 0-6 months of age, 44.3% (19579/44194 between 7-18 months, and 39.5% (17472/44194 between 19 months and 7 years. Four or more OM episodes before 7 years were reported by 39.5% (12620/31982 and by 64.0% (2482/3881 of those who had their OM debut between 0-6 months; by 48.2% (4998/10378 with debut between 7-18 months; and by 28.7% (4996/17344 with debut between 19 months and 7 years. These figures are essentially unchanged from earlier figures from Denmark. VT insertion at least once was reported by 26,1% in the 7-year interview. Assuming recordings in the Danish National Patient Registry to be gold standard, maternal self-reportings in DNBC of insertion of VT showed high sensitivity (96.4%, specificity (98.2%, and positive (94.8% and negative predictive values (98.8%. CONCLUSION: OM affects nearly 2/3 of preschool children in Denmark despite reduction in known OM risk factors.

  9. Improved retention experience mastoidecto-my tympanoplasty osteopontin treatment of otitis media%改良乳突切除术保留骨桥鼓室成形术治疗中耳乳突炎的体会

    Institute of Scientific and Technical Information of China (English)

    李翔宇; 孙海燕; 梁振; 王东海; 张刚

    2014-01-01

    AIM:To investigate the clinical efficiency of the treatment for chronic otitis mastoidea after intactbridge mastoitym-panoplasty (IBM).METHODS:The charts of 83 ears that suf-fered chronic otitis media (including patients with cholesteatoma, granulation type),which underwent the treatment of IBMwere re-viewed.RESULTS:83 cases were observed after 1 month to 4 years,and hearing improvement rate was 68.67%;no efficiency rate was 3 1 .32%,dry ear within 3 months.Hearing recovery ef-ficiency of chronic otitis mastoidea is 95 .65%,followed by chron-ic otitis media of 85 .7 1% and the worst, cholesteatoma, of 34.37%.CONCLUSION:Long-term repeated pus hearing pro-gressive declines in chronic suppurative otitis media patients should recieved modified mastoid bone bridge resection retaining undergoing tympanoplasty,and obtain dry ear,listening,to pre-vent hearing loss.On cholesteatoma,carious type otitis media pa-tients,should remove the lesion as soon as possible based on the retention of mastoid air cells and the bone bridge simultaneous tympanoplasty.%目的:研究改良乳突切除术保留骨桥鼓室成形术治疗中耳乳突炎治疗效果.方法:选取2013-01/2013-12来我院接受治疗的患有慢性化脓性中耳乳突炎的病患83例,对病患实行改良乳突切除保留骨桥同期鼓室成形术,首先对病患的耳部内侧进行切口,将外耳道的皮瓣和乳突进行暴露,之后使用电钻将乳突气房部分进行磨除,保留骨桥将乳突及鼓窦鼓室出现的病变组织进行清除.结果:病患听力得到改善的有效率为68.67%,治疗无效率为31.32%;病患在三个月内均获得干耳,慢性单纯型中耳乳突炎患者,有效率95.65%,骨疡型,有效率85.71%,最差为胆脂瘤型,有效率为34.37%.结论:对慢性化脓性中耳乳突炎病患尽早实行改良乳突切除保留骨桥鼓室成形术可以对病患的听力起到较好的治疗效果,值得在实际临床中进行推广.

  10. [Otitis externa, a self-inflicted disease?].

    Science.gov (United States)

    Bizindavyi, F; Guyot, J-P; Kos, M-I

    2007-10-03

    Otitis externa, an inflammation of the external auditory canal is the most frequent cause of ENT consultation all over the world. It can be caused by viral, bacterial or fungal infections. In most of the cases it is provoked by anatomical causes and, even more frequently inadvertently, by the patient himself. Typically, otitis externa is an isolated episode of short duration, easily treated with topical medication. It evolves rarely to the atypical forms of chronic otitis externa and malignant otitis externa. It is important to search for an allergy, eczema or immunodepression in cases of chronic otitis externa and for diabetes in cases of malignant otitis externa.

  11. Otitis Media with Effusion in Young Children. Clinical Practice Guideline, Quick Reference Guide for Clinicians, [and] Parent Guide, Consumer Version, Number 12.

    Science.gov (United States)

    Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

    Otitis media with effusion and its related hearing loss have been associated with delayed language development, particularly if the disease is recurrent or of long duration, although available data are insufficient to establish a causal linkage. This guide presents recommendations based on extensive reviews of the relevant medical and…

  12. Lack of Impact of Body Mass Index at Young Age on Otitis Media Occurrence During Preschool Years : Wheezing Illnesses Study Leidsche Rijn Cohort Study

    NARCIS (Netherlands)

    Venekamp, Roderick P; Menger, Jan-Thijs; Uiterwaal, Cuno S P M; van der Ent, Cornelis K; Smit, Henriette A; Schilder, Anne G M; de Hoog, Marieke L A

    2016-01-01

    Using data on weight and height at 6 and 11 months of age and primary care electronic health records data from 1960 children participating in the Wheezing Illnesses Study Leidsche Rijn birth cohort study, we found that body mass index at 6 and 11 months of age was not associated with otitis media oc

  13. Increased biofilm formation by nontypeable Haemophilus influenzae isolates from patients with invasive disease or otitis media versus strains recovered from cases of respiratory infections

    NARCIS (Netherlands)

    Puig, C.; Domenech, A.; Garmendia, J.; Langereis, J.D.; Mayer, P.; Calatayud, L.; Linares, J.; Ardanuy, C.; Marti, S.

    2014-01-01

    Biofilm formation by nontypeable (NT) Haemophilus influenzae remains a controversial topic. Nevertheless, biofilm-like structures have been observed in the middle-ear mucosa of experimental chinchilla models of otitis media (OM). To date, there have been no studies of biofilm formation in large coll

  14. Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children

    NARCIS (Netherlands)

    Sjoukes, Alies; Venekamp, Roderick P; van de Pol, Alma C; Hay, Alastair D; Little, Paul; Schilder, Anne GM; Damoiseaux, Roger Amj

    2016-01-01

    BACKGROUND: Acute otitis media (AOM) is one of the most common childhood infectious diseases and a significant reason for antibiotic prescriptions in children worldwide. Pain from middle ear infection and pressure behind the eardrum is the key symptom of AOM. Ear pain is central to children's and pa

  15. Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years

    NARCIS (Netherlands)

    Damoiseaux, RAMJ; van Balen, FAM; Hoes, AW; Verheij, TJM; de Melker, RA

    2000-01-01

    Objective To determine the effect of antibiotic treatment for acute otitis media in children between 6 months and 2 years of age. Design Practice based, double blind, randomised, placebo controlled trial. Setting 53 general practices in the Netherlands. Subjects 240 children aged 6 months to 2 years

  16. Otitis interna, media, and externa with destruction of the left tympanic bulla and subluxation and septic arthritis of the left temporomandibular joint in an alpaca (Vicugna pacos).

    Science.gov (United States)

    Galvan, Noe; Middleton, John R; Cook, Cristi; Britt, Lisa G; Kuroki, Keiichi

    2013-03-01

    A 1.5-year-old, 37.7 kg, female alpaca was evaluated for a 2-week history of weight loss, left ear droop, and deviation of the rostral mandible to the right. Antemortem radiography and postmortem examination revealed otitis interna, media, and externa, destruction of the left tympanic bulla, and subluxation and septic arthritis of the left temporomandibular joint.

  17. An Analysis of the Application of Wullstein TypeⅢTympanoplasty to Patients with Chronic Suppurative Otitis Media%经典Wullstein Ⅲ型鼓室成形术在慢性化脓性中耳炎手术中的应用分析

    Institute of Scientific and Technical Information of China (English)

    宋勇莉; 张昌明; 闫辉; 陈阳; 卢连军; 邱建华

    2014-01-01

    Objective To explore the indication and efficacy of Wullstein typeⅢtympanoplasty in treating the patients with chronic suppurative otitis media. Methods Thirty-four patients (34 ears)were studied who underwent canal wall-down tympanoplasty retrospectively. In all patients, ossicular chain destructions were confirmed during the operation while stapes kept intact with good mobility. The patients were divided into two groups according to the reception of partial ossicular replacement prosthesis (PORP). 11 cases underwent type Ⅲ tympanoplasty (type Ⅲ group) and 23 cases received PORP (PORP group). The average postoperative air-conduction thresholds and air-bone gaps (ABG) were measured and compared at 0.5, 1, 2 and 4 kHz. Results The preoperative air-conduction thresholds for type Ⅲ and PROP groups were 46.59±16.60 dB HL and 44.23±12.31 dB HL, respectively. The postoperative air-conduction thresholds for type Ⅲ and PROP groups were 34.89±10.34 dB HL and 37.08±14.36 dB HL, and the increments of the air-conduction thresholds after the surgery were 11.70±19.30 dB HL and 7.14±14.39 dB HL, respectively. The ABG changes of typeⅢgroup were 7.73±14.93 dB HL, and for PORP group were 7.17±13.63 dB HL before and after the surgery. There was no statistically significant difference between the two groups in the increment of air-conduction thresholds and ABG changes (P>0.05). Conclusion The myringostapediopexy or myringolenticulopexy can be reserved in the wall-down tympanoplasty for it showed equal efficacy in hearing reconstruction with PORP. Meanwhile, further observations are needed for long term outcomes.%目的:探讨经典Wullstein Ⅲ型鼓室成形术在慢性化脓性中耳炎手术中的适应证及其术后听力效果。方法回顾性分析行开放式Ⅲ型鼓室成形术的患者34例(34耳),患者均有听骨链破坏而镫骨结构完整,鼓膜内陷与镫骨头或砧骨豆状突直接连接,根据术中是否植入

  18. Characteristics and outcomes of acute otitis media in children carrying streptococcus pneumoniae or haemophilus influenzae in their nasopharynx as a single otopathogen after introduction of the heptavalent pneumococcal conjugate vaccine.

    Science.gov (United States)

    Caeymaex, Laurence; Varon, Emmanuelle; Levy, Corinne; Béchet, Stéphane; Derkx, Véronique; Desvignes, Véronique; Doit, Catherine; Cohen, Robert

    2014-05-01

    After PCV7 implementation, clinical characteristics were investigated in 832 young children with acute otitis media, carrying a single S. pneumoniae or H. influenzae in their nasopharynx. As compared with H. influenzae, S. pneumoniae-associated acute otitis media was less frequently associated with treatment failure (odds ratio = 0.5; 95% confidence interval: 0.36-0.83) and recurrence (odds ratio = 0.4; 95% confidence interval: 0.22-0.75). Post-PCV7 serotype replacement seemed not to affect the acute otitis media characteristics in these children.

  19. O papel de novas vacinas na prevenção da otite média The role of new vaccines in the prevention of otitis media

    Directory of Open Access Journals (Sweden)

    Felippe Felix

    2008-08-01

    Full Text Available A Otite Média é uma das doenças infecciosas mais comuns da infância e a diminuição de sua incidência levaria a um grande impacto econômico e social para o mundo. Como uma das formas de prevenção temos as vacinas. As duas vacinas escolhidas para esta revisão são as vacinas antipneumocócica e antiinfluenza. Esta revisão da literatura procurou mostrar os resultados dos principais estudos sobre essas vacinas e seu papel na prevenção da otite média. A vacina antipneumocócica polissacarídea 23-valente não alterou a incidência de otite média pela ineficácia para menores de 2 anos, grupo de maior incidência dessa enfermidade. A vacina antipneumocócica heptavalente, apesar de não provocar grande queda na incidência geral de otite média, mudou o perfil de seus microorganismos causadores, diminuindo os episódios de otite média com efusão e recorrente e aumentando as otites causadas por H. influenza, M. catarrhalis e sorotipos de pneumococo ausentes da vacina heptavalente. A vacina antiinfluenza com vírus inativado mostrou-se efetiva na redução da otite média aguda nos períodos de maior incidência desse vírus. Os otorrinolaringologistas devem estar cientes do papel dessas novas vacinas já disponíveis no Brasil e seu impacto na redução da otite média, para saber orientar adequadamente os seus pacientes.Otitis media is one of the most common infectious diseases of infancy; a reduction in its incidence would have a significant economic and social impact. Vaccines may play a role in the prevention of otitis media. This report discusses vaccines against pneumococci and influenza viruses. We reviewed the literature for results of studies examining the role of these vaccines in the prevention of otitis media. The 23-valent polysaccharide anti-pneumococcal vaccine did not modify the incidence of otitis media in children aged 2 years less, the age group with the highest incidence of otitis. The heptavalent anti

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

    Directory of Open Access Journals (Sweden)

    Terhi Tapiainen

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

  1. The critical role of myeloperoxidase in Streptococcus pneumoniae clearance and tissue damage during mouse acute otitis media.

    Science.gov (United States)

    Xiang, Yun; Jin, Chunfang; Wang, Wei; Wang, Zimeng; Huang, Yifei; Fan, Fangmei; Ma, Yurong; Zhang, Xuemei; Xu, Wenchun; Yin, Yibing; He, Yujuan

    2017-04-01

    We have recently reported that neutrophils play a pivotal role in innate defense against Streptococcus pneumoniae ( Spn) during mouse acute otitis media (AOM). However, the underlying mechanism remains unclear. By constructing models of pneumococcal AOM in C57BL/6 mice and using a specific inhibitor in vivo, we investigated the role of myeloperoxidase (MPO), one of the most important protein components of neutrophils. Experiment results showed a significant increase in MPO production of the recruited neutrophils in Spn-infected mice. Neutrophils killed Spn in a MPO-dependent manner. MPO facilitated the generation of reactive oxygen species (ROS), and consequently promoted Spn clearance at an early stage and exacerbated tissue damage. Moreover, MPO induced neutrophil apoptosis and necrosis, which, in turn, worsened tissue damage. In summary, our study demonstrates that neutrophil MPO plays a paradoxical role in bacterial clearance and tissue damage in pneumococcal AOM.

  2. THE EFFECT OF EXOGENOUS SURFACTANT ON THE EUSTACHIAN TUBE FUNCTION IN THE GERBIL MODEL OF SECRETORY OTITIS MEDIA

    Institute of Scientific and Technical Information of China (English)

    郑国玺; 朱宏亮; 康全清; 韦俊荣; 张晓彤

    2003-01-01

    Objective To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into middle ear space, studying the effect of surfactant on Eustachian tube opening function. Results It has been showed that the injection of killed streptococcus pneumoneac bacteria by the transtympanic route, successfully developed a secretory otitis media model. Eustachian tube opening pressure in ears with SOM was significantly greater than those without effusion (P<0.01). Irrigation the middle ear space with surfactant resulted in a dramatic decrease in eustachian tube passive opening pressure in both normal and patients (P<0.01). Conclusion The results indicate that flushing with exogenous surfactant by the transtympanic rote reduce of eustachian tube surface tension, and it benefits the Eustachian tube opening.

  3. Associations between symptoms, clinical findings and the short-term prognosis among children with otitis media: A cohort study

    DEFF Research Database (Denmark)

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

    2013-01-01

    -related factors influence the course of OM. The aim of this study was to analyze to what extent symptoms at the time of initial diagnosis are associated with the short-term course of otitis media. Methods: Cohort study in general practice comprising 747 children between 0 and 7 years with a new ear symptom....... At the first consultation the GPs registered symptoms, results of otoscopy and tympanometry, together with diagnosis and treatment. The children were followed up four weeks later. Results: Sleep problems at inclusion are statistically significant associated with having one or more symptom after four weeks...... and 7 years with a flat curve is 8.94 (CI: 4.18–19.11) when compared to children without a flat curve. Conclusion: Sleep problems at inclusion were the only symptom statistically significant associated with having one or more symptoms after four weeks in children between 0 and 2 years....

  4. Genome-wide association study for acute otitis media in children identifies FNDC1 as disease contributing gene

    Science.gov (United States)

    van Ingen, Gijs; Li, Jin; Goedegebure, André; Pandey, Rahul; Li, Yun Rose; March, Michael E.; Jaddoe, Vincent W. V.; Bakay, Marina; Mentch, Frank D.; Thomas, Kelly; Wei, Zhi; Chang, Xiao; Hain, Heather S.; Uitterlinden, André G.; Moll, Henriette A.; van Duijn, Cornelia M.; Rivadeneira, Fernando; Raat, Hein; Baatenburg de Jong, Robert J.; Sleiman, Patrick M.; van der Schroeff, Marc P.; Hakonarson, Hakon

    2016-01-01

    Acute otitis media (AOM) is among the most common pediatric diseases, and the most frequent reason for antibiotic treatment in children. Risk of AOM is dependent on environmental and host factors, as well as a significant genetic component. We identify genome-wide significance at a locus on 6q25.3 (rs2932989, Pmeta=2.15 × 10−09), and show that the associated variants are correlated with the methylation status of the FNDC1 gene (cg05678571, P=1.43 × 10−06), and further show it is an eQTL for FNDC1 (P=9.3 × 10−05). The mouse homologue, Fndc1, is expressed in middle ear tissue and its expression is upregulated upon lipopolysaccharide treatment. In this first GWAS of AOM and the largest OM genetic study to date, we identify the first genome-wide significant locus associated with AOM. PMID:27677580

  5. Optical-fiber-coupled inferometric measurement of tympanic membrane temperature: a new diagnostic tool for acute otitis media

    Science.gov (United States)

    DeRowe, Ari; Ophir, Eyal; Sade, Sharon; Fishman, Gadi; Ophir, Dov; Grankin, Mila; Katzir, Abraham

    1998-07-01

    A novel infrared (IR) transparent optical fiber coupled to a hand held otoscope and a radiometer was constructed and used to measure the temperatures of the tympanic membrane (TM) and to distinguish between diseased and healthy middle ears. A greater temperature difference between TM readings was found when Acute Otitis Media (AOM) existed in one of the ears examined. This supports the hypothesis that acute inflammation of the middle ear will result in elevated local temperature when measured in such a way that the reading is taken only from the TM without interference of the external canal. The use of an optical fiber enabled temperature measurements of the TM with high spatial resolution eliminating the external ear canal interference. A small patient population was examined and the initial results were statistically significant. In the hands of the primary care physician, this tool would prevent misdiagnosis of AOM preventing indiscriminate use of antibiotics and avoiding complications by early diagnosis.

  6. ModA2 Phasevarion Switching in Nontypeable Haemophilus influenzae Increases the Severity of Experimental Otitis Media.

    Science.gov (United States)

    Brockman, Kenneth L; Jurcisek, Joseph A; Atack, John M; Srikhanta, Yogitha N; Jennings, Michael P; Bakaletz, Lauren O

    2016-09-01

    Several human-adapted bacterial pathogens use a phasevarion (ie, a phase-variable regulon) to rapidly and reversibly regulate the expression of many genes, which include known virulence factors, yet the influence of phasevarion-mediated regulation in pathogenesis remains poorly understood. Here we examine the impact of the nontypeable Haemophilus influenzae (NTHI) ModA2 phasevarion on pathogenesis and disease severity in a chinchilla model of experimental otitis media. Chinchillas were challenged with NTHI variant populations that were either inoculated ON and remained ON, inoculated OFF and shifted ON, or inoculated OFF and remained OFF, within the middle ear. We show that populations that shift from OFF to ON within the middle ear induce significantly greater disease severity than populations that are unable to shift. These observations support the importance of phasevarion switching in NTHI pathogenesis and the necessity to considered phasevarion regulation when developing methods to treat and prevent infection.

  7. Properdin deficiency associated with recurrent otitis media and pneumonia, and identification of male carrier with Klinefelter syndrome.

    Science.gov (United States)

    Schejbel, Lone; Rosenfeldt, Vibeke; Marquart, Hanne; Valerius, Niels Henrik; Garred, Peter

    2009-06-01

    Properdin is an initiator and stabilizer of the alternative complement activation pathway (AP). Deficiency of properdin is a rare X-linked condition characterized by increased susceptibility to infection with Neisseria meningitidis associated with a high mortality rate. We report properdin deficiency in a large Pakistani family. The index cases were found by screening for immunodeficiency due to a history of recurrent infections. This revealed absent AP activity, but normal classical and lectin pathway activity. Sequencing of the properdin gene (PFC) revealed a novel frameshift mutation. When all available relatives (n=24) were screened for the mutation, four affected males, four female carriers and a male heterozygous carrier were identified. He was subsequently diagnosed with Klinefelter syndrome. A questionnaire revealed a striking association between properdin deficiency and recurrent otitis media (P=0.0012), as well as recurrent pneumonia (P=0.0017). This study is the first to show a significant association between properdin deficiency and recurrent infections.