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Sample records for chronic suppurative otitis

  1. 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.

  2. 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.

  3. 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%

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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....

  9. 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.

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

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    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...

  11. 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....

  12. 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.

  13. 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...

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

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    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....

  15. 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.

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

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    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....

  17. 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.

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

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    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.

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

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    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.

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

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    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

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

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    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...

  2. 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....

  3. 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.

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

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    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

  5. 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.

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

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    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

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

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    Devi Prasad

    2015-06-01

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

  8. 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

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

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    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

  10. 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

  11. 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.

  12. 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....

  13. 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.

  14. 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

  15. 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.

  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. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. [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.

  1. 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.

  2. 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

  3. 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.

  4. 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。

  5. 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.

  6. 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.

  7. 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。

  8. 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.

  9. 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.

  10. 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.)

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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。

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

  2. 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

  3. 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。

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. Recurrent chronic suppurative osteomyelitis of the mandible

    Directory of Open Access Journals (Sweden)

    Rajkumar G

    2010-01-01

    Full Text Available Osteomyelitis of the maxillofacial skeleton is a rare condition in recent times. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis (CSO. This case report describes the successful surgical treatment of CSO of the mandible in an 18-year-old adult. Treatment included a pre-surgical course of antibiotics followed by sequestrectomy, resection of the coronoid process and removal of the pathologically fractured condylar process of the left side of the mandible. On post-operative clinical review at 1 week, the extra oral draining sinus healed with improved mouth opening.

  10. 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。

  11. 鼓室成形术在慢性化脓性中耳炎手术中的适应证及其对术后听力效果的影响%Influence of Tympanoplasty in Chronic Suppurative Otitis Mediaadaptation Syndrome and Postoperative Effect of Hearing

    Institute of Scientific and Technical Information of China (English)

    王跃武; 谢瑞昀; 朱友莲; 叶伟伟

    2014-01-01

    目的:探讨型鼓室成形术在慢性化脓性中耳炎手术中的适应证及对术后听力效果的影响。方法:将本院2009年1月-2013年12月收治的168例慢性化脓性中耳炎患者的临床资料进行回顾性分析,患者均行完壁或开放型鼓室成形术,观察鼓室成形术的手术适应证及对患者术后听力效果的影响。结果:治疗后,患者气导听阈与骨导听阈显著降低(P<0.05)。术后无严重并发症发生,随访6个月出现26例复发病例,复发率为15.48%。结论:鼓室成形术治疗慢性化脓性中耳炎效果显著,并发症少,可改善患者的听力水平,值得临床推广使用。%Objective:To study the influence of tympanoplasty in chronic suppurative otitis media on the postoperative effect of hearing.Method:The clinical data of 168 cases of chronic suppurative otitis mediapatients in our hospital from January 2009 to December 2013 were retrospectively analyzed,patients underwent complete wall or open tympanoplasty, thetympanoplastic operation indication and effect on the listening effect of postoperative patients were observed.Result:After treatment,threshold of hearing by air conduction and bone conduction threshold decreased significantly(P<0.05).No serious postoperative complications,follow-up of six months in 26 cases of recurrence,the recurrence rate was 15.48%. Conclusion:The effect of tympanoplasty for chronic suppurative otitis media significantly, fewer complications,patients can improve listening level,is worthy of clinical use.

  12. 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.

  13. 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

  14. 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

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    ... 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 ...

  18. 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

  19. 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

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

    Directory of Open Access Journals (Sweden)

    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.”

  1. 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

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

    Science.gov (United States)

    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.

  3. 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.

  4. Suppurative otitis and ascending meningoencephalitis associated with Bacteroides tectus and Porphyromonas gulae in a captive Parma wallaby (Macropus parma) with toxoplasmosis.

    Science.gov (United States)

    Giannitti, Federico; Schapira, Andrea; Anderson, Mark; Clothier, Kristin

    2014-09-01

    A 6-year-old female Parma wallaby (Macropus parma) at a zoo in California developed acute ataxia and left-sided circling. Despite intensive care, clinical signs progressed to incoordination and prostration, and the animal was euthanized. At necropsy, the left tympanic cavity was filled with homogeneous suppurative exudate that extended into the cranium expanding the meninges and neuroparenchyma in the lateral and ventral aspect of the caudal ipsilateral brainstem and medulla oblongata. Microscopically, the brainstem showed regional severe suppurative meningoencephalitis with large numbers of neutrophils, fewer macrophages, and lymphocytes admixed with fibrin, necrotic cellular debris, hemorrhage, and mineralization, with numerous intralesional Gram-negative bacilli. Bacteroides spp. and Porphyromonas spp. were isolated on anaerobic culture from the meninges, and the bacteria were further characterized by partial 16S ribosomal RNA gene sequencing as Bacteroides tectus and Porphyromonas gulae. Bacterial aerobic culture from the meninges yielded very low numbers of mixed flora and Proteus spp., which were considered contaminants. Culture of Mycoplasma spp. from middle ear and meninges was negative. Additionally, Toxoplasma gondii cysts were detected by immunohistochemistry in the heart and brain, and anti-Toxoplasma antibodies were detected in serum. The genera Bacteroides and Porphyromonas have been associated with oral disease in marsupials; but not with otitis and meningoencephalitis. The results of the present work highlight the importance of performing anaerobic cultures in the diagnostic investigation of cases of suppurative otitis and meningoencephalitis in macropods.

  5. 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

  6. 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

  7. 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...

  8. [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.

  9. 化脓性中耳炎患者临床护理措施探讨%Discussion on Clinical Nursing Measures for Patients With Suppurative Otitis Media

    Institute of Scientific and Technical Information of China (English)

    李硕

    2016-01-01

    化脓性中耳炎是耳鼻喉科常见疾病,该病由耳道感染引起,发病率高,易复发,如不及时治疗,可引起耳痛、耳鸣、鼓膜穿孔甚至听力障碍;科学的护理措施有助于该病转归,降低并发症发生率。本文将结合化脓性中耳炎的临床特点及临床治疗原则,对该病的护理措施进行总结分析,以便提高其治疗效果,改善患者生活质量。%Suppurative otitis media is a common disease in otorhinolaryngology, the disease caused by an ear canal infection, high incidence, recurrence, if not treated in time, cause earache, tinnitus, tympanic membrane perforation even hearing impairment; Scientific nursing measures are helpful to the prognosis of the disease and reduce the incidence of complications. This article will combine the clinical characteristics and clinical treatment principles of suppurative otitis media, to summarize and analyze the nursing measures, so as to improve the treatment effect and improve the quality of life of patients.

  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. Intracanalicular antibiotics may obviate the need for surgical management of chronic suppurative canaliculitis

    Directory of Open Access Journals (Sweden)

    Mohan E

    2008-01-01

    Full Text Available Chronic suppurative lacrimal canaliculitis is an important cause of ocular surface discomfort. Treatment with topical antibiotics is often inadequate and surgical treatment by canaliculotomy and canalicular curettage has been the mainstay of treatment in the past. The role of canalicular antibiotic irrigation has been inadequately studied. We report the clinical features, microbiological profile and treatment outcome in a series of 12 patients with suppurative lacrimal canaliculitis. Two patients had Actinomyces infection, five had Nocardia infection and seven patients had polymicrobial infection. Three patients had resolution of canaliculitis on combination broad-spectrum topical antibiotic therapy using ciprofloxacin and fortified cefazolin. In nine patients, topical antibiotic therapy was combined with canalicular irrigation using fortified cefazolin. All patients had excellent resolution of canaliculitis without the need for surgical treatment. Availability of broad-spectrum antibiotics and canalicular irrigation may offer an alternative to surgery in the management of suppurative lacrimal canaliculitis.

  12. 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.

  13. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  15. The application detection of otitis media suppurative by high quality nursing of high quality nursing%优质护理在化脓性中耳炎40例中的应用

    Institute of Scientific and Technical Information of China (English)

    黄秀花; 阮奕劲; 薛远琼

    2015-01-01

    目的:观察优质护理在化脓性中耳炎患者中的应用效果。方法:选取80例慢性化脓性中耳炎患者作为研究资料,按照护理方法的不同分为对照组40例和观察组40例。结果:观察组患者鼓膜充血、听力改善情况优于对照组,疼痛分级优于对照组,差异具有统计学意义(P <0.05)。结论:优质护理在化脓性中耳炎患者中的应用可以明显的改善临床症状,降低疼痛敏感度,值得临床推广。%Objective To approach aresult of otitis media suppurative by high quality nursing.Methods Select 80 cases clinical data of otitis media suppurative patients,which was to be divided into two groups by nursing,routine nursing group 40 cases and high quality nursing group 40 cases.Results The tympanic membrane hyperemia improved、listening to improve proportion of high quality nursing group were better than routine nursing group,the pain grading high quality nursing group were better than routine nursing group (P <0.05),the difference were statistical significance.Conclusion The clinical symptoms of otitis media suppurative by high quality nursing are improved,Pain sensitivity is decreased,which is to be used.

  16. The Epidemiology of Chronic Suppurative Lung Disease and Bronchiectasis in Children and Adolescents

    Science.gov (United States)

    McCallum, Gabrielle B.; Binks, Michael J.

    2017-01-01

    In the modern era, the global burden of childhood chronic suppurative lung disease (CSLD) remains poorly captured by the literature. What is clear, however, is that CSLD is essentially a disease of poverty. Disadvantaged children from indigenous and low- and middle-income populations had a substantially higher burden of CSLD, generally infectious in etiology and of a more severe nature, than children in high-income countries. A universal issue was the delay in diagnosis and the inconsistent reporting of clinical features. Importantly, infection-related CSLD is largely preventable. A considerable research and clinical effort is needed to identify modifiable risk factors and socioeconomic determinants of CSLD and provide robust evidence to guide optimal prevention and management strategies. The purpose of this review was to update the international literature on the epidemiology, etiology, and clinical features of pediatric CSLD. PMID:28265556

  17. 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. ...

  18. STUDY OF AEROBIC AND ANAEROBIC BACTERIA IN CHRONIC SUPPURATIVE OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Satyanarayana

    2015-04-01

    Full Text Available One hundred six patients with clinical diagnosis of CSOM were investigated bacteriologically using appropriate aerobic and anaerobic techniques. Positive cultures were obtained in 100 specimens. Aerobic bacteria alone were present in 51%, anaerobic bacteria alone in 10% and a combination of both in 34% of aural swabs . The anaerobes isolated were Bacteroides 30%, Peptostreptococci 26%, followed by others. Aerobic bacteriology showed the predominance of Pseudomonas 30.4% followed by Staphylococcus aureus 21.4%. Metronidazole was found to be most effective (87% drug aga inst anaerobes and Amikacin (98% against aerobes.

  19. Socioeconomic challenges of chronic suppurative otitis media management in state tertiary health facility in Nigeria

    Directory of Open Access Journals (Sweden)

    O.A. Afolabi

    2014-03-01

    Conclusion: The socioeconomic cost of CSOM is still very high both financially and non-financially. Children are at the receiving end, there is a need for capacity building to reduce the cost burden and out of pocket expenses through health insurance scheme will go a long way.

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Chronic suppurative osteomyelitis with proliferative periostitis related to a fully impacted third molar germ: a report of two cases

    Science.gov (United States)

    2016-01-01

    In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed Garré's sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit. PMID:27595089

  4. Chronic suppurative osteomyelitis with proliferative periostitis related to a fully impacted third molar germ: a report of two cases.

    Science.gov (United States)

    Park, Joonhyoung; Myoung, Hoon

    2016-08-01

    In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed Garré's sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.

  5. 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

  6. 117例化脓性中耳炎患者的病原菌分布及药敏性分析%Distribution and drug sensitivity of pathogens in 117 patients with suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    胡峰; 黄彩忠; 黄闻军; 张利红

    2012-01-01

    目的 了解化脓性中耳炎患者的病原菌分布及其耐药性,以指导临床用药.方法 收集2009年2月—2011年2月医院疑似化脓性中耳炎患者中耳分泌物,采用Bact-IST微生物分析系统进行细菌培养和药敏试验.结果 117份标本中有微生物生长92株,其中细菌88株,真菌4株;病原菌检出首位的为金黄色葡萄球菌,占47.8%,其次为鲍氏不动杆菌、铜绿假单胞菌,占19.6%、17.4%;金黄色葡萄球菌对万古霉素、替考拉宁敏感率为100.0%,铜绿假单胞菌、鲍氏不动杆菌对亚胺培南等药物的敏感率为100.0%.结论 引起化脓性中耳炎的病原菌以金黄色葡萄球菌,鲍氏不动杆菌和铜绿假单胞菌为常见;药物敏感试验对临床用药有指导意义.%OBJECTIVE To investigate the pathogens distribution and drug resistance in suppurative otitis media, so as to guide the clinical usage of antibiotics.METHODS Middle ear discharges were collected from patients with suspected suppurative otitis media that admitted in our hospitalfrom Feb.2009 to Feb.2011, and bacterial culture and drug susceptibility test were performed using Bact-IST microbiological analysis system.RESULTS There were 92 strains of microbes isolated from 117 cases, 88 of them were bacteria and 4 were fungus.Isolation rates were as follows; Staphylococcus aureus was47.8%, Acinetobacter baumanli was 19.6%.Pseudmonas aeruginosa was 17.4%.S.anreus was 100.0% sensitive to vancomycin and teicoplanin, P.aeruginosa and A.baumannii were 100.0% sensitive to imipenem.CONCLUSION S.aureus, P.aeruginosa and A.baumannii are the main pathogenic bacteria causing suppurative otitis media.Performing the ear discharge culture and drug susceptibility test is of great value for clinical drug application.

  7. 133例儿童化脓性中耳炎病原菌和药敏分析%Distribution and drug sensitivity of pathogens in 133 children with suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    庞丹

    2016-01-01

    Objective To guide proper clinical medication through analysing the main pathogen and the drug resistant situation of suppurative otitis media of the local children .Methods Making the bacterial culture and antibiotic susceptibility tests with the ear secretion collected randomly of 133 children with suppurative otitis media .Results Among the 133 cases ,110 pathogenic germs were separated totally ,as the detectable rate was 98 .23% ,and Among them ,56 streptococcus pneumoniae ,26 staphylococcus au‐reus (3 multi‐drug resistant to oxacillin) ,11 streptococcus pyogenes ,4 Haemophilus influenza and 13 others .Streptococcus pneu‐moniae was susceptible of ceftriaxoneo ,cefotaxime ,chloramphenicol ,levofloxacin ,quinupristin/dalfopristin and vancomycin ,while was resistant to clindamycin ,tetracycline ,sulfamethoxazole and erythromycin .11 .54% of the total detectable rate of MRSA in Staphylococcus aureus ,produce to β‐ lactamase detection rate was 84 .61% .Streptococcus pyogenes had a high resistance rate to erythrocin ,while a low rate to the other antimicrobial .Conclusion The main pathogen of the local children suppurative otitis media are Streptococcus pneumonia ,Staphylococcus aureus and Streptococcus pyogenes .The clinicians should use antibiotics reasonably according to the antimicrobial susceptibility results .%目的:探讨该地区儿童化脓性中耳炎的主要致病菌与耐药情况,指导临床合理用药。方法对133例儿童化脓性中耳炎的耳分泌物进行细菌培养鉴定与药物敏感试验。结果133例耳脓液标本中共分离出致病菌110株,检出率为98.23%。其中肺炎链球菌56株,金黄色葡萄球菌26株(M RSA 3株),化脓链球菌11株,流感嗜血杆菌4株,其他13株。肺炎链球菌对头孢曲松、头孢噻肟、氯霉素、左氧氟沙星、万古霉素敏感,对克林霉素、四环素、复方磺胺甲噁唑、红霉素耐药。金黄色葡萄球菌中M RS A总检出率11.54

  8. 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

  9. Treating low- and medium-potency bisphosphonate-related osteonecrosis of the jaws with a protocol for the treatment of chronic suppurative osteomyelitis: report of 7 cases.

    NARCIS (Netherlands)

    Alons, K.; Kuijpers, S.C.; Jong, Edo de; Merkesteyn, J.P.R. van

    2009-01-01

    OBJECTIVE: Treatment of bisphosphonate-related osteonecrosis of the jaws has been reported to be very difficult. In this article a small series of 7 patients, treated with a relatively simple protocol, similar to the treatment of chronic suppurative osteomyelitis, consisting of surgery and antimicro

  10. 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.

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

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    Silva N.

    2001-01-01

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

  13. 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

  14. 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.

  15. 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

  16. Hyper IgM syndrome presenting as chronic suppurative lung disease

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    Montella Silvia

    2012-09-01

    Full Text Available Abstract The Hyper-immunoglobulin M syndromes (HIGM are a heterogeneous group of genetic disorders resulting in defects of immunoglobulin class switch recombination. Affected patients show humoral immunodeficiency and high susceptibility to opportunistic infections. Elevated serum IgM levels are the hallmark of the disease, even though in few rare cases they may be in the normal range. Hyper IgM is associated with low to undetectable levels of serum IgG, IgA, and IgE. In some cases, alterations in different genes may be identified. Mutations in five genes have so far been associated to the disease, which can be inherited with an X-linked (CD40 ligand, and nuclear factor-kB essential modulator defects or an autosomal recessive (CD40, activation-induced cytidine deaminase, and uracil-DNA glycosylase mutation pattern. The patient herein described presented with recurrent upper and lower respiratory infections and evidence of suppurative lung disease at the conventional chest imaging. The presence of low serum IgG and IgA levels, elevated IgM levels, and a marked reduction of in vivo switched memory B cells led to a clinical and functional diagnosis of HIGM although the genetic cause was not identified.

  17. The Likelihood of Preventing Respiratory Exacerbations in Children and Adolescents with either Chronic Suppurative Lung Disease or Bronchiectasis

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    O’Grady, Kerry-Ann F; Grimwood, Keith

    2017-01-01

    Chronic suppurative lung disease (CSLD) and bronchiectasis in children and adolescents are important causes of respiratory morbidity and reduced quality of life (QoL), also leading to subsequent premature death during adulthood. Acute respiratory exacerbations in pediatric CSLD and bronchiectasis are important markers of disease control clinically, given that they impact upon QoL and increase health-care-associated costs and can adversely affect future lung functioning. Preventing exacerbations in this population is, therefore, likely to have significant individual, familial, societal, and health-sector benefits. In this review, we focus on therapeutic interventions, such as drugs (antibiotics, mucolytics, hyperosmolar agents, bronchodilators, corticosteroids, non-steroidal anti-inflammatory agents), vaccines and physiotherapy, and care-planning, such as post-hospitalization management and health promotion strategies, including exercise, diet, and reducing exposure to environmental toxicants. The review identified a conspicuous lack of moderate or high-quality evidence for preventing respiratory exacerbations in children and adolescents with CSLD or bronchiectasis. Given the short- and long-term impact of exacerbations upon individuals, their families, and society as a whole, large studies addressing interventions at the primary and tertiary prevention phases are required. This research must include children and adolescents in both developing and developed countries and address long-term health outcomes. PMID:28393062

  18. 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 ...

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

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    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

  20. 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.

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

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    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.

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

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    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.

  3. Community-acquired intracranial suppurative infections: A 15-year report

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    Taner Yildirmak

    2014-01-01

    Full Text Available Background: The aim of this study was to retrospectively evaluate the characteristics, treatment, and prognosis of patients with intracranial suppurative infection (ISI by review of clinical, radiological, and laboratory findings. Methods: The data collected from all patients who had been diagnosed with ISI and followed up at the Infectious Diseases and Clinical Microbiology Department of the study site between 1998 and 2013 were reviewed. Results: Of the 23 ISI patients identified, the mean age was 38.21 ± 12.61 years (range: 19-67 years, median: 34 and mean symptom duration was 22.25 ± 20.22 days. Headache was the most common symptom, the frontal lobe the most common localization of ISI, and mastoiditis due to chronic suppurative otitis media the most common source of infection causing ISI. Proteus mirabilis, Pseudomonas spp., Peptostreptococcus spp., Enterococcus avium, Mycobacterium tuberculosis complex, and Toxoplasma gondii were isolated from the specimens collected from 6 (37.5% of the 16 patients who underwent invasive procedures. Of these 16 patients, 2 underwent craniotomy, 12 burr hole aspiration, and 2 stereotactic biopsy. The rate of recurrence was 0% and the rates of sequelae and fatality were both 8%. Conclusions: ISI should be considered in male patients presenting with headache and neurological signs and symptoms, whether with or without fever, on admission for early diagnosis and provision of timely, adequate therapy and, if required, surgical intervention to reduce mortality and sequelae rates.

  4. Chronic suppurative joint effusion due to burkholderia pseudomallei: A case report

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    Madhavi Deshmukh

    2013-01-01

    Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. pseudomallei in the clinical laboratory is very difficult, owing to low awareness of physicians to the nonspecific clinical manifestations, lack of responsiveness among microbiologists outside endemic areas, identification systems in the average sentinel laboratory, and the biosafety conditions necessary to process these organisms. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography (CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Culture was confirmed as Burkholderia pseudomallei on Vitek2C, which was sensitive to ceftazidime and trimethoprim/sulfmethoxazole. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia. This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized.

  5. 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

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    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

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

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

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    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.

  8. 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.

  9. 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.

  10. 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.

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

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    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. Children with chronic suppurative lung disease have a reduced capacity to synthesize interferon-gamma in vitro in response to non-typeable Haemophilus influenzae.

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    Susan J Pizzutto

    Full Text Available Chronic suppurative lung disease (CSLD is characterized by the presence of a chronic wet or productive cough and recurrent lower respiratory infections. The aim of this study was to identify features of innate, cell-mediated and humoral immunity that may increase susceptibility to respiratory infections in children with CSLD. Because non-typeable Haemophilus influenzae (NTHi is commonly isolated from the airways in CSLD, we examined immune responses to this organism in 80 age-stratified children with CSLD and compared their responses with 51 healthy control children. Cytokines involved in the generation and control of inflammation (IFN-γ, IL-13, IL-5, IL-10 at 72 hours and TNFα, IL-6, IL-10 at 24 hours were measured in peripheral blood mononuclear cells challenged in vitro with live NTHi. We also measured circulating IgG subclass antibodies (IgG1 and IgG4 to two H. influenzae outer membrane proteins, P4 and P6. The most notable finding was that PBMC from children with CSLD produced significantly less IFN-γ in response to NTHi than healthy control children whereas mitogen-induced IFN-γ production was similar in both groups. Overall there were minor differences in innate and humoral immune responses between CSLD and control children. This study demonstrates that children with chronic suppurative lung disease have an altered systemic cell-mediated immune response to NTHi in vitro. This deficient IFN-γ response may contribute to increased susceptibility to NTHi infections and the pathogenesis of CSLD in children.

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

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    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.

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

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    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.

  15. In vitro antifungal susceptibility of Malassezia pachydermatis strains isolated from dogs with chronic and acute otitis externa.

    Science.gov (United States)

    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.

  16. 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

  17. 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...

  18. Acute Obstructive Suppurative Pancreatic Ductitis in an Asymptomatic Patient

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    Eisha Wali

    2015-01-01

    Full Text Available Acute obstructive suppurative pancreatic ductitis (AOSPD, defined as suppuration from the pancreatic duct without associated pseudocyst, abscess, or necrosis, is a rare complication of chronic pancreatitis. We present the first case of AOSPD in an asymptomatic patient with a polymicrobial infection and review the literature on this rare clinical entity.

  19. [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.

  20. Anaerobic bacteria in otitis media.

    Science.gov (United States)

    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.

  1. 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

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

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    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

  3. Analysis of pathogens and drug sensitivity on 87 cases of chronic suppurative osteomyelitis%87例慢性化脓性骨髓炎病原菌构成及药敏分析

    Institute of Scientific and Technical Information of China (English)

    陈爱宝; 龚琦; 宋建辉; 曾国庆

    2012-01-01

    Objective To analyse constitutes strains of pathogenic bacteria and drug sensitivity test of 87 cases of chronic suppurative osteomyelitis. Methods Bacteria culture and drug sensitive test were performed by taking sinus secretions or tissue in deep focus of infection from patients with chronic suppurative osteomyelitis. Results A total of 120 strains of pathogenic bacteria were isolated. From high to low infection rate the top 3 bacteria as Staphylococcus aureus ( 30% ), Pseudomonas aeruginosa (25% ), Escherichia coli ( 14.2% ). Vancomycin, imipenem were the highest rate of sensitive drug. Conclusion The main pathogens of chronic suppurative osteomyelitis were composed with Staphylococcus aureus, Pseudomonas aeruginosa. Drug sensitive test is the important basis for selection of antibiotics.%目的 分析87 例慢性化脓性骨髓炎的病原菌菌种构成、药敏实验结果.方法 取慢性化脓性骨髓炎患者窦道深部分泌物或病灶组织做细菌培养及药敏试验.结果 共培养出病原菌120 株,感染率由高到低前三位菌为金黄色葡萄球菌(占30%)、铜绿假单胞菌(占25%)、大肠埃希菌(占14.2%).万古霉素、亚胺培南是敏感率最高药物.结论 慢性化脓性骨髓炎的病原菌构成以金黄色葡萄球菌、铜绿假单胞菌为主,药敏试验是选用抗菌药物的重要依据.

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

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    M.T. Goodarzi

    2013-07-01

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

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

    Science.gov (United States)

    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

  6. 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 ...

  7. 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 ...

  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. 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.)

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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

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

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    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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. New combination for the therapy of canine otitis externa. I. Microbiology of otitis externa.

    Science.gov (United States)

    Kiss, G; Radványi, S; Szigeti, G

    1997-02-01

    In order to compound a new drug combination against canine otitis externa (OE), 515 dogs affected with OE were subjected to physical examination and microbiological analysis of their ear exudates. OE was erythematous-ceruminous in 83 per cent and suppurative in 17 per cent of the patient material. Erythematous-ceruminous inflammations were characterised by severe pruritus and accumulation of brownish, greasy cerumen in the auditory canal. The yeast Malassezia pachydermatis was isolated from the ears of 76 per cent of the dogs, often in combination with Staphylococcus intermedius bacteria. M pachydermatis showed the most sensitivity, in decreasing order of efficacy, to ketoconazole, econazole, clotrimazole, miconazole and nystatin. S intermedius isolates were most sensitive to amoxycillin-clavulanic acid, enrofloxacin, cephalexin and gentamicin. The microorganism most frequently isolated from dogs with suppurative OE was Pseudomonas aeruginosa; in some cases Proteus, Streptococcus and Pasteurella were also isolated. The P aeruginosa isolates showed the highest sensitivity to gentamicin, polymyxin B and tobramycin.

  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. Osteomielitis crónica supurativa en el maxilar superior: reporte de un caso clínico Chronic osteomyelitis suppurative in the maxilar superior: report of a clinical case

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    L.N. Souza

    2010-12-01

    Full Text Available La Osteomielitis es una infección del tejido óseo que involucra a todas las estructuras del hueso provocada por microorganismos. El cuadro clínico se caracteriza generalmente por la presencia de fístula de drenaje, dolor intenso, inflamación, movilidad de los dientes involucrados en la zona afectada, fiebre y edema. El tratamiento consiste en medicamentoso y/o quirúrgico. En este artículo se presenta un caso de Osteomielitis crónica supurativa en el maxilar superior, que acomete a un paciente del sexo femenino de 82 años, en el cual se discuten los aspectos diagnósticos e histopatológicos como el tratamiento correspondiente del caso.Osteomyelitis is an infection of bone tissue that involves all structures of the bone caused by microorganisms. The clinical picture is generally characterized by the presence of fistula drainage, severe pain, swelling, mobility of teeth involved in the affected area, fever and edema. Treatment involves medication and / or surgery. This article presents a case of chronic suppurative osteomyelitis in the maxilar superior of a female 82 years old patient, as well as a discussion of clinical and histopathological aspects and the treatment employed.

  3. 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.

  4. 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

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

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    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

  6. Analysis of bacterial spectrum and drug sensitivity of chronic suppurative sinusitis%慢性鼻窦炎患者鼻腔(脓性)分泌物的细菌谱及其药敏分析

    Institute of Scientific and Technical Information of China (English)

    苟立华; 胡韫科; 白成祥

    2015-01-01

    坦、头孢唑啉等抗菌药物敏感,在进行抗菌治疗前应密切监测抗菌谱的改变,以便及时调整用药。%Objective:To investigate the bacterial distribution and drug sensitivity characteristics of chronic suppurative sinusi-tis.Methods:This study collected nasal secretions of 89 cases chronic suppurative sinusitis patients before operation,and nasal secre-tions were culture in medium.Disk diffusion method (Kirby-Bauer,K-B)was used for drug sensitivity test.Sensitivity of bacteria strain to cefazolin,ceftazidime,cefepime,imipenem,meropenem,vancomycin,cefoperazone Shubatan,ciprofloxacin and other anti-biotics were analyzed.Results:After the submission of purulent secretion specimens of nasal meatus in 89 cases chronic suppurative si-nusitis patients with sticky,we found that 80 of the patients were detected bacteria.Exclusion of Streptococcus /yellow Neisseria nasal flora,the positive rate was 89.89% (80 /89).80 patients were detected in 82 strains of bacteria,a total of 15 species,of which 1 case of nasal meatus sticky purulent secretion specimens there were 2 strains of bacteria.15 kinds of Staphylococcus aureus were detec-ted bacteria,Escherichia coli,Pseudomonas,Staphylococcus aureus,Enterobacter aerogenes,5 kinds of bacteria occupy the top 5,re-spectively,accounted for 18.29%,14.63%,14.63%,13.41 % and 10.98%.Drug sensitivity test of Staphylococcus aureus showed that all of the Staphylococcus aureus was sensitive to vancomycin,the sensitivity was 100%;the sensitivity of cefazolin,ceftazidime, cefepime,imipenem,meropenem,cefoperazone sulbactam,ciprofloxacin and other antibiotics were 0%.All the Staphylococcus epi-dermidis were sensitive to imipenem,meropenem,vancomycin,cefoperazone sulbactam,the sensitivity was 100%;followed by cefazo-lin,the sensitivity was 83.33%,and to ceftazidime,cefepime,ciprofloxacin sensitive,were all below 30%.Escherichia coli,Pseudo-monas aeruginosa and Enterobacter aerogenes and other gram negative bacteria were

  7. 慢性化脓性鼻窦炎的菌种分布和药物敏感性分析%Analysis of bacterial distribution and drug sensitivity of chronic suppurative sinusitis

    Institute of Scientific and Technical Information of China (English)

    徐冰; 黄才俊

    2015-01-01

    Objective To investigate the bacterial distribution and drug sensitivity characteristics of chronic suppurative sinusitis.Methods Nasal secretions of 89 cases of chronic suppurative sinusitis patients before operation were collected in this study,and nasal secretions were culture in medium.Disk diffusion method (Kirby-Bauer,K-B)was used for drug sensitivity test.Sensitivity of bacteria strain to cefazolin,ceftazidime,cefepime,imipenem,mero-penem,vancomycin,cefoperazone -sulbactam,ciprofloxacin and other antibiotics were analyzed.Results After the submission of purulent secretion specimens of nasal meatus in 89 cases chronic suppurative sinusitis patients with sticky,we found that 80 of the patients were detected bacteria.The positive rate was 89.89% (80/89).80 patients were detected in 82 strains of bacteria,a total of 15 species,of which 1 cases of nasal meatus sticky purulent secretion specimens there were 2 strains of bacteria.In 15 kinds of staphylococcus aureus were detected bacteria,staphylococcus aureus,escherichia coli,pseudomonas,enterobacter aerogenes,5 kinds of bacteria occupy the top 5,respectively, accounted for 21.95%,18.29%,14.63%,13.41%,10.98%.Drug sensitivity test of staphylococcus aureus showed that all of the staphylococcus aureus was sensitive to vancomycin,the sensitivity was 100%;the sensitivity of cefazo-lin,ceftazidime,cefepime,imipenem,meropenem,cefoperazone sulbactam,ciprofloxacin and other antibiotics were 0.00%.All the staphylococcus epidermidis were sensitive to imipenem,meropenem,vancomycin,cefoperazone sulbac-tam,the sensitivity was 100.00%;followed by cefazolin,the sensitivity was 86.67%,and to ceftazidime,cefepime, ciprofloxacin sensitive,were all below 30.00%.Escherichia coli,pseudomonas aeruginosa and enterobacter aerogenes and other gram negative bacteria were sensitive to imipenem,meropenem,the sensitivity was 100.00%.Conclusion The bacterial infection in patients with chronic suppurative sinusitis pathogens

  8. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... otitis. Fungal external otitis (otomycosis), typically caused by Aspergillus niger or Candida albicans, is less common. Boils are ... of fullness in the ear. Otomycosis caused by Aspergillus niger usually causes grayish black or yellow dots (called ...

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. [Otitis externa and cerumen obturans].

    Science.gov (United States)

    Pieren, C

    1995-11-01

    Otitis externa and cerumen obturans are two of the most frequently encountered disturbances in the external auditory canal. Both conditions can lead to hearing loss due to reduced sound transmission. Other symptoms include ear pressure, pain and secretion. Acute otitis externa occurs frequently during the swimming season. The main symptoms are local pain and secretion. Treatment consists of careful and frequent cleaning and application of topical medication to the outer ear canal and prescription of medication against pain. Systemic antibiotics are only rarely necessary and are indicated if perichondritis or lymphadenitis are present. Chronic otitis externa is often caused by eczema of the outer ear canal. Allergies, systemic diseases, such as diabetes mellitus, and manipulation by the patient must be ruled out. Therapy includes the application of topical steroid solutions. The natural pH of the skin can be reestablished by use of diluted acetic acid solutions. Blockage of the outer ear canal by cerumen [cerumen obturans] can bring the patient to the office because of sudden hearing loss. After cleaning of the ear canal, a screening hearing test should be performed to assure that the problem has been resolved.

  14. Acute otitis externa: an update.

    Science.gov (United States)

    Schaefer, Paul; Baugh, Reginald F

    2012-12-01

    Acute otitis externa is a common condition involving inflammation of the ear canal. The acute form is caused primarily by bacterial infection, with Pseudomonas aeruginosa and Staphylococcus aureus the most common pathogens. Acute otitis externa presents with the rapid onset of ear canal inflammation, resulting in otalgia, itching, canal edema, canal erythema, and otorrhea, and often occurs following swimming or minor trauma from inappropriate cleaning. Tenderness with movement of the tragus or pinna is a classic finding. Topical antimicrobials or antibiotics such as acetic acid, aminoglycosides, polymyxin B, and quinolones are the treatment of choice in uncomplicated cases. These agents come in preparations with or without topical corticosteroids; the addition of corticosteroids may help resolve symptoms more quickly. However, there is no good evidence that any one antimicrobial or antibiotic preparation is clinically superior to another. The choice of treatment is based on a number of factors, including tympanic membrane status, adverse effect profiles, adherence issues, and cost. Neomycin/polymyxin B/hydrocortisone preparations are a reasonable first-line therapy when the tympanic membrane is intact. Oral antibiotics are reserved for cases in which the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection. Chronic otitis externa is often caused by allergies or underlying inflammatory dermatologic conditions, and is treated by addressing the underlying causes.

  15. 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

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    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

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

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    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

  17. Eosinofiele otitis media

    NARCIS (Netherlands)

    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

  18. 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.

  19. 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.

  20. Pharm GKB: Acute suppurative thyroiditis [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Accession Id: PA165108138 External Vocabularies MeSH: Thyroiditis, Suppurative (D013969) SnoMedCT: Acute su... (N0000002947) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute suppurative thyroiditis ...

  1. 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.

  2. 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.

  3. 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。

  4. Acute suppurative neonatal parotitis: Case report.

    LENUS (Irish Health Repository)

    Khan, Sardar U

    2012-02-01

    Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.

  5. Acute suppurative neonatal parotitis: Case report.

    Science.gov (United States)

    Khan, Sardar U; O'Sullivan, Peter G; McKiernan, John

    2010-02-01

    Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.

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

    Directory of Open Access Journals (Sweden)

    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

  7. 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

  8. 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,…

  9. 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。

  10. 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.

  11. Cat’s external otitis - diagnose and treatment

    Directory of Open Access Journals (Sweden)

    Degi, J.

    2008-06-01

    Full Text Available Otitis externa is a frequent finding in cats, with a prevalence rate of 2-10 % of all feline patients seen in general practice. Otodectes cyanotis, the ear mite, is responsible for approximately 50% of all feline otitis externa cases. However, other infectious and inflammatory conditions frequently either cause or predispose the cat to ear disease. In 20-30 % of chronic feline ear cases the initiating cause remains unknown.

  12. 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

  13. 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.

  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.

  15. 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。

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Suppurative intracranial processes in 15 domestic ruminants

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Lopes Câmara

    2014-05-01

    Full Text Available In addition to listeriosis which is relatively common in ruminants, there are three other uncommon suppurative intracranial processes (SIP identifiable in adult ungulates as brain abscess, basilar empyema and suppurative meningitis. The present paper reports the epidemiological, clinical, laboratorial, pathological and microbiological findings of 15 domestic ruminants with SIP. A total of 15 animals were selected (eight sheep, four cattle and three goats; with the definitive diagnoses of basilar empyema (n=3, brain abscess (n=1, listeriosis (n=5 and suppurative meningitis (n=6. Hematology revealed leukocytosis with inversion of the lymphocyte/ neutrophil ratio in 4 cases. In the majority of animals, cerebrospinal fluid (CSF presented light yellow coloration and cloudy aspect due to neutrophilic pleocytosis (15 - 997 leukocytes/µL. Microbiological culture of CSF or central nervous system (CNS fragments resulted on isolation of Trueperella (Arcanobacterium pyogenes,Listeria monocytogenes,Escherichia coli and Stenotrophomonas sp. In a goat with thalamic abscess, microbiological assay was not performed, but Gram positive bacilli type bacteria were observed in histology. The diagnosis of these outbreaks was based on the association of epidemiological, clinical, pathological and bacteriological findings; reiterating that the infectious component remains an important cause of CNS disease in domestic ruminants and also shows the need for dissemination of information about the most effective preventive measures for the ranchers.

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

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    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

  2. 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.

  3. Analysis of the Effect of In-tact Bridge Tympanoplasty on Chronic Suppu-rative Otomastoiditis%慢性化脓性中耳乳突炎患者行完桥式鼓室成形术治疗的效果分析

    Institute of Scientific and Technical Information of China (English)

    陈从云; 马赛; 赵选俊; 刘熙

    2014-01-01

    Objective To investigate and analyze the treatment effect of in-tact bridge tympanoplasty in the treatment of chronic suppurative otomastoiditis. Methods The subjects were the 28 cases with chronic suppurative otomastoiditis admitted in our hospital in the recent three years. In-tact bridge tympanoplasty was given to the selected 28 patients and the therapeutic outcome was observed after the operation, and based on this, the patients were given a follow-up about 7 months for observing the status of recovery. Results The dry ear time of the selected patients was about 3-6 weeks. The surgeries of 24 patients were successful, the success rate was 85.7%. There was statistically significant difference in the status of the patients before and after treatment (P<0.05), which showed that the therapeutic effect was remarkable. Conclusion This study shows that the therapeutic effect of in-tact bridge tympanoplasty on chronic suppurative otomastoiditis is significant, the hearing of the patients is improved, so in-tact bridge tympanoplasty has certain clinical and promotional value.%目的:探讨和分析慢性化脓性中耳乳突炎患者实施完桥式鼓室成形术治疗效果。方法研究对象为该院收治的28例慢性化脓性中耳乳突炎患者,对所选取的这28例患者实施完桥式鼓室成形术,在手术后对其结果进行观察,并在基础上对患者实施随访,对其术后的恢复状况进行观察,观察时间为7个月左右。结果所选患者的干耳时间大约在3~6周左右,其中手术成功的病患为24例,其成功率是85.7%,通过病患术前和术后的对比,所得到的成效差异有统计学意义(P<0.05)。结论通过该研究可知,对慢性化脓性中耳乳突炎患者实施完桥式鼓室成形术,所获得的治疗效果较为显著,同时也使得患者听力得到了相应的提高,在临床中具有一定的临床价值与推广价值。

  4. Clinical observation of self Chinese herbal medicine prescription in the treatment of chronic suppurative osteomyelitis after firearm wound of hand and foot%自拟中药方治疗手足火器伤后慢性化脓性骨髓炎临床观察

    Institute of Scientific and Technical Information of China (English)

    于爱军; 丁海生; 周志玲; 袁进国; 丁英奇

    2014-01-01

    目的:探讨自拟中药方外敷治疗手足火器伤后慢性化脓性骨髓炎的临床效果。方法将66例手足火器伤后慢性化脓性骨髓炎患者随机分为治疗组和对照组各33例。对照组给予常规治疗和护理措施,治疗组在对照组基础上加用自拟中药方外敷患处。比较2组术前症状控制情况、急性期症状消退时间、术后创口愈合情况及不良反应情况。结果治疗组待术时间短于对照组,术前症状控制及术后创口愈合情况均优于对照组,差异均有统计学意义(P ﹤0.05)。结论自拟中药方外敷治疗手足火器伤后慢性化脓性骨髓炎可有效控制临床症状,缩短疗程,提高疗效及生存质量,值得临床推广应用。%Objective To discussion the clinical effect of self Chinese herbal medicine prescription in the treatment of chronic suppurative osteomyelitis after firearm wound of hand and foot. Methods 66 cases of patients with chronic suppurative osteomyelitis after firearm wound of hand and foot were randomly divided into treatment group and control group,each of 33 ca-ses. Control group received conventional treatment and care measures,treatment group were given with self Chinese herbal med-icine prescription based on control group. Compared the symptom control situation before surgery,acute symptoms subside time,postoperative wound healing situation and adverse reactions of two groups. Results The time to be surgery of treatment group was shorter than control group,the postoperative symptom control situation and wound healing situation were better than control group,the differences were statistically significant(P ﹤ 0. 05). Conclusion The treatment of self Chinese herbal medi-cine prescription for chronic suppurative osteomyelitis after firearm wound of hand and foot can effectively control symptoms and shorten the course of treatment,improve the efficacy and quality of life,worthy of clinical application.

  5. 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.

  6. Case of concurrent Riedel's thyroiditis, acute suppurative thyroiditis, and micropapillary carcinoma.

    Science.gov (United States)

    Hong, Ji Taek; Lee, Jung Hwan; Kim, So Hun; Hong, Seong Bin; Nam, Moonsuk; Kim, Yong Seong; Chu, Young Chae

    2013-03-01

    Riedel's thyroiditis (RT) is a rare chronic inflammatory disease of the thyroid gland. It is characterized by a fibroinflammatory process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation can mask an accompanying thyroid neoplasm and can mimic invasive thyroid carcinoma. Therefore, diagnosis can be difficult prior to surgical removal of the thyroid, and histopathologic examination of the thyroid is necessary for a definite diagnosis. The concurrent presence of RT and other thyroid diseases has been reported. However, to our knowledge, the association of RT with acute suppurative thyroiditis and micropapillary carcinoma has not been reported. We report a rare case of concurrent RT, acute suppurative thyroiditis, and micropapillary carcinoma in a 48-year-old patient.

  7. Acute suppurative parotitis in a 33-day-old patient.

    Science.gov (United States)

    Avcu, Gulhadiye; Belet, Nursen; Karli, Arzu; Sensoy, Gulnar

    2015-06-01

    Acute suppurative parotitis is a rare disease in childhood. Its incidence is higher in premature newborns. Parotid swelling and pus drainage from Stenson's duct is pathognomonic, and Staphylococcus aureus is the causative agent in most cases. Here, a 33-day-old patient with acute suppurative parotitis is presented.

  8. CT of malignant otitis externa. Computertomographie der malignen Otitis externa

    Energy Technology Data Exchange (ETDEWEB)

    Klose, K.C.; Elies, W. (Technische Hochschule Aachen (Germany, F.R.). Klinik fuer Radiologische Diagnostik Technische Hochschule Aachen (Germany, F.R.). Klinik fuer HNO)

    1991-06-01

    Computed tomography was performed preoperatively in 20 patients suffering from malignant external otitis. The CT findings were nearly completely confirmed by the intraoperative findings. A circumscribed or diffuse thickening of the cartilaginous wall of the external auditory canal and an inflammatory infiltration of the subtemporal fossa are, in combination, most suspicious signs of malignant external otitis. Computed tomography enabels detailed information on the extension of the pneumatic system and the grade of involvement of bones and soft tissues in malignant external otitis. A modified classification of malignant external otitis based on computed tomographic findings is proposed. (orig.).

  9. 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....

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.

  18. Otitis externa maligna

    OpenAIRE

    2014-01-01

    La otitis externa maligna es una enfermedad cuyo diagnóstico y tra- tamiento supone un reto para cualquier especialista. Es una infección severa que afecta al conducto auditivo externo (óseo/cartilaginoso) y a los tejidos blandos adyacentes. Suele afectar a pacientes inmuno- comprometidos y la diabetes mellitus es condición asociada hasta en 65% de los casos. En la mayoría de los casos el agente causal es la Pseudomonas aeruginosa. El diagnóstico debe basarse en historia clínica y exploración...

  19. Complicated necrotizing otitis externa.

    Science.gov (United States)

    Nawas, Mariam T; Daruwalla, Vistasp J; Spirer, David; Micco, Alan G; Nemeth, Alexander J

    2013-01-01

    Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications.

  20. Multifocal suppurative granuloma caused by Actinobacillus lignieresii in the peritoneum of a beef steer

    Science.gov (United States)

    KASUYA, Kazufumi; MANCHANAYAKE, Tilusha; UENOYAMA, Kei; KAWA, Sayaka; TAKAYAMA, Kou; IMAI, Naoto; SHIBAHARA, Tomoyuki

    2016-01-01

    An imported crossbred Angus beef steer aged eight to twelve months died suddenly on the eighth day of a quarantine period in Japan. Gross examination showed the peritoneum and mesentery consisted of numerous nodules of various sizes. Histological examination revealed chronic suppurative granulomatous peritonitis with eosinophilic rosettes surrounding colonies of Gram-negative bacilli. The bacteria isolated from the nodules were confirmed to be Actinobacillus lignieresii based on the results of 16S rRNA gene sequencing and immunohistochemistry. Antibiotic sensitivity testing showed that the isolate was resistant to penicillin. Thus, a diagnosis of atypical actinobacillosis caused by A. lignieresii was made. PMID:27773882

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

    Directory of Open Access Journals (Sweden)

    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.

  3. Otitis externa por Demodex cati

    OpenAIRE

    L. Real; Ortuñez, A.; Verde Arribas, Mª T.; Navarro, L.; Vilela, C

    2010-01-01

    La demodicosis por Demodex cati es una enfermedad parasitaria poco común que se presenta bajo tres formas clínicas: generalizada, localizada y otitis externa ceruminosa u otodemodicosis. El objetivo de esta comunicación es presentar dos casos clínicos de otitis ceruminosa causada por D.cati sin la presencia de otros síntomas cutáneos.

  4. Bacterial Interference in Nasopharyngeal Bacterial Flora of Otitis-prone and Non-otitis-prone Children

    NARCIS (Netherlands)

    J.M. Bernstein; S. Sagahtaheri-ALtaie; D.M. Dryja; J. Wactawski-Wende

    1994-01-01

    textabstractThe quantitative bacteriology of the adenoid was studied in 34 otitis-prone and 25 non-otitis prone children. Viridans streptococci appeared to be the predominant normal flora in children who are non-otitis prone. There was a significant decrease in viridans streptococci in the otitis-pr

  5. A DESCRIPTIVE STUDY OF FUNGAL INFECTIONS IN CHRONICALLY DISCHARGING EARS

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-08-01

    Full Text Available BACKGROUND : Chronic Suppurative Otitis Media (CSOM is a disease of multiple aetiology and well known for its persis tence and recurrence inspite of treatment and are the bearbug of otologist, paediatrician and general practitioner. One of the reason s for the refractoriness to treatment and chronicity is coexist ing fungal infection of the ear. OBJECTIVES: Are to find out the prevalence of fungal infections in chronic discharging ears and to identify and isolate the type of fungus prevalent in these ears . MATERIALS AND METHOD S: Tertiary care hospital level descrip tive study was conducted in 50 cases of CSOM with actively discharging ears for a period of one year starting from February 2013. For all the cases aural swabs were collected from the diseased ear and were used for direct microscopic examination in potassi um hydroxide wet mount. Ear swab was cultured on Sabouraud’s dextrose agar plate for fungal cultures. The patient characteristics were prospectively recorded and results were analysed. CONCLUSION : There is high prevalence of coexisting fungal infection in actively discharging ears of CSOM patients

  6. 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

  7. 耳内镜下复方酮康唑、氧化锌软膏治疗慢性外耳道炎的临床疗效%Under endotoscope compound ketoconazole zinc oxide ointment in the treatment of chronic otitis externa

    Institute of Scientific and Technical Information of China (English)

    黄涛

    2015-01-01

    目的:探讨耳内镜下复方酮康唑软膏、氧化锌软膏治疗慢性外耳道炎的疗效.方法:收治慢性外耳道炎患者82例,耳内镜下外耳道涂抹复方酮康唑、氧化锌软膏等治疗.结果:1周后复诊,治愈58例,治愈率70.7%;2周后复诊,治愈74例,治愈率90.2%,治疗效果满意.结论:耳内镜下采用复方酮康唑软膏、氧化锌软膏等治疗慢性外耳道炎具有满意的疗效.%Objective:To explore the curative effect of under endotoscope compound ketoconazole ointment and zinc oxide ointment in the treatment of chronic otitis externa.Methods:82 patients with chronic otitis externa were selected.They were given compound ketoconazole and zinc oxide ointment treatment in external auditory canal under endotoscope.Results:After 1 week of subsequent visit,58 cases were cured,the cure rate was 70.7%.After 2 weeks of subsequent visit,74 cases were cured,the cure rate was 90.2% .The treatment effect was satisfactory.Conclusion:Using compound ketoconazole ointment and zinc oxide ointment under endotoscope in the treatment of chronic otitis externa have satisfactory curative effect.

  8. [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.

  9. Effect of Binghuang ear drop treatment on otitis externa in guinea pigs.

    Science.gov (United States)

    Zhai, Suo-qiang; Yu, Ning; Guo, Wei-Wei; Zhang, Yue

    2014-12-01

    To investigate the pharmacodynamic effects of Binghuang ear drop on acute suppurative otitis externa in guinea pig model. Thirty guinea pigs were randomly divided into three groups, with ten animals in each group. Group A animals had normal ear canal and Binghuang ear drops (two drops, B.I.D) were applied in both ears for 7 days; Group B animals had induced otitis externa and received identical prescription as group A; Group C had normal ear canal and were treated with normal saline (two drops, B.I.D) for 7 days. After the treatments, the external morphology of ear canals was observed and the paraffin sections of external auditory canal were prepared and examined under the microscope. The inflammatory manifestation and cell infiltration into the skin of group B was significantly attenuated after the Binghuang ear drops treatment. In contrast, no allergy or side effects were produced by Binghuang ear drops application in the animals with normal ear canals. Binghuang ear drops could be used to treat acute otitis externa by eliciting anti-bacterial effects.

  10. 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?

  11. 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.

  12. [A case of brucellosis presenting with suppurative parotitis involvement].

    Science.gov (United States)

    Kanmaz, Lutfi; Karakeçili, Faruk; Çıkman, Aytekin; Özçiçek, Fatih; Karavaş, Erdal

    2016-01-01

    Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.

  13. MOUTH FLOOR DIFFUSE SUPPURATION COMPLICATED BY CERVICOTHORACIC NECROTIZING FASCIITIS – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Violeta TRANDAFIR

    2013-03-01

    Full Text Available Necrotizing fasciitis is a severe soft tissue infection, often life-threatening, characterized by necrosis of the subcutaneous and fascial tissue, which can be extended along the fascial plans, affecting the adjacent vessels, nerves and muscle tissue. The predisposing factors of the disease include: advanced age, immuno-compromised bodies, diabetes, chronic alcoholism and chronic smoking. Necrotizing fasciitis in head and neck segments is rare, usually with an odontogenic source of infection. In the early stages of evolution, a necrotizing fasciitis is difficult to differentiate from the non-necrotizing infection of the soft tissue. Due to its extremely severe evolution, an early presumptive diagnosis is necessary (based on clinical and imaging aspects, as well as a prompt aggressive surgery backed by an intensive care support. The clinical case of an immunocompromised patient admitted for a mouth floor diffuse suppuration, previously complicated with cervicothoracic necrotizing fasciitis with aggressive evolution, is discussed in the following.

  14. Role of IgE in Eosinophilic Otitis Media

    Directory of Open Access Journals (Sweden)

    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.

  15. 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).

  16. Otitis: anatomy every practitioner should know.

    Science.gov (United States)

    Griffin, Craig

    2009-11-01

    Chronic otitis externa is a difficult, frustrating problem. Four etiologic components must be considered: primary and secondary causes and perpetuating and predisposing factors.1 Usually, these cases are complex and involve more than one component. Perpetuating factors are changes in the anatomy and physiology of the ear that occur in response to inflammation in the ear canal and the perpetuating factors already present. They are self-perpetuating, are not disease specific, and include failure of self-cleaning mechanisms and proliferative changes that create folds and stenosis of the lumen of the ear canal. Elimination of perpetuating factors often requires aggressive cleaning of the ear and long-term therapy. It is important to avoid damaging key structures while aggressively cleaning the ear. Therefore, to adequately diagnose and manage perpetuating factors, veterinarians must recognize normal ear anatomy and physiology.

  17. 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,…

  18. 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

  19. Necrotizing otitis externa: a painless reminder.

    Science.gov (United States)

    Thio, Daniel; Reece, Phillip; Herdman, Rory

    2008-08-01

    Necrotizing otitis externa is a necrotizing osteomyelitis of the skull base that predominantly affects diabetic and immunocompromised patients. Pseudomonas aeruginosa is the most frequently implicated organism. Patients present with severe otalgia, otorrhoea with or without facial palsy, or rarely, facial pain as a symptomatic feature. We report a case of necrotizing otitis externa presenting with totally painless otorrhoea and highlight the need for a high index of suspicion when treating patients with otitis externa.

  20. 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。

  1. 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.

  2. 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.

  3. Pediatric Suppurative Parotitis in Cambodia 2007-2011

    Science.gov (United States)

    Stoesser, Nicole; Pocock, Joanna; Moore, Catrin Elisabeth; Soeng, Sona; Chhat, Hor Put; Sar, Poda; Limmathurotsakul, Direk; Day, Nicholas; Thy, Vann; Sar, Vuthy; Parry, Christopher M.

    2012-01-01

    The causes of suppurative parotitis in Cambodian children are not known. We describe 39 cases at the Angkor Hospital for Children, Siem Reap between January 2007 and July 2011 (0.07/1000 hospital attendances). The median age was 5.7 years with no neonates affected. B. pseudomallei was cultured in 29 (74%) cases. No deaths occurred; one child developed a facial nerve palsy. PMID:22531239

  4. 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

  5. Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Lyul; Cho, June Sik; Kwon, Soon Tae; Lee, Sang Jin; Rhee, Byung Chull [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1993-11-15

    Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as result of partial or complete obstruction of the bile duct, and may manifest clinically severe form of disease, rapidly deteriorating to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying cause were 12 benign disease(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis(n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients resulting in improvement of general condition and failed in three patients. The procedure were preterminated due to the patient's condition in two and biliary-proto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggest that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.

  6. Otitis and autism spectrum disorders

    OpenAIRE

    Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose

    2010-01-01

    The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to oc...

  7. 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.

  8. 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.

  9. 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

  10. 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...

  11. 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

  12. 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.

  13. Ascertainment of aurin ear drops antimicrobial and healing effect in dog otitis

    Directory of Open Access Journals (Sweden)

    Borisov Ivan

    2004-01-01

    Full Text Available Microbiological and clinical examinations have been made, related to the effect of Aurin ear drops - the solution "Primavet - Sofia" on dogs with acute and chronic conditions of external and media otitis. The pharmaceutical compatibility of the active substances and solution stability were examined. The inhibitory effects in vitro of Acidum boricum, Acidwn salicylicum Ethanolum and Aurin - solution on laboratory referents and clinically isolated strains of microorganisms were studied. The dosage and manner of application were specified and was considered the effect on different clinical forms of otitis were specified. In the course of the one-year examination period, it was ascertained that Aurin-solution possesses the necessary stability. The active Aurin-solution substances (Acidum boricum Acidum salicylicum, Novocainum secure optimal composition of supporting substances, and high inhibitory activity in vitro on microbial strains in the examined agents of dog otitis. A dosage of 10 to 20 drops and touching the earconch with 5-10 drops twice a day, in the course of 5-7 days, has local antiseptic, anti-inflammatory, antimycotic and pain soothing effects. The healing effect of Aurin is due to selective antibacterial and antimycotic effects of the active substances used. The effectiveness against otitis is due to synergism of the effects of active and supporting substances. The obtained clinical results present grounds for recommending Aurin - ear drops as an effective method of healing dog otitis.

  14. La otitis en la infancia

    OpenAIRE

    1998-01-01

    Clasificación de la otitis/Factores de riesgo/Sintomatología/Tratamiento/ ¿Por qué fallan algunos tratamientos médicos?/ ¿Cuándo debemos sospechar que existe una alergia a los antibióticos?/ ¿Qué debemos hacer ante la sospechad e una alergia a los medicamentos?/ ¿Cómo se deben aplicar las gotas en el oído?/ ¿Qué sucede con la fiebre o con el dolor?/ ¿Cuándo se ponen tubos ventilatorios?

  15. Hazards of steroid injection: Suppurative extensor tendon rupture

    Directory of Open Access Journals (Sweden)

    Woon Colin

    2010-01-01

    Full Text Available Local steroid injections are often administered in the office setting for treatment of trigger finger, carpal tunnel syndrome, de Quervain′s tenosynovitis, and basal joint arthritis. If attention is paid to sterile technique, infectious complications are rare. We present a case of suppurative extensor tenosynovitis arising after local steroid injection for vague symptoms of dorsal hand and wrist pain. The progression of signs and symptoms following injection suggests a natural history involving bacterial superinfection leading to tendon rupture. We discuss the pitfalls of local steroid injection and the appropriate management of infectious extensor tenosynovitis arising in such situations.

  16. An Efficacy Observation on Ergan'an Granule in Treating Simple Type of Chronic Suppurative Otitis Media%"耳疳安冲剂"的研制及治疗慢性化脓性中耳炎(单纯型)疗效观察

    Institute of Scientific and Technical Information of China (English)

    罗克强; 杨大章; 喻妮; 杨丽华; 鞠海; 李凯鹏; 王忠植

    2004-01-01

    目的:观察自行研制的"耳疳安冲剂"及中西医结合治疗慢性化脓性中耳炎(单纯型)的疗效.方法:确诊为慢性化脓性中耳炎(单纯性)的患者105例随机分为三组:中药组(30例)接受耳疳安冲剂口服;西药组(30例)联合口服交沙霉素(Josa-mycin)和增效联磺片(SMZ+SD+TMP);中西医结合组(45例)联合服用以上中药和西药.结果:中西医结合组、中药组、西药组治愈率分别为77.8%、40.0%、46.7%,中西医结合组与其它两组治愈率比较统计学上均有显著性差异(P<0.01),中药组和西药组疗效无显著性差异(P>0.05).结论:"耳疳安冲剂"治疗慢性化脓性中耳炎(单纯型)有一定效果,中西医结合治疗慢性化脓性中耳炎(单纯型)标本兼顾,可显著提高疗效,提高治愈率.

  17. 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.

  18. Malignant otitis externa: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Rejee Ebenezer

    2011-01-01

    Full Text Available Destruction of condyle of mandible is an extremely rare complication of malignant otitis externa. Here we describe such a rare instance in a patient with malignant otitis externa. It is very important to diagnose this category of patients and treat them accordingly. The available data indicate the need for external drainage. We report a case with malignant otitis externa with temporomandibular involvement treated successfully with radical mastoidectomy and drainage of the joint through the external auditory canal and an external incision was avoided.

  19. [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.

  20. 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.

  1. 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.

  2. Management of malignant (necrotising) otitis externa.

    Science.gov (United States)

    Hollis, S; Evans, K

    2011-12-01

    Although malignant (necrotising) otitis externa is not a common diagnosis, there have been a number of recently reported cases with pathogens other than Pseudomonas aeruginosa as the causative organism. In addition, there are many published reports of resistance to antibiotics in cases of malignant otitis externa caused by Pseudomonas aeruginosa. This review aims to assess the cases reported and to clarify the current opinion on the diagnostic criteria and management of such cases.

  3. 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.

  4. Discrimination of suppurative cholangitis from nonsuppurative cholangitis with computed tomography (CT)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Kyung [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kim, Suk [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)], E-mail: kimsuk@medigate.net; Lee, Jun Woo; Kim, Chang Won [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kim, Gwang Ha; Kang, Dae Hwan [Department of Gastrointestinal Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Jo, Hong Jae [Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)

    2009-03-15

    Purpose: Suppurative cholangitis is characterized by obstruction, inflammation, and pyogenic infection of the biliary tract. This disease represents a true emergency. The purpose of this study was to compare the computed tomography (CT) findings between acute calculous suppurative and nonsuppurative cholangitis and to determine if there are findings that assist in the differential diagnosis. Materials and methods: Fifteen patients with acute suppurative cholangitis were enrolled in this study. Findings at endoscopic retrograde cholangiopancreaticography (ERCP) were the standard of reference for suppurative cholangitis. To compare the findings of suppurative cholangitis with those of nonsuppurative cholangitis, 35 patients with nonsuppurative cholangitis were randomly selected. The following findings were evaluated: the presence of papillitis, the presence of stones in the ampulla, the presence of intrahepatic stones, the presence of early inhomogeneous enhancement of the liver, the degree of bile duct dilatation, the degree of bile duct wall thickening and presence of cholecystitis. Sensitivity and specificity for each of the individual findings were calculated. Statistical analyses were performed the Pearson {chi}{sup 2} test, Fisher's exact test and the Mann-Whitney U test. Results: Papillitis showed the highest specificity 86% with 60% sensitivity. Marked inhomogeneous enhancement of the liver during the arterial phase showed 80% specificity with 60% sensitivity. In multivariate logistic analysis, papillitis and marked early inhomogeneous enhancement of the liver were the most significant predictors of acute suppurative cholangitis. The combination of these two CT findings improved specificity (97% specificity) for the diagnosis of suppurative cholangitis. Conclusion: Papillitis and marked early inhomogeneous enhancement of the liver were found to be the most discriminative CT findings for the diagnosis of acute suppurative cholangitis and the

  5. Ultrasonographic evaluation of suppurative cervical lymphadenitis in children: Focusing on abscess formation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Hee; Kang, Byung Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Sun Wha [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1999-12-15

    To analyze the US findings of suppurative cervical lymphadenitis in children and define the US features of drainable abscess. We retrospectively evaluated the US findings od suppurative cervical lymphadenitis in 22 children (age: 40 days-14 years). Among them, eighteen were confirmed by drainage or needle aspiration, and four diagnosed on the basis of typical findings of abscess on enhanced CT. Echogenicity, shape (ratio of long/short diameter) of suppurative lymph nodes, and the changes of adjacent soft tissues on US were assessed, and color signal patterns of 17 suppurative lymph nodes on color Doppler imaging were also recorded. We compared the US with CT findings (n=14). Eight of 22 were abscess of typical US pattern, showing the characteristic anechoic central cores. Fourteen demonstrated low echogenicity with mottled anechoic portions, atypical US pattern. Ratio of long/short diameter measured more than 2 in 16 of 22 and less than 2 in 6. Adjacent subcutaneous tissue was the thickened and increased in echogenicity with hypoechoic irregular lines in all lines. On color Doppler imaging, only peripheral pattern was seen in four of 5 suppurative lymph of typical pattern. In 12 suppurative lymph nodes of atypical pattern, there were 4 peripheral pattern, 2 central patterns and 6 mixed patterns. Compared the US findings with CT, all three suppurative lymph nodes of typical US pattern showed peripheral rim enhancement. Peripheral rim enhancement containing low attenuated internal portion (n=8) and inhomogeneous enhancement (n=3) were observed in 11 suppurative lymph nodes of atypical pattern. Any lymph node with complex echogenicity containing mottled anechoic portions with adjacent edematous subcutaneous tissue as well as central anechoic core could be regarded as the findings of drainable abscess in US diagnosis of suppurative cervical lymphadenitis in children.

  6. 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

  7. 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

  8. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome

    Science.gov (United States)

    Ursani, Mohammad A.; Appleyard, Joan; Whiteru, Onome

    2016-01-01

    Patient: Male, 44 Final Diagnosis: PAPASH syndrome Symptoms: Recurrent skin ulcers • diarrhea • inflammatory arthritis Medication: Prednisone • anti-tumor necrosis factor Clinical Procedure: N/A Specialty: Rheumatology Objective: Rare disease Background: Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). Case Report: A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. Conclusions: Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various

  9. Active middle ear implantation for patients with sensorineural hearing loss and external otitis: long-term outcome in patient satisfaction

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Hashemi, J.; Cremers, C.W.R.J.; Mulder, J.J.S.; Snik, A.F.M.

    2013-01-01

    OBJECTIVE: To study long-term subjective benefit of patients with sensorineural hearing loss and chronic external otitis who use active middle ear implants. DESIGN: Single-subject repeated measures in a preintervention and postintervention design with multiple postintervention measurements (question

  10. Identification and antimicrobial susceptibility patterns of bacteria causing otitis externa in dogs.

    Science.gov (United States)

    Zamankhan Malayeri, Hamed; Jamshidi, Shahram; Zahraei Salehi, Taghi

    2010-06-01

    Bacterial agents are considered important pathogens causing external otitis in dogs. It is essential to carry out bacterial culture and antimicrobial susceptibility test in the case of otitis externa, particularly for chronic or recurring cases. Sterile swab samples were obtained from terminal part of vertical ear canals of 74 dogs with otitis externa for cytology, bacterial culture and antimicrobial susceptibility test. Cytologic smears were stained using Gram and Giemsa staining methods. Aerobic bacterial culture performed on blood agar and MacConkey agar. Among total number of 92 isolated bacteria, 68 were Staphylococcus intermedius. Other isolated bacteria included: Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Pasteurella canis, and six other species of coagulase-negative Staphylococcus. Antimicrobial susceptibility test were performed for all isolated bacteria using 14 antibiotics. Based on the results of this study, all isolated Staphylococcus spp. were sensitive to amikacin, enrofloxacin, and rifampin, and had low resistance to gentamicin, cephalothin and ceftriaxone. More than half of gram-positive isolates were resistant to penicillin and ampicillin. Generally, all isolated gram-negative bacteria, were sensitive to amikacin and enrofloxacin, and had low resistance to ceftriaxone and gentamicin. They were highly resistant to penicillin, eythromycin, and cephalothin. Regarding the results of this study, in cases of uncomplicated otitis externa, it is possible to select antimicrobial drugs merely based on cytology, but it is recommended to perform bacterial culture and antimicrobial susceptibility test. However, in complicated or refractory cases, antimicrobials should be selected based on bacterial culture and antimicrobial susceptibility test.

  11. Fungal otitis externa as a cause of tympanic membrane perforation: a case series.

    Science.gov (United States)

    Song, James Eingun; Haberkamp, Thomas J; Patel, Riddhi; Redleaf, Miriam I

    2014-08-01

    We describe a series of 11 patients--8 men and 3 women, aged 18 to 70 years (mean: 46.0)--who had fungal otitis externa that had been complicated by a tympanic membrane perforation. These patients had been referred to us for evaluation of chronic, mostly treatment-refractory otitis externa, which had manifested as otorrhea, otalgia, and/or pruritus. Seven of the 11 patients had no history of ear problems prior to their current condition. Five patients had been referred to us by a primary care physician and 4 by an otolaryngologist; the other 2 patients were self-referred. All patients were treated with a thorough debridement of the ear and one of two antifungal medication regimens. Eight of the 11 patients experienced a complete resolution of signs and symptoms, including closure of the tympanic membrane perforation. The other 3 patients underwent either a tympanoplasty (n = 2) or a fat-graft myringotomy (n = 1) because the perforation did not close within a reasonable amount of time. This series demonstrates that the nonspecific signs and symptoms of fungal otitis externa can make diagnosis difficult for both primary care physicians and general otolaryngologists. This study also demonstrates that most cases of tympanic membrane perforation secondary to fungal otitis externa will resolve with cleaning of the ear and proper medical treatment. Therefore, most patients with this condition will not require surgery.

  12. Suppurative supraclavicular bacille calmette-guerine lymphadenitis - A case report, awareness and management options

    OpenAIRE

    U S Udgaonkar; Patil, S S; Rekha, V.B.; Shah, S.

    2015-01-01

    Diagnosis of Bacille calmette-guerine (BCG) adenitis is clinical. Conventional laboratory tests do not differentiate BCG adenitis from tuberculous adenitis. We report a case of a 3-month-old healthy baby presenting with suppurative BCG adenitis. FNAC revealed AFB on ZN-Staining, later confirmed to be Mycobacterium bovis by multiplex PCR. The treatment of suppurative BCG adenitis is needle aspiration. Anti-tubercular treatment is unwarranted.

  13. Suppurative supraclavicular bacille calmette-guerine lymphadenitis - A case report, awareness and management options

    Directory of Open Access Journals (Sweden)

    U S Udgaonkar

    2015-01-01

    Full Text Available Diagnosis of Bacille calmette-guerine (BCG adenitis is clinical. Conventional laboratory tests do not differentiate BCG adenitis from tuberculous adenitis. We report a case of a 3-month-old healthy baby presenting with suppurative BCG adenitis. FNAC revealed AFB on ZN-Staining, later confirmed to be Mycobacterium bovis by multiplex PCR. The treatment of suppurative BCG adenitis is needle aspiration. Anti-tubercular treatment is unwarranted.

  14. [The practice guideline 'Otitis externa' (first revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology].

    Science.gov (United States)

    Mylanus, E A M

    2008-05-24

    The first revision of the practice guideline 'Otitis externa' from the Dutch College of General Practitioners describes diagnostic, therapeutic and preventive aspects of care and focuses mainly on the acute form of the disease. In comparison with the previous guideline, some modest but valuable improvements have been made with regard to diagnosis and medical treatment. For acute otitis externa, treatment with acid and corticosteroid eardrops is considered the treatment of choice, rather than treatment with acid eardrops only. The guideline clearly discusses indications for referral of patients with otitis externa to an otorhinolaryngologist. Hypersensitivity and more severe pathology should be excluded in persistent cases. For chronic otitis externa, an otorhinolaryngologist can provide surgical treatment with a good chance of success and a low recurrence rate.

  15. Coryneform bacteria associated with canine otitis externa.

    Science.gov (United States)

    Aalbæk, Bent; Bemis, David A; Schjærff, Mette; Kania, Stephen A; Frank, Linda A; Guardabassi, Luca

    2010-10-26

    This study aims to investigate the occurrence of coryneform bacteria in canine otitis externa. A combined case series and case-control study was carried out to improve the current knowledge on frequency and clinical significance of coryneform bacteria in samples from canine otitis externa. A total of 16 cases of otitis externa with involvement of coryneform bacteria were recorded at two referral veterinary hospitals in Denmark and the US, respectively. Coryneform bacteria were identified by partial 16S rRNA gene sequencing. Corynebacterium auriscanis was the most common coryneform species (10 cases). Small colony variants of this species were also observed. Other coryneform isolates were identified as Corynebacterium amycolatum (3 cases), Corynebacterium freneyi (2 cases) and an Arcanobacterium-like species (1 case). The coryneform bacteria were in all cases isolated together with other bacteria, mainly Staphylococcus pseudintermedius alone (n=5) or in combination with Malassezia pachydermatis (n=5). Some coryneform isolates displayed resistance to fusidic acid or enrofloxacin, two antimicrobial agents commonly used for the treatment of otitis externa in dogs. The frequency of isolation of coryneform bacteria was 16% among 55 cases of canine otitis externa examined at the Danish hospital during 2007. In contrast, detectable levels of coryneform bacteria were not demonstrated in samples from the acustic meatus of 35 dogs with apparently healthy ears, attending the hospital during the same year. On basis of the current knowledge, these coryneform bacteria should be regarded as potential secondary pathogens able to proliferate in the environment of an inflamed ear canal.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  18. 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.

  19. [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.

  20. 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.

  1. Coryneform bacteria associated with canine otitis externa

    DEFF Research Database (Denmark)

    Aalbæk, Bent; Bemis, David A.; Schjærff, Mette;

    2010-01-01

    This study aims to investigate the occurrence of coryneform bacteria in canine otitis externa. A combined case series and case-control study was carried out to improve the current knowledge on frequency and clinical significance of coryneform bacteria in samples from canine otitis externa. A total...... of 16 cases of otitis externa with involvement of coryneform bacteria were recorded at two referral veterinary hospitals in Denmark and the US, respectively. Coryneform bacteria were identified by partial 16S rRNA gene sequencing. Corynebacterium auriscanis was the most common coryneform species (10...... cases). Small colony variants of this species were also observed. Other coryneform isolates were identified as Corynebacterium amycolatum (3 cases), Corynebacterium freneyi (2 cases) and an Arcanobacterium-like species (1 case). The coryneform bacteria were in all cases isolated together with other...

  2. 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.

  3. 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).

  4. Prevalence of otitis externa in stray cats in northern Italy.

    Science.gov (United States)

    Perego, Roberta; Proverbio, Daniela; Bagnagatti De Giorgi, Giada; Della Pepa, Alessandra; Spada, Eva

    2014-06-01

    Feline otitis externa is a dermatological disorder that has not been evaluated much in stray cats. One hundred and eighty-seven stray cats were randomly selected during a trap-neuter-release programme to investigate the prevalence of otitis externa in stray cat colonies in northern Italy. Swabs for cytological examination were obtained from the external ear canal of each cat. A direct otoscopic assessment of the external ear canal was made in 86/187 cats. Cytological evidence of otitis externa was present in 55.1% of cats. The influence on otitis of age, gender, habitat and season of sampling was tested, but no risk factors were found. Otodectes cynotis (as a sole agent or in combination) was the primary cause of otitis in 53.3% of cats. Cocci and rods, either alone or in combination with other agents, were perpetuating factors in 71.8% and 29.1% of cats, respectively. Pregnancy status was a risk factor for otitis caused by coccal infections. Malassezia species, alone or in combination, was the perpetuating factor in 50.5% of cats with otitis. Urban habitat and winter season were risk factors for otitis associated with Malassezia species. Demodex cati was identified as an incidental finding in two cats. There was good agreement between otoscopy and cytology with regard to the diagnosis of otitis externa. The results of this study show a high prevalence of otitis externa in stray colony cats and provide information on causal factors for feline otitis externa.

  5. Management of radiation-induced otitis externa

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, A.C. (Royal Free Hospital, London (UK). Dept. of Otorhinolaryngology)

    1990-06-01

    Four cases of otitis externa secondary to radiotherapy are described. This fairly common complication of irradiation to the head and neck, may impede a satisfactory completion of the therapy. Water precautions and regular otoscopic examination of the ears should be encouraged as prevention or early recognition of the condition is essential for the well being of the patient. The treatment of established otitis externa consists of frequent aural toilet and the application of weak antiseptic solutions. However, complete resolution will not occur until the cutaneous reaction has fully settled. (author).

  6. 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

  7. Pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis: efficacy of anti-tumor necrosis factor α therapy.

    Science.gov (United States)

    Bruzzese, Vincenzo

    2012-12-01

    We report the case of a patient with a simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis. This condition differs from both the PASH (pyoderma gangrenosum, acne, and suppurative hidradenitis) syndrome, in which arthritis is absent, and the PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome, in which suppurative hidradenitis is lacking. Our patient failed to respond to etanercept therapy, whereas all dermatologic and rheumatic manifestations completely regressed following infliximab infusion. We therefore propose that simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and seronegative spondyloarthritis might represent a distinct syndrome that could be termed the PASS syndrome. Tumor necrosis factor α therapies seem to play selective roles.

  8. Acute suppurative thyroiditis in children secondary to pyriform sinus fistula.

    Science.gov (United States)

    Sai Prasad, T R; Chong, Chia Li; Mani, Anna; Chui, Chan Hon; Tan, Carolyn Eng Looi; Tee, Wen Sim Nancy; Jacobsen, Anette Sundfor

    2007-08-01

    Acute suppurative thyroiditis (AST), a potential complication of pyriform sinus fistula (PSF), is a rare clinical condition as the thyroid gland is remarkably resistant to infections. Lack of awareness of the entity contributes to the rarity and frustrating recurrences. We performed a retrospective review of all cases of AST due to PSF treated at our institution over a 10-year period. The clinical data, investigations, operative findings and procedures, microbial culture reports and follow-up were recorded and analyzed. Between January 1997 and September 2006, 12 cases (8 males and 4 females) of AST due to PSF were treated. Nine patients (75%) underwent successful complete excision, seven of whom had initial incision and drainage procedures. In three patients (25%) with recurrence, one underwent complete excision at a later procedure, one patient had multiple recurrences with six incision and drainage procedures and two failed attempts of excision of PSF before final successful complete excision. The third patient is awaiting re-excision of the PSF tract. All patients, except the one awaiting re-excision, are well with no further recurrences during the follow-up period that ranged from 18 to 96 months (median, 46.5 months). AST due to PSF is a challenging entity in terms of diagnosis and management as recurrences are common despite meticulous dissection. High index of suspicion and radiological investigations such as barium studies and computed tomography scan aid in the delineation and excision of the fistulous tract.

  9. 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

  10. 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

  11. 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

  12. Malignant external otitis: early scintigraphic detection

    Energy Technology Data Exchange (ETDEWEB)

    Strashun, A.M.; Nejatheim, M.; Goldsmith, S.J.

    1984-02-01

    Pseudomonas otitis externa in elderly diabetics may extend aggressively to adjacent bone, cranial nerves, meninges, and vessels, leading to a clinical diagnosis of ''malignant'' external otitis. Early diagnosis is necessary for successful treatment. This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomylitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis. Skull radiographs were negative in all of the eight patients studied. Thin-section tomography was positive in one of the seven patients studied using this modality. CT scanning suggested osteomyelitis in three of nine patients. Both Tc-99m and Ga-67 citrate scintigraphy were positive in 10 of 10 patients. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis.

  13. 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.

  14. Epidemiology of acute otitis in pediatric patients

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    Maddalena Perotti

    2011-03-01

    Full Text Available Introduction. Acute otitis is one of the most common pediatric infectious diseases that requires an accurate diagnosis in order to direct appropriate therapy to reduce the risk of complications. In this study pathogens collected from pediatric patients and their antibiotic susceptibility patterns were evaluated. Methods. Between May 2009 and May 2010, 739 samples (swabs taken from nasopharynx in case of acute otitis media and/or from ears in case of acute external otitis, collected from 680 patients, suffering of otalgia, admitted to the emergency department of our Hospital were studied.The specimens were submitted for routine bacterial cultures and the susceptibility tests were performed according to Clinical Laboratory Standards. Nitrocefin was used to detect ß-lactamase activity. Results. 316 samples (42.8% of 739 were negative, 102 (13.8% were positive for Streptococcus pneumoniae, 97 (13.1% for Moraxella catarrhalis, 68 (9.2% for Haemophilus influenzae, 62 (8.4% for Pseudomonas aeruginosa, 49 (6.6% for Staphylococcus aureus, 36 (4.9% for Streptococcus pyogenes, 5 (0.7% for Gram negative and 4 (0.5% for Candida spp. Antibiotic susceptibility tests showed that amikacin, ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam were active against all Gram negative strains isolated.We found one strain of MRSA. Of 102 Streptococcus pneumoniae, 5 (4.9% were penicillin resistant and 25 (24.5% were erythromycin resistant, showing the prevalence of constitutive phenotype (80%. All M. catarrhalis strains were ß-lactamase producers while all H. influenzae were ß-lactamase negatives. Conclusions. The prevalent etiological agents in pediatric acute otitis are S. pneumoniae, M. catharralis, and H. influenzae, as reported in literature. In external acute otitis P. aeruginosa prevails in particular in summer.

  15. 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.

  16. Suppurative meningitis: A life-threatening complication in male macroprolactinomas

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    Farida Chentli

    2013-01-01

    Full Text Available Background: Suppurative meningitis (SM or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT. Our aim was to analyze its frequency among male macroprolactinomas (MPRL deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared. Materials and Methods: We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing. Results: Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4 th case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction. Conclusion: SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4 th one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases.

  17. 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

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

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    Norma de Oliveira Penido

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

  19. TUBERCULAR SUPPURATIVE VASITI S PRESENTED AS AN INGUINAL MASS : A RARE CASE REPORT

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    Kavimozhy

    2015-07-01

    Full Text Available We report a case of suppurative vasitis that presented as an inguinal mass in a n elderly man. Infectious vasitis, while rarely reported in the literature, is thought to be caused by Escherichia coli, mycobacteria causing tuberculosis, and other rare urogenital pathogens such as Haemophilus influenza. We report a case of tuberculous vasitis occurring as a primary infectious suppurative vasitis is rare and presenting as an inguinal mass is unusual. Only, very few cases were reported in literature with such presentation.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Recurrent malignant otitis externa: management and outcome.

    Science.gov (United States)

    Omran, Ahmed Amin; El Garem, Hany Farouk; Al Alem, Reyad Khalil

    2012-03-01

    Necrotizing (malignant) external otitis (NEO) is an infection involving the temporal and the adjacent bones. It is a rare type of external otitis that occurs primarily in immunocompromised persons. The present study aimed to evaluate its management and outcome in recurrent cases. Ten patients attending the ENT Department, Alexandria University were included. They had recurrence of otitis externa over a period of 6 months after-cure, as well as severe night otalgia and high ESR level. Peri-auricular soft tissue swelling, cranial nerve paralysis and trismus were the main persistent or developing presentations in recurrent cases. Extensive surgical intervention was performed in four patients with unsatisfactory outcome. On the other hand, satisfactory results were obtained with those treated with specific medical therapy after culture and sensitivity test and those who underwent minimal surgical intervention. In conclusion, NEO is an aggressive disease that necessitates conservative management and local debridement of sequestrated tissues. The ESR is a good indicator of treatment response. It is recommended to be meticulous in treatment of cases with recurrent NEO and extensive surgical interventions are discouraged.

  7. External Otitis: An Unusual Presentation in Neonates

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    Peymaneh Alizadeh Taheri

    2016-01-01

    Full Text Available Acute otitis externa (AOE is an infection of the external auditory canal, the auricle, and the outer surface of the tympanic membrane. Although AOE is one of the most common otologic conditions encountered in pediatric population, it is known to primarily affect children older than 2 years. We report a case of AOE caused by Staphylococcus aureus in a 23-day-old neonate. A 23-day-old female infant presented to our neonatology clinic with irritability and discharge from the right ear. There were yellow otorrhea, mild erythema, and edema of right external ear canal. There was no sign of otitis media on otoscopy. The results of laboratory tests were insignificant. The discharge culture grew colonies of methicillin-sensitive Staphylococcus aureus. After 48 hours of treatment with intravenous cloxacillin, significant improvement was observed. The present case highlights an unusual presentation of staphylococcal infection in a neonate. This is the first case of methicillin-sensitive Staphylococcus aureus otitis externa in an immunocompetent newborn.

  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. The treatment of pediatric secretory otitis media%儿童分泌性中耳炎的治疗进展

    Institute of Scientific and Technical Information of China (English)

    农光耀

    2015-01-01

    Children with secretory otitis media refers to the eustachian tube is blocked due to children or obstruction caused by conductive deafness and pathological changes of the middle ear effusion, appear easily hearing loss and ear stuffy middle ear suppurative inflammatory disease. If not treated in time, will seriously affect the language and mental development of children. This article is to review about the present situation of the treatment of pediatric secretory otitis media.%儿童分泌性中耳炎是指由于儿童咽鼓管不通畅或者阻塞后引起的传导性聋及鼓室积液的病理改变,极易出现听力下降及耳闷等中耳非化脓性炎性疾病。若不及时给予治疗,将严重影响儿童的语言及智力发育。本文则对儿童分泌性中耳炎的治疗现状予以综述。

  10. 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...

  11. Mastoiditis mimicry: retro-auricular cellulitis related to otitis externa.

    Science.gov (United States)

    Block, Stan L

    2014-09-01

    Retro-auricular cellulitis associated with otitis externa is now the great mimicker of mastoiditis. It may be the most common cause of this specific cellulitis/auricular protrusion when it is associated with otitis externa. This column presents six cases of children who presented with peri-auricular redness, four of whom had protuberant ear and retro-auricular cellulitis.

  12. Unexpected cause of malignant otitis externa: A rare case report

    Directory of Open Access Journals (Sweden)

    Abdulla Al-otaibi

    2011-01-01

    Full Text Available Malignant otitis externa is an uncommon infection affecting the ear canal and temporal bone. The most common causative organism is Pseudomonas aeruginosa. In this article, we report a malignant otitis externa caused by actinomycosis, a case never been reported before in the literature.

  13. A Novel Mycobacterium cosmeticum-Like Bacterium Isolated from the Ear Swab of a Patient with Otitis Externa

    Directory of Open Access Journals (Sweden)

    Jeanette W. P. Teo

    2015-01-01

    Full Text Available We describe the identification and characterization of a novel nontuberculous mycobacterium (NTM, isolated from an ear swab of an adult male patient with chronic otitis externa. Genetically, the bacterium is most closely related to Mycobacterium cosmeticum; however, growth and biochemical features indicate that it is distinctly different. Here, we highlight for the first time an unusual NTM that is a probable cause of ear infection.

  14. 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.

  15. 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.

  16. [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.

  17. 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...

  18. Experimental treatment of recurrent otitis externa

    Directory of Open Access Journals (Sweden)

    M.H. Mileva

    2015-04-01

    Full Text Available The aim of this research is to determine the effect of the hybrid material based on polyvinyl alcohol and silver nanoparticles (PVA/AgNps in the treatment of the otitis externa as an additional component in the commercial product “Betazon Trio”. It was established that the experimental creamy formula with silver concentration 600 mg/L is suitable for recovery of the microbial homeostasis when it is administrated once daily in dose 1 ml over a period of 14 days.

  19. The analysis of bacteria strains and sensitivity of bacteria to antibiotics in acute obstructive cholangitis with suppuration

    Institute of Scientific and Technical Information of China (English)

    顾彬

    2013-01-01

    Objective To analyze the changes of bacteria stains in acute obstructive cholangitis with suppuration(AOSC) and sensitivity of different bacteria strains to antibiotics in recent decade. Methods The data of bacterial

  20. 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.

  1. [A study of otitis externa associated with Malassezia].

    Science.gov (United States)

    Shiota, Ryoko; Kaneko, Takamasa; Yano, Hiroaki; Takeshita, Kimiko; Nishioka, Keiko; Makimura, Koichi

    2009-01-01

    Malassezia-positive smears can be recognized from otitis externa, however, there are few references in the literature to the relation between Malassezia and otitis externa. Therefore, the bacterial and clinical characteristics of 72 cases (63 patients) with otitis externa were investigated at the Department of Otorhinolaryngology, Takinomiya General Hospital to analyze this. Thirty-seven cases were bacterial otitis externa, 20 cases were fungal otitis externa, and 15 cases were etiological agents unknown in this study. The causative organisms in fungal otitis externa were the genera Aspergillus (10 cases), Malassezia (5) and Candida (5), respectively. We suspected that 5 cases were caused by Malassezia because Malassezia cell counts were greater than 10 per field (x 400), and a large number of Malassezia were isolated from all cases. In these cases, many squamous epithelial cells were observed by direct examination, and cells from the middle or basal layer of the ear canal were also recognized in three cases. Therefore, accelerated turnover of epidermal cells of the ear canal was suggested. The main symptoms were itching and fullness in the ear, with observations of redness and erosion in objective deterioration, and we felt that these conditions were similar to seborrheic dermatitis (SD). In addition, these five cases were confirmed as fungus-related otitis externa by their improvement with antifungal agents.

  2. Necrotic cervical nodes: Usefulness of diffusion-weighted MR imaging in the differentiation of suppurative lymphadenitis from malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki, E-mail: hkato@gifu-u.ac.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); High-level Imaging Diagnosis Center, Gifu University Hospital, Gifu (Japan); Kato, Zenichiro, E-mail: zenkato@mac.com [Department of Pediatrics, Gifu University School of Medicine, Gifu (Japan); Teramoto, Takahide, E-mail: t-tera@gifu-u.ac.jp [Department of Pediatrics, Gifu University School of Medicine, Gifu (Japan); Mizuta, Keisuke, E-mail: kmizuta@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Aoki, Mitsuhiro, E-mail: aoki@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Makita, Hiroki, E-mail: makitah@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Kato, Keizo, E-mail: keizo@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan)

    2013-01-15

    Purpose: The purpose of this study was to assess the efficacy of diffusion-weighted (DW) MR imaging for the differentiation between suppurative lymphadenitis and malignancy in necrotic cervical lymph nodes. Materials and methods: Fifteen patients with suppurative lymphadenitis, 40 with squamous cell carcinoma (SCC), eight with lymphoma, and six with thyroid cancer were accompanied by necrotic cervical nodes. All 69 patients underwent 1.5-T MR imaging including DW and 58 underwent gadolinium-enhanced MR imaging. Necrotic area-to-spinal cord signal intensity ratios (SIR) on T1-, T2- and DW images and apparent diffusion coefficients (ADCs) [10{sup −3} mm{sup 2}/s] were correlated with the pathologies. Results: Nineteen necrotic cervical nodes with suppurative lymphadenitis, 67 with SCC, 10 with lymphoma, and 12 with thyroid cancer were identified. SIR on DW images was higher in suppurative lymphadenitis (2.50 ± 1.21) than in malignancies (1.29 ± 0.67) (p < .01), and ADC value was lower in suppurative lymphadenitis (0.89 ± 0.21) than in malignancies (1.46 ± 0.46) (p < .01). SIR on T1-weighted images was higher in thyroid cancer (1.95 ± 0.53) than in suppurative lymphadenitis (0.87 ± 0.17), SCC (0.92 ± 0.13), and lymphoma (0.95 ± 0.09) (p < .01). No significant difference in SIR on T2-weighted images was found between suppurative lymphadenitis (1.46 ± 0.50) and malignancies (1.61 ± 0.56). Conclusion: DW imaging with ADC measurements may play a supplementary role in the differentiation of necrotic cervical nodes between suppurative lymphadenitis and malignancy.

  3. 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

  4. 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.

  5. 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

  6. 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)

  7. 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.

  8. Otitis externa. Management in the primary care office.

    Science.gov (United States)

    Mirza, N

    1996-05-01

    Otitis externa is a widespread problem that is most commonly caused by Pseudomonas aeruginosa. Pain, ear discharge, and edema of the ear canal are the main manifestations. The presence of granulation tissue is an ominous sign that usually indicates necrotizing otitis externa or even a neoplastic process. It is important for primary care physicians to be familiar with methods of ear cleaning and use of topical medications for otitis externa. It is equally vital to be aware of the importance of a timely referral to an otolaryngologist when a serious underlying cause is suspected.

  9. 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.

  10. 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.

  11. Malignant otitis externa: An Australian case series.

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVES: To establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution. STUDY DESIGN: Retrospective cohort outcomes study. METHODS: 24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I-IV. Laboratory investigations Including C-reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded. RESULTS: Radiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001). CONCLUSIONS: Malignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing. MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.

  12. Suppurative necrotizing granulomatous lymphadenitis in adult-onset Still’s disease: a case report

    Directory of Open Access Journals (Sweden)

    Assimakopoulos Stelios F

    2012-10-01

    Full Text Available Abstract Introduction Lymphadenopathy is found in about 65% of patients with adult-onset Still’s disease and is histologically characterized by an intense, paracortical immunoblastic hyperplasia. Adult-onset Still’s disease has not been previously described as an etiology of suppurative necrotizing granulomatous lymphadenitis. Case presentation We describe a 27-year-old Greek man who manifested prolonged fever, abdominal pain, increased inflammatory markers, episodic skin rash and mesenteric lymphadenopathy histologically characterized by necrotizing granulomatous adenitis with central suppuration. Disease flares were characterized by systemic inflammatory response syndrome with immediate clinico-laboratory response to corticosteroids but the patient required prolonged administration of methylprednisolone at a dose of above 12mg/day for disease control. After an extensive diagnostic work-up, which ruled out any infectious, malignant, rheumatic or autoinflammatory disease the patient was diagnosed as having adult-onset Still’s disease. The patient is currently treated with 4mg of methylprednisolone, 100mg of anakinra daily and methotrexate 7.5mg for two consecutive days per week and exerts full disease remission for six months. Conclusion To the best of our knowledge this is the first report of suppurative necrotizing granulomatous lymphadenitis attributed to adult-onset Still’s disease. This case indicates that the finding of a suppurative necrotizing granulomatous lymphadenitis should not deter the consideration of adult-onset Still’s disease as a potential diagnosis in a compatible clinical context; however, the exclusion of other diagnoses is a prerequisite.

  13. Epidemiological and Microbiological Diagnosis of Suppurative Keratitis in Gangetic West Bengal, Eastern India

    Directory of Open Access Journals (Sweden)

    Basak Samar

    2005-03-01

    Full Text Available PURPOSE: To determine the epidemiologcial pattern and risk factors involved in suppurative corneal ulceration in Gangetic West Bengal, eastern India, and to identify the specific microbial agents responsible for corneal infections. METHODS: All patients with suspected microbial keratitis presenting to the corneal clinic at Disha Eye Hospital, Barrackpore, West Bengal, India, from January 2001 to December 2003 were evaluated. Sociodemographic data and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping and cultures were performed. RESULTS: Over a three-year period, 1198 patients with suppurative keratitis were evaluated. Ocular trauma was the most common predisposing factor in 994 (82.9% patients (P< 0.0001, followed by use of topical corticosteroids in 231 (19.28% patients. Cultures were positive in 811 (67.7% patients. Among these culture positive cases, 509 (62.7% patients had pure fungal infections (P< 0.001, 184 (22.7% patients had pure bacterial infections and 114 (14.1% had mixed fungal with bacterial infections. Acanthamoeba was detected in 4 (0.49% patients. The most common fungal pathogen was Aspergillus spp representing 373 (59.8% of all positive fungal cultures (P< 0.0001, followed by Fusarium spp in 132 (21.2% instances. Most common bacterial isolate was Staphylococcus aureus, representing 127 (42.6% of all the bacterial culture (P< 0.0001 followed by Pseudomonas spp 63 (21.1%. CONCLUSION: Suppurative keratitis in Gangetic West Bengal, most often occurs after a superficial corneal trauma with vegetative or organic materials. Fungal ulcers are more common than bacterial ulcers. Aspergillus spp and Staphylococcus aureus were the most common fungus and bacteria respectively. These ′regional′ findings have important public health implications for the treatment and prevention of suppurative corneal ulceration in this region of India.

  14. Epidemiological Aspect and common Bacterial and Fungal isolates from Suppurative Corneal Ulcer in Mymensingh Region.

    Science.gov (United States)

    Moid, M A; Akhanda, A H; Islam, S; Halder, S K; Islam, R

    2015-04-01

    This prospective study was done to find out the epidemiological factors of suppurative corneal ulcer and the common causative bacterial and fungal isolates from the, patients with suppurative corneal ulcer in secondary and tertiary level hospital at Mymensingh region. A total 100 samples of corneal scrapings were collected purposively from clinically diagnosed suppurative corneal ulcer patients from March 18, 2012 to March 17, 2013. Out of the total 100 samples, bacterial species were 29(29%) cases and the fungal spacies were 71(71%) identified by the culture in blood agar, chocolate agar and sabouraud's agar media and also by microscopic examination. The bacterial species were streptococcus pneumonae 12 cases (12%), Staphylococcus aureus 9 cases (9%), pseudomonas in 6 cases (6%), and Streptococcus pyoganes 2 cases (2%). Fungal species were aspergillus fumigatus 61 cases (61%), aspergillus niger 10 cases (10%). Out of the study populations, most of the populations were from the age group of 41 to 60 years (39 %), followed 21 to 40 years (34%) age group. Considering the sex, male were 67%, female were 33%. The majority of patients came from the rural area of Mymensingh region; occupationally they were farmers (44%). Ocular trauma due to agricultural materials was the most common associated factor (71%). The etiological and epidemiological pattern of suppurative corneal ulcer varies significantly with geographical region, patient population and health of the cornea. The present study was carried out to explore the epidemiological pattern, causative bacterial and fungal specie by laboratory procedure from corneal scraping and to invent a prospective guide line for the management of corneal ulcer in the community.

  15. 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...

  16. 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.

  17. 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.

  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. 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

  20. 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.

  1. Cholesteatoma and meningoencephalitis in a dog with chronic otitis externa.

    Science.gov (United States)

    Newman, Ashleigh W; Estey, Chelsie M; McDonough, Sean; Cerda-Gonzalez, Sofia; Larsen, Meegan; Stokol, Tracy

    2015-03-01

    A 10-year-old female spayed German Shepherd dog, with a year-long history of recurrent left ear infections, was presented for progressive ataxia, head tilt, and pain on opening of the mouth. On physical examination, a large amount of ceruminous debris was present in the left ear and multiple neurologic defects localizing to the cerebellum and vestibular system were identified. Magnetic resonance imaging (MRI) demonstrated a minimally contrast-enhancing mass within the left bulla, an intracranial space-occupying, heterogeneously contrast-enhancing lesion at the level of the left cerebello-medullary junction, and contrast enhancement of the ipsilateral meninges. Cerebrospinal fluid analysis revealed a marked mixed cell pleocytosis (nucleated cell count 655 cells/μL). The mass was visualized within the horizontal ear canal by otoscopic examination and a biopsy was taken. Impression smears of the biopsy contained many anucleate keratinized squamous epithelial cells, mild mixed inflammation, and few presumptive fibroblasts. With the provided clinical history and MRI findings, a cytologic diagnosis of cholesteatoma was made. A ventral bulla osteotomy was performed, and histopathologic examination of resected tissue confirmed the cytologic diagnosis of cholesteatoma. The dog's clinical symptoms improved postoperatively, but the dog died of unrelated causes, 3.5 months later. To our knowledge, this is the first description of the cytologic features of a cholesteatoma, which is a nonneoplastic, but locally invasive epidermoid cyst, in the middle ear of dogs.

  2. 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

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

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    Nicholas Liu

    2016-04-01

    Full Text Available Background The aim of this study was to assess the prevalence of hospitalisation for otitis media across the different risk indicators for Western Australian children (less than 15 years old over a 10-year period. Method This retrospective population-based study used the deidentified detailed data of children under the age of 15 years, hospitalised for otitis media (OM, as determined by principal diagnosis (ICD-10AM and obtained from the Western Australian (WA Hospital Morbidity Dataset for 10 financial years from 1999–2000 to 2008–2009. Various risk indicators, including age, gender, Indigenous status, insurance status, hospital area, hospital type, and length of stay were also analysed. Results Out of 26,294 cases of in-hospital care, Indigenous children comprised 4.7 per cent (n=1,226, while the non-Indigenous children comprised 95.3 per cent (n=25,068. The majority of the children, nearly 98.8 per cent, were admitted for chronic OM. The children were grouped into three age groups, namely, 0–4 years, 5–9 years, and 10–14 years. Nearly two-thirds of all cases were in the 0–4-year age group. Significantly more non-Indigenous (51 per cent than Indigenous children (2 per cent had private health insurance. The hospitalisation rates were directly proportional between the number of Indigenous children living in the area and the increasing remoteness of the area along with greater socioeconomic disadvantage. There were 24 per cent more cases from very remote areas compared to highly accessible areas, and there were 60 per cent more cases from the most disadvantaged socioeconomic category, compared with the least disadvantaged category, for Indigenous children. Conclusion These data depict the variations in prevalence of otitis media hospitalisations within the community, as affected by various risk indicators.

  4. Mucinous adenocarcinoma associated with chronic suppurative hidradenitis: Report of a case and review of the literature

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    Natalia Mukai

    2016-01-01

    Conclusion: Malignant degeneration to mucinous adenocarcinoma must be suspected in patients with a history of long-term CSH. In such cases, local biopsies and a radiological examination, such as MRI can help in the diagnosis.

  5. 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.

  6. A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers

    Science.gov (United States)

    2013-10-01

    Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers Authors: DISTRIBUTION STATEMENT A. Paul C. Algra, LT, MC...May 2012 – May 2013 4. TITLE AND SUBTITLE A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers...SUPPLEMENTARY NOTES 14. ABSTRACT To prevent acute otitis externa (AOE) in the saturation setting and to decrease the side effects

  7. 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…

  8. Alteración funcional de la ATM: Otitis externa de presentación atípica Functional Alteration of the temporomandibular joint: Infrequent clinical Presentation for external otitis

    Directory of Open Access Journals (Sweden)

    J.L. Cebrián Carretero

    2009-12-01

    preceded by trauma. A complete history and thorough clinical exploration allows for good diagnosis without the need for additional studies. Patients and Methods: We present three clinical cases that were referred to the Paediatric Maxilofacial Surgery Service of the La Paz Hospital with diagnoses of acute temporomandibular joint (TMJ pathology. The final diagnosis in all three was acute external otitis (AEO. Discussion: AEO is the second most frequent cause of otalgia after acute medial otitis. Humidity, repeated traumas and glandular obstruction can promote infection. The clinical symptoms are characterised by pain, itchiness, suppuration and, occasionally, hearing loss. Sometimes mandible movement without malocclusion is painful. The last symptom can cause confusion and lead to an erroneous diagnosis of TMJ pathology, something that is quite rare in children. Childhood TMJ pathology is characterised by painful mouth opening and dental disocclusion. An otoscopy will allow a differential diagnosis of the two clinical entities and avoid an unnecessary radiological exploration. Conclusion: Given the rarity of TMJ pathology in small children, AEO must be ruled out before subjecting the patient to radiological examination.

  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. 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.

  12. [The current views of the treatment of diffuse external otitis].

    Science.gov (United States)

    Fedorova, O V; Shadrin, G B

    2016-01-01

    The objective of the present study was to evaluate the clinical effectiveness and safety of the local application of triderm for the treatment of diffuse external otitis. The study included 68 patients presenting with bacterial and fungal diffuse external otitis. The treatment in the form of local empiric therapy was continued till the results of microbiological treatment became apparent. The beneficial outcome achieved in 91.2% of the patients was clinically manifest as the regression of the inflammatory process in the external auditory meatus. No complications, such as ototoxic events, either local or systemic allergic reactions, were documented. The authors substantiate the possibility of the application of the medication under consideration for the treatment of diffuse external otitis based on the knowledge of the mechanism of the actin of its constituent components, viz. betamethasone, dipropionate, gentamicin sulfate, and clotrimazole, taking into account the occurrence of the most common causative agents of diffuse external otitis. It is concluded that triderm is a safe medication for the local application and, probably, for the initial empiric therapy of diffuse external otitis to be continued till the results of the microbiological treatment become apparent.

  13. 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.

  14. The management of otitis externa in UK general practice.

    Science.gov (United States)

    Pabla, L; Jindal, M; Latif, K

    2012-03-01

    Acute otitis externa is common and provides a heavy workload for general practitioners. We aim to determine the first-line treatment used by general practitioners in the management of otitis externa and subsequent second-line treatment in a hospital ENT clinic. In addition, this study aims to ascertain whether local and national guidelines are being followed appropriately. A prospective observational study on the management of otitis externa in consecutive patients referred to an ENT emergency clinic was undertaken. Data were collected and analysed on symptoms, initial management by general practitioners, findings and treatment in the ENT clinic. A total of 106 patients were studied. The mean duration of symptoms before presentation to clinic was 13 days; 42% of patients received no treatment by their GP prior to referral to the ENT emergency clinic. Only 14% of patients received topical antibiotics alone, whilst 44% received oral antibiotics, either alone or in conjunction with topical antibiotics by their GP. Of the 106 patients, 86% received topical antibiotics in the ENT emergency clinic and oral antibiotics were reserved for those presenting with complicated acute otitis externa. Topical antibiotics are associated with a decrease in disease persistence, whilst oral antibiotics are associated with an increase. However, general practitioners are prescribing oral antibiotics more often than required. There are few regional guidelines and no explicit national guidelines on the management of acute otitis externa for GPs to refer to. We suggest the implementation of national guidelines to aid clinical practice.

  15. 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.

  16. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

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    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R. (Department of Otolaryngology, Lady Davis Carmel Hospital, Haifa (Israel))

    1991-06-01

    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

  17. Preliminary results on scintigraphic evaluation of malignant external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Malamitsi, J.; Maragoudakis, P. (Hippocrateion Hospital, Athens (Greece). Dept. of Nuclear Medicine); Papafragou, K.; Koukouliou, V. (Athens Univ. (Greece). Dept. of Medical Physics); Kalatzis, Y.; Adamopoulos, G.; Proukakis, C. (Hippocrateion Hospital, Athens (Greece). ORL Univ. Clinic)

    1993-06-01

    Malignant external otitis (MEO) is a potentially fatal otitis occurring in diabetic and immunosuppressed patients, which may cause cranial nerve palsies and massive thrombophlebitis of the brain. We studied five diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid and gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves. This combined assessment helped us to diagnose and follow-up soft tissue and temporal bone infection, especially in the case of transsphenoidal extension of the disease, since conventional radiology and computed tomography were of no particular help. On the basis of these results, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad (diabetes, granuloma, and Pseudomonas aeruginosa) is not always present. (orig.).

  18. 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...

  19. Pyoderma gangrenosum, acne and suppurative hidradenitis syndrome following bowel bypass surgery.

    Science.gov (United States)

    Marzano, Angelo V; Ishak, Rim S; Colombo, Antonella; Caroli, Francesco; Crosti, Carlo

    2012-01-01

    The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (PASH) has recently been described as a new disease entity within the spectrum of autoinflammatory syndromes, which are an emerging group of inflammatory diseases distinct from autoimmune, allergic and infectious disorders. PASH syndrome is similar to PAPA (pyogenic arthritis, acne and PG), but it differs in lacking the associated arthritis and on a genetic basis. PAPA syndrome is caused by mutations in a gene involved in the regulation of innate immune responses, the PSTPIP1, while no mutations have been detected to date in patients with PASH syndrome. We report a young male patient who developed coexisting disseminated PG, typical suppurative hidradenitis and acneiform eruption on the face, after he had undergone bowel bypass surgery for obesity. The cutaneous manifestations associated with bowel bypass syndrome often mimic PG or other neutrophilic dermatoses, suggesting a pathogenesis related to neutrophil-mediated inflammation for this condition. This is the first report describing PASH syndrome after bariatric surgery, and we propose to include such neutrophilic dermatoses in the list of complications occurring after bowel bypass surgery. Extensive genetic studies may help to clarify the etiopathogenesis of PASH as well as of autoinflammatory diseases in general.

  20. 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.

  1. Clinical practice guideline: acute otitis externa executive summary.

    Science.gov (United States)

    Rosenfeld, Richard M; Schwartz, Seth R; Cannon, C Ron; Roland, Peter S; Simon, Geoffrey R; Kumar, Kaparaboyna Ashok; Huang, William W; Haskell, Helen W; Robertson, Peter J

    2014-02-01

    The American Academy of Otolaryngology--Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the updated Clinical Practice Guideline: Acute Otitis Externa, as a supplement to Otolaryngology-Head and Neck Surgery. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 8 recommendations developed address appropriate diagnosis of acute otitis externa (AOE) and the use of oral and topical antimicrobials and highlight the need for adequate pain relief. An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group.

  2. 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.

  3. 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.

  4. The clinical course of acute otitis media in high-risk Australian Aboriginal children: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Skull Susan A

    2005-06-01

    Full Text Available Abstract Background It is unclear why some children with acute otitis media (AOM have poor outcomes. Our aim was to describe the clinical course of AOM and the associated bacterial nasopharyngeal colonisation in a high-risk population of Australian Aboriginal children. Methods We examined Aboriginal children younger than eight years who had a clinical diagnosis of AOM. Pneumatic otoscopy and video-otoscopy of the tympanic membrane (TM and tympanometry was done every weekday if possible. We followed children for either two weeks (AOM without perforation, or three weeks (AOM with perforation, or for longer periods if the infection persisted. Nasopharyngeal swabs were taken at study entry and then weekly. Results We enrolled 31 children and conducted a total of 219 assessments. Most children had bulging of the TM or recent middle ear discharge at diagnosis. Persistent signs of suppurative OM (without ear pain were present in most children 7 days (23/30, 77%, and 14 days (20/26, 77% later. Episodes of AOM did not usually have a sudden onset or short duration. Six of the 14 children with fresh discharge in their ear canal had an intact or functionally intact TM. Perforation size generally remained very small (Streptococcus pneumoniae (82%, Haemophilus influenzae (71%, and Moraxella catarrhalis (95%; 63% of swabs cultured all three pathogens. Conclusion In this high-risk population, AOM was generally painless and persistent. These infections were associated with persistent bacterial colonisation of the nasopharynx and any benefits of antibiotics were modest at best. Systematic follow up with careful examination and review of treatment are required and clinical resolution cannot be assumed.

  5. 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…

  6. [The swimmer's otitis. An up to date and prevention options].

    Science.gov (United States)

    Caramia, G; Serafini, V; Loggi, A

    2013-01-01

    The swimmer's otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A) is protective-acting, the second one (B) is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post) preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.

  7. Biofilm production by clinical staphylococci strains from canine otitis

    Science.gov (United States)

    Moreira, Camila Alencar; de Oliveira, Lis Christina; Mendes, Marina Silveira; Santiago, Thiago de Melo; Barros, Eduardo Bedê; de Carvalho, Cibele Barreto Mano

    2012-01-01

    This study determined the species of 54 staphylococci isolates from canine otitis and their ability to produce biofilm through the Congo red agar method, confirmed by scanning electron microscopy. The most frequently identified species were S. intermedius and S. simulans. Results showed that 30% of the strains were biofilm producers. PMID:24031841

  8. 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.

  9. Biofilm production by clinical staphylococci strains from canine otitis.

    Science.gov (United States)

    Moreira, Camila Alencar; de Oliveira, Lis Christina; Mendes, Marina Silveira; Santiago, Thiago de Melo; Barros, Eduardo Bedê; de Carvalho, Cibele Barreto Mano

    2012-01-01

    This study determined the species of 54 staphylococci isolates from canine otitis and their ability to produce biofilm through the Congo red agar method, confirmed by scanning electron microscopy. The most frequently identified species were S. intermedius and S. simulans. Results showed that 30% of the strains were biofilm producers.

  10. Biofilm production by clinical staphylococci strains from canine otitis

    OpenAIRE

    Moreira, Camila Alencar; de Oliveira, Lis Christina; Mendes, Marina Silveira; Santiago, Thiago de Melo; Barros, Eduardo Bedê; CARVALHO Cibele Barreto Mano de

    2012-01-01

    This study determined the species of 54 staphylococci isolates from canine otitis and their ability to produce biofilm through the Congo red agar method, confirmed by scanning electron microscopy. The most frequently identified species were S. intermedius and S. simulans. Results showed that 30% of the strains were biofilm producers.

  11. Biofilm production by clinical Staphylococci strains from canine otitis

    Directory of Open Access Journals (Sweden)

    Camila Alencar Moreira

    2012-03-01

    Full Text Available This study determined the species of 54 staphylococci isolates from canine otitis and their ability to produce biofilm through the Congo red agar method, confirmed by scanning electron microscopy. The most frequently identified species were S. intermedius and S. simulans. Results showed that 30% of the strains were biofilm producers.

  12. Biofilm production by clinical Staphylococci strains from canine otitis

    OpenAIRE

    Camila Alencar Moreira; Lis Christina de Oliveira; Marina Silveira Mendes; Thiago de Melo Santiago; Eduardo Bedê Barros; Cibele Barreto Mano de Carvalho

    2012-01-01

    This study determined the species of 54 staphylococci isolates from canine otitis and their ability to produce biofilm through the Congo red agar method, confirmed by scanning electron microscopy. The most frequently identified species were S. intermedius and S. simulans. Results showed that 30% of the strains were biofilm producers.

  13. 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

  14. 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

  15. 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...

  16. [Malignant otitis externa with disfunction of the temporomandibular articulation].

    Science.gov (United States)

    Rojas Casanova, P; Pila Pérez, R; Dieguez Tejada, R; Pila Peláez, M

    1993-01-01

    Here we present a case of a female patient 70 years old stricken with diabetes mellitud 40 years of evolution with manifestations of malignant external otitis accompanied by disfunction of the temporomandibular articulation. Here we will show the clinical characteristics and the diagnosis in our patient likewise its treatment. We will expound the most important aspects of the entity at this present time.

  17. 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

  18. 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

  19. 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)

  20. The swimmer's otitis. An up to date and prevention options

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    G. Caramia

    2013-08-01

    Full Text Available The swimmer’s otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A is protective-acting, the second one (B is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.

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

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    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.

  2. 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

  3. ِDiagnosis of causes of suppurative arthritis in sheep in Mosul, Iraq

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    S. H. Arslan

    2009-01-01

    Full Text Available The prevalence of suppurative arthritis in one hundred sheep from both sexes and different ages were studied. Aspiration of synovial fluid from knee joint of animals showed signs of lameness with reluctant to move in addition to decrease in the body weight and loss of appetite. Physical and bacterial examination of the synovial fluid was revealed green color, turbid and containing pus. Mucin clot showed difference in degree of clotting, and increased number in leukocyte, neutrophile but decreased in lymophocytes and monocyte. The result showed that Streptococcus dysagalactiae was predominate 61.1% while Arcanobacterium pyogenes and Pseudomonas aeruginosa were the less 5.5%, also the result showed that all the strains were more sensitive to the Ciprofloxacin. This study is considered to be the first attempt to isolate bacteria from Sheep joints in Mosul-Iraq.

  4. Acute suppurative thyroiditis secondary to piriform sinus fistula: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Diez, O.; Anorbe, E.; Aisa, P.; Saez De Ormijana, J.; Aguirre, X.; Paraiso, M. [Department of Radiology, Hospital Santiago Apostol, C/Olaguibel 29, E01004 Vitoria-Gasteiz (Spain)

    1998-11-01

    We present a typical case of acute suppurative thyroiditis (AST), associated with a piriform sinus fistula. We illustrate the case with an ultrasound picture of a hypoechogenic perithyroid mass and a CT scan using intravenous iodine contrast showing a perithyroid hypodense mass with peripheral enhancement, the mass also having intrathyroid involvement. When clinical and radiological findings suggest the presence of AST, it is necessary to rule out the presence of a piriform sinus fistula by means of a radiological study with barium contrast. Piriform sinus fistula is a rare abnormality derived from the branchial arch which is directly related to recurrent episodes of AST; surgical excision is hence, necessary to avoid such episodes. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  5. Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

    Science.gov (United States)

    Önal, Zerrin; Çullu-Çokuğraş, Fügen; Işıldak, Hüseyin; Kaytaz, Asım; Kutlu, Tufan; Erkan, Tülay; Doğusoy, Gülen

    2015-01-01

    Gastroesophageal reflux is considered a risk factor for recurrent or persistent upper and lower respiratory tract conditions including asthma, chronic cough, sinusitis, laryngitis, serous otitis and paroxysmal laryngospasm. Fifty-one subjects with recurrent (more than three) episodes of upper respiratory tract infection (URTI), serous otitis or sinusitis who had been admitted to an earnose- throat (ENT) outpatient clinic during the previous year were enrolled in the present study to evaluate the presence of laryngeal and/or esophageal reflux. The participants, who were randomly selected, were questioned about symptoms of reflux, including vomiting, abdominal pain, failure to thrive, halitosis, bitter taste in the mouth, chronic cough, heartburn, constipation and hoarseness. All subjects had an endoscopic examination, an otoscopic examination, a tympanogram and upper GI system endoscopy. Esophagitis was diagnosed endoscopically and histologically. The likelihood of occurrence of esophagitis was found to be higher only among subjects with postglottic edema/erythema as determined by pathological laryngeal examination. The reflux complaints reported did not predict the development of esophagitis, but the odds of esophagitis occurring were ninefold greater among subjects with recurrent otitis. Of the subjects, 45.1% were Helicobacter pylori-positive. However, no association was found between esophagitis and Helicobacter pylori positivity. The likelihood of the occurrence of esophagitis was found to be increased in the presence of recurrent otitis media and/or postglottic edema, irrespective of the presence of reflux symptoms. We concluded that, in contrast to the situation where adults are concerned, the boundaries for discriminating laryngopharyngeal reflux from gastroesophageal reflux are somewhat blurred in pediatric patients.

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

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    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

  7. 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...

  8. Efficacy of Argentine propolis formulation for topical treatment of canine otitis externa

    OpenAIRE

    L.A Lozina; M.E Peichoto; S.I Boehringer; P. Koscinczuk; G.E Granero; O.C Acosta

    2010-01-01

    The therapeutic effects of Argentine propolis ear drop formulation on canine otitis externa were evaluated. Forty-eight dogs with symptoms of otitis externa were randomly assigned to double-blinded, controlled clinical trial to evaluate the efficacy of topical formulation with propolis versus a topical placebo in the treatment of otitis externa. The propolis preparation and placebo were administrated into both external ear canals, twice daily for 14 days. Throughout the study, clinical examin...

  9. Acute Otitis due to Vibrio fluvialis after Swimming

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    Ping-Jen Chen

    2012-01-01

    Full Text Available A 40-year-old female presented with purulent exudate through the left auditive duct and pain in the left ear region, which intensified during mastication. After collection of the pus from the left ear lesion, amoxicillin-clavulanic acid for seven days was prescribed for a presumed diagnosis of acute otitis. Four days later, the pus culture grew V. fluvialis which is further identified by API 20E identification system (bioMérieux. Following the successful completion of a course of antibiotics, the patient recovered completely and without complication. To the best of our knowledge, this is the first case of Vibrio fluvialis otitis after swimming in an immunocompetent patient.

  10. [Bacteriology and mycology of otitis externa in dogs].

    Science.gov (United States)

    Bornand, V

    1992-01-01

    The bacterial and fungal flora of 1118 ears of dogs with otitis externa and 100 ears of healthy control dogs were studied in order to isolate the causative agents. The yeast Malassezia pachydermatis (56%) was by far the most common organism in otitic dogs followed by the bacteria Staphylococcus intermedius (23%), Pseudomonas aeruginosa (12%), Proteus spp. (6%) and Streptococcus canis (5%). A statistical analysis of observed results showed that the incidence of these organisms is significant in otitic dogs. Many strains of S.intermedius, P.aeruginosa and Proteus spp. are resistant to antimicrobial agents commonly used to treat otitis externa. Therefore an antimicrobial susceptibility testing was performed using "Cobas Bact" for these bacterias. Furthermore, 80 strains of M.pachydermatis were submitted to identification-kits (API 20 CAUX, API STAPH, Cobas Micro). The observed results showed that an identification with these tests was not possible.

  11. Otitis externa: a practical guide to treatment and prevention.

    Science.gov (United States)

    Sander, R

    2001-03-01

    Otitis externa is most commonly caused by infection (usually bacterial, although occasionally fungal), but it may also be associated with a variety of noninfectious systemic or local dermatologic processes. The most characteristic symptom is discomfort that is limited to the external auditory canal, while the most characteristic signs are erythema and swelling of the canal with variable discharge. Excessive moisture and trauma, both of which impair the canal's natural defenses, are the two most common precipitants of otitis externa, and avoidance of these precipitants is the cornerstone of prevention. Thorough cleansing of the canal is essential for diagnosis and treatment, but flushing should be avoided. Acidification with a topical solution of 2 percent acetic acid combined with hydrocortisone for inflammation is effective treatment in most cases and, when used after exposure to moisture, is an excellent prophylactic. Other prophylactic measures such as drying the ears with a hair dryer and avoiding manipulation of the external auditory canal may help prevent recurrence.

  12. Clinical and microbiological study of otitis externa in sheep

    Directory of Open Access Journals (Sweden)

    M. I. Al-Farwachi

    2008-01-01

    Full Text Available In this study one hundred Awassi sheep were examined clinically and bacteriologically for isolation and identification of the bacterial agents of otitis externa in sheep. The main clinical signs appeared included weakness, pale mucus membrane, auricular discharge, cough, anorexia, emaciation, and nasal discharge. Results revealed isolation of bacteria from (45% examined swabs. The most being from right ear. Younger animals were more frequently infected than older animals. Pseudomonas aeruginosa, Staphylococcus aureus, Mannheimia haemolytica, Staph. epidermidis, Pasteurella multocida, Streptococcus spp., Acintobacter spp., Escherichia coli and Klebsiella pneumonia were isolated. The results revealed that the most bacterial isolates were resistance to the bactericidal effect of the normal serum included Streptococcus pneumonia, Staphylococcus aureus, Mannheimia haemolytica. While the most bacterial isolates were produced hydroxymate siderophore included Staphylococcus aureus, Mannheimia haemolytica, Streptococcus pneumonia. The obtained results indicated to the importance of determination of serum resistance as a bacterial virulence factor in otitis externa in sheep.

  13. 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.)

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

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    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.

  15. 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.

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

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    Leticia Reis Borges

    2013-07-01

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

  17. Fusobacterium necrophorum otitis and mastoiditis in infants and young toddlers.

    Science.gov (United States)

    Stergiopoulou, T; Walsh, T J

    2016-05-01

    There is an increased recovery of Fusobacterium necrophorum from cases of otitis media and mastoiditis in the pediatric population. These infections may be highly severe, causing local osteomyelitis, bacteremia, and Lemierre's syndrome. The severity and difficulties in providing optimal treatment for these infections may be especially difficult in this age group due to immunological immaturity and delayed presentation. In this review of literature, we present and analyze the clinical presentation, management, and outcome of otic infections caused by F. necrophorum in infants and young toddlers less than 2 years old. Search in Pubmed was conducted for reported cases in the English literature for the time period of the last 50 years. Twelve well-described cases were retrieved with F. necrophorum otitis and mastoiditis and complications reported in all cases. Treatment included both intravenously with antimicrobial agents (beta lactams plus metronidazole) and mastoidectomy. Lemierre's syndrome and Lemierre's syndrome variants developed in 60 % of the patients. Dissemination of the infection as distal osteomyelitis and septic shock were also reported. The outcome was favorable in all the cases. Otitis and mastoiditis infections in children less then 2 years old are invasive infections, and severe complications can occur.

  18. 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.

  19. Reproducibility of ear cytology in dogs with otitis externa.

    Science.gov (United States)

    Lehner, G; Louis, C Sauter; Mueller, R S

    2010-07-03

    Eighty-three dogs with clinical signs of otitis externa and with ear cytology revealing microbial organisms were studied. Samples were collected from both ears of each dog by inserting two swabs successively into each ear canal, rotating each once through 360 degrees and then rolling it out in a line on to a glass slide. For each animal, four single parallel smears (SPS) were made on one slide, which was then appropriately labelled to identify the animal as well as the order of the samples. The slides, one representing each animal, were subsequently stained with modified Wright's stain. Six high-power fields of every SPS were counted. Golden retrievers and West Highland white terriers were found to be predisposed to developing otitis externa (P=0.0006 and P=0.0123, respectively). Otitis externa occurred significantly more frequently in dogs with pendulous pinnae than in dogs with erect pinnae (P=0.0009). There was no significant difference between the first and the second samples with respect to the number of microorganisms found (P>0.1 for cocci and P>0.5 for rods and yeasts), and there was a substantial agreement between the results of the two successive swabs for the presence of cocci (kappa=0.765) and rods (kappa=0.705). For yeasts, the agreement was only moderate (kappa=0.581).

  20. Malignant otitis externa in a healthy non-diabetic patient.

    Science.gov (United States)

    Liu, Xiao-Long; Peng, Hong; Mo, Ting-Ting; Liang, Yong

    2016-08-01

    A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function. Computed tomography (CT) and magnetic resonance imaging (MRI) studies at our hospital showed osteomyelitis involving the left temporal, occipital, and sphenoid bones, the mandible, and an epidural abscess. Routine blood testing and tests of immune function were normal, and no evidence of other infectious processes was found. He was diagnosed with malignant otitis externa (MOE). Bone debridement and incision and drainage of the epidural abscess were performed, and vancomycin was administered because culture results revealed Corynebacterium jeikeium, Corynebacterium xerosis, and Enterococcus faecalis. MOE should be considered in healthy patients with external otitis who fail initial treatment.

  1. 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.

  2. 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

  3. 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

  4. 76 FR 39883 - Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis...

    Science.gov (United States)

    2011-07-07

    ... for the Treatment of Acute Otitis Media; Public Workshop AGENCY: Food and Drug Administration, HHS... Acute Otitis Media. This public workshop is intended to provide information for and gain perspective... of clinical trials of antibacterial agents for the treatment of acute otitis media (middle...

  5. 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.

  6. 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.

  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. Recurrent malignant otitis externa with multiple cranial nerve involvement: A case report

    Directory of Open Access Journals (Sweden)

    Đerić Dragoslava

    2016-01-01

    Full Text Available Introduction. Necrotizing otitis externa is a rare but conditionally fatal infection of external auditory canal with extension to deep soft tissue and bones, resulting in necrosis and osteomyelitis of the temporal bone and scull base. This condition is also known as malignant otitis due to an aggressive behavior and poor treatment response. Early diagnosis of malignant otitis is a difficult challenge. We present an illustrative case of necrotizing otitis externa and suggest some strategies to avoid diagnostic and treatment pitfalls. Case Outline. A 70-year-old patient presented with signs of malignant otitis externa, complicated by peripheral facial palsy. Adequate diagnostic and treatment procedures were performed with clinical signs of resolution. The recurrence of malignant infection had presented three months after previous infection with multiple cranial nerve neuropathies and signs of jugular vein and lateral sinus thrombosis. An aggressive antibiotic treatment and surgery were carried out, followed by substantial recovery of the patient and complete restoration of cranial nerves’ functions. Conclusion. Necrotizing otitis externa is a serious condition with uncertain prognosis. The suspicion of malignant external otitis should be raised in cases of resistance to topical treatment, especially in patient with predisposing factors. Evidence-based guideline for necrotizing otitis externa still doesn’t exist and treatment protocol should be adjusted to individual presentation of each patient.

  13. 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...

  14. Magnetic resonance imaging findings in a red kangaroo (Macropus rufus) with otitis.

    Science.gov (United States)

    Okeson, Danelle M; Coke, Rob L; Kochunov, Peter; Davis, M Duff

    2008-12-01

    Magnetic resonance imaging (MRI) was performed on an adult, male Red kangaroo (Macropus rufus) with a history of nonspecific neurologic signs and acute discharge from the left ear. MRI revealed findings consistent with otitis and possible osteomyelitis of the temporal and mastoid bones. To the authors' knowledge, this is the first report of otitis and MRI findings in a kangaroo.

  15. 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.

  16. Squamous cell carcinoma of the middle ear arising from CSOM: A case report

    Directory of Open Access Journals (Sweden)

    S R Davanageri

    2014-01-01

    Full Text Available Squamous cell carcinoma occurring in a background of chronic suppurative otitis media (CSOM is a rare complication. It runs an aggressive course. Hence early identification is significant to prevent disease progression and to improve the survival rate. Subjecting granulation tissue from middle ear for histopathologic examination is of importance to rule out associated malignant change.

  17. ASYMPTOMATIC ABSENT EPIGLOTTIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vaibhav Shahi

    2015-03-01

    Full Text Available Absence or hypoplasia of the epiglottis is a rare anomaly. Most patients, with absent or hypoplastic epiglottis, have presented, life-threatening symptoms of respiratory distress and severe aspiration in infancy or early childhood. We report a case of completely asymptomatic 30 year old female with absent epiglottis posted for modified radical mastoidectomy for chronic suppurative otitis media (CSOM.

  18. ASYMPTOMATIC ABSENT EPIGLOTTIS: A CASE REPORT

    OpenAIRE

    2015-01-01

    Absence or hypoplasia of the epiglottis is a rare anomaly. Most patients, with absent or hypoplastic epiglottis, have presented, life-threatening symptoms of respiratory distress and severe aspiration in infancy or early childhood. We report a case of completely asymptomatic 30 year old female with absent epiglottis posted for modified radical mastoidectomy for chronic suppurative otitis media (CSOM).

  19. 38 CFR 4.87 - Schedule of ratings-ear.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Schedule of ratings-ear...—ear. Diseases of the Ear Rating 6200Chronic suppurative otitis media, mastoiditis, or cholesteatoma... of the substance 10 6208Malignant neoplasm of the ear (other than skin only) 100 Note: A rating...

  20. Incidence of otitis externa following swimming pool attendance--a case study in 6 indoor pools

    Energy Technology Data Exchange (ETDEWEB)

    Borneff, M.; Geyer, G.

    1982-08-01

    A bacteriological study of the microflora in the auditory meatus of patients with otitis externa after swimming in correlation to the water flora was done during winter 80/81. Six indoor-pools (monthly controls ahead had proven unobjectionable water quality) were analyzed daily, while all swimmers were asked to come for otologic examination whenever symptoms of otitis externa appeared. In a control group without otitis externa the auditory canal was inspected and swabs were taken immediately after swimming. The results indicate, that a short term contamination of the ear canal is possible by swimming in water of unobjectionable quality; this however does not necessarily lead to clinical appearances. Since the incidence of otitis externa in our study (0.01%) was not higher than the morbidity rate in nonswimmers, the data support the concept of the multiplex etiology for otitis externa.

  1. A 3-D analysis of the protympanum in human temporal bones with chronic ear disease.

    Science.gov (United States)

    Pauna, Henrique F; Monsanto, Rafael C; Schachern, Patricia; Paparella, Michael M; Cureoglu, Sebahattin

    2017-03-01

    Eustachian tube dysfunction is believed to be an important factor to cholesteatoma development and recurrence of disease after surgical treatment. Although many studies have described prognostic factors, evaluation methods, or surgical techniques for Eustachian tube dysfunction, they relied on the soft tissues of its structure; little is known about its bony structure-the protympanum-which connects the Eustachian tube to the tympanic cavity, and can also be affected by several inflammatory conditions, both from the middle ear or from the nasopharynx. We studied temporal bones from patients with cholesteatoma, chronic otitis media (with and without retraction pockets), purulent otitis media, and non-diseased ears, looking for differences between the volume of the protympanum, the diameter of the Eustachian tube isthmus, and the distance between the anterior tympanic annulus and the promontory. Light microscopy and 3-D reconstruction software were used for the measurements. We observed a decrease of volume in the lumen of the four middle ear diseased ears compared to the control group. We observed a significant decrease in the volume of the protympanic space in the cholesteatoma group compared to the chronic otitis media group. We also observed a decrease in the bony space (protympanum space) in cholesteatoma, chronic otitis media with retraction pockets, and purulent otitis media compared to the control group. We found a correlation in middle ear diseases and a decrease in the middle ear space. Our findings may suggest that a smaller bony volume in the protympanic area may trigger middle ear dysventilation problems.

  2. Non-suppurative cellulitis: risk factors and its association with Staphylococcus aureus colonization in an area of endemic community-associated methicillin-resistant S. aureus infections.

    Science.gov (United States)

    Eells, S J; Chira, S; David, C G; Craft, N; Miller, L G

    2011-04-01

    Suppurative methicillin-resistant Staphylococcus aureus (MRSA) skin infections are common and associated with MRSA colonization, but little is known about non-suppurative cellulitis and its relationship with MRSA colonization in areas endemic for community-associated MRSA. We prospectively enrolled patients hospitalized for non-suppurative cellulitis (n=50) and matched controls (n=100) and found S. aureus colonization was similar in cases and controls (30% vs. 25%, P=0·95). MRSA was uncommon in cases (6%) and controls (3%) (P=0·39). All MRSA isolates were USA300 by pulsed-field gel electrophoresis. Independent risk factors for non-suppurative cellulitis were diabetes (OR 3·5, 95% CI 1·4-8·9, P=0·01) and homelessness in the previous year (OR 6·4, 95% CI 1·9-20·9, P=0·002). These findings suggest that MRSA may only rarely be causative of non-suppurative cellulitis.

  3. Necrotizing (malignant otitis externa: An unusual localization of mucormycosis

    Directory of Open Access Journals (Sweden)

    Tuzcu A

    2006-01-01

    Full Text Available Malignant otitis externa (MOE is a severe infection of external auditory canal and skull base. A 17-year-old diabetic girl was admitted with diabetic ketoacidosis. Cellulitis of her right ear occurred on the second day of hospitalization and a black necrotic scar in the same region appeared on the next day. The lesion rapidly invaded to right side of neck and surrounding tissue of the patient. Therefore, antimycotic therapy was started. Unfortunately the patient died on seventh day of hospitalization because of probably extensive fungal invasion. Physicians should suspect MOE connected to mucormycosis especially in patients with cutaneous lesions of ear unresponsive to antibiotic therapy.

  4. 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.

  5. The Causes Incidence of Otitis Media in Children Clinical Research%化脓性中耳炎发病原因分析及临床治疗研究

    Institute of Scientific and Technical Information of China (English)

    江澜

    2014-01-01

    目的:探讨小儿化脓性中耳炎的发病因素,论述临床综合治疗的预后。方法选择2012年1月~2014年2月在我院进行住院治疗的小儿化脓性中耳炎60例,占耳鼻喉科初诊小儿的4.0%(60/1500),对发病因素进行调查。同时所有小儿都给予综合治疗。结果多因素回归logistic分析结果显示病毒感染、合并耳部疾病与家族遗传是导致小儿化脓性中耳炎的主要独立危险因素(P<0.05)。60例患儿的治愈率为93.3%,有效率为100.0%。治疗后患儿的耳鸣和头晕症状评分明显降低,与治疗前对比差异明显(P<0.05)。结论小儿化脓性中耳炎的发病因素包括病毒感染、合并耳部疾病与家族遗传,基于综合的临床治疗能有效改善预后。%ObjectiveToinvestigatethepathogenicfactorsinchildrenwithotitismedia,discusstheclinicalprognosisbythecomprehensive treatment. Methods 60 cases of children with otitis media during January 2012 to February 2014 in my hospital for hospitalization ,accounting for 4.0%of newly diagnosed pediatric otorhinolaryngology(60/1500),were investigated the pathogenic factors. While al children were given comprehensive treatment. Results Multivariate logistic regression analysis showed that viral infection,disease and familial combined ear suppurative otitis media in children led to a major independent risk factor(P<0.05). Cure rate of 60 cases of children was 93.3 %,the effective rate was 100.0 %. After treatment of children with tinnitus and dizziness symptom score decreased significantly with pre-treatment comparison differences are significant(P<0.05). Conclusion The risk factors in children with otitis media ,including viral infections ,Combination ear disease and familial inheritance , based on a comprehensive clinical treatment can improve the prognosis.

  6. 疏风解毒胶囊治疗急性化脓性扁桃体炎57例%Shufeng Detoxification Capsules for Treating Acute Suppurative Tonsillitis in 57 Cases

    Institute of Scientific and Technical Information of China (English)

    李东彤

    2015-01-01

    Objective To observe the clinical efficacy of Shufeng Detoxification Capsules in treating acute suppurative tonsillitis. Methods Totally 110 patients with acute suppurative tonsillitis were randomized into the treatment group( n=57)and the control group( n=53) according to the sequence of seeing doctor. The control group received cefuroxime and other conventional treatment,while on this basis the treatment group was added with Shufeng Detoxification Capsules. According to the clinical situation,the fever patients was given the defervesce treatment. The sore throat disappearance time,defervesce time and clinical effect after 5 d were observed and compared between the two groups. The throat condition was followed up. Results The sore throat disappearance time and defervesce time in the treatment group were significantly shorter than those in the control group( P < 0. 05);the effective rate in the observation group was 98. 25%,which is significantly higher than 86. 79% in the control group with( P < 0. 05);the follow up after 1 month showed that 4 cases of pharyngeal discomfort in the treatment group had the history of chronic tonsillitis,while in 11 cases of pharyngeal discomfort in the control group,9 cases had the history of chronic tonsillitis,the difference was statistically significant( P < 0. 05). Conclusion Shufeng Detoxification Capsules combined with the anti-infective therapy can accelerate the recovery in the patients with acute suppu-rative tonsillitis,especially can block the chronic process of acute attack of chronic tonsillitis and reach the long term efficacy.%目的:观察疏风解毒胶囊治疗急性化脓性扁桃体炎的临床疗效。方法将110例患者按就诊顺序随机分为治疗组57例和对照组53例。对照组患者给予头孢呋辛等常规治疗,治疗组患者在对照组基础上加用疏风解毒胶囊治疗;发热患者根据临床情况给予退热治疗。观察两组患者咽痛消失时间、退热时间,5d后

  7. Chronic Diarrhea

    Science.gov (United States)

    ... Tub Rash Lymphatic Filariasis Pinworms Pubic Lice ("Crabs") Swimmer's Ear (otitis externa) Scabies Trachoma Information for Specific ... may help speed recovery. Avoid beverages that contain caffeine, such as tea, coffee, and many soft drinks. ...

  8. 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.

  9. 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

  10. [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.

  11. Antimicrobial susceptibility of staphylococci isolated from otitis externa in dogs.

    Science.gov (United States)

    Lilenbaum, W; Veras, M; Blum, E; Souza, G N

    2000-07-01

    Samples were obtained from 65 unmedicated adult dogs, processed for isolation of Staphylococcus species and tested for susceptibility to penicillin G, gentamicin, oxacillin, tetracycline, trimethoprim-sulphamethoxazole, streptomycin, ampicillin and rifampin. Forty-four isolates were obtained, which represents 67.7% of samples. Coagulase-negative species were most commonly found, and the most frequently isolated staphylococcus species were Staph. epidermidis and Staph. aureus. Other species, such as Staph. simulans, Staph. haemolyticus, Staph. saprophyticus and Staph. intermedius were also isolated. Resistance to antibiotics was frequently observed, with 90.9% of the isolates showing resistance to at least one drug. The most active antimicrobial agents against staphylococci isolated from otitis externa of dogs were rifampin and oxacillin. Multidrug resistance was a common finding, and one strain of Staph. haemolyticus species, was resistant to all tested antimicrobial agents. Resistance to three or more different drugs was a common finding, observed in 16 strains (36.4%) of both coagulase-positive and coagulase-negative staphylococci. This study highlights the emergence of cases of otitis externa determined by coagulase-negative staphylococcus strains and once more emphasizes the need for bacterial culture with species identification and susceptibility testing of swab specimens from the ear canal in order to choose appropriate antimicrobial agents.

  12. 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.

  13. Scedosporium apiospermum: a rare cause of malignant otitis externa.

    Science.gov (United States)

    McLaren, Oliver; Potter, Christian

    2016-09-09

    A 79-year-old man, with a history of well-controlled diabetes mellitus, presented with left-sided otalgia. With an initial diagnosis of simple otitis externa, he was discharged on topical drops. He represented 2 months later with worsening otalgia and discharge. A diagnosis of malignant otitis externa was made based on clinical and radiological findings. Intravenous Tazocin and Gentamicin were given based on previous bacterial culture from ear swabs. The patient failed to improve and developed left-sided facial nerve palsy. His condition stabilised following a change in antimicrobial therapy and his management continued in the community on intravenous Meropenem with twice weekly aural toilet. Repeated nuclear medicine imaging failed to demonstrate resolution. A bony sequestration was removed from the external auditory canal in the outpatient clinic, which following extended culture grew Scedosporium apiospermum; his management was subsequently changed to oral Voriconazole. This led to rapid clinical improvement and disease resolution over a 6 -week period.

  14. 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

  15. Pleuritis and suppurative pneumonia associated with a hypermucoviscosity phenotype of Klebsiella pneumoniae in California sea lions (Zalophus californianus).

    Science.gov (United States)

    Jang, Spencer; Wheeler, Liz; Carey, Roberta B; Jensen, Bette; Crandall, Claudia M; Schrader, Kimmi N; Jessup, David; Colegrove, Kathleen; Gulland, Frances M D

    2010-02-24

    The aim of this study is to document the isolation of a hypermucoviscosity (HMV) phenotype of Klebsiella pneumoniae from 25 cases of suppurative pneumonia and pleuritis and two cases of abscesses in California sea lions (Zalophus californianus) from the central California coast, representing the first report of this zoonotic pathogen from the marine environment and only the second report in non-humans. Animals died 2h to 4 days after first being observed sick on beaches. Clinical signs varied from dyspnoea to coma. Gross post-mortem examination of 25 cases revealed fibrinous pleuritis, copious pus in the pleural cavity and suppurative bronchopneumonia. K. pneumoniae isolates obtained from lung and pleural swabs and the hepatic and subcuticular abscesses were highly mucoid on blood agar culture media and were positive to the "string test". Twenty-one of the 27 isolates were examined by PCR and all were positive for rmpA and K2wyz and negative for K1magA genes. Although pneumonia and pleuritis have previously commonly been observed in marine mammals, their association with pure cultures of a zoonotic bacteria, K. pneumoniae HMV phenotype, has not. This report provides further evidence of the role marine mammals play as sentinels of health risks to humans from coastal waters.

  16. Surveillance of multidrug resistant suppurative infection causing bacteria in hospitalized patients in an Indian tertiary care hospital

    Institute of Scientific and Technical Information of China (English)

    Nabakishore Nayak; Rajesh K Lenka; Rabindra N Padhy

    2014-01-01

    Objective:To examine antibiograms of a cohort of suppurative bacteria isolated from wound-swabs from hospitalized patients of all economic groups of a typicalIndian teaching hospital. Methods:In surveillance, antibiotic resistance patterns of10 species of suppurative bacteria isolated from wound-swabs over a period of24 months were recorded.Those were subjected to antibiotic sensitivity test, using16 prescribed antibiotics of5 different groups(3 aminoglycosides, 4 beta-lactams,3 cephalosporins,4 fluoroquinolones, and2 stand-alone) in each6-month interval of the study period.Results:Of1156 samples collected,819 samples yielded pathogenic bacteria, of which,Staphylococcus aureus(S. aureus),Streptococcus pyogenes(S. pyogenes), Escherichia coli(E. coli),Pseudomonas aeruginosa(P. aeruginosa),Enterococcus faecalis(E. faecalis), Klebsiella pneumoniae(K. pneumoniae),Acinetobacter baumannii(A. baumannii),Enterobacter aerogenes(E. aerogenes),Proteus mirabilis(P. mirabilis) andProteus vulgaris(P. vulgaris) were isolated in the order of predominance.Isolated bacterial strains were floridly multidrug resistant.Strains ofE. faecalis andS. aureus were found resistant to vancomycin, one of the newly introduced antibiotics.Conclusions:Of theseS. aureus, particularly the methicillin resistant strain predominates, followed by strains ofS. pyogenes andP. aeruginosa that were in the higher proportions of multidrug resistance.

  17. [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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Vibrant Soundbridge surgery in patients with severe external otitis: complications of a transcanal approach

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Mulder, J.J.S.; Snik, A.F.M.; Cremers, C.W.R.J.

    2011-01-01

    OBJECTIVE: To evaluate the transcanal surgical implantation of the semi-implantable Vibrant Soundbridge (VSB) device in patients with severe external otitis. STUDY DESIGN: Retrospective analysis. METHODS: Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13

  1. Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

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    Somnath Saha

    2013-01-01

    Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.

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

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    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.

  3. 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.

  4. 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.

  5. Occurrence of Malassezia species in Persian and domestic short hair cats with and without otitis externa.

    Science.gov (United States)

    Shokri, Hojjatollah; Khosravi, Alireza; Rad, Mohammadali; Jamshidi, Shahram

    2010-03-01

    The yeasts of the Malassezia genus are opportunistic microorganisms in the skin and auricular canal of human and animals, mainly cats, and can cause otitis externa and dermatitis disorders. The aim of this study was to evaluate the occurrence of different species of Malassezia in the external ear canal of cats with and without otitis externa. Thirty-one normal cats and 82 animals with otitis externa were clinically examined. Sterile cotton swabs were used to collect specimens from the external ear canal and streaked onto the surface of Sabouraud dextrose agar (SDA) and modified Dixon agar. Malassezia yeasts were isolated from 95.1% and 48.4% of the cats with and without otitis externa, respectively. The rate of isolation in affected animals versus normals was highly significant (Potitis, 57.7% were identified as M. pachydermatis (with significant frequency; Potitis externa can be associated with lipid-dependent Malassezia species in addition to the non lipid- dependent species M. pachydermatis.

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

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    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

  7. 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....

  8. Cervical internal carotid artery pseudoaneurysm complicating malignant otitis externa: first case report.

    Science.gov (United States)

    Baker, Andrew; Rizk, Habib; Carroll, William; Lambert, Paul

    2015-03-01

    Pseudoaneurysm of the internal carotid artery (ICA) is a rare complication of head and neck infections. To date, three cases of petrous ICA pseudoaneurysm have been described as a complication of otogenic infection, including only one secondary to malignant otitis externa. We present here the first case of cervical ICA pseudoaneurysm as a complication of malignant otitis externa, and stress the importance of timely diagnosis to avoid fatal outcomes.

  9. Single photon emission computed tomography/computed tomography of the skull in malignant otitis externa.

    Science.gov (United States)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Kamaleshwaran, Koramadai Karuppusamy; Agrawal, Kanhaiyalal; Gupta, Ashok Kumar; Mittal, Bhagwant Rai

    2012-01-01

    Malignant otitis externa is a severe, rare infective condition of the external auditory canal and skull base. The diagnosis is generally made from a range of clinical, laboratory, and imaging findings. Technetium 99m methylene diphosphonate bone scintigraphy is known to detect osteomyelitis earlier than computed tomography. The authors present a patient with bilateral malignant otitis externa where the extent of skull base involvement was determined on 3-phase bone scintigraphy with single photon emission computed tomography/computed tomography.

  10. 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...

  11. Nasal carriage of Staphylococcus schleiferi from healthy dogs and dogs with otitis, pyoderma or both.

    Science.gov (United States)

    May, Elizabeth R; Kinyon, Joann M; Noxon, James O

    2012-12-07

    In veterinary medicine, Staphylococcus schleiferi was previously assumed to be an inhabitant of carnivore skin, however, more recently, it has been repeatedly documented in the literature as both an inhabitant and as a pathogen. In order to determine the frequency of nasal carriage, and the methicillin susceptibility pattern of S. schleiferi from healthy dogs as well as dogs with otitis and/or pyoderma, a prospective study including 24 dogs with healthy ears and skin, 27 dogs with healthy ears and pyoderma, 15 dogs with otitis without pyoderma and 20 dogs with both otitis and pyoderma was performed. Specimens were obtained and cultured and isolates were identified as S. schleiferi based on growth and biochemical characteristics. S. schleiferi was isolated from the nares of 1 healthy dog, 3 dogs with recurrent pyoderma, 2 dogs with recurrent otitis, and 1 dog with both recurrent otitis and pyoderma. One of the S. schleiferi isolates was methicillin resistant. Nasal carriage of S. schleiferi does occur in healthy dogs as well as dogs with otitis and pyoderma. Methicillin resistant and sensitive S. schleiferi can be found in the nares of dogs with diseased ears and skin.

  12. [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.

  13. Diagnosis and medical treatment of otitis externa in the dog and cat : review article

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2002-07-01

    Full Text Available Otitis externa is no longer viewed as an isolated disease of the ear canal, but is a syndrome that is often a reflection of underlying dermatological disease. Causes are classified as predisposing (increase the risk of otitis ; primary (directly induce otitis, secondary (contribute to otitis only in an abnormal ear or in conjunction with predisposing factors and perpetuating (result from inflammation and pathology in ear, prevent resolution of otitis. Common primary causes include foreign bodies, hypersensitivity (particularly atopy and food allergy, keratinisation disorders (most commonly primary idiopathic seborrhoea and hypothyroidism and earmites, particularly in cats. A systematic diagnostic procedure is required to identify causes and contributing factors. This should include history, clinical examination, otoscopy and cytology in all cases and culture and sensitivity as well as otitis media assessment and biopsy in severe and recurrent cases. Ancillary tests may be required depending on the underlying cause. Treatment consists of identifying and addressing predisposing and primary factors ; cleaning the ear canal ; topical therapy ; systemic therapy where necessary ; client education ; follow-up ; and preventive and maintenance therapy as required.

  14. Septic arthritis of the temporomandibular joint caused by Aspergillus flavus infection as a complication of otitis externa.

    Science.gov (United States)

    Varghese, Lalee; Chacko, Rabin; Varghese, George M; Job, Anand

    2015-03-01

    Septic arthritis of the temporomandibular joint (TMJ) is a very rare complication of otitis externa that can lead to ankylosis and destruction of the joint. We report the case of a 74-year-old man who developed aspergillosis of the TMJ following otitis externa. To the best of our knowledge, this is the first reported case of TMJ septic arthritis secondary to otitis externa caused by Aspergillus flavus. The patient was successfully managed with condylectomy, debridement, and drug treatment with voriconazole.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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. 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

    Science.gov (United States)

    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

  1. 化脓性胆管炎的研究进展%Research progress of acute suppurative cholangitis

    Institute of Scientific and Technical Information of China (English)

    杨川义

    2013-01-01

    急性化脓性胆管炎(acute suppurative cholangitis,ASC)是由于急性胆管梗阻并继发化脓性感染所致,是肝外胆道梗阻的一种严重并发症.本病起病急骤,病情复杂而进展迅速,并发症多而且病死率高,是良性胆道疾患引起病人死亡的主要病症,已引起临床普遍重视.本文对急性化脓性胆管炎的病因、病理变化、诊断标准以及治疗等研究进展作一综述.

  2. 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

  3. 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

  4. 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

  5. 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…

  6. 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…

  7. 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.

  8. 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.

  9. In vitro antimicrobial resistance of Pseudomonas aeruginosa isolated from canine otitis externa in Rio de Janeiro , Brazil

    Directory of Open Access Journals (Sweden)

    B. Penna

    2011-12-01

    Full Text Available Isolates of Pseudomonas aeruginosa (167 were obtained from 528 samples of canine otitis externa, identified by biochemical reactions and tested for susceptibility to 10 antimicrobials. The most effective drug was ciprofloxacin. The study reports alarming resistance among P. aeruginosa isolated from canine otitis externa samples in Rio de Janeiro, Brazil.

  10. 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.

  11. 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.

  12. 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.

  13. Jun N-Terminal Protein Kinase Enhances Middle Ear Mucosal Proliferation during Bacterial Otitis Media▿

    Science.gov (United States)

    Furukawa, Masayuki; Ebmeyer, Jörg; Pak, Kwang; Austin, Darrell A.; Melhus, Åsa; Webster, Nicholas J. G.; Ryan, Allen F.

    2007-01-01

    Mucosal hyperplasia is a characteristic component of otitis media. The present study investigated the participation of signaling via the Jun N-terminal protein kinase (JNK) mitogen-activated protein kinase in middle ear mucosal hyperplasia in animal models of bacterial otitis media. Otitis media was induced by the inoculation of nontypeable Haemophilus influenzae into the middle ear cavity. Western blotting revealed that phosphorylation of JNK isoforms in the middle ear mucosa preceded but paralleled mucosal hyperplasia in this in vivo rat model. Nuclear JNK phosphorylation was observed in many cells of both the mucosal epithelium and stroma by immunohistochemistry. In an in vitro model of primary rat middle ear mucosal explants, bacterially induced mucosal growth was blocked by the Rac/Cdc42 inhibitor Clostridium difficile toxin B, the mixed-lineage kinase inhibitor CEP11004, and the JNK inhibitor SP600125. Finally, the JNK inhibitor SP600125 significantly inhibited mucosal hyperplasia during in vivo bacterial otitis media in guinea pigs. Inhibition of JNK in vivo resulted in a diminished proliferative response, as shown by a local decrease in proliferating cell nuclear antigen protein expression by immunohistochemistry. We conclude that activation of JNK is a critical pathway for bacterially induced mucosal hyperplasia during otitis media, influencing tissue proliferation. PMID:17325051

  14. ACUTE OTITIS EXTERNA AS SEEN AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU.

    Directory of Open Access Journals (Sweden)

    Francis A Ibiam

    2013-03-01

    Full Text Available Aim: is to evaluate clinical features of AOE diagnosed in and to update the previous study from our facility.Methods: A prospective, clinical and laboratory study in a tertiary health facilityResults: A total of 3793 consecutive patients that attended the otorhinolaryngology clinics of the university of Nigeria teaching hospital Enugu during the period under study were assessed for clinical diagnosis of otitis externa. A total of 155 ears from127 patients were diagnosed clinically and confirmed by microbial studies as having acute otitis externa. There were 66 males and 61 females out of the 127 patients seen.71 ears had only bacteria isolated from the culture of their ear swab specimens, 28 fungus only and, 32 ears had both bacterial and fungal isolates while 24 ears had no isolates of microbes of the 3793 patients assessed.Conclusions: Acute otitis externa is a common disease in Enugu with no gender bias and there were three times more cases of bacterial otitis externa than fungal otitis externa.

  15. 冰黄滴耳液在豚鼠急性外耳道炎中的治疗作用研究%Pharmacodynamic Effects of Binghuang Ear drop on Acute Suppurative Otitis Externa Experimentally induced in Guinea Pigs

    Institute of Scientific and Technical Information of China (English)

    翟所强; 于宁; 郭维维; 张悦

    2012-01-01

    目的 观察冰黄滴耳液治疗豚鼠急性化脓性中耳炎中的药效学作用.方法 30 只豚鼠,随机分为3组(A,B,C组),每组10 只(20耳),A组豚鼠10 只(正常外耳道),用2% 浓度的冰黄滴耳液,一天两次,一次两滴滴入双侧外耳道,共滴7d;B组是应用全敏型肺炎克雷伯杆菌外耳道造模成功后的豚鼠10 只(外耳道炎),用2% 浓度的冰黄滴耳液,一天两次,一次两滴滴入双侧外耳道,共滴7d;C组豚鼠10 只(正常外耳道),用生理盐水一天两次,一次两滴滴入双侧外耳道,共滴7d.7d 后行外耳道观察并拍像,取外耳道组织用4%多聚甲醛固定,常规制作石蜡切片,光镜观察结果.结果 与造模前比,冰黄滴耳液可以减轻外耳道的炎性反应,炎性细胞浸润程度明显减轻,对正常外耳道皮肤无过敏及副作用.结论 冰黄滴耳液的抗菌效应可用于急性外耳道炎的治疗.

  16. 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.

  17. [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.

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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...

  3. [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.

  4. 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.

  5. Herniation of the temporomandibular joint into the external auditory meatus secondary to benign necrotising otitis externa.

    Science.gov (United States)

    Tan, Neil C-W; Wilson, Alan; Buckland, Jonathan

    2009-03-01

    The temporomandibular joint (TMJ) is intimately related to the external auditory meatus (EAM). Herniation of the joint into the EAM occurs secondary to neoplasia, trauma, inflammation and developmental problems [Conover GL, Crammond RJ. Tympanic plate fracture from mandibular trauma. J Oral Maxillofac Surg 1985;43:292-4; Ali TS, Rubinstein JT. Rheumatoid arthritis of the temporomandibular joint with herniation into the external auditory canal. Ann Otol Rhinol Laryngol 2000;109:177-9]. Benign necrotising otitis externa (BNOE) is an uncommon condition characterized by avascular necrosis of the tympanic plate that has been described as a sequela of simple otitis externa. [Wormald PJ. Surgical management of benign necrotizing otitis externa. J Laryngol Otol 1994;108:101-5.] We present a case of BNOE that resulted in a posterior herniation of the TMJ capsule into the EAM.

  6. [Clinical and pathophysiological patterns of otitis externa and overview of problematic cases].

    Science.gov (United States)

    Dzepina, Davor; Ajduk, Jakov; Zurak, Kreso

    2011-01-01

    Otitis externa can sometimes present itself as a difficult clinical problem, in cases such as unsuccessful outcome of usual therapy, prolonged duration of symptoms or frequent recurrencies with local or systemic complications. In these cases more attention should be focused on possible errors made in establishing the right diagnosis, incorrect sequence of applying therapeutical measures, or presence of unrecognized problems, including individual patient factors, characteristics of the pathogen, or other. In this article we present a case report of a 84-year-old patient with complicated otitis externa, together with a short review of physiology, patophysiology, diagnostic and therapeutical measures in external otitis, and suggest a possible clinical approach in the management of problematic cases.

  7. An update on microbiological causes of canine otitis externa in Campania Region, Italy

    Institute of Scientific and Technical Information of China (English)

    Luisa De Martino; Francesca Paola Nocera; Karina Mallardo; Sandra Nizza; Eleonora Masturzo; Filomena Fiorito; Giuseppe Iovane; Piergiorgio Catalanotti

    2016-01-01

    Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region (Italy) and the antibiotic susceptibility patterns of the iso-lated strains. Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination, bacteriological analysis and antimicrobial susceptibility tests were performed. Results: Thirty-one out of 122 dogs were positive for yeast species (25.4%, 95% con-fidence interval (CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachy-dermatis (21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species (74.6%;CI:65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius (45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the con-trary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment. Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.

  8. An update on microbiological causes of canine otitis externa in Campania Region,Italy

    Institute of Scientific and Technical Information of China (English)

    Luisa De Martino; Francesca Paola Nocera; Karina Mallardo; Sandra Nizza; Eleonora Masturzo; Filomena Fiorito; Giuseppe Iovane; Piergiorgio Catalanotti

    2016-01-01

    Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.

  9. 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.

  10. [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.

  11. 急性化脓性腹膜炎的护理体会%Nursing Experience of Acute Suppurative Peritonitis

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    张美玲

    2015-01-01

    Objective To explore the nursing experience of patients with acute suppurative peritonitis. Methods Select 70 cases in our hospital with acute suppurative peritonitis, are secondary peritonitis, standardized training the nurses nursing learning peritonitis before and after the operation, preoperative observing the condition, fasting, continuous gastrointestinal decompression, establish vein channel and give psychological nursing. After the operation half decubitus, strengthen nutrition, the strict observation condition, pay attention to the abdominal cavity drainage tube, record the clinical data and nursing process, observe the patients. Results 70 patients after treatment and nursing in our hospital, were restored to health, life signs smoothly, without complications. Conclusion The correct speciifcation of the preoperative and postoperative nursing can promote the recovery of the disease patients, reduce the postoperative complications, which actively face pain, but in the promotion of the clinical application.%目的:探讨急性化脓性腹膜炎患者的护理体会。方法选取我院急性化脓性腹膜炎患者70例,均为继发性腹膜炎,规范化培训本科室护士学习腹膜炎的术前及术后护理,术前注意观察病情、禁食、持续胃肠减压、建立静脉通道并给于心理护理。术后半卧位,加强营养,严密观察病情,注意腹腔引流管,记录各项临床资料和护理过程,观察患者疗效。结果70例患者经过我院的治疗及护理后,均恢复健康,生命体征平稳,未出现并发症。结论正确规范化的术前术后护理可以促进患者疾病恢复,减少术后并发症,使其积极面对病痛,可在临床应用推广。

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

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    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

  13. 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

  14. Mycological investigation in patients with acute otitis media

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    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.

  15. Occurrence of Malassezia pachydermatis in Dogs with Otitis Externa

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    Kemal METİNER

    2016-07-01

    Full Text Available Swab samples taken from a total of 100 dogs which were suspected about otitis externa symptoms such as ear discharge, skin rash (exanthema, flaking off, inflammation, rash and stink were mycologically examined. The swabs were inoculated onto Sabouraud Dextrose Agar (SDA containing 0.05% chloramphenicol and 0.05% cycloheximide, and were incubated at 37 °C for 7 days. After the incubation, isolates were evaluated by morphological, physiological and biochemical characteristics. Thirty six out of these isolates were identified as Malessezia pachydermatis, six as Candida spp., and two of them were identified as Aspergillus spp. M. pachydermatis was isolated from 15 of 33 (42.4% one to three years old, 10 of 30 (33.3% four to six years old, 8 of 19 (42.1% seven to ten years old, 1 of 8 (12.5% ten to twelve years old and 2 of 9 (22.2% older than twelve years old dogs. There has been no isolation occured under one year old dog. The agent was isolated 17 of 46 (36.9% females, while 19 of 54 (35.1% males. Crossbred animals and the terriers have the highest occurrence rates (25 and 22.2% respectively if the percentage of M. pachydermatis isolation from a breed verses all affected dogs was evaluated. Though, German Shepherds have the highest occurrence rate (57.1% when evaluated within the breeds. Differences according to age, gender and breed characteristics were not statistically significant (P>0.05.

  16. 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.

  17. Single photon emission computed tomography/computed tomography for malignant otitis externa: lesion not shown on planar image.

    Science.gov (United States)

    Chen, Yu-Hung; Hsieh, Hung-Jen

    2013-01-01

    Malignant otitis externa is a severe and rare infection of the external acoustic meatus. Triphasic bone and (67)Ga scintigraphies are used to initial detect and follow-up the response of therapy. With single photon emission computed tomography/computed tomography images, the diagnostic sensitivity is higher. We presented a case with malignant otitis externa with initial negative planar scintigraphic finding. The lesion was detected by photon emission computed tomography/computed tomography images. We concluded that the photon emission computed tomography/computed tomography should be performed routinely for patients with suspected malignant otitis externa, even without evidence of lesion on planar images.

  18. 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…

  19. Hearing loss in adults surviving pneumococcal meningitis is associated with otitis and pneumococcal serotype.

    Science.gov (United States)

    Heckenberg, S G B; Brouwer, M C; van der Ende, A; Hensen, E F; van de Beek, D

    2012-09-01

    We assessed the incidence of hearing loss and its relationship with clinical characteristics and pneumococcal serotypes in adults surviving pneumococcal meningitis. We analysed hearing loss in 531 adults surviving pneumococcal meningitis included in two prospective nationwide cohort studies performed from April 1998 through to October 2002 and March 2006 through to January 2009. Hearing loss was evaluated on admission and discharge for all patients. Severe hearing loss was assessed by pure tone average on audiology and corrected for age, or by the combination of hearing loss on discharge and a score on the Glasgow Outcome Scale below 5, which could not be explained by other neurological sequelae. A total of 531 episodes of pneumococcal meningitis with non-lethal outcome were included. Predisposing conditions for pneumococcal meningitis were present in the majority of patients (64%), most commonly otitis (36%). Hearing loss was present at discharge in 116 patients (22%) and was classified as mild in 53% and severe in 47%. Hearing loss was related to otitis (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.66-4.02; p otitis, but not disease severity. Otitis and resulting perilympathic inflammation contribute to meningitis-associated hearing loss.

  20. 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.