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Sample records for chronic suppurative otitis

  1. Pattern of chronic suppurative otitis media.

    Science.gov (United States)

    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.

    Science.gov (United States)

    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. Role of computed tomography in unsafe chronic suppurative otitis media.

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    Berry, S; Gandotra, S C; Saxena, N C

    1998-04-01

    Thirty Patients of Unsafe chronic suppurative otitis media were subjected to pre-operative CT scanning followed by surgical exploration of the middle ear and mastoid, and their scans were compared with the peroperative data. High resolution CT scanning has been advocated for evaluation of unsafe chronic suppurative otitis media as it is capable of delineating detail required to detect Labyrinthine fistulae, Facial canal erosion, Sinus and Dural plate erosion and Ossicular integrity. Our results showed CT scan to be highly sensitive for soft tissue density mass in the middle ear and mastoid. Dural plate exposure, Sinus plate erosion, Facial canal and Stapes integrity, moderately sensitive for Malleus and Incus integrity and least sensitive for Lateral canal fistulae. Both Axial and Coronal scans were done as many important structures are best seen in only one of these planes. The principal merit of CT scan of the Tomporal bone lies in its inherent ability to depict pathology which is not clinically evident. PMID:23119400

  6. Ossicular Chain Status in Chronic Suppurative Otitis Media in Adults

    OpenAIRE

    Varshney, Saurabh; Nangia, Ashutosh; Bist, S. S.; R. K. Singh; Gupta, N.; Bhagat, S.

    2010-01-01

    This study was conducted to find out the status of the ossicles in cases of chronic suppurative otitis media (CSOM). One hundred and fifty cases of CSOM, who underwent surgery, were included and their intra-operative ossicular chain findings noted. Ossicular erosion was found to be much more common in unsafe CSOM than in safe CSOM. Malleus was found to be the most resistant ossicle to erosion whereas incus was found to be the most susceptible.

  7. Ossicular chain status in chronic suppurative otitis media in adults.

    Science.gov (United States)

    Varshney, Saurabh; Nangia, Ashutosh; Bist, S S; Singh, R K; Gupta, N; Bhagat, S

    2010-10-01

    This study was conducted to find out the status of the ossicles in cases of chronic suppurative otitis media (CSOM). One hundred and fifty cases of CSOM, who underwent surgery, were included and their intra-operative ossicular chain findings noted. Ossicular erosion was found to be much more common in unsafe CSOM than in safe CSOM. Malleus was found to be the most resistant ossicle to erosion whereas incus was found to be the most susceptible. PMID:22319706

  8. Topical vs Combination Ciprofloxacin in the Management of Discharging Chronic Suppurative Otitis Media

    OpenAIRE

    Renukananda, G.S.; U P, Santosh; George, Nitha Mary

    2014-01-01

    Objectives: To study the microbial flora and determine the efficacy of topical ciprofloxacin ear drops in comparison with combination of topical and oral ciprofloxacin as first line management in patients diagnosed with chronic suppurative otitis media.

  9. Radiologic and surgical findings in chronic suppurative otitis media.

    Science.gov (United States)

    Gül, Aylin; Akdağ, Mehmet; Kiniş, Vefa; Yilmaz, Beyhan; Şengül, Engin; Teke, Memik; Meriç, Faruk

    2014-11-01

    Our aim in this study was to evaluate the efficiency of preoperative temporal bone computed tomography (CT) in detecting pathologic conditions in patients with chronic suppurative otitis media (CSOM). The intraoperative findings and temporal bone CT results of 350 patients who were diagnosed with CSOM between September 1, 2010, and June 1, 2013, were compared. Comparison parameters were as follows: the presence of cholesteatoma, erosion of the outer ear bone canal, erosion of the middle ear chain, erosion of the dural plate, erosion of the lateral semicircular canal, erosion of the sigmoid sinus wall, and dehiscence of the facial canal. The contribution of CT was limited in showing the outer ear canal destruction, dural plate destruction, facial canal destruction, lateral semicircular canal destruction, and destruction of the sigmoid sinus wall. However, CT was more sensitive in detecting cholesteatoma and erosion of the ossicular chain. These results indicate that preoperative CT of patients with CSOM serves as an important guide for otolaryngologists, although there are limitations in the evaluation of the CT results. PMID:25377960

  10. 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

  11. 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.

  12. 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

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

    DEFF Research Database (Denmark)

    Homøe, Preben; Bjarnsholt, Thomas; Wessman, Marcus;

    2009-01-01

    Biofilm may explain the recurrences and recalcitrant episodes of otorrhea in chronic suppurative otitis media (CSOM). This study investigates bacterial biofilm in Greenlanders with CSOM and chronic otitis media with effusion (COME). The study is partly blinded, prospective and retrospective. Six...... children with CSOM, four children with COME and ten adults with CSOM were included in this study. Cultures were obtained and examined by standard methods. Otorrhea or glue was collected from the children and smears were prepared. Middle ear mucosa biopsies were obtained from the adults. Smears and biopsies...

  14. 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....

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    BACKGROUND:: Children in the developing parts of the world have a high prevalence of chronic suppurative otitis media (CSOM). It is estimated that 65 to 330 million people worldwide have CSOM, yet very little is known about the natural course of the disease. The Inuit population of the Arctic...... regions is among those with the highest prevalences of CSOM. The aim of this study was to examine the long-term tympanic membrane changes since childhood among Inuit adolescents in Greenland and estimate the proportion of individuals affected by CSOM. METHODS:: Follow-up study (2009) on a population......-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...

  16. 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...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  18. A case-control study of nutritional factors associated with chronic suppurative otitis media in Yemeni children

    NARCIS (Netherlands)

    M.A. Elemraid; I.J. Mackenzie; W.D. Fraser; G. Harper; B. Faragher; Z. Atef; N. Al-Aghbari; B.J. Brabin

    2011-01-01

    Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings, but there are few studies of their interactions. The aim is to evaluate nutritional factors associated with CSOM in Yemeni children. A case-control study of 75 children with CSOM and 74 health

  19. 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.

  20. BACTERIOLOGICAL PROFILE OF CHRONIC SUPPURATIVE OTITIS MEDIA CASES AT A TERTIARY CARE CENTRE IN KARNATAKA

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    Anjana

    2016-02-01

    Full Text Available Chronic Suppurative Otitis Media (CSOM is one of the most common chronic diseases of childhood. It is one of the common causes of deafness and can also cause permanent perforation. AIM This study was carried out to know the bacterial aetiology of CSOM and their antibiotic susceptibility pattern. MATERIALS AND METHODS Hundred patients with symptoms of CSOM who were not on antibiotics were included in the present study. Gram stain, culture and sensitivity and biochemical reactions were carried out to identify the organism and to assess their antibiotic susceptibility pattern. RESULTS The most common organism isolated in this study was Staphylococcus aureus (45.6% followed by Pseudomonas aeruginosa (34.7%, Klebsiella pneumoniae (6.5%, Proteus mirabilis (4.3%, Enterococcus fecalis (2.1%, Citrobacter koseri (2.1%, Acinetobacter baumannii (2.1% and Bacteroides (2.1%. Staphylococcal isolates showed highest susceptibility to commonly used antibiotics, gentamycin, ciprofloxacin. Most of the gram negative isolates showed susceptibility to amikacin, ciprofloxacin, third generation cephalosporins. CONCLUSION The study of microbial pattern and their antibiotic susceptibility determines the prevalent bacterial organisms causing CSOM in local area and helps to decide empirical treatment of otitis media and its complications for successful outcome, thus to prevent the emergence of resistant strains.

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

    Science.gov (United States)

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

    2015-01-01

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

  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. 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

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

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    Mittal, Rahul; Lisi, Christopher V; Gerring, Robert; Mittal, Jeenu; Mathee, Kalai; Narasimhan, Giri; Azad, Rajeev K; Yao, Qi; Grati, M'hamed; Yan, Denise; Eshraghi, Adrien A; Angeli, Simon I; Telischi, Fred F; Liu, Xue-Zhong

    2015-10-01

    Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. PMID:26248613

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements. OBJECTIVES: We investigated the prevalence of chronic suppurative...... otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds. METHODS: In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low......-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. RESULTS: Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane...

  6. 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.

  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. 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

  9. 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

  10. 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

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

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    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

  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. 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.

  15. Suppurative otitis media after tympanostomy tube placement

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    Baljošević Ivan

    2003-01-01

    Full Text Available Suppurative otitis media after tympanostomy tube placement is the most frequent complication of this surgical intervention. Otorrhea that occurs in the first two weeks following tube placement is called early, late otorrhea occurs at least two weeks following placement. Early otorrhea is usually a result of either an infection that already existed when the tube was placed, or contamination of the external auditory canal during operation. Late otorrhea is mostly a result of upper respiratory tract infection. Material and methods Our investigation was performed at the ENT Department, Mother and Child Health Care Institute in Belgrade. The research included children treated for secretory or recurrent otitis media. Results and discussion We have examined 411 children implanted with 796 tympanostomy tubes in the last three years. We investigated changes within two weeks after operation. Suppuration was recorded with 81 children (19.7%. Staphylococcus aureus was established in 33 (40.7% Pseudomonas aeruginosa in 26 (32%, Haemophilus influenzae in 12 (15% and Streptococcus pneumoniae in 10 (12.3% cases. All children were treated with antibiotic ear drops according to the antibiogram for a period of 7 days. Full recovery was achieved after treatment with Ciprofloxacin drops in 67%, Neomycin in 18% and Gentamycin in 9% of cases. In other cases a combination of drops and oral antibiotics was used. Conclusion In cases of suppurative otitis media after implantation of tympanostomy tubes, the secret should be treated with suction and after that antibiotic drops should be applied during 5 to 7 days. If suppuration is persistent, drops should be used with oral antibiotics.

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

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    André Souza de Albuquerque Maranhão

    2016-02-01

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

  17. 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

  18. 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.

  19. 慢性化脓性中耳炎并发全聋的临床研究%Clinical study of chronic suppurative otitis media with hearing loss

    Institute of Scientific and Technical Information of China (English)

    茹仙古丽•艾山

    2013-01-01

    Objective Study on chronic suppurative otitis media (CSOM) related factors associated with deafness. Methods Were retrospective analysis of 2007~2010 CSOM with extremely deaf or deaf in our hospital 32 cases of 34 ears (observation group) and the clinical data, with the same period without loss of CSOM operation in 34 ears (control group) were compared. Results Chronic suppurative otitis media caused total deafness or extremely deaf related risk factors include pus and blood lfow, ossicular damage and stapes footplate or board structure disappeared, accompanied by labyrinthine ifstula, the difference was obvious that there was statistically signiifcant (P<0.05). Conclusion Extremely complicated CSOM deaf or deaf with pus and blood lfow, cholesteatoma right ossicular erosion of the stapes footplate board structure or disappear, labyrinthine ifstula and other relevant, Should be promptly controlled cholesteatoma and middle ear infections.%目的:研究慢性化脓性中耳炎(CSOM)并发全聋的相关因素。方法回顾性分析我院2007至2010年CSOM并发极度聋或全聋的患者32例34耳(观察组)的临床资料,与同期不伴全聋的CSOM手术患者34耳(对照组)进行比较。结果慢性化脓性中耳炎致全聋或极度聋相关的危险因素包括流脓血,听骨链破坏及镫骨足板或板上结构消失、伴有迷路瘘管,两组比较差异明显,有统计学意义(P<0.05)。结论 CSOM并发极度聋或全聋与流脓血,胆脂瘤对听骨链侵蚀,镫骨板上结构或足板消失,迷路瘘管等相关,应及时控制胆脂瘤和中耳感染。

  20. 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

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    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.

  1. 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。

  2. 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.

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

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

    2009-06-15

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

  4. 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.

  5. 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

  6. Treatment of Chronic Suppurative Otitis Media with Antimicrobial Drugs:Clinical Analysis of 352 Cases%抗菌药物治疗慢性化脓性中耳炎352例临床分析

    Institute of Scientific and Technical Information of China (English)

    金鹏

    2015-01-01

    OBJECTIVE:To analyze the clinical rational use of antimicrobial agents in the treatment of chronic suppurative otitis media.METHODS:The clinical data of 352 patients with chronic suppurative otitis media randomly selected in Xiangyang First People's Hospital between January 2013 and June 2014 were analyzed retrospectively. RESULTS:Of the 352 ear canal discharge samples, pathogens were isolated in 321 ( positive bacterial culture rate of 91.19%) .Antimicrobial agents were use in all (100.00%) .CONCLUSION:The clinical use of antimicrobial agents should be rational based on bacterial culture and drug resistance, meanwhile attaching importance to the mode of administration and frequency of use of antimicrobial agents in order to enhance the level of clinical rational use of antimicrobial agents.%目的:分析慢性化脓性中耳炎治疗中抗菌药物合理应用情况。方法:随机选择襄阳市第一人民医院2013年1月至2014年6月间慢性化脓性中耳炎352例病例临床治疗资料进行回顾性分析。结果:352例耳道分泌物标本中分离出病原菌分泌物标本321例(细菌培养阳性率为91.19%);本组患者抗菌药物利用率达到100.00%。结论:临床抗菌药物应用时应根据细菌培养、耐药性结果合理用药,并注意给药方式、使用频率,以提升医院抗菌药物的临床合理用药水平。

  7. 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

  8. 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

  9. Acute and chronic otitis media.

    Science.gov (United States)

    Morris, Peter S; Leach, Amanda J

    2009-12-01

    Otitis media (OM) is a common illness in young children. OM has historically been associated with frequent and severe complications. Nowadays it is usually a mild condition that often resolves without treatment. For most children, progression to tympanic membrane perforation and chronic suppurative OM is unusual (low-risk populations); this has led to reevaluation of many interventions that were used routinely in the past. Evidence from a large number of randomized controlled trials can help when discussing treatment options with families. Indigenous children in the United States, Canada, Northern Europe, Australia, and New Zealand experience more OM than other children. In some places, Indigenous children continue to suffer from the most severe forms of the disease. Communities with more than 4% of the children affected by chronic tympanic membrane perforation have a major public health problem (high-risk populations). Higher rates of invasive pneumococcal disease, pneumonia, and chronic suppurative lung disease (including bronchiectasis) are also seen. These children will often benefit from effective treatment of persistent (or recurrent) bacterial infection. PMID:19962027

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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。

  16. 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.

  17. 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.

  18. 多层螺旋CT对慢性化脓性中耳炎的诊断价值%Diagnostic value of MSCT in the diagnosis of chronic suppurative otitis media

    Institute of Scientific and Technical Information of China (English)

    闫呈新; 杨可乐; 岳云; 刘林祥

    2011-01-01

    Objective To evaluate the value of multislice spiral computed tomography ( MSCT ) and its post-processing images in the diagnosis and guiding clinical treatment of the chronic suppurative otitis media ( CSOM ). Methods Seventy-five cases (90 ears) with CSOM were examined by MSCT. The classifications of CSOM were done on the basis of axial images, coronal and sagittal of multiplanar reconstruction images and compared with those of clincal and pathological results in all cases. Results The classifications of CSOM with MSCT in 90 ears included pure type in 14 , type of cholesteatoma in 40 and type of granuloma in 36 , while were 12 ,44 and 34 respectively after operation,the diagnostic accurate rate were 97. 8%, 95. 6% and 97. 8%, the sensitivity was 100%, 90. 9% and 100% ,respectively in classification of SCOM with CT. There was no bony destruction in pure type,and ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the type of cholesteatoma than that in the type granuloma. The direct axial plane and coronal,sagittal multiplanar reformation in diagnosing CSOM were correspondent,but in showing the middle ear structure and lesions were different. Conclusion Combination of CT axial image, coronal and sagittal of MPR is helpful in the diagnosis of CSOM,anatomical variances and otogenic intracranial and extracranial complications, which can provide valuable information for project of clinical treatment and the choice of operative pathway.%目的 探讨多层螺旋CT及其图像后处理技术对慢性化脓性中耳炎(CSOM)诊断分型及临床治疗的价值.方法 对75例90耳CSOM病人行HRCT薄层扫描,将横断面图像、MPR图像(冠状位和矢状位)相结合,进行CSOM诊断分型,然后与临床诊断及手术病理结果进行对照分析.结果 经MSCT诊断的CSOM为单纯型14耳,肉芽肿型40耳,胆脂瘤型36耳,临床及手术诊断结果的分型分别为12耳、44耳、34耳,MSCT与临床手

  19. The Analysis of the Main Pathogenic Bacteria and Drug Sensitivity in Patients with Chronic Suppurative Otitis Media and Patients with Middle Ear Cholesteatoma in Xinjiang%新疆地区慢性化脓性中耳炎及中耳胆脂瘤病原菌及药敏分析

    Institute of Scientific and Technical Information of China (English)

    顾兴智; 牛良军; 尤乐都斯·克尤木; 张华

    2014-01-01

    Objective To study the main pathogenic bacteria and drug sensitivity in patients with chronic sup-purative otitis media and patients with middle ear cholesteatoma in Xinjiang ,and to provide evidence for reasonable u-sing antibiotics for the two diseases .Methods We performed a retrospective analysis of the middle ear secretion bac-terial culture results of 409 patients with chronic suppurative otitis media and middle ear cholesteatoma at our hospi-tal from January 2008 to December 2013 .Results ①There were 361 strains of microbes isolated from 409 patients , and 16 of them were fungi ,and 245 were bacteria .There was a statistical significance of the pathogen detection rate about G+ and G- bacteria between chronic suppurative otitis media and middle ear cholesteatoma (χ2 =12 .216 ,P=0 .000) .②Staphylococcus aureus(in 78 of 254 ears ,30 .7% ) ,pseudomonas aeruginosa(in 46 of 254 ears ,18 .1% ) , coagulase-negative staphylococcus(in 42 of 254 ears ,16 .5% ) ,and proteus mirabilis(in 20 of 254 ears ,7 .87% ) were the most frequently insolated pathogens in chronic suppurative otitis media ,while staphylococcus aureus(in 26 of 107 ears ,24 .30% ) ,pseudomonas aeruginosa(in 17 of 107 ears ,15 .9% ) ,coagulase-negative staphylococcus (in 16 of 107 ears ,15 .0% ) ,and proteus mirabilis(in 14 of 107 ears ,13 .1% ) were the most frequently insolated patho-gens in middle ear cholesteatoma .③Staphylococcus aureus and coagulase -negative staphylococcus were all sensi-tive to quinoline nupu ting /dalfopristin ,teicoplanin ,vancomycin ,and moxifloxacin .The sensitivity of coagulase -negative staphylococcus to gentamicin ,trimethoprim -sulfamethoxazole ,and erythromycin in the middle ear chol-esteatoma were higher than those of in chronic suppurative otitis media .The sensitivity of pseudomonas aeruginosa to ceftazidime ,and imipenem were lower in the middle ear cholesteatoma .The drug sensitivity of pseudomonas aeruginosa ,proteus to trimethoprim/sulfamethoxazole and

  20. 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.

  1. 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.

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

    International Nuclear Information System (INIS)

    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

  3. Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report

    OpenAIRE

    Kumar, G Ravi; Syed, Basheer Ahmed; Prasad, N.; Praveen, SP

    2013-01-01

    ABSTRACT Chronic suppurative osteomyelitis (CSO) of the maxillofacial region is primarily caused by infections of odontogenic microorganisms. It may also arise as a complication of dental extractions, maxillofacial trauma, inadequate treatment of a fracture and irradiation to the mandible. This condition is characterized by areas of devitalized bone (sequestra) which serves as a nidus for recurrent episodes of infection. This case report describes a case of CSO in an untreated right subcondyl...

  4. STUDY OF CHRONIC SUPPURATIVE OTTIS MEDIA PATIENTS ATTENDING TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Nagajyothi

    2015-01-01

    Full Text Available The present study was conducted to find out the common bacterial flora of both aerobic and aerobic which are prevalent in chronic suppurative otitis media and to know the antibiotic susceptibility of organisms in CSOM. The study period was from J anuary to December – 2006 in Dept of Microbiology , Kurnool Medical college , Kurnool. A total of 200 ear swabs were bacteriologically investigated both in aerobic and anaerobic cultures. Out of 200 swabs , 180 comprised study group , 20 comprised of control g roup. Highest incidence of CSOM is observed in age group below 10 years . Prevalence is more in males than females. Incidence of various species of aerobic organisms in the order of preference - Staphylococcus (45% , Pseudomonas (25% , Proteus ( 15% , Klebsie lla (7% , E.coli (4% , miscellaneous(4%.Incidence of anaerobic organisms are in the order of preference as Bacteriodes and Peptococci.

  5. Sensorineural hearing loss in chronic otitis media.

    Science.gov (United States)

    MacAndie, C; O'Reilly, B F

    1999-06-01

    Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss. PMID:10384849

  6. 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

  7. Myringoplasty with and without Cortical Mastoidectomy in Treatment of Non-cholesteatomatous Chronic Otitis Media: A Comparative Study

    OpenAIRE

    Hazem Mohammed Abdel Tawab; Fadi Mahmoud Gharib; Algarf, Tareq M; ElSharkawy, Louay S

    2014-01-01

    OBJECTIVE To compare the outcome and success of repair of uncomplicated tympanic membrane perforations with myringoplasty alone and when combined with mastoidectomy. METHODS A prospective study where 40 patients with non-cholesteatomatous chronic suppurative otitis media (CSOM) were recruited during the period of June 2013 to December 2013 from the outpatient clinic of Otorhinolaryngology department, Faculty of medicine, Cairo University. Patients were managed medically and after dryness of t...

  8. 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.”

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. [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.

  14. 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...

  15. 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...

  16. 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 be us...

  17. Participation of mast cells in chronic otitis media

    Directory of Open Access Journals (Sweden)

    Tomasz Durko

    2011-10-01

    Full Text Available In the pathogenesis of chronic otitis media (COM, much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of mast cells in chronic otitis media in relationship to different clinical courses of COM, bacterial infections and types of disease. The MCs expression was measured immunohistochemically in paraffin-embedded granulation tissue specimens taken during surgery, by staining with a monoclonal antibody against tryptase. The density of tryptase-positive mast cells was lower in tissue samples from the group with a good clinical course than in those from the group with poor healing and recurrence (p = 0.006. There were no differences between the groups of patients with granulomatous and cholesteatomatous chronic otitis media (p = 0.66 or between the groups of patients with and without bacterial infection (p = 0.30, although the density of mast cells was lower for those with Pseudomonas aeruginosa/Proteus sp./ /Staphyloccocus MRSA infection. In conclusion, the expression of mast cells in chronic otitis media granulation tissue was found to differ depending on the clinical course of the disease, but not on bacterial infection or type of COM. This may suggest that mast cells contribute to the maintenance of the inflammatory process, but not to antibacterial defense in chronic otitis media. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 479–485

  18. [Severe forms of cholesteatomatous chronic otitis (author's transl)].

    Science.gov (United States)

    Fleury, P; Basset, J M; Aben-Moha, G; François, M; Royer, P

    1982-01-01

    Eighty further case-reports of patients, hospitalized for particularly severe forms of cholesteatomatous chronic otitis since 1977, are analyzed. -Cholesteatomas were associated with spontaneous atticotomy and atrial invasion in 37 cases, while in 8 patients the cholesteatoma was revealed by the presence of premalleal and anterior subligamental perforations. -New features were observed in 7 cases of cholesteatomatous and osteomatous chronic otitis. -Giant cholesteatoma was present in 12 cases, and unilateral tumors in 6 patients. -Four rarer types of lesion, obviously of a serious nature, were observed, including: -polypoid and hemorrhagic tumors (6 cases), -persistently highly fetid cholesteatomas (6 cases), and those that appeared to be "under pressure" (13 cases). -Finally, 7 cases were unusual and disturbing, demonstrating early extensive osteitic recurrence less than 6 months after initial excision. Widespread evidement is necessary for the majority of these cases. PMID:7103344

  19. Audiometry and ossicular condition in chronic otitis media

    OpenAIRE

    mohsen Rajati Haghi; Mohamad Mahdi Ghasemi; Mehdi Bakhshaee; Atefeh Taghati; Atefeh Shahabipour

    2009-01-01

      Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM). Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA) findings of COM patients with the ossicular condition determined during surgery. M...

  20. 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.

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

    OpenAIRE

    Silva N.

    2001-01-01

    Swab samples obtained from 96 dogs with chronic otitis externa were cultured for the isolation of Staphylococcus species. Of 57 staphylococcal strains, 41 (72%) were coagulase-negative (CNS). The identification of staphylococci strains was made by standard procedures for the routine identification of staphylococci in clinical practice. S. sciuri was the most frequent species isolated (22.8%) from chronic otitis externa in dogs followed by S. intermedius (12.3%), S. auricularis (10.5%) and S. ...

  2. The Prevalence of Labyrinthine Fistula in Chronic Otitis Media Surgery in Shiraz, Southern Iran

    OpenAIRE

    Faramarzi, A H; Heydari, S T; Rusta, M

    2011-01-01

    Background The incidence of fistulas found during the surgery for chronic otitis media with cholesteatoma has been reported in a wide range in different geographical areas. This study aims to find the prevalence of labyrinthine fistula in the south of Iran. Methods A prospective cross sectional study of 787 (504 ears belong to 462 patients) consecutive tympanoplasty with or without mastoidectomy for chronic otitis media was performed. Data on preoperative clinical and preoperative and postope...

  3. 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.

  4. 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.

  5. Audiometry and ossicular condition in chronic otitis media

    Directory of Open Access Journals (Sweden)

    mohsen Rajati Haghi

    2009-07-01

    Full Text Available   Introduction: Ossicular chain injury is one of the most common causes of hearing loss in chronic otitis media (COM. Although definite diagnosis of ossicular discontinuity is made intraoperatively, preoperative determination of ossicular chain injury will help the surgeon decide about reconstruction options and hearing prognosis of the patient. In this study we compared preoperative pure tone audiometry (PTA findings of COM patients with the ossicular condition determined during surgery. Materials and Methods: 97 Patients with COM who underwent ear surgery for the first time were included in the study. A checklist of preoperative clinical findings, audiometric parameters and intraoperative findings was filled out for all patients. Results: Mean amount of Air-Bone Gap (ABG, Bone Conduction threshold (BC and Air Conduction threshold (AC of 97 Patients were 35.17, 13.13 and 48.30 respectively. In ears with or without cholesteatoma, granulation tissue, or otorrhea, mean of AC, BC, and ABG were not significantly different. In ossicular erosion and discontinuity (OD, mean of AC and BC thresholds increased significantly but ABG didn’t change significantly. Conclusion: According to the results of this study, in preoperative assessment of COM patients to predict ossicular condition we recommend considering AC, BC and ABG levels together instead of using ABG alone as is routine in our daily practice.

  6. 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.

  7. 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

  8. Evaluation of cholesteatoma frequency in patients with chronic otitis media

    Directory of Open Access Journals (Sweden)

    Amad Meimaneh Jahromi

    2010-04-01

    Full Text Available ntroduction: Chronic otitis media (COM is regarded as one of the disabling diseases which have a great influence on the quality of life. Because of the surgical approach of cholesteatoma, timely diagnosis is very important in management of patients with COM. The purpose of this study was to assess the frequency of cholesteatoma in patients with COM, demographic factors and disease related factors. Materials and Methods: In this retrospective study, medical records of 100 patients with COM who had surgery since 2005 to 2009 in Imam Reza Hospital were selected. Patients’ age, gender, duration of COM, clinical manifestations, location of perforation of tympanic membrane and presence or absence of cholesteatoma were analyzed by SPSS statistical software and some tables and graphs were planned. Results: patients   included 70 males and 30 females with an average age of 23.08 ± 11.35. Mean of COM duration was 8.04 ± 7.14 years. The most common manifestations of the disease were otorrhea (92% and hearing loss (80%. The most frequent type of tympanic perforation was total perforation. Frequency of cholesteatoma was 42% and it was more common in males than females (42.9% and 40%. Presence of choleasteatoma was related to gender, age, location of tympanic perforation, presence of otorrhea and hearing loss. Conclusion: Prevalence of cholesteatoma in patients  with COM  in  Mashhad  is more than  other  cites of Iran and  also other  countries, but it is less than prevalence of non cholesteatomatos COM. It is very important to pay more attention to patients with COM who are evaluated about presence of cholesteatoma, specially those with otorrhea, hearing loss, total perforation of tympanic membrane or male gender.

  9. 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

  10. The Validity of Computed Tomography in Complicated Chronic Otitis Media

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    M. Sadoghi

    2007-10-01

    Full Text Available Background/Objective: We assessed the validity of computed tomography (CT in the diagnosis of complicated chronic otitis media (COM. "nPatients and Methods: The findings obtained from a pre-operative high resolution CT of temporal bone including coronal and axial views of 20 patients with complicated COM were compared to their intraoperative findings."nResults: In our study, CT was helpful in determining the anatomy of the mastoid and could accurately predict the mastoid air cell aeration, size and status of ossicles, presence of lateral semicirculal canal (SCC fistula and post-auricular fistula (All sensitivities equal to 100%. But it overdiagnosed the erosion of tegmen (positive predictive value of 50%. CT was unable to distinguish between cholesteatoma and fluid (abscess or effusion and granulation tissue or polyps and was also unable to correctly reveal the facial nerve dehiscence and had a low sensitivity for showing erosion of facial canal (50% and sigmoid sinus (60%."nConclusion: Because most complications resulting from cholesteatoma are caused by bony erosions, CT is helpful in determining the complications of COM. CT can accurately predict the extent of disease and is helpful in detection of some complications such as fistula of Lateral Semicircular Canal (LSC, erosions of dural plate and ossicular erosions. However, it is unable to distinguish between cholesteatoma, mucosal disease and fluid, and little it did contribute to detecting the facial nerve course and dehiscence. It cannot also be used for the diagnosis of the sigmoid sinus problems which could be related to no contrast administration in our study.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Silva N.

    2001-01-01

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

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

    Science.gov (United States)

    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

  15. Is Cholesteatoma a Risk Factor for Graft Success Rate in Chronic Otitis Media Surgery?

    OpenAIRE

    Faramarzi, Mohammad; Dehbozorgi, Mohammad Mehdi; Heydari, Seyed Taghi

    2015-01-01

    Introduction: In developing countries, chronic otitis media (COM) and cholesteatoma are relatively prevalent. Within the field of otology, COM surgery remains one of the most common surgical treatments. Most recent studies evaluating the potential prognostic factors in COM surgery have addressed graft success rate and types of middle ear and mastoid pathology. There has been much controversy about this issue until the present time. This study evaluated the effect of cholesteatoma on the GSR i...

  16. Comparative Study Between Radiological and Surgical Findings of Chronic Otitis Media

    OpenAIRE

    Prata, Anelise Abrahao Salge; Antunes, Marcos Luiz; Abreu, Carlos Eduardo Cesario de; Frazatto, Ricardo; Lima, Bruno Thieme

    2011-01-01

    Introduction: The chronic otitis media (COM) is a prevalent disease and the most frequent cause of indication to mastoidectomy. Many studies have evaluated the use of tomography (CT) of temporal bones for preoperative evaluation of COM and its indication in the preoperative approach is still controversial nowadays. Objective: To evaluate the sensitivity of the clinical and radiological findings of COM according to the intraoperative surgical results and histopathological findings. Method: Tra...

  17. An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

    OpenAIRE

    Yildirim-Baylan, Muzeyyen; Ozmen, Cihan Akgul; GUN, Ramazan; Yorgancilar, Ediz; AKKUŞ, Zeki; Topcu, Ismail

    2011-01-01

    This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, t...

  18. A STUDY ON CHRONIC OTITIS MEDIA ACTIVE MUCOSAL TYPE WITH SINUSITIS AS FOCAL SEPSIS

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    Shankaranarayanan Gopalakrishnan

    2012-11-01

    Full Text Available AIM : To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal disease, to emphasizethe need of proper diagnostic endoscopic evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery.METHODS : 60 Patients in the age groups of 18-49 years Chronic otitis media active mucosal disease were identified and screened for evidence of Focal Sepsis in Pasanasal sinus by Diagnostic Nasal endoscopy andcomputed tomography of paranasal diseases. Then Functional endoscopic sinus surgery was done to clear sinusitis and middle ear mucosal disease status assessed.RESULTS :Evaluation revealed that sinusitis in these patients was the cause for persistent discharge. All patients hadone or more evidence of sinusitis like pus in middle meatus, deviated nasal septum and turbinoseptal deformities,prominent enlarged bullae, enlarged middle turbinate on DNE and CT. The otoendoscopy showed inflamed and boggy middle ear mucosal status. All patients underwent septoplasty/FESS depending on findings. Out of 60 patients 52 patient had improvement in middle ear mucosal status with surgery.In the adult population sinusitis is the most important focal sepsis in case of persistent ear discharge in ChronicOtitis Media active mucosal type of disease.A proper diagnostic nasal evaluation of all Chronic Otitis Media activemucosal type of patients is necessary in comprehensive management of the disease. The clearance of sinusitis hasimproved the middle ear mucosal status. Unilateral ear discharge is associated with sinusitis only on the corresponding side, which is in concurrence with our study. Functional endoscopic sinus surgery has emerged as the best procedure for clearance of sinusitis.

  19. Laryngopharyngeal Reflux in Children with Chronic Otitis Media with Effusion

    Science.gov (United States)

    Górecka-Tuteja, Anna; Jastrzębska, Izabela; Składzień, Jacek; Fyderek, Krzysztof

    2016-01-01

    Background/Aims To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. Methods Children aged 7–10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3–5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. Results Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. Conclusions LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease. PMID:27193974

  20. CHRONIC OTITIS MEDIA: HIGH RESOLUTION COMPUTED TOMOGRAPHIC EVALUATION OF THE TEMPORAL BONE WITH SURGICAL CORRELATION

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    Chakenahalli P.

    2016-05-01

    Full Text Available PURPOSE To correlate the sensitivity and specificity of High Resolution Computed Tomography (HRCT findings of temporal bone in chronic otitis media with surgical findings. MATERIALS & METHODS HRCT of temporal bone of fifty patients with chronic otitis media were evaluated prospectively between July 2012 and December 2013. The various pathological findings, complications and important anatomical variations were evaluated. These findings were compared with intraoperative findings. Statistical methods were carried out using SPSS for Windows (Version 16.0 and Minitab (Version 11.0 for windows. The sensitivity, specificity, false positive and false negative rates were calculated. The level of significance was considered significant for P-values <0.05. RESULTS HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner’s septum, cholesteatoma extension in middle ear and mastoid, and presence of complications like mastoiditis, mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion, labyrinthine fistula and intracranial complications with a P value <0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Among the findings related to adjacent neurovascular structures, facial canal dehiscence was commonest followed by anterior lying sigmoid sinus and low lying dura. In ossicular erosion, incus was most commonly involved followed by stapes and malleus. Most of the mastoid in this study was sclerotic followed by pneumatised and diploic. The epitympanum and mastoid antrum were the most commonly involved areas in cholesteatoma followed by aditus, mastoid air cells, posterior tympanum, mesotympanum, hypotympanum, protympanum and perilabyrinthine air cells in decreasing order of frequency. CONCLUSIONS HRCT temporal bone is a reliable investigation in preoperative

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

    OpenAIRE

    Zafar Iqbal; Satish Chandra Sharma; Hiba Sami; Amit Kumar

    2016-01-01

    Myiasis is a disease caused by fly larvae and aural myiasis is a rare clinic condition often occurring in children or mentally retarded people. We report the case of an unusual presentation of a unilateral aural myiasis in a 3-year-old female child patient belonging to a slum with unilateral chronic otitis media caused by Musca domestica (housefly) larvae. Eight larvae were removed from the external auditory canal while five more larvae were located in the middle ear cavity and were removed t...

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

    Science.gov (United States)

    Szymański, Marcin; Ataide, Andre; Linder, Thomas

    2016-02-01

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

  3. 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 depression (p social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests. PMID:22566178

  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. 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

  6. 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.

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

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    Zafar Iqbal

    2016-01-01

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

  8. 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.

  9. 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 diet has been proven effective, in combination with drugs, in relieving 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.

  10. 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.

  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. Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

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    Thripthi Rai

    2014-01-01

    Full Text Available Aim: To assess radiological findings in Chronic otitis media (COM, its involvement in middle ear and adjacent structure and to compare with similar published data. The ability of the radiological investigations to detect the various pathological and anatomical variations were evaluated and compared with intraoperative findings. COM is a long standing inflammation of the middle ear cleft without reference to etiology or pathogenesis. Due to the strategic location of the tympanomastoid compartment, separated from the middle and posterior cranial fossa by the thinnest of bony partitions, otitis media has the potential for intracranial extension. Hence, it becomes very important to know the location and extent of the disease before proceeding to surgical treatment. Radiological examination of the temporal bone helps us to achieve this objective. The present work has been undertaken to study the role of radiological imaging of the temporal bone as a diagnostic modality in COM and its use in determining the lines of management as in the type of surgical intervention required. Materials and Methods: This is a prospective study in which total of 50 cases with COM were studied. Results: HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner′s septum, cholesteatoma extension in the middle ear and mastoid, and presence of complications such as mastoiditis and mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion and labyrinthine fistula and intracranial complications with a P < 0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Conclusion: HRCT is highly reliable and findings are in par with intraoperative findings in this study.

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

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    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

  16. An evaluation of preoperative computed tomography on patients with chronic otitis media.

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    Yildirim-Baylan, Muzeyyen; Ozmen, Cihan Akgul; Gun, Ramazan; Yorgancilar, Ediz; Akkuş, Zeki; Topcu, Ismail

    2012-03-01

    This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, the status of the ossicles, presence or absence of facial canal dehiscence and semicircular canal (SCC) dehiscence and the presence or absence of dural plate erosion, and sigmoid sinus thrombosis. Fifty-six patients were recruited in the study, 30 males and 26 females. The age range was from 16 to 67 years with a mean of 26.51 ± 1.4 years. The preoperative CT scan imaging in cases of cholesteatoma, ossicular chain erosion and SCC dehiscence have good correlation with the intraoperative findings. The specificity of preoperative CT scan in detecting facial canal dehiscence, dural plate erosion and sigmoid sinus thrombosis in patient of COM were weak. Preoperative computed tomography evaluation is fairly useful especially in cases of cholesteatoma. According to the results of this study, CT is of value particularly in the definition of cholesteatoma, and in determining ossicular chain erosion and semicircular canal fistula. PMID:23449285

  17. Comparative Study Between Radiological and Surgical Findings of Chronic Otitis Media

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    Prata, Anelise Abrahao Salge

    2011-01-01

    Full Text Available Introduction: The chronic otitis media (COM is a prevalent disease and the most frequent cause of indication to mastoidectomy. Many studies have evaluated the use of tomography (CT of temporal bones for preoperative evaluation of COM and its indication in the preoperative approach is still controversial nowadays. Objective: To evaluate the sensitivity of the clinical and radiological findings of COM according to the intraoperative surgical results and histopathological findings. Method: Transversal retrospective study through collection of record data of patients with COM submitted to mastoidectomy in the period from 2007 through 2008 in our service. Results: From a total of 82 ears, 40.24% had cholesteatoma. The CT presented 72.73% of sensitivity in the identification of cholesteatoma, 56.67% in the identification of changes to the ossicular chain and 100% in that of erosion of the lateral semicircular canal. Conclusion: The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, large changes of the ossicular chain and erosion of the lateral semicircular canal. For minor changes to the ossicular chain, the facial nerve canal and the tympanic tegmen they described low sensitivity.

  18. Volumetric Changes in the Bony External Auditory Canal in Unilateral Chronic Otitis Media

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    Park, Jae Hong; Noh, MinHo; Park, Seung Bum; Park, Kye Hoon; Han, Jong Kyu; Kim, Hyun Jeong

    2016-01-01

    Background and Objectives Pneumatization of air cells in the mastoid bone is decreased in chronic otitis media (COM). A decrease in the size of the external auditory canal (EAC) is also found frequently in patients with COM, but this has been little studied. We compared the size of affected bony EACs and the contralateral side in patients with single-side COM using high-resolution computed tomography. Subjects and Methods In total, 99 patients with single-side COM were included. Four indicators related to the size of the bony EAC and IAC were measured using high-resolution computed tomography: the axial and coronal lengths of the tympanic membrane, the length of the isthmus, and the area of the bony ear canal. We also compared both internal auditory canals as negative controls. These assessments were made by radiologists who were blinded to the objective of this study. Results In patients with single-side COM, the axial length of the tympanic membrane was significantly shorter than normal, and the volume of the EAC was also significantly smaller. The length of the isthmus of the EAC was shorter on the affected side, but the difference was not significant. The IAC volume showed no difference between the two sides. Conclusions COM affects general temporal bony development, including the bony EAC and mastoid bone. Therefore, whether to correct this should be considered when preparing for COM surgery. PMID:27144233

  19. Anaerobic bacteria in otitis media.

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

    1977-01-01

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

  20. 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

  1. 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.

  2. 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

  3. Otitis media with effusion

    Science.gov (United States)

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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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

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

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    Naghibi

    2015-12-01

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

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

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

    2016-06-01

    Chronic otitis media with effusion (OME) is associated with irreversible changes in the middle ear, sometimes leading to hearing loss and abnormal language development in children. While the pathogenesis of OME is not fully understood, inflammatory and allergic factors are thought to be involved. The study aimed to investigate the role of cytokines in the local development of chronic OME, and assess differences in the cytokine profiles between atopic and non-atopic children. 84 atopic and non-atopic children with chronic OME (mean age of 6 years 7 months) were studied. Age-matched children with hypertrophy of the adenoids and Eustachian tube dysfunction served as the control group. The number of past acute otitis media (AOM) episodes, their age, and the type of effusion were recorded for all children. Pro-inflammatory cytokine concentrations (TNF-α, IL-1β, IL-6 and IL-8) were determined and the presence of pathogenic bacteria in the patients' effusions was examined. High concentrations of TNF-α, IL-1β, IL-6 and IL-8 were found in the effusions in all children with chronic OME, with the highest levels observed in the non-atopic group. The atopic group showed persistently high IL-1β levels, while in the non-atopic children, IL-1β and TNF-α levels positively correlated with the patient's age and the number of past AOM episodes. Pathogenic bacteria were more frequently isolated from effusions in non-atopic children. In both atopic and non-atopic children, pro-inflammatory cytokines are found at high concentrations. This argues in favor of instituting anti-inflammatory management for treating OME, regardless of atopy. PMID:26078091

  11. 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.

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

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    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.

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Suppurative intracranial processes in 15 domestic ruminants

    OpenAIRE

    2014-01-01

    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 ba...

  1. A review of techniques for the investigation of otitis externa and otitis media.

    Science.gov (United States)

    Murphy, K M

    2001-11-01

    Otitis externa, inflammation of the externa ear canal, is relatively easy to diagnose based on the history and physical examination findings. The diagnosis of otitis media, inflammation of the middle ear cavity, is more challenging, with the work-up being both costly and, at times, invasive. The pathogenesis of otitis externa has been classified into predisposing, primary, and perpetuating factors. It is critical to the management of ear disease that the clinician recognize and investigate which factors are contributing to each individual patient's ear disease. Failure to identify and address the primary and/or predisposing factors is the most common cause of chronic recurrent otitis externa. Chronic inflammation of the ear canal leads to the development of the perpetuating factors, which may be the major reason for treatment failure, regardless of the primary cause of the ear disease. In this article, the predisposing, primary, and perpetuating factors involved in ear disease will be presented, along with a review of the techniques used in the diagnosis of otitis externa and otitis media. PMID:11793879

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

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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

  3. 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

  4. 慢性化脓性中耳炎的螺旋CT检查 (附74例93耳分析)%The Application of Spiral CT in Chronic Otitis Media

    Institute of Scientific and Technical Information of China (English)

    胡春洪; 肖根生; 诸伟; 谢道海; 刘济生; 王雪元; 陈剑华; 付引弟; 丁乙

    2000-01-01

    Objective:To assess the value of spiral CT in diagnosis and treatment of chronic otitis media.Methods:The spiral CT findings of 74 cases including 93 ears proved by operation and pathology were studied.Results:The lesions such as the disruption of the ossicular chain showed in spiral CT or three-dimensional image were in accord with those seen in the operation,the accuracy was 95.7%,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the typeⅢ chronic otitis media.Conclusion:Spiral CT is helpful to diagnose and definite the chronic otitis media,three-dimensional image can provide valuable information for surgery.%目的:探讨螺旋CT检查在慢性化脓性中耳炎诊治中的价值。方法:研究74例93耳慢性化脓性中耳炎,比较术前CT所见与手术及病理结果。结果:螺旋CT所见与手术结果基本相符,CT与病理分型符合率为95.7%。Ⅲ型慢性化脓 性中耳炎听骨链及中耳骨壁破坏较Ⅱ型范围广且程度重。三维CT听骨链显示情况与手术一致。结论:螺旋CT检查有助于慢性化脓性中耳炎的诊断和分型,三维CT成像对制定手术方案,提高手术安全性有很大潜力。

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

    Directory of Open Access Journals (Sweden)

    Nicholas Parkinson

    2006-10-01

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

  6. 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.

  7. 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。

  8. 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.

  9. 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

  10. 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

  11. [Emotions and bodily experience in Hidradenitis Suppurative-Acne Inversa].

    Science.gov (United States)

    Tugnoli, S; Bettoli, V; Agnoli, C; Caracciolo, S

    2016-01-01

    Hidradenitis Suppurative-Acne Inversa is one of the most debilitating chronic skin diseases. It seriously affects the emotional and relational life of the patient, it has a significant psychiatric comorbidity and it impairs the quality of life. We present the report of a clinical situation with onset of the illness in a young woman during pregnancy, a case characterized by particular evolution, severe systemic involvement, strong psycho-emotional impact on the patient and impairment of subjective well-being of the caregiver. The clinical evaluation highlights mainly the relevance of the bodily experience, that stands out as a central issue in the sufference of the patient. She feels an uncanny foreignness to herself and a lacerating wound of her identity, related to her desirability, her femininity and her motherhood. Specific personality factors, which are likely to have influenced and guided the experience of illness and the quality of the relationship with the treatment team, are also evaluated. This case exemplifies, at different levels, the clinical complexity of Hidradenitis Suppurative-Acne Inversa and its impact on individual subjectivity. This disease requires an integrated intervention by a multidisciplinary team, providing for the assessment, the treatment and the evaluation of outcomes. It is necessary an effective operational link between different competences, in order to promote the patient compliance and to activate and develop the best care and the right psychological support. PMID:27424511

  12. 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,…

  13. 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.

  14. 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.

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

    International Nuclear Information System (INIS)

    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 flaccida (35

  16. 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

  17. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... small area, as when pus accumulates in a boil (furuncle) or pimple. Malignant external otitis is a ... Aspergillus niger or Candida albicans, is less common. Boils are usually caused by Staphylococcus aureus . Certain people, ...

  18. 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。

  19. THE ROLE OF ALLERGIC RHINITIS IN THE DEVELOPMENT OF OTITIS MEDIA WITH EFFUSION

    OpenAIRE

    Ranjan Kumar

    2013-01-01

    ABSTRACT: The significant incidence of atopy associated with otitis media with effusion (OME) has suggested a role of allergy in the pathogenesis of OME. Past studies implicated allergy in the pathogenesis of otitis media [OM]. Otitis media is a common condition, especially in children. Most episodes of OM were associated with an upper res piratory viral infection and are short- lived and self-limiting with or without medical tre atment. However, chronic OM with ...

  20. Evaluation of Replication of Variants Associated with Genetic Risk of Otitis Media

    OpenAIRE

    E Kaitlynn Allen; Ani Manichaikul; Wei-Min Chen; Rich, Stephen S.; Daly, Kathleen A.; Michèle M Sale

    2014-01-01

    The first Genome Wide Association Study (GWAS) of otitis media (OM) found evidence of association in the Western Australian Pregnancy Cohort (Raine) study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM). Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS...

  1. 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.

  2. 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.

  3. 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.

  4. The Importance of Right Otitis Media in Childhood Language Disorders

    Directory of Open Access Journals (Sweden)

    Paulino Uclés

    2012-01-01

    Full Text Available Studies relating chronic otitis media and language disorders in children have not reported consistent findings. We carried out the first selective study aimed at discerning the role of chronic right otitis media in children less than 3 years of age in language development. A total of 35 children were studied using a full linguistic protocol, auditory brainstem responses, and middle latency responses. Twelve children had a history of chronic exclusive right otitis media. Seventeen age-matched children were selected as controls. Also, three children having a history of chronic left otitis media were compared with three age-matched controls. Linguistic tests showed significant differences between patients and controls in phonetic, phonological, and syntax scores but not semantics. Correlation studies between linguistic scores and auditory evoked responses in the whole cohort showed a significant coefficient in phonetic and phonological domains. These results emphasize the causative effect of right ear chronic otitis media and indicate that it mainly impairs phonetic and phonological coding of sounds, which may have implications for prophylactic treatment of at-risk children.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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。

  10. 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.

  11. 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.

  12. Changing anaerobic spectrum in suppurative lung disease: a case report.

    Science.gov (United States)

    Beena, V K; Kumari, G R; Rao, P V; Murty, M V; Shivananda, P G

    1996-01-01

    A spectrum of three different anaerobes were isolated from a debilitated patient with suppurative lung disease, within a two-year period. Repeated isolation from three consecutive samples and symptomatic relief with metronidazole provide clinical evidence of anaerobic lung infection. This case emphasizes the importance of anaerobic culture in cases of protracted pulmonary suppurative disease. PMID:8822645

  13. 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....

  14. 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

  15. 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

  16. Mucin production and mucous cell metaplasia in otitis media

    DEFF Research Database (Denmark)

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

    2012-01-01

    Otitis media (OM) with mucoid effusion, characterized by mucous cell metaplasia/hyperplasia in the middle ear cleft and thick fluid accumulation in the middle ear cavity, is a subtype of OM which frequently leads to chronic OM in young children. Multiple factors are involved in the developmental...

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Development of Animal Models of Otitis Media

    OpenAIRE

    Park, Moo Kyun; Lee, Byung Don

    2013-01-01

    Otitis media is defined as inflammation of the middle ear, including the auditory ossicles and the Eustachian tube. Otitis media is a major health problem in many societies. The causes of otitis media includes infection and anatomic/physiologic, host, and environmental factors. In general, otitis media is a childhood disease, and anatomic and physiologic changes have great effects on its development. Thus, in vitro or human experimental studies of otitis media are difficult. Several experimen...

  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. 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

  4. 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

  5. Bone scanning in severe external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Levin, W.J.; Shary, J.H. 3d.; Nichols, L.T.; Lucente, F.E.

    1986-11-01

    Technetium99 Methylene Diphosphate bone scanning has been considered an early valuable tool to diagnose necrotizing progressive malignant external otitis. However, to our knowledge, no formal studies have actually compared bone scans of otherwise young, healthy patients with severe external otitis to scans of patients with clinical presentation of malignant external otitis. Twelve patients with only severe external otitis were studied with Technetium99 Diphosphate and were compared to known cases of malignant otitis. All scans were evaluated by two neuroradiologists with no prior knowledge of the clinical status of the patients. Nine of the 12 patients had positive bone scans with many scans resembling those reported with malignant external otitis. Interestingly, there was no consistent correlation between the severity of clinical presentation and the amount of Technetium uptake. These findings suggest that a positive bone scan alone should not be interpreted as indicative of malignant external otitis.

  6. 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).

  7. THE ROLE OF ALLERGIC RHINITIS IN THE DEVELOPMENT OF OTITIS MEDIA WITH EFFUSION

    Directory of Open Access Journals (Sweden)

    Ranjan Kumar

    2013-03-01

    Full Text Available ABSTRACT: The significant incidence of atopy associated with otitis media with effusion (OME has suggested a role of allergy in the pathogenesis of OME. Past studies implicated allergy in the pathogenesis of otitis media [OM]. Otitis media is a common condition, especially in children. Most episodes of OM were associated with an upper res piratory viral infection and are short- lived and self-limiting with or without medical tre atment. However, chronic OM with effusion (OME has significant sequelae, is refractory to mo st medical treatments, and frequently requires surgical intervention. A large body of epid emiologic and mechanistic evidence supports a role for allergic rhinitis [AR] as a risk for OM. To establish the association of allergic rhinitis with otitis media with effusion 100 childr en of age group 5 to14 were taken, 50 children were suffering from otitis media[test group] & 50 we re healthy[control group]. These children were evaluated clinically & a battery of laboratory tests was performed in all children to establish the prevalence of allergic rhinitis in the m. Out of 50 children with otitis media 12 were suffering from allergic rhinitis & out of 50 health y children 3 were suffering from allergic rhinitis. Chi-square test was performed and the 'P0. 05' value was found to be 0.0127[uncorrected] and was highly significant. The se findings indicate that prevalence of allergic rhinitis is more in persons suffering from OME as compared to healthy individuals

  8. 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。

  9. 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

  10. 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.

  11. 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.

  12. 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

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

    International Nuclear Information System (INIS)

    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

  14. 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.

  15. 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

  16. 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...

  17. 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.

  18. 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.

  19. 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

  20. Chronic granulomatous disease

    Directory of Open Access Journals (Sweden)

    Nair Pradeep

    2005-01-01

    Full Text Available A 2½-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease.

  1. Chronic granulomatous disease.

    Science.gov (United States)

    Nair, Pradeep S; Moorthy, Prasanna K; Suprakasan, S; Jayapalan, Sabeena; Preethi, K

    2005-01-01

    A 2(1/2)-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease. PMID:16394414

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. [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.

  10. Middle ear infection (otitis media) (image)

    Science.gov (United States)

    ... is an inflammation and/or infection of the middle ear. Acute otitis media (acute ear infection) occurs ... or viral infection of the fluid of the middle ear, which causes production of fluid or pus. ...

  11. The external otitis necrotizing about 45 cases

    International Nuclear Information System (INIS)

    Necrotizing external otitis is a serious infection of the ear canal, it can develop life-threatening. It occurs primarily in elderly diabetic or immunocompromised. Pseudomonas aeruginosa is the most common germ involved. This is a retrospective study of 45 cases of necrotizing otitis externa collected in ENT and CMF from the military hospital in Tunis and ENT and CMF of Rabta over a period of 10 years from 1994 to 2003 .

  12. 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.

  13. 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.

  14. Determinants of sensorineural hearing loss in chronic middle-ear disease.

    Science.gov (United States)

    Kasliwal, Neeraj; Joshi, Sanjeev; Pareek, S M

    2004-10-01

    A statistical study was carried out on SNHL in CSOM. The study group consisted of 1,828 patients suffering from CSOM who underwent surgery at our centre from 1982 to 2001, out of these 510 cases with unilateral CSOM were selected for this study by a strict selection criteria so as to eliminate covariables such as exposure to acoustic trauma, head injury, previous ear surgery and hereditary causes. The healthy ear served as control. We determined the average SNHL in relation to the age of onset, duration of disease, examining it in relation to other eventual aural complications such as cholesteatoma, ossicular chain erosion und otorrhea.On the basis of data obtained we observed consistent co-relation between severity of SNHL and duration of the disease, presence of cholesteatoma, ossicular erosion, attic and subtotal perforations. These findings suggest that more severe middle ear disease may result in SNHL and thus early intervention in cases of chronic suppurative Otitis media is desired. PMID:23120094

  15. 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

  16. 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

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

    Science.gov (United States)

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

    2015-07-01

    Streptococcus pneumoniae strains lacking capsular polysaccharide have been increasingly reported in carriage and disease contexts. Since most cases of otitis media involve more than one bacterial species, we aimed to determine the capacity of a nonencapsulated S. pneumoniae clinical isolate to induce disease in the context of a single-species infection and as a polymicrobial infection with nontypeable Haemophilus influenzae. Using the chinchilla model of otitis media, we found that nonencapsulated S. pneumoniae colonizes the nasopharynx following intranasal inoculation, but does not readily ascend into the middle ear. However, when we inoculated nonencapsulated S. pneumoniae directly into the middle ear, the bacteria persisted for two weeks post-inoculation and induced symptoms consistent with chronic otitis media. During coinfection with nontypeable H. influenzae, both species persisted for one week and induced polymicrobial otitis media. We also observed that nontypeable H. influenzae conferred passive protection from killing by amoxicillin upon S. pneumoniae from within polymicrobial biofilms in vitro. Therefore, based on these results, we conclude that nonencapsulated pneumococci are a potential causative agent of chronic/recurrent otitis media, and can also cause mutualistic infection with other opportunists, which could complicate treatment outcomes. PMID:26014114

  18. 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

    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 auto-inflammatory disorders may share pathogenic commonalities. PMID:27530224

  19. 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

  20. Allergic rhinitis is associated with otitis media with effusion

    DEFF Research Database (Denmark)

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

    2012-01-01

    Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....

  1. 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.

  2. 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.

  3. A survey of mycotic otitis externa of dogs in Lisbon.

    Science.gov (United States)

    Bernardo, F M; Martins, H M; Martins, M L

    1998-09-01

    One hundred and thirteen dogs of different breeds and with different clinical forms of external otitis were mycologically and bacteriologically examined. Forty six of those dogs showed abnormal cerumen with a high yeasts contamination. These yeasts belong to four species: Malassezia pachydermatis (80.4%), Cryptococcus laurentii (13.1%), Candida parapsilosis (4.3%) and Trichosporon cutaneum (2.1%). All strains, excepting C. laurentii were highly lipolytic. Most of the clinical cases associated with those yeasts were chronic, with hyperkeratosis and lichenification, and most of them were relapsed otitis (91.3%). The most affected dogs were a pendulous ears breeding (65.7%) and males (86.8%). Some dogs had other cutaneous disorders (seborrhoeic dermatitis, pemphigus). In vitro tests, using seven different antifungal drugs were systematically performed. All strains revealed to be 5-fluorocytosine-resistant and 32% of them were also resistant to nystatin. One M. pachydermatis isolated was resistant to all of the tested antifungal drugs. PMID:18473540

  4. 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

  5. [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.

  6. Acute otitis media in children

    Science.gov (United States)

    2014-01-01

    Introduction Acute otitis media (AOM) is a common reason for primary care visits in children. Yet, there is considerable debate on the most effective treatment. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments (analgesics, antibiotics, and myringotomy) in children with AOM? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics, delayed antibiotics, immediate antibiotics, longer courses of antibiotics, and myringotomy. PMID:25229555

  7. 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.

  8. 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...

  9. 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).

  10. 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

  11. Acute otitis media: characterization and risk factors

    OpenAIRE

    Amalia Nieves Álvarez

    2011-01-01

    La otitis media aguda es una de las infecciones respiratorias superiores más frecuentes en la infancia, fundamentalmente en niños menores de seis años. Su elevada incidencia y recidiva se deben a la interacción entre diferentes factores de riesgo. El signo más específico de presentación es la otalgia, acompañándose de fiebre, malestar y disminución de la audición.Por la frecuencia de niños con otitis media aguda en las consultas externas y de urgencia del hospital, nos planteamos conocer su c...

  12. Innate Immunity: Orchestrating Inflammation and Resolution of Otitis Media.

    Science.gov (United States)

    Kurabi, Arwa; Pak, Kwang; Ryan, Allen F; Wasserman, Stephen I

    2016-01-01

    Otitis media (OM) is a common disease in young children, accounting for more office visits and surgeries than any other pediatric condition. It is associated with an estimated cost of five billion dollars annually in the USA. Moreover, chronic and recurrent middle ear (ME) disease leads to hearing loss during critical periods of language acquisition and learning leading to delays in reaching developmental milestones and risking permanent damage to the ME and inner ear in severe cases. Therefore, research to understand the disease pathogenesis and identify new therapeutics is important. Although OM is a multifactorial disease, targeting the molecular mechanisms that drive inflammation and OM resolution is critical. In this review, we discuss the current evidence suggesting that innate immune receptors and effectors play key roles in OM by mediating both the ME inflammatory responses and recovery. PMID:26732809

  13. 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

  14. 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

  15. 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

  16. 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. PMID:26894630

  17. 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.

  18. Acute otitis media: characterization and risk factors

    Directory of Open Access Journals (Sweden)

    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.

  19. Epidemiology of acute otitis in pediatric patients

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. Antibiotics for acute otitis media in children

    Directory of Open Access Journals (Sweden)

    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.

  5. Evaluation of replication of variants associated with genetic risk of otitis media.

    Science.gov (United States)

    Allen, E Kaitlynn; Manichaikul, Ani; Chen, Wei-Min; Rich, Stephen S; Daly, Kathleen A; Sale, Michèle M

    2014-01-01

    The first Genome Wide Association Study (GWAS) of otitis media (OM) found evidence of association in the Western Australian Pregnancy Cohort (Raine) study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM). Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS of COME/ROM had P-values ranging from P = 0.06-0.80. After removal of SNPs previously genotyped in our GWAS of COME/ROM (N = 21) and those that failed Fluidigm assay design (N = 1), 26 SNPs were successfully genotyped in 716 individuals from our COME/ROM family population. None of the SNP associations replicated in our family-based population (unadjusted P = 0.03-0.93). Replication in an independent sample would confirm that these represent novel OM loci, and that further investigation is warranted. PMID:25089819

  6. Evaluation of replication of variants associated with genetic risk of otitis media.

    Directory of Open Access Journals (Sweden)

    E Kaitlynn Allen

    Full Text Available The first Genome Wide Association Study (GWAS of otitis media (OM found evidence of association in the Western Australian Pregnancy Cohort (Raine study, but lacked replication in an independent OM population. The aim of this study was to investigate association at these loci in our family-based sample of chronic otitis media with effusion and recurrent otitis media (COME/ROM. Autosomal SNPs were selected from the Raine OM GWAS results. SNPs from the Raine cohort GWAS genotyped in our GWAS of COME/ROM had P-values ranging from P = 0.06-0.80. After removal of SNPs previously genotyped in our GWAS of COME/ROM (N = 21 and those that failed Fluidigm assay design (N = 1, 26 SNPs were successfully genotyped in 716 individuals from our COME/ROM family population. None of the SNP associations replicated in our family-based population (unadjusted P = 0.03-0.93. Replication in an independent sample would confirm that these represent novel OM loci, and that further investigation is warranted.

  7. 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.

  8. 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。

  9. 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...

  10. 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.

  11. Evaluation of the subjective effect of middle ear implantation in hearing-impaired patients with severe external otitis.

    OpenAIRE

    Snik, A.F.M.; van Duijnhoven, N. T. L.; Mulder, J.J.S.; Cremers, C.W.R.J.

    2007-01-01

    The subjective benefit of middle ear implantation was studied in a group of 23 hearing-impaired patients who could not use conventional hearing aids owing to severe chronic external otitis. Changes in hearing disability (Abbreviated Profile of Hearing Aid Benefit [APHAB]) and changes in quality of life (Glasgow Benefit Inventory [GBI]) were determined. Mean benefit value on the APHAB for the subscale Ease of Communication was close to the mean reference value for conventional hearing aids. Fo...

  12. 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.

  13. 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

  14. 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.

  15. [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.

  16. 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.

  17. 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.

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

    International Nuclear Information System (INIS)

    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) [10−3 mm2/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

  19. 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.

  20. 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

  1. 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.

  2. Chronic granulomatous disease presenting as refractory pneumonia in late adulthood

    OpenAIRE

    SARWAR, Ghulam; de Malmanche, Theo; Rassam, Loui; Grainge, Christopher; Williams, Andrew; Arnold, David

    2015-01-01

    We present a case of refractory pneumonia in an adult patient with underlying chronic granulomatous disease (CGD). Her lobectomy tissue grew B urkholderia cepacia and histopathology revealed diffuse severe pneumonic consolidation with suppurative/necrotizing granulomata. An initial attempt to find an underlying immune deficiency was unsuccessful. Following recurrent invasive infections, repeat immunological assessment revealed reduced neutrophil function, demonstrating skewed carrier status (...

  3. 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.

  4. 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...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Prevention of otitis media: now a reality?

    Science.gov (United States)

    Schuerman, Lode; Borys, Dorota; Hoet, Bernard; Forsgren, Arne; Prymula, Roman

    2009-09-25

    Acute otitis media (AOM), one of the most common childhood diseases, is associated with a substantial medical, social and economic burden. Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are the two main causes of bacterial OM. The 7-valent pneumococcal CRM(197)-conjugate vaccine (7vCRM, Prevnar/Prevenar, Wyeth) demonstrated efficacy against AOM caused by vaccine pneumococcal serotypes. Protection against overall AOM was also observed with an 11-valent pneumococcal protein D-conjugate vaccine (11Pn-PD) in the Pneumococcal Otitis Efficacy Trial (POET). Following POET, an optimized 10-valent pneumococcal non-typeable H. influenzae protein D-conjugate vaccine (PHiD-CV; Synflorix, GlaxoSmithKline Biologicals) was developed. This vaccine includes serotypes 1, 5, and 7F, in addition to those already included in 7vCRM, and was recently licensed in Europe for active immunization against invasive disease and AOM caused by S. pneumoniae in infants and children from 6 weeks up to 2 years of age. The use of protein D as carrier protein permits avoidance of possible interferences known to occur with some conjugate vaccines, and has the added potential benefit of providing protection against NTHi. This review seeks to highlight the recent advances in the field of OM vaccination, with a focus on data regarding the recently licensed PHiD-CV. PMID:19666154

  10. 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.

  11. 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.

  12. 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...

  13. Stan scheller: the forerunner of clinical studies on using propolis for poor and chronic nonhealing wounds.

    Science.gov (United States)

    Kucharzewski, M; Kubacka, S; Urbanek, T; Wilemska-Kucharzewska, K; Morawiec, T

    2013-01-01

    For hundreds of years poor and chronic nonhealing wounds have constituted a serious problem to medicine. What is more, treating such wounds is an expensive let alone a long-lasting process. The following paper describes Professor Scheller's achievements in using propolis for poor and chronic non-healing wounds. The authors' intention was to present the results connected with the use of the ethanolic extract propolis, in the treatment of patients suffering from burns, venous crural ulceration, local sacral bone pressure ulcers, suppurative osteitis and arthritis, suppurative postoperative local wound complications, and infected traumatic wounds.

  14. 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.

  15. 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.

  16. 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

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Nicholas Liu

    2016-04-01

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

  19. 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

  20. A retrospective study on cholesteatoma otitis media coexisting with cholesterol granuloma.

    Science.gov (United States)

    Luo, Linghui; Gong, Shusheng; Bai, Guangping; Wang, Jibao

    2002-01-01

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

  1. 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.

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

    OpenAIRE

    Fletcher, Mark A.; Bernard Fritzell

    2012-01-01

    Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POE...

  3. 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…

  4. 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.

  5. ANTIBACTERIAL PROPERTIES OF HOLMIUM TO CAUSATIVE AGENTS OF SUPPURATIVE -INFLAMMATORY COMPLICATIONS IN PATIENTS WITH TRAUMA

    Directory of Open Access Journals (Sweden)

    Poddubnaya H. N.

    2012-06-01

    Full Text Available Article denotes to determination of antibacterial action of polyoxometalate holmium to causative agents of suppurative-inflammatory process in wounds of patients, which were suffered from trauma. Method of serial dilutions was used for determination of minimal inhibiting concentration (MIC of holmium to staphylococci, enterococci and E. coli. Registration of holmium action shows the strong antibacterial influence to staphylococci and enterococci (MIC of holmium action to staphylococcal and enterococcal strains same 1 10 M, to strains of E.coli – 2,5 10 M. Solutions of holmium don’t have antibacterial action to strains of E.coli.

  6. 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.

  7. 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.

  8. Major histocompatibility complex class II alleles and haplotypes associated with non-suppurative meningoencephalitis in greyhounds.

    Science.gov (United States)

    Shiel, R E; Kennedy, L J; Nolan, C M; Mooney, C T; Callanan, J J

    2014-09-01

    Non-suppurative meningoencephalitis is a breed-restricted canine neuroinflammatory disorder affecting young greyhounds in Ireland. A genetic risk factor is suspected because of the development of disease in multiple siblings and an inability to identify a causative infectious agent. The aim of this study was to examine potential associations between dog leucocyte antigen (DLA) class II haplotype and the presence of the disease. DLA three locus haplotypes were determined in 31 dogs with non-suppurative meningoencephalitis and in 115 healthy control dogs using sequence-based typing (SBT) methods. All dogs were unrelated at the parental level. Two haplotypes (DRB1*01802/DQA1*00101/DQB1*00802 and DRB1*01501/DQA1*00601/DQB1*02201) were significantly (P = 0.0099 and 0.037) associated with the presence of meningoencephalitis, with odds ratios (95% confidence interval) of 5.531 (1.168-26.19) and 3.736 (1.446-9.652), respectively. These results confirm that there is an association between DLA class II haplotype and greyhound meningoencephalitis, suggesting an immunogenetic risk factor for the development of the disease. Greyhound meningoencephalitis may be a suitable model for human neuroinflammatory diseases with an immunogenetic component. PMID:24851745

  9. Cochlear implant challenges encountered in tuberculous otitis media

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  10. Group A Streptococcal Suppurative Arthritis and Osteomyelitis of the Shoulder With Brachial Plexus Palsy in a Newborn.

    Science.gov (United States)

    Dierig, Alexa; Ritz, Nicole; Tacke, Uta; Heininger, Ulrich

    2016-10-01

    Osteoarticular infections in the newborn period are rare. A serious complication is paralysis of the affected extremity resulting from either pain or direct involvement of the nerve. We report a newborn with combined osteomyelitis and suppurative arthritis caused by Streptococcus pyogenes presenting with right brachial plexus palsy. PMID:27622687

  11. 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.

  12. The Incidence of Exudative Otitis Media in HIV Infected Children

    OpenAIRE

    Nuriddin U. Narzullaev, PhD

    2012-01-01

    Diseases of the ENT organs are among the commonly prevalent and dangerous pathologies of childhood, occurring as a complication of respiratory, bacterial diseases and HIV infection. One of the serious complications of HIV infection in children is the lesion of ENT organs. In HIV infected children, in addition to suppurative diseases occur middle ear diseases with nonsuppurative origin. A total of 79 HIV infected children aged 3-14 years with different pathologies of the nasal cavity, nasophar...

  13. P物质在慢性中耳炎肉芽及纤维组织中的表达及意义%Expression and the meanings of substance P in the periodontal tissues and the meanings of substance P in the chronic otitis media granulation tissue

    Institute of Scientific and Technical Information of China (English)

    孙斌; 成颖; 许珉

    2013-01-01

    Objective:Identify the contribution of neuropeptide P to the forming of middle ear granulation tissue,reveals the influence of neurogenic inflammation to otitis media and provides some laboratory proof to under-stand the process and evolution of otitis media. Methods:Collecting granulation tissue and fibrous tissue in middle ear cavity of otitis media patients. Immunity class dyeing and observed the express of neuropeptide P substance. Results: Dyeing of SP situates in granulation tissue and fibrous tissue; Linear relationship between SP and otitis medial(X2= 25.9919,v = 9, P<0. 05),The expression of SP in the serious affection of middle ear and broader granulation are more than in the slight and small;Dyeing in the group of granulation tissues is heavy than that of fibrous tissues (μ = 3. 4782,P<0. 05). Conclusion:The neurogenic inflammation mediated by the SP can affect the formation and de-velopment ol tne granulation tissue; 1 ne degree of tne neurogenic inflamination can allect tne amount of tne granula-tion tissue in the middle ear cavity; The neurogenic inflammation mediated by the SP has become weak in the middle-ear space during the later period of tympanitis.%目的:探讨P物质(SP)在中耳肉芽组织形成及转归中的作用,揭示神经源性炎症对中耳炎性病变的影响.方法:收集中耳炎患者中耳腔肉芽组织及纤维组织,免疫组化染色,观察SP的表达情况.结果:SP在中耳肉芽及纤维组织中呈阳性表达;SP表达强弱与中耳病变的轻重存在线性相关关系(χ2=25.9919,ν=9,P<0.05)即在中耳病变较重、肉芽范围广者,SP表达高于中耳病变较轻、肉芽范围小者;肉芽组织组SP表达高于纤维组织组(SymbolmA@_=3.4782,P<0.05).结论:由SP介导的神经源性炎症反应在肉芽组织形成和发展中起到一定作用;神经原性炎症的强弱影响着中耳腔肉芽组织的增生程度;中耳炎后期,由SP启动的神经源性炎症反应在中耳腔已经减弱.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Auditory Deprivation and Early Conductive Hearing Loss from Otitis Media.

    Science.gov (United States)

    Gunnarson, Adele D.; And Others

    1990-01-01

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

  1. 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

  2. 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...

  3. 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

  4. 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)

  5. Bacterial otitis media: a new non-invasive rat model.

    NARCIS (Netherlands)

    Tonnaer, E.L.G.M.; Sanders, E.A.M.; Curfs, J.H.A.J.

    2003-01-01

    This study describes the development of a physiological rat model for otitis media. The model is based on the assumption that bacteria, intranasally introduced into the nasopharynx, will be transferred into the middle ear cavity during swallowing provided that the ambient air pressure is higher than

  6. Antibiotics for acute otitis media in children (Review)

    NARCIS (Netherlands)

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

    2013-01-01

    BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. OBJECTIVES: To assess the effects of antibiotics for children with AOM. SEARCH METHODS: We search

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. 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. PMID:26701945

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

    Directory of Open Access Journals (Sweden)

    Thornton Ruth B

    2011-10-01

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

  11. 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...

  12. Clinical-scintigraphy discordance in a case of malignant external otitis.

    Science.gov (United States)

    Morales-Avellaneda, T; González-Ramírez, A I; Rodríguez-Alfonso, B; Mucientes-Rasilla, J; García-Berrocal, J R; De Diego, B

    2012-09-01

    We report the case of an immunocompromised female patient with external otitis, who developed a picture of external otitis with poor response to conventional treatment and subsequent isolation of Pseudomona Aeruginosa in the ear secretion culture. The final diagnosis was malignant external otitis. Our objective is to describe the scintigraphic findings as well as to analyze their correlation with the clinical pattern and to evaluate the possible causes of the discordance found. PMID:23067529

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

    OpenAIRE

    BELLUSSI, L.; M. Mandalà; Passàli, FM; Passàli, GC; Lauriello, M; Passali, D

    2005-01-01

    Purpose of this study was to correlate results from a survey on otitis media and the State-Trait Anxiety Inventory test. This survey investigated prevalence of otitis media (OM) in our territory, influence on development of language and personality and social costs. State-Trait Anxiety Inventory is a suitable test to differentiate state anxiety caused by a specific event [in this case, otitis media with effusion (OME)] from a trait anxiety (anxious personality) in parents and caregivers. The ...

  14. Aetiology of canine otitis externa: a retrospective study of 100 cases.

    Science.gov (United States)

    Saridomichelakis, Manolis N; Farmaki, Rania; Leontides, Leonidas S; Koutinas, Alexander F

    2007-10-01

    The objective of this retrospective study was to investigate in 100 dogs with otitis externa (OE) the possible associations between signalment, history, clinical and laboratory findings and the various primary, secondary and perpetuating causative factors of ear canal inflammation. The age of the dogs ranged from 3 months to 14 years (median: 4.75 years) and they included 45 males and 55 females. Cocker spaniels, Jura des Alpes and Brittany spaniels were significantly overrepresented among dogs with OE when compared to the hospital canine population. In the majority of the cases, OE was chronic-recurrent (63%) or bilateral (93%). Allergic dermatitis (43/100 dogs), grass awns (12/100) and otoacariasis (7/100) were the most common primary causative factors; no primary factor could be incriminated in 32 cases and more than one was found in three dogs. Malassezia spp. (66/100 dogs), cocci (38/100) and rods (22/100) were the secondary causative factors, while ear canal stenosis (38/100) and tympanic membrane perforation-otitis media (25/100) were the most important perpetuating factors. Atopic dermatitis and adverse food reactions-associated OE was more common in females and dogs with a history of pruritic skin disease, while grass awn-induced OE occurred in cocker spaniels and acute cases. Tympanic membrane perforation was less frequent in atopic dermatitis and adverse food reactions-associated OE, but more common when otoscopic and ear canal cytological examination revealed the presence of grass awns and rods, respectively. Finally, cocci overgrowth was positively associated with ear canal stenosis. PMID:17845622

  15. [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.

  16. 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.

  17. 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.

  18. Acute Otitis due to Vibrio fluvialis after Swimming

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Adriana Mosca

    2011-12-01

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

  20. Gradenigo's syndrome--a rare complication of otitis media.

    Science.gov (United States)

    Jagadeesan, Padmaja; Madeswaran, K; Thiruppathy, S P; Kalairajan, D; Inbasekaran, V

    2002-11-01

    Petrous apicitis is a rare intracranial complication of otitis media. A 4-year-old female child was presented with persistent ear discharge, retro-orbital pain and lateral rectus palsy (triad of Gradenigo's syndrome). A right temporal burr-hole was placed and tapping was done under antibiotic coverage. Turbid cerebrospinal fluid could be drained. Follow-up could not be done as the patient refused treatment and was discharged against medical advice. PMID:12797641

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

    Directory of Open Access Journals (Sweden)

    Leticia Reis Borges

    2013-07-01

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

  2. 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.

  3. 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.

  4. 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. PMID:26951264

  5. 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. PMID:26233245

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. Myringoplasty with temporalis fascia : Analysis of 200 cases

    OpenAIRE

    Mathai, John

    1999-01-01

    Two hundred cases of chronic suppurative otitis media with dry ear were taken up for myringoplasty operation by underlay technique through transcanal route. Autologous temporalis fascia was used as the graft material in all cases. Surgery was done during the period from April 1987 to November 1992. The patients were reviewed 5 years after the surgery [1997] and analysed.

  11. 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...

  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. 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.

  15. Xylitol Syrup for the Prevention of Acute Otitis Media

    Science.gov (United States)

    Corwin, Michael J.; Vezina, Richard M.; Pelton, Steven I.; Feldman, Henry A.; Coyne-Beasley, Tamera; Mitchell, Allen A.

    2014-01-01

    BACKGROUND: Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption. METHODS: We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age. RESULTS: A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI –0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI –1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57). CONCLUSIONS: Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children. PMID:24394686

  16. [Acute otitis media in children: antibiotic therapy or watchful waiting?].

    Science.gov (United States)

    Amrhein, P; Hospach, A; Sittel, C; Koitschev, A

    2013-05-01

    Acute otitis media is one of the most common infections in childhood and the options of therapy have been examined in numerous studies. Nevertheless, there are controversial opinions regarding the question whether antibiotic therapy makes sense. This is proved through the many different ways that the primary treatment of the middle ear infection is handled throughout the international community. This work gives an overview of the current knowledge and based on these results gives practical recommendations to assist with the diagnosis and treatment of the individual patients. PMID:23247747

  17. 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.

  18. 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

  19. 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.

  20. Streptococcus salivarius 24SMB administered by nasal spray for the prevention of acute otitis media in otitis-prone children.

    Science.gov (United States)

    Marchisio, P; Santagati, M; Scillato, M; Baggi, E; Fattizzo, M; Rosazza, C; Stefani, S; Esposito, S; Principi, N

    2015-12-01

    This paper reports the results of the first study in which Streptococcus salivarius 24SMB, a safe α-haemolytic strain capable of producing bacteriocin-like substances with significant activity against acute otitis media (AOM) pathogens, was intranasally administered in an attempt to reduce the risk of new episodes of AOM in otitis-prone children. In this prospective, randomized, double-blind, placebo-controlled study, 100 children aged 1-5 years with histories of recurrent AOM were randomized 1:1 to receive an intranasal S. salivarius 24SMB or placebo twice daily for 5 days each month for 3 consecutive months. Fifty treated children and 47 who received placebo who were compliant with study protocol were followed monthly for 6 months. The number of children who did not experience any AOM was higher among the children treated with the S. salivarius 24SMB preparation than among those in the placebo group (30.0 vs 14.9%; p = 0.076). Moreover, the number of children who received antibiotics during the study period was lower among the children treated with S. salivarius 24 SMB than among those who received placebo (70 vs 83.0%; p = 0.13). Compared with the children who were not colonized by S. salivarius 24SMB after treatment, the number of colonized children who experienced any AOM was significantly lower (42.8 vs 13.6%; p = 0.03). Similar results were observed when the children treated with antibiotics for AOM were analysed (67.8 vs 95.5%; p = 0.029). This study revealed the ability of intranasally administered S. salivarius 24SMB to reduce the risk of AOM in otitis-prone children. PMID:26385346

  1. 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.

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

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    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

  3. 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.

  4. Treatment of otitis media by transtympanic delivery of antibiotics.

    Science.gov (United States)

    Yang, Rong; Sabharwal, Vishakha; Okonkwo, Obiajulu S; Shlykova, Nadya; Tong, Rong; Lin, Lily Yun; Wang, Weiping; Guo, Shutao; Rosowski, John J; Pelton, Stephen I; Kohane, Daniel S

    2016-09-14

    Otitis media is the most common reason U.S. children receive antibiotics. The requisite 7- to 10-day course of oral antibiotics can be challenging to deliver in children, entails potential systemic toxicity, and encourages selection of antimicrobial-resistant bacteria. We developed a drug delivery system that, when applied once to the tympanic membrane through the external auditory canal, delivers an entire course of antimicrobial therapy to the middle ear. A pentablock copolymer poloxamer 407-polybutylphosphoester (P407-PBP) was designed to flow easily during application and then to form a mechanically strong hydrogel on the tympanic membrane. U.S. Food and Drug Administration-approved chemical permeation enhancers within the hydrogel assisted flux of the antibiotic ciprofloxacin across the membrane. This drug delivery system completely eradicated otitis media from nontypable Haemophilus influenzae (NTHi) in 10 of 10 chinchillas, whereas only 62.5% of animals receiving 1% ciprofloxacin alone had cleared the infection by day 7. The hydrogel system was biocompatible in the ear, and ciprofloxacin was undetectable systemically (in blood), confirming local drug delivery and activity. This fast-gelling hydrogel could improve compliance, minimize side effects, and prevent systemic distribution of antibiotics in one of the most common pediatric illnesses, possibly minimizing the development of antibiotic resistance. PMID:27629487

  5. Societal costs and burden of otitis media in Portugal

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    Speets AM

    2011-04-01

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

  6. 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.

  7. [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.

  8. 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.

  9. 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.

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

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    Ruth B Thornton

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

  11. 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.

  12. 77 FR 24716 - Scientific Information Request on Medical Devices To Treat Otitis Media With Effusion

    Science.gov (United States)

    2012-04-25

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Medical.... ACTION: Request for Scientific Information Submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of otitis media...

  13. 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.

  14. 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.

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

    Science.gov (United States)

    Daigler, G E; Markello, S J; Cummings, K M

    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. PMID:2000018

  16. 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.

  17. 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.

  18. ROLE OF ADENOID AND NASOPHARYNGEAL FLORA IN THE ETIOLOGY OF SEROUS OTITIS MEDIA

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    Akshay

    2015-09-01

    Full Text Available OBJECTIVES: To identify the common bacteria found in the nasopharynx of patients of serous otitis media, to study the prevalence of adenoiditis in patient of serous otitis media and to study the bacteria isolated from operated adenoid tissue of patients of serous otitis media. METHOD AND MATERIA LS : Study was carried out on clinically diagnosed 40 cases of serous otitis media. Patients were operated under general anaesthesia. At the commencement of the surgery, a sterile swab was taken with an applicator from the surface of the adenoid. Prior to surgery, the adenoid tissue was palpated and confirmed. Adenoidectomy was done by curettage method using adenoid curette and the specimen was immediately transported in normal saline to the microbiology lab in a sterile bottle along with the surface swab. RESULT: 95% culture shows bacterial growth , males are more common in serous otitis media and most bacteria isolated from nasopharyngeal swab and adenoid are Gram positive bacteria includes Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus species, Streptococcus viridians, Streptococcus pyogenes and Gram negative bacteria includes Moraxella catarrhalis, Klebsiella pneumonia. CONCLUSION: T he nasopharyngeal and adenoid bacterial flora is polymicrobial in nature and there is no difference in the pathogens isolated from nasopharynx swab or adenoid culture in patients of serous otitis media.

  19. [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.

  20. 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.

  1. 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.

  2. Magnetic resonance imaging and computerized tomography in malignant external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Gherini, S.G.; Brackmann, D.E.; Bradley, W.G.

    1986-05-01

    In malignant external otitis (MEO), determining the anatomic extent of disease and evaluating the physiologic response to therapy remain a problem. Magnetic resonance imaging (MRI) has recently become available in limited clinical settings. Four patients with MEO were evaluated using MRI, computerized tomography (CT), technetium-99 (Tc-99) bone scanning, and gallium-67 citrate (Ga-67 citrate) scanning. MRI is superior to CT, Tc-99 bone scanning, and Ga-67 citrate scanning in evaluating the anatomic extent of soft tissue changes in MEO. MRI alone cannot be relied upon to determine the physiologic response to therapy. MRI can, however, serve as a valuable guide to the interpretation of Tc-99 bone and Ga-67 citrate scans, and in this respect, MRI is extremely useful in the treatment of MEO.

  3. Medical prevention of recurrent acute otitis media: an updated overview.

    Science.gov (United States)

    Marchisio, Paola; Nazzari, Erica; Torretta, Sara; Esposito, Susanna; Principi, Nicola

    2014-05-01

    Acute otitis media (AOM) is one of the most common pediatric diseases; almost all children experience at least one episode, and a third have two or more episodes in the first three years of life. The disease burden of AOM has important medical, social and economic effects. AOM requires considerable financial assistance due to needing at least one doctor visit and a prescription for antipyretics and/or antibiotics. AOM is also associated with high indirect costs, which are mostly related to lost days of work for one parent. Moreover, due to its acute symptoms and frequent recurrences, AOM considerably impacts both the child and family's quality of life. AOM prevention, particularly recurrent AOM (rAOM), is a primary goal of pediatric practice. In this paper, we review current evidence regarding the efficacy of medical treatments and vaccines for preventing rAOM and suggest the best approaches for AOM-prone children. PMID:24678887

  4. 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.

  5. 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.

  6. 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.

  7. A case of superficial suppurative necrolytic dermatitis of miniature schnauzers with identification of a causative agent using patch testing.

    Science.gov (United States)

    Murayama, Nobuo; Midorikawa, Kuniaki; Nagata, Masahiko

    2008-12-01

    A 9-year-old, castrated male, miniature schnauzer presented with malaise, anorexia, fever and severe inflammatory skin lesions on the dorsum, thighs and pinnae. The lesions developed 2 days after bathing with a commercial shampoo. Histopathological examination of skin samples revealed neutrophilic exocytosis, parakeratosis, epidermal hyperplasia and neutrophilic infiltration in the superficial dermis. Skin lesions resolved completely after 14 days of treatment with prednisolone and ofloxacin. Patch testing performed on the patient and a clinically healthy dog showed erythema at the site exposed to the culprit shampoo 48 h later only on the patient. Histopathological findings of the erythematous reaction were similar to those of the spontaneous skin lesions. Based on these findings, the dog was diagnosed with superficial suppurative necrolytic dermatitis of miniature schnauzers. The patch test results suggested that contact dermatitis to a commercial shampoo played a role in the pathogenesis of this disease.

  8. A case of superficial suppurative necrolytic dermatitis of miniature schnauzers with identification of a causative agent using patch testing.

    Science.gov (United States)

    Murayama, Nobuo; Midorikawa, Kuniaki; Nagata, Masahiko

    2008-12-01

    A 9-year-old, castrated male, miniature schnauzer presented with malaise, anorexia, fever and severe inflammatory skin lesions on the dorsum, thighs and pinnae. The lesions developed 2 days after bathing with a commercial shampoo. Histopathological examination of skin samples revealed neutrophilic exocytosis, parakeratosis, epidermal hyperplasia and neutrophilic infiltration in the superficial dermis. Skin lesions resolved completely after 14 days of treatment with prednisolone and ofloxacin. Patch testing performed on the patient and a clinically healthy dog showed erythema at the site exposed to the culprit shampoo 48 h later only on the patient. Histopathological findings of the erythematous reaction were similar to those of the spontaneous skin lesions. Based on these findings, the dog was diagnosed with superficial suppurative necrolytic dermatitis of miniature schnauzers. The patch test results suggested that contact dermatitis to a commercial shampoo played a role in the pathogenesis of this disease. PMID:19037916

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Worden Katherine A

    2008-10-01

    Full Text Available Abstract Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42. OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10. Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465

  11. 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...

  12. 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....

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

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    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.

  15. Prevalence of Malassezia spp. in the ears of asymptomatic cattle and cattle with otitis in Brazil.

    Science.gov (United States)

    Duarte, E P; Melo, M M; Hahn, R C; Hamdan, J S

    1999-06-01

    Yeasts of the genus Malassezia are lipophilic microorganisms that are saprophytes that can act as opportunistic pathogens in animals. Malassezia pachydermatis is commonly isolated from the ear canal and skin of healthy dogs, or in association with seborrheic dermatitis and otitis externa conditions. The objective of the present study was to determine the occurrence of Malassezia spp. in the ears of healthy bovines and bovines with otitis. Specimens (secretion or cerumen) were collected with sterile swabs, inoculated onto Mycosel medium, supplemented with olive oil, and incubated at 35 degrees C for 1 week. Yeasts were identified according to morphological characteristics, growth in Dixon medium at 32 degrees C and Sabouraud glucose medium modified by the addition of Tween 20, 40 or 80. The results showed that 54.7% of the cultures were positive in bovines with otitis (75) and 34.6% were positive in healthy bovines (378). Analysis of the positive cultures (41) from animals with otitis allowed presumptive identification of 24 strains corresponding to M. globosa (12), M. slooffiae (5), M. furfur (5) and M. sympodialis (2). Further studies on a larger number of animals may confirm the trend verified thus far, i.e. a higher frequency of isolation of Malassezia spp. from animals with otitis than from healthy animals (P<0.01) and a predominance of the species M. globosa. PMID:10498444

  16. 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.

  17. Suppurative rhinitis associated with Haemophilus species infection in a cat : clinical communication

    OpenAIRE

    Milner, R J; J.H. Horton; Crawford, P C; J. O'Kelley; Nguyen, A.

    2004-01-01

    A young cat with signs of chronic rhinitis was evaluated for underlying anatomical, inflammatory, or infectious disease. Initial diagnostics were significant for the isolation of an unusual pathogen, Haemophilus species. Isolation using a human RapID(TM) NH system erroneously identified the isolate as H. segnis, a human pathogen. No database of veterinary pathogens (Haemophilus) are included in the system and animal pathogens will either be erroneously identified or yield a unique biocode not...

  18. Severe Pulmonary Suppuration with Infection-Induced Systemic Inflammatory Response Syndrome following Tongue Cancer Surgery in a Patient Undergoing Tocilizumab Therapy for Rheumatoid Arthritis

    OpenAIRE

    Kenji Yamagata; Nobutake Shimojo; Hiroyuki Ito; Junya Ijima; Shogo Hasegawa; Toru Yanagawa; Taro Mizutani; Hiroki Bukawa

    2014-01-01

    A 65-year-old woman with rheumatoid arthritis treated by tocilizumab (TCZ) presented with tongue squamous cell carcinoma. While surgery was performed without any complications the aspiration pneumonia rapidly worsened by postoperative day 2 and severe pulmonary suppuration in the right lung field with infection-induced systemic inflammatory response syndrome (SIRS) was diagnosed. Antibiotic and respirator treatment improved her condition. The anti-inflammatory effect of TCZ may mask the sympt...

  19. 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.

  20. Malignant external otitis: long-term (months) antimicrobial therapy

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, M.; Aber, R.C.; Conner, G.H.; Baum, S.

    1982-04-01

    Since Chandler's initial report in 1968 on malignant external otitis (MEO), this entity has been recognized in its earlier stages with increasing frequency. As a result of this, the availability of new antimicrobial agents, and the judicious use of surgery, there has been an improvement in the results of therapy. There remains, however, a subgroup of patients who continue to experience a significant mortality from this infection. A review and selected discussion of our experience with MEO from 1976 to 1979 is presented. Six patients have been diagnosed and successfully treated for MEO. They presented with problems ranging from severe otalgia to multiple cranial neuropathy. For the most part, therapy consisted of the now standard aminoglycoside and carbenicillin combination. Two of the patients were in the high mortality risk group. One of these patients developed an osteomyelitis which extended across the skull base resulting in bilateral cranial neuropathies. His therapy included surgery as well as long-term (months) outpatient treatment with tobramycin and carbenicillin with an excellent result. The second patient was treated similarly. The efficacy of this approach is discussed as well as the usefulness of radionuclide bone scanning in assessing the course and therapy of patients with MEO.

  1. [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.

  2. Complementary and Alternative Medicine Treatment Options for Otitis Media

    Science.gov (United States)

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-01-01

    Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  3. 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.

  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. [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.

  6. 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.

  7. Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial.

    OpenAIRE

    Uhari, M.; Kontiokari, T; Koskela, M.; Niemelä, M. (Mika)

    1996-01-01

    OBJECTIVE: To examine whether xylitol, which reduces the growth of Streptococcus pneumoniae, might have clinical importance in the prevention of acute otitis media. DESIGN: A double blind randomised trial with xylitol administered in chewing gum. SETTING: Eleven day care nurseries in the city of Oulu. Most of the children had had problems with recurrent acute otitis media. SUBJECTS: 306 day care children: 149 children in the sucrose group (76 boys; mean (SD) age 4.9 (1.5) years) and 157 in th...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kari J. Kværner

    2009-10-01

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

  12. 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

  13. Mycological investigation in patients with acute otitis media

    Directory of Open Access Journals (Sweden)

    O. J. Akinjogunla

    2012-07-01

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

  14. Atypical streptococcal infection of gingiva associated with chronic mouth breathing.

    Science.gov (United States)

    Haytac, M Cenk; Oz, I Attila

    2007-01-01

    Streptococcal infections of oral tissues are mainly seen in young children who experience a variety of upper respiratory tract infections. The disease is characterized by fever, lymphadenopathy, and ulcers on the gingiva, lips, and tonsils. This case report presents an atypical streptococcal infection of the gingiva in an 18-year-old man. The patient was referred to the periodontology department complaining of a 2-month history of gingival enlargement. He had persistent fever (39.5 degrees C) and general malaise for 2 weeks. Intraoral examination revealed extremely inflamed and enlarged gingiva with spontaneous bleeding and suppuration. Based on the otolaryngologic consultation and the hematologic, immunologic, and microbiologic tests, the final diagnosis was an atypical streptococcal gingivitis with chronic adenoid-related mouth breathing and oral hygiene neglect as contributing factors. Treatment consisted of a broad-spectrum antibiotic regimen, supragingival and subgingival debridement, adenoidectomy, and scaling and root planing. A good response to nonsurgical therapy was achieved despite poor patient compliance, and no recurrence of gingival enlargement was observed after 1 year. Streptococcal gingivitis should be included in the differential diagnosis of suppurative gingival enlargements. Furthermore, chronic mouth breathing may initiate and/or contribute to this disease.

  15. The Effects of an Early History of Otitis Media on Children's Language and Literacy Skill Development

    Science.gov (United States)

    Winskel, Heather

    2006-01-01

    Background: Otitis media (OM) or middle ear infection is a common childhood illness and is most frequent during the crucial first 3 years of life when speech and language categories are being established, which could potentially have a long-term effect on language and literacy skill development. Aims: The purpose of the current study was to…

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

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    L.A Lozina

    2010-12-01

    Full Text Available 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 examination and microbiological analysis of dogs ear exudates were made. The most frequent microorganisms isolated in culture media were: Malassezia pachydermatis (54.2%, Staphylococcus aureus (43.8%, coagulase-negative Staphylococcus (25.0%, Pseudomonas aeruginosa (20.8%, Candida albicans (18.8%, Proteus mirabilis (16.7%, Streptococcus spp. (16.7%, Enteroccocus faecalis (12.5%, Escherichia coli (12.5%, Staphylococcus intermedius (6.3%, Klebsiella spp. (4.2%, andCandida glabrata (2.1%. Whereas the control group did not recover from the infectious ear disease, the propolis preparation exhibited antimicrobial activity against most of the microorganisms isolated from samples of the treated group. In addition, no propolis-adverse effects were observed. This allowed propolis-treated patients to show a significant improvement of the clinical parameters. Thus, this new Argentine propolis ear drop formulation may be used for topical treatment of otitis externa in dogs.

  18. Ten-Year Study of the Stringently Defined Otitis-prone Child in Rochester, NY.

    Science.gov (United States)

    Pichichero, Michael E

    2016-09-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14.8% and 2.4% receiving tympanostomy tubes, respectively. Significantly more often respiratory syncytial virus infection led to AOM in sOP than non-otitis-prone children that correlated with diminished total respiratory syncytial virus-specific serum IgG. sOP children produced low levels of antibody to Streptococcus pneumoniae and Haemophilus influenzae candidate vaccine protein antigens and to routine pediatric vaccines. sOP children generated significantly fewer memory B cells, functional and memory T cells to otopathogens following nasopharyngeal colonization and AOM than non-otitis-prone children and they had defects in antigen-presenting cells. PMID:27273691

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  20. First isolation of the Stephanoascus ciferrii in feline otitis in Brazil

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    Angelita dos Reis Gomes

    2014-09-01

    Full Text Available Ear infections in cats are uncommon, especially involving yeasts. This report describes the first isolation of the Stephanoascus ciferrii, teleomorph of the Candida genus, in a case of feline otitis in Brazil. The identification and characterization of Stephanoascus ciferrii were confirmed by the Vitek2 System (BioMerieux ®.

  1. SPECT imaging in evaluating extent of malignant external otitis: case report

    International Nuclear Information System (INIS)

    Otitis externa, a benign inflammatory process of the external auditory canal, is general responsive to local therapy. Some patients however, develop a less controllable disease leading to chondritis and osteomyelitis of the base of the skull. The direct invasive characteristic of the disease has led to the descriptive term malignant external otitis (MEO), more appropriately called necrotizing or invasive external otitis. Malignant external otitis is caused by an aggressive pseudomonas or proteus infection that almost exclusively occurs in elderly diabetic patients. The primary imaging modalities previously used in the diagnosis and evaluation of MEO were standard planar scintigraphic techniques with technetium-99M (/sup 99m/Tc) bone agents and gallium-67 (67Ga), and pluridirectional tomography. The advent of high resolution computed tomography (CT) effectively allowed demonstration of the soft tissue extension and bone destruction associated with MEO, but still suffered from the low sensitivity constraints of all radiographic techniques in determining early inflammatory bone involvement. Recent work suggests that scintigraphic detection of MEO with /sup 99m/Tc-MDP and 67Ga, combined with the cross-sectional resolution of single photon emission computed tomography (SPECT) may be of value in planning treatment of this inflammatory condition

  2. The upper respiratory tract microbiome and its potential role in bovine respiratory disease and otitis media

    Science.gov (United States)

    Lima, Svetlana F.; Teixeira, Andre Gustavo V.; Higgins, Catherine H.; Lima, Fabio S.; Bicalho, Rodrigo C.

    2016-01-01

    The upper respiratory tract (URT) hosts a complex microbial community of commensal microorganisms and potential pathogens. Analyzing the composition and nature of the healthy URT microbiota and how it changes over time will contribute to a better understanding of the pathogenesis of pneumonia and otitis. A longitudinal study was conducted including 174 Holstein calves that were divided in four groups: healthy calves, calves diagnosed with pneumonia, otitis or both diseases. Deep pharyngeal swabs were collected on days 3, 14, 28, and 35 of life, and next-generation sequencing of the 16S rRNA gene as well as quantitative PCR was performed. The URT of Holstein dairy calves aged 3 to 35 days revealed to host a highly diverse bacterial community. The relative abundances of the bacterial genera Mannheimia, Moraxella, and Mycoplasma were significantly higher in diseased versus healthy animals, and the total bacterial load of newborn calves at day 3 was higher for animals that developed pneumonia than for healthy animals. Our results corroborate the existing knowledge that species of Mannheimia and Mycoplasma are important pathogens in pneumonia and otitis. Furthermore, they suggest that species of Moraxella can potentially cause the same disorders (pneumonia and otitis), and that high neonatal bacterial load is a key contributor to the development of pneumonia. PMID:27363739

  3. The Effects of Early Bilateral Otitis Media with Effusion on Educational Attainment: A Prospective Cohort Study.

    Science.gov (United States)

    Peters, Sylvia A. F.; And Others

    1994-01-01

    Examination of the relationship between educational attainment and long-lasting, bilateral otitis media with effusion (OME) in 270 Dutch children (ages 2 to 4) found that, at age 7, early bilateral OME affected spelling ability but not reading ability. Effects of treatment with ventilation tubes were not found. (DB)

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

    Directory of Open Access Journals (Sweden)

    Chia-Huei Chu

    2014-01-01

    Full Text Available Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1% but it was not noticeably associated with outcome (P= 0.41. The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, P=0.04. Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases.

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

    Science.gov (United States)

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

    2015-12-01

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

  6. [Cerebral artery infarction presented as an unusual complication of acute middle otitis].

    Science.gov (United States)

    Moscote-Salazar, Luis Rafael; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Gutiérrez-Paternina, Juan José

    2013-01-01

    Introducción: la otitis media aguda es una inflamación del oído medio frecuente en la edad pediátrica. Aproximadamente 2 % de todos los casos desarrolla complicaciones intracraneales, más específicamente meningitis; por lo general, los infartos cerebrales originados por esta última son venosos. Rara vez se ha descrito la ocurrencia de un infarto arterial cerebral como complicación directa de la otitis media aguda. Caso clínico: niña de 12 meses de edad quien fue llevada a un servicio de urgencias por síndrome febril secundario a otitis media aguda y alteración del estado de conciencia. A la exploración física se identificó que estaba somnolienta, con anisocoria, midriasis en el ojo derecho y hemiparesia izquierda. Con la tomografía axial computarizada de cerebro se apreció un infarto arterial cerebral extenso. Los padres no autorizaron la craniectomía descompresiva y la paciente falleció a las 48 horas de su ingreso hospitalario. Conclusiones: a pesar de los recursos tecnológicos con los que se dispone actualmente, el infarto cerebral relacionado con la otitis media aguda tiene una evolución tórpida. Los signos neurológicos focalizadores y el deterioro progresivo deben apuntar a la ineficacia del tratamiento antimicrobiano instaurado.

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

    Science.gov (United States)

    Denning, Jennifer; Mayberry, Wanda

    1987-01-01

    Thirty-five preschoolers, assigned to otitis media (OM) or no OM groups, were administered the Southern California Postrotary Nystagmus Test and the Miller Assessment for Preschoolers (MAP). Children with a history of OM had significantly decreased scores on the Stepping and Vertical Writing MAP tests, indicating vestibulospinal dysfunction. (SK)

  8. Application of myringotomy and ventilation tube insertion in the hearing rehabilitation of children with secretory otitis media%鼓膜切开置管术在儿童分泌性中耳炎听力康复中的应用

    Institute of Scientific and Technical Information of China (English)

    苗英章; 步桂清; 张秀者; 荣宏; 张勋

    2003-01-01

    AIM: To study the role of the myringotomy and ventilation tube insertion inthe hearing rehabilitation of the children with secretory otitis media(SOM).METHODS: Myringotomy and ventilation tube insertions were performed in56 children with chronic SOM. RESULTS: The pure-tone threshold average(PTA) of six months after operation in 50 cases(91 ears) was improvedsignificantly compared with the preoperative PTA( P < 0. 01 ). The effectiverate of myringotomy and ventilation tube insertion was 92. 3%. CONCLU-SION: As a therapeutic method in the hearing rehabilitation of the childrenwith chronic SOM, the myringotomy and veptilation tube insertion should beused as primary surgical therapy.

  9. TEMPORALIS FASCIA VERSUS TRAGAL PERICHONDRIUM : A COMPARATIVE STUDY OF OUTCOMES AS GRAFT MATERIAL IN TYMPANOPLASTY

    Directory of Open Access Journals (Sweden)

    Adip K

    2013-12-01

    Full Text Available Chronic suppurative otitis media is a major cause of morbidity with a large proportion ofpatients presenting with a tubo - tympanic type o f disease. Type 1 tympanoplasty has been established as the standardized treatment of choice for such patients.Right since the early years of this century a number of grafts have been used for tympanoplasty.Still , there exists a controversy about which is the best graft material.A good graft material is one which is locally available , is easily harvested , is viable, easy to place and gives a good healing result. Both temporalis fascia and tragal perichondrium satisfy all these criteria. Our study was aimed out to find which amongst these two is a better graft material by comparing the efficacy of tragal perichondrium as graft material to that of temporalis fascia. KEY WORDS : Chronic suppurative otitis media , tympanoplasty , temporalis fascia , tragal perichondrium

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

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-01-01

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

  11. Analysis of Adenoid Vegetation Children with Different Types of Tympanograms and Secretory Otitis Media%腺样体肥大患儿鼓室导抗图与分泌性中耳炎的关系探讨

    Institute of Scientific and Technical Information of China (English)

    高永平; 田从哲; 刘会清; 孟胜环; 刘海燕

    2013-01-01

    目的:探讨腺样体肥大患儿的不同鼓室导抗图与分泌性中耳炎的关系。方法回顾性分析2009年1月~2011年6月收治的328例腺样体肥大患儿的临床资料,分析统计分泌性中耳炎的发病例(耳)数及声导抗测试诊断分泌性中耳炎的阳性率。结果328例腺样体肥大患儿中有104例(169耳)最终经鼓膜穿刺或鼓膜置管确诊为分泌性中耳炎(31.71%,104/328),其中鼓室导抗图为B型者89例152耳,最终确诊为分泌性中耳炎者为86例147耳,阳性率为96.71%(147/152);鼓室导抗图为C型(负压在-150 daPa以上)者33例49耳,最终确诊为分泌性中耳炎者为16例20耳,阳性率为40.82%(20/49);鼓室导抗图为A s型者2例2耳最终均确诊为分泌性中耳炎。结论腺样体肥大患儿无论有无听力下降主诉,均应行声导抗测试,B型鼓室导抗图对鼓室积液判断的准确率最高,C型次之,As型也有鼓室积液的可能。%Objective To explore the relationship between adenoid vegetation children with different types of tympanograms and secretory otitis media in children and diagnosis of secretory otitis media .Methods A retrospec-tive study was carried out among 328 cases with adenoid vegetation in children ,including simple adenoid vegetation and associated with chronic tonsillitis and tonsillar hypertrophy ,from August 2010 to May 2012 .The incidence of secretory otitis media and outcomes of tympanometry for the diagnosis were analyzed .Results 104 cases were diag-nosed with secretory otitis media by tympanic membrane puncture or tympanostomy tube in 328 cases with adenoid vegetation (32 .31% );86 cases (147 ears) were finally diagnosed as secretory otitis media among 89 cases (152 ears) with type B tympanogram (147/152 ,96 .63% );16 cases (20 ears) were finally diagnosed secretory otitis media among 33 cases (49 ears) with type C tympanogram (20/49 ,40 .82% );2 cases (2 ears) with

  12. OSSIC U LAR DEFECTS AND AUDIOLOGICAL PROFILE OF CHRONIC OTITIS MEDIA

    OpenAIRE

    Sathyaki; Jyothi Swarup; Mohan; Mamatha Rani; Anu; Manjunath

    2014-01-01

    BACKGROUND: CSOM is a common disorder which causes hearing deficit. It can be due to perforation of tympanic membrane or ossicular erosion. AIM: To study the ossicular erosion and audiological profile in patients with CSOM. MATERIALS AND METHODS: A total of 30 patients with CSOM who underwent surgery were included in the study. RESULTS: Hearing loss was significantly higher in males and in patient s with ossicular erosion. CONCLUSION: Ossicular erosio...

  13. OSSIC U LAR DEFECTS AND AUDIOLOGICAL PROFILE OF CHRONIC OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Sathyaki

    2014-02-01

    Full Text Available BACKGROUND: CSOM is a common disorder which causes hearing deficit. It can be due to perforation of tympanic membrane or ossicular erosion. AIM: To study the ossicular erosion and audiological profile in patients with CSOM. MATERIALS AND METHODS: A total of 30 patients with CSOM who underwent surgery were included in the study. RESULTS: Hearing loss was significantly higher in males and in patient s with ossicular erosion. CONCLUSION: Ossicular erosion can give rise to hearing loss of more than 60dB

  14. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  15. Asymptomatic mucormycosis of middle ear: An incidental finding during tympanoplasty

    Directory of Open Access Journals (Sweden)

    K Biniyam

    2014-01-01

    Full Text Available Mucormycosis is a fungal infection, commonly affecting the paranasal sinuses. An aggressive invasive form of infection is common in people with uncontrolled diabetes and in immunocompromised people. Mucormycosis affecting temporal bone is a rare entity, most of the reported cases are of invasive disease in diabetic people. We report a case of mucormycosis of middle ear cavity which was found incidentally in a healthy nondiabetic woman while performing revision tympanoplasty for chronic suppurative otitis media.

  16. Relevance of Pure Tone Average (PTA) as a Predictor for Incus Erosion

    OpenAIRE

    Mohanty, Sanjeev; Gopinath, M.; Subramanian, Mukundan; Vijayan, Nisha

    2011-01-01

    Between 40 and 90% of tympanoplasty require middle ear ossicular chain reconstruction. Ossicular discontinuity usually cannot be determined unless an operation is performed. The main objective was to determine the predictive value of pre-operative audiological factors in diagnosing incudal necrosis in patients with tubotympanic chronic suppurative otitis media. A retrospective clinical study of 20 patients who underwent ossicular reconstruction with autologous incus over a period of two years...

  17. Virulence phenotypes of low-passage clinical isolates of Nontypeable Haemophilus influenzae assessed using the chinchilla laniger model of otitis media

    Directory of Open Access Journals (Sweden)

    Hogg Justin

    2007-06-01

    Full Text Available Abstract Background The nontypeable Haemophilus influenzae (NTHi are associated with a spectrum of respiratory mucosal infections including: acute otitis media (AOM; chronic otitis media with effusion (COME; otorrhea; locally invasive diseases such as mastoiditis; as well as a range of systemic disease states, suggesting a wide range of virulence phenotypes. Genomic studies have demonstrated that each clinical strain contains a unique genic distribution from a population-based supragenome, the distributed genome hypothesis. These diverse clinical and genotypic findings suggest that each NTHi strain possesses a unique set of virulence factors that contributes to the course of the disease. Results The local and systemic virulence patterns of ten genomically characterized low-passage clinical NTHi strains (PittAA – PittJJ obtained from children with COME or otorrhea were stratified using the chinchilla model of otitis media (OM. Each isolate was used to bilaterally inoculate six animals and thereafter clinical assessments were carried out daily for 8 days by blinded observers. There was no statistical difference in the time it took for any of the 10 NTHi strains to induce otologic (local disease with respect to any or all of the other strains, however the differences in time to maximal local disease and the severity of local disease were both significant between the strains. Parameters of systemic disease indicated that the strains were not all equivalent: time to development of the systemic disease, maximal systemic scores and mortality were all statistically different among the strains. PittGG induced 100% mortality while PittBB, PittCC, and PittEE produced no mortality. Overall Pitt GG, PittII, and Pitt FF produced the most rapid and most severe local and systemic disease. A post hoc determination of the clinical origins of the 10 NTHi strains revealed that these three strains were of otorrheic origin, whereas the other 7 were from patients

  18. Polymerase Chain Reaction, Bacteriologic Detection and Antibiogram of Bacteria Isolated from Otitis Media with Effusion in Children, Shiraz, Iran

    OpenAIRE

    Mahmood Shishegar; Abolhasan Faramarzi; Tayyebe Kazemi; Akbar Bayat; Mohammad Motamedifar

    2011-01-01

    Background: Otitis media with effusion is one of the leading causes of hearing loss in children. Effective treatment of effusion in the middle ear requires appropriate empirical treatment and characterization of responsible pathogens. Objective of the present study was to detect pathogens in clinical samples from patients with otitis media with effusion in our area and to determine the sensitivity profile of isolated organisms to commonly used antibiotics. Methods: Sixty three samples of midd...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  20. 急性化脓性骨髓炎患者的临床治疗体会%Clinical Experience in Treating Patients with Acute Suppurative Osteomyelitis

    Institute of Scientific and Technical Information of China (English)

    崔巍

    2013-01-01

    Objective:To investigate the clinical curative effect observation of acute suppurative osteomyelitis. Methods:from 2010 January ~2012 year in April 40 cases of acute suppurative osteomyelitis patients, early diagnosis, prompt treatment, active control and prevent the spread of inflammation, and can also be partial trephination and drainage or open window decompression operation treatment. Results:after treatment and drainage flushing, all patients were 3~ 4 weeks after operation were cured.Conclusions: acute suppurative osteomyelitis in the early stage of poisoning symptoms, should take seriously highly, for early treatment. The treatment process should pay attention to the protection of limb, prevent pathologic fracture, complications such as sepsis.%  目的:探讨急性化脓性骨髓炎临床疗效观察。方法:选取2010年1月~2012年4月收治的40例急性化脓性骨髓炎患者临床,早期诊断、及时治疗,积极控制并防止炎症扩散,也可以局部钻孔引流或开窗减压等手术治疗。结果:经治疗及引流冲洗,所有患者均术后3~4周治愈出院。结论:急性化脓性骨髓炎在早期即有中毒症状,应高度重视,争取早期治疗。治疗过程中还要注意保护患肢,预防病理性骨折、败血症等并发症。

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

    Directory of Open Access Journals (Sweden)

    Taketo Otsuka

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

  2. CORRELATING THE SITE OF TYMPANIC MEMBRANE PERFORATION WITH HEARING LOSS

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    Priya

    2015-10-01

    Full Text Available AIMS AND OBJECTIVES: To study the various sites of perforation in patients with chronic suppurative otitis media (CSOM - Safe type and to study the relationship of the perforator quadrant with the degree of hearing loss. MATERIALS AND METHODS: Cross sectional prospective study conducted between June 2014 - June 2015 in the department of ENT; 103 ears of 88 patients wit h tympanic membrane perforation – chronic suppurative otitis media ( S afe type at Chettinad hospital and research institute; Chennai . RESULTS: The sites/locations of perforations on the tympanic membrane were correlated with their mea nhearing levels (dB using chi - square test. Out of 103 perforated tympanic membranes, 29 had all four quadrant perforation (28.16%. Out of these 29 patients 7 had severe conductive hearing loss (24% and 16 had moderate conductive hearing loss (55% . CONC LUSION: The location of perforation on the tympanic membrane has effect on the magnitude of hearing loss. It has a significant impact in chronic suppurative otitis media

  3. Primer reporte de aislamiento de Staphylococcus schleiferi subespecie coagulans en perros con pioderma y otitis externa en Chile First report of isolation of Staphylococcus schleiferi subspecies coagulans from dogs with pyoderma and external otitis in Chile

    Directory of Open Access Journals (Sweden)

    L Muñoz

    2012-01-01

    Full Text Available Staphylococcus schleiferi subesp. coagulans fue identificado y descrito por primera vez por Igimi y col (1990 en perros con otitis. El objetivo de este reporte fue determinar la frecuencia de aislamiento de S. schleiferi subesp. coagulans en muestras de perros con pioderma y/u otitis externa en Chile y establecer los perfiles de resistencia frente a antimicrobianos de uso habitual y caracterizar molecularmente la resistencia a quinolonas. Se obtuvieron muestras de 237 caninos adultos diagnosticados con pioderma y/u otitis externa, en el Hospital Veterinario de la Universidad de Chile. La identificación de Staphylococcus schleiferi subesp. coagulans se realizó con BBL™ Crystal GP. La concentración mínima inhibitoria se determinó mediante el método de dilución en agar. El panel de antimicrobianos utilizado fue oxacilina, amoxicilina, cefradina, mupirocina, clindamicina, enrofloxacino, doxiciclina, tetraciclina, kanamicina y sulfametoxazol / trimetoprim. De 237 muestras analizadas, 135 fueron aisladas de pioderma y 102 de otitis. Staphylococcus spp. se identificó en 117 y 52 de las muestras respectivamente. S. schleiferi subesp. coagulans se identificó en 8 cepas aisladas desde pioderma (6,8% y en 11 cepas de otitis (21,2%. Todas las cepas de S. schleiferi subesp. coagulans de pioderma y el 54,5% de otitis resultaron sensibles a todos los antimicrobianos. La susceptibilidad fue de un 90,9% mupirocina, enrofloxacino y sulfametoxazol/trimetoprim; 81,8% a amoxicilina y kanamicina y el 72,7% a clindamicina. Solo una cepa aislada de otitis presentó multirresistencia. La cepa de Staphylococcus schleiferi subesp. coagulans que evidenció resistencia fenotípica a quinolonas presentó mutación en los genes gyrA y grlA.Staphylococcus schleiferi subsp. coagulans was identified and described for the first time in 1990 by Igimi et al (1990 in dogs with otitis. The objective of this report was to determine the frequency of isolation of S

  4. ROLE OF HIGH RESOLUTION COMPUTED TOMOGRAPHY IN THE EVALUATION OF SUPPURATIVE DISEASES OF MIDDLE EAR AND MASTOIDS AND THEIR COMPLICATIONS WITH SURGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Deb Kr

    2016-02-01

    Full Text Available OBJECTIVE High Resolution Computed Tomography (HRCT, a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the suppurative diseases of middle ear and mastoid with their complications on HRCT and to correlate these imaging findings surgically. Our study shows good correlation of various HRCT findings in suppurative diseases of middle ear & mastoids with intra-operative findings. MATERIALS AND METHODS This retrospective study included 60 patients who were referred to the Department of Radiodiagnosis, Assam Medical College with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to HRCT examination. The imaging findings of all cases were correlated with the surgical findings. RESULTS Out of 60 patients, 63.3% had unsafe CSOM with cholesteatoma. The HRCT findings with surgical correlation showed a high 91.89% sensitivity for identifying cholesteatoma. HRCT also provided good sensitivity for detecting erosion of scutum (90.32%, erosion of ossicular chain (86.96% and erosion of lateral semi-circular canal (80%. HRCT had lower sensitivity (66.67% for identifying facial canal dehiscence. CONCLUSION The HRCT findings showed a good sensitivity with intraoperative findings in identification of cholesteatoma, erosion of scutum, ossicular chain and semi-circular canal.

  5. Comparative study of the microbial profile from bilateral canine otitis externa.

    Science.gov (United States)

    Oliveira, Lis C; Leite, Carlos A L; Brilhante, Raimunda S N; Carvalho, Cibele B M

    2008-08-01

    Fifty dogs with bilateral otitis externa were studied over a 10-month period. The exudates of both external ears were obtained, using sterile swabs, and microorganisms were isolated according to standard microbiological techniques. Antimicrobial susceptibility testing of Staphylococcus intermedius was done by the agar diffusion method. There was bacterial and/or fungal growth in all of the samples. These were all polymicrobial infections. Anaerobic bacteria were not isolated in any sample. The most common pathogens isolated were S. intermedius and Malassezia pachydermatis. A statistically significant difference (P intermedius strains to penicillin, ampicillin, erythromycin, tetracycline, and clindamycin were found. The results suggest that in bilateral canine otitis externa, each ear should be cultured separately and considered as separate units.

  6. Gentamicin iontophoresis in the treatment of bacterial otitis externa in the guinea pig model.

    Science.gov (United States)

    King, D M; Estrem, S A

    1990-10-01

    Pseudomonas otitis externa is one of the most common infections treated by otolaryngologists. Infections induced in 30 guinea pigs appeared similar to that seen in humans. The ears were then placed into four treatment groups: group A, which received a single cleaning; group B, which received a single cleaning followed by gentamicin drops 4 times daily; group C, which received a single cleaning followed by a single gentamicin iontophoresis treatment; and group D, the control group, which received no treatment. Infections were analyzed by grading edema, purulence, and erythema. An average of 10.2 days was required for control group to return to normal appearance. Groups A, B, and C had mean resolution times of 5.9, 4.7, and 4.3 days, respectively. Gentamicin iontophoresis appears to be promising, with results as good as drop therapy in otitis externa in the guinea pig model. PMID:2215045

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated...... with different factors like insertion of VT and use of antibiotics. OBJECTIVE: We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental...... was significantly improved after 13 months. The improvement of HRQOL was significantly lower for children with sleep problems compared with children without sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work during the preceding 3 months due...

  8. Comparing Cerumen Bacterial Flora in Acute Otitis Externa Patients and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Keyvan Kiakojori

    2010-07-01

    Full Text Available Introduction: In spite of the fact that acute otitis media is a systemic and symptomatic disease with sever otalgia, otitis media with effusion (OME is an asymptomatic and silent disease. OME is the most common cause of conductive hearing loss in children and has adverse effects on speech development and cognitive skills. Results: Among 1001 children under study, 57 subjects (5.7% were diagnosed with OME, more than 50% of which were asymptomatic. Periodic otalgia and turning up television volume were the most common symptoms. Conclusion: Regarding the improved knowledge on diagnosis and treatment of OME especially in younger children, hearing problems or cognitive and linguistic skills retardation may be avoided by promoting general information.

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

    Science.gov (United States)

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

    1994-06-01

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

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

    Science.gov (United States)

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

    2007-02-01

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

  11. Comparative study of the microbial profile from bilateral canine otitis externa

    OpenAIRE

    Oliveira, Lis C.; Leite, Carlos A.L.; Raimunda S.N. Brilhante; Carvalho, Cibele B. M.

    2008-01-01

    Fifty dogs with bilateral otitis externa were studied over a 10-month period. The exudates of both external ears were obtained, using sterile swabs, and microorganisms were isolated according to standard microbiological techniques. Antimicrobial susceptibility testing of Staphylococcus intermedius was done by the agar diffusion method. There was bacterial and/or fungal growth in all of the samples. These were all polymicrobial infections. Anaerobic bacteria were not isolated in any sample. Th...

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Herbal medicines for the treatment of acute otitis media: protocol for a systematic review

    OpenAIRE

    Son, Mi Ju; Kim, Yun Hee; Kim, Young-Eun; Lee, Hye Won; Lee, Myeong Soo

    2013-01-01

    Introduction The aim of this systematic review is to analyse the trial data on the efficacy of herbal medicines for acute otitis media. Methods and analysis The following 11 databases will be searched from their inception: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Allied and Complementary Medicine Database (AMED), the Cochrane Central Register of Controlled Trials (CENTRAL), China Network Knowledge Infrastructure (CNKI) and five Korean databases (...

  14. Complications of acute otitis media in children: case reports and review of literature.

    Science.gov (United States)

    Adhami, Maya; Tohme, Souheil

    2010-01-01

    This is a report of three cases of complications of acute otitis media. The first case describes coalescent mastoiditis seen in a ten-month-old infant, the second case is petrositis, sigmoid sinus thrombosis and otitic hydrocephalus seen in a five-year-old child and the third case is an extradural abscess encountered in a three-year-old child. The assessment, diagnosis and treatment of each case are illustrated and discussed. PMID:21409946

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

    Directory of Open Access Journals (Sweden)

    Ejikeugwu Chika

    2013-01-01

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

  16. Update on acute otitis media in children younger than 2 years of age

    OpenAIRE

    McWilliams, Colin J.; Goldman, Ran D.

    2011-01-01

    Question As concern about antimicrobial resistance grows, I am aware of the need to reduce unnecessary antibiotic treatment; however, in my practice I see many children with acute otitis media (AOM) and this is the most common reason I prescribe antibiotics. Most of these children are young and otherwise healthy, and I am uncertain about when to prescribe antibiotics and when to endorse “watchful waiting.” Which children will benefit from antibiotic treatment?

  17. Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children

    OpenAIRE

    Xu, Qingfu; Pichichero, Michael E.; Casey, Janet R.; Zeng, Mingtao

    2009-01-01

    After our recent discovery of a Streptococcus pneumoniae 19A “superbug” (Legacy strain) that is resistant to all Food and Drug Administration–approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) ...

  18. Microbiological effects and clinical use of xylitol in preventing acute otitis media

    OpenAIRE

    Tapiainen, T. (Terhi)

    2002-01-01

    Abstract The purpose was to evaluate the microbiological mechanism of action of xylitol and to assess its use in clinical practice for preventing acute otitis media (AOM). To test whether the effect of xylitol on S. pneumoniae is inhibited by fructose, a total of 20 strains of S. pneumoniae were exposed to xylitol in the presence of fructose and other carbon sources. Addition of 5% xylitol to the media resulted in marked growth inhibition, an effect which was totally el...

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

    OpenAIRE

    PEREIRA, Agnes de Fátima Faustino; Silva, Thiago Cruvinel da; CALDANA, Magali de Lourdes; Machado, Maria Aparecida Andrade Moreira; Marilia Afonso Rabelo BUZALAF

    2009-01-01

    Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM). Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles s...

  20. Experimental acute otitis media : aspects on treatment, protection and structural changes

    OpenAIRE

    Westman, Eva

    2003-01-01

    Acute otitis media (AOM) is a common disease in childhood and is one of the most common causes for outpatient antibiotic treatment. The major aetiological agents of AOM have varied over the decades. Now the three most common pathogens are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The resistance patterns of these organisms have also varied from the beginning of the antibiotic era to the situation we have today with an increasing incidence of penicillin-resista...

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

    Science.gov (United States)

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

    2010-01-01

    Purpose: The aim of the present study was to examine the long-term consequences of early-life otitis media (OM) and the associated hearing loss (HL) on language skills of school-aged children. Method: In a prospective study, the middle-ear status of 65 Dutch healthy-born children was documented every 3 months during their first 2 years of life;…

  2. Prevalence of otitis media with effusion in children with bilateral sensorineural hearing loss.

    OpenAIRE

    Das, V K

    1990-01-01

    A cohort of 164 children born within the defined boundaries of greater Manchester during the years 1981 to 1984 inclusive were identified as having bilateral sensorineural hearing loss, giving a prevalence of 1.2/1000 population of 1/817 births. Ninety three children developed an additional conductive hearing loss secondary to otitis media with effusion lasting more than three months and 39 of these (42%) required surgical treatment. Those with congenital infections, adverse perinatal factors...

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Arola, M; Ziegler, T; Ruuskanen, O

    1990-05-01

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

  6. 婴幼儿分泌性中耳炎早期诊断及手术干预%The Early Diagnosis and Surgical Intervention for Secretory Otitis Media in Infants

    Institute of Scientific and Technical Information of China (English)

    王素芳; 韩富根; 僧东杰; 王燕楠

    2014-01-01

    ,distortion products OAE and temporal bone CT. The average hearing threshold of surgical intervention group was significantly lower than that of the observation group. The incidence of acute otitis media in one year was significantly lower than that of the observation group. Conclusion The surgical intervention can help to alleviate the hearing loss of chronic secretory otitis media in infants and can reduce the incidence of acute otitis media.

  7. Effect of successive irrigation of subarachnoid cavity on body temperature and cerebrospinal fluid-related index in suppurative meningitis model dogs

    Institute of Scientific and Technical Information of China (English)

    Yong Liu; Guohou He; Yuanyuan Wang; Xueqiang Chen; Qibin Wang

    2006-01-01

    BACKGROUND: At present, suppurative meningitis is mainly treated through anti-infection with antibiotics, depressing encephalic pressure with mannitol , lowering body temperature with drugs, supporting treatment,etc. However, it takes a long course of treatment and has poor therapeutic effect. Successive irrigation of subarachnoid cavity maybe have better effect on suppurative meningitis.OBJECTIVE: We compared the successive irrigation of subbarachnoid cavity with routine therapeutic methods to observe the effect of successive irrigation of subarachnoid cavity on the body temperature, cerebrospinal fluid pressure, the number of white blood cell and the level of protein of suppurative meningitis dogs.DESIGN: A randomized and controlled animal experiment.SETTING: Institute of Neuroscience, Taihe Hospital Affiliated to Yunyang Medical College.MATERIALS: Totally 17 healthy adult male Beagle dogs, of common grade, weighing 9 to 10 kg, were involved in the experiment, and raised in the 20 ℃ temperature with relative humidity of 50% for 1 week.They were randomized into 3 groups: normal group (n=5), control group (n=5) and irrigation group (n=6).Artificial cerebrospinal fluid was prepared according to the level of glucose and chloride of cerebrospinal fluid of normal dogs, and then it was sterilized with high pressure.METHODS: This experiment was carried out in the experimental animal center of Yunyang Medical College from April to August 2001.① After the dogs were anesthetized,1 mL fresh staphylococcus aureus liquid [(1.5-1.6) ×109 L-1] was injected into medullary cistern to establish suppurative meningitis models.② After models were successfully established, intravenous drip infusion of 1.2 ×106 U/(kg.d), muscular injection of sulday were performed in the control group. The irrigation of subarachnoid meningitis was conducted in the irrigation group besides the routine treatments in the control group: Artificial cerebrospinal fluid was successively injected into

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

    Directory of Open Access Journals (Sweden)

    Jørund Straand

    2009-11-01

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

  9. 阿奇霉素治疗化脓性扁桃体炎的临床研究%Clinical Study on Azithromycin in Treatment of Suppurative Tonsillitis

    Institute of Scientific and Technical Information of China (English)

    崔佳菲

    2016-01-01

    Objective Clinical effect of azithromycin in treatment of suppurative tonsil itis is to be studied. Methods Chose 122 patients of suppurative tonsil itis who were treated in hospital from May 2013 to February 2015and separated them into control group(60 patients)and study group(62 patients)at random that were given penicil in sodium treatment and azithromycin treatment respectively,and then observed and compared treatment effects between two groups. Results Patients’body-temperature recovery time,pus embolus eliminated time,their sore-throat relieved time and tonsil inflammation disappeared time in study group were much shorter than counterparts in control group,besides,treatment efficacy in study group was much higher than that in control group[91.94% vs 71.67%],there was a differential between two groups and such a differential had statistic value(P < 0.05). Conclusion Azithromycin is effective in treatment of suppurative tonsil itis,it is conducive to relieving patients’symptoms and having them recovered quickly.%目的:对化脓性扁桃体炎患者应用阿奇霉素治疗的临床效果进行分析研究。方法选取于2013年5月~2015年2月在我院接受治疗的化脓性扁桃体炎患者122例,并随机分为对照组(60例)和实验组(62例),对分别应用青霉素钠和阿奇霉素的疗效进行观察并比较。结果实验组患者的体温恢复时间、脓栓消除时间、咽痛缓解时间以及扁桃体红肿消除时间均短于对照组,治疗总有效率高于对照组[91.94% vs 71.67%],组间差异经 t 检验,有统计学意义(P <0.05)。结论化脓性扁桃体炎患者应用阿奇霉素治疗的临床效果十分满意,对促进患者临床症状的缓解以及病情恢复具有至关重要的作用。

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

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    DEFF Research Database (Denmark)

    Brygge, K; Sørensen, C H; Colding, H;

    1998-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gilberto Eduardo Marrugo Pardo

    2005-10-01

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

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

    OpenAIRE

    Gilberto Eduardo Marrugo Pardo; Diana Lucía Gómez Rodríguez

    2005-01-01

    Antecedentes: las consecuencias de la otitis media con efusión crónica en la audición, en el desarrollo cognitivo, lingüístico y de habilidades comunicativas son las principales razones a considerar para la búsqueda, diagnóstico y tratamiento adecuado de esta patología en los niños. Objetivo: comparar el rendimiento operativo de la neumatoscopia e impedanciometria como métodos diagnósticos de la efusión del oído medio. Material y métodos: estudio de pruebas diagnósticas, recolección prospecti...

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

    Directory of Open Access Journals (Sweden)

    Sonia Grisales

    1992-01-01

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

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

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

    Science.gov (United States)

    Esposito, Silvano; Novelli, Andrea; Noviello, Silvana

    2005-06-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  18. Maxillary Chronic Osteomyelitis Caused by Domestic Violence: A Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Tamyris Inácio Oliveira

    2014-01-01

    Full Text Available Maxillary osteomyelitis is a rare condition defined as inflammation of the bone primarily caused by odontogenic bacteria, with trauma being the second leading cause. The present report documents a rare case of maxillary osteomyelitis in a 38-year-old female who was the victim of domestic violence approximately a year prior to presentation. Intraoral examination revealed a lesion appearing as exposed bony sequestrum, with significant destruction of gingiva and alveolar mucosa in the maxillary right quadrant, accompanied by significant pain, local edema, and continued purulence. Teeth numbers 11, 12, 13, 14, and 15 were mobile, not responsive to percussion, and nonvital. Treatment included antibiotic therapy for seven days followed by total enucleation of the necrotic bone tissue and extraction of the involved teeth. Microscopic findings confirmed the clinical diagnosis of chronic suppurative osteomyelitis. Six months postoperatively, the treated area presented complete healing and there was no sign of recurrence of the lesion.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    years of age. Cognitive function was measured by the Boerge Prien validated group intelligence test (Danish Børge Prien Prøve, BPP). We adjusted for potential confounders with and without stratification by hearing impairment. Furthermore, we examined the association between hospitalisation with OM......BACKGROUND: Otitis media (OM) is a very common condition in children and occurs during years that are critical to the development of learning, literacy, and math skills. Therefore, among a large cohort of Danish conscripts, we aimed to examine the association between hospitalisation with OM...

  20. Radiographic appearance of the middle ear after ventral bulla osteotomy in five dogs with otitis media

    International Nuclear Information System (INIS)

    Radiographs of the middle ear were made in five dogs 60 to 78 months after ventral bulla osteotomy was performed to treat otitis media. The clinical results of surgery were considered satisfactory in four dogs and unsatisfactory in one. In 4 dogs with satisfactory results, radiographs demonstrated complete reformation of the bulla in 3 operated middle ears (3 dogs), with partial bulla reformation in the three middle ears (3 dogs). Radiographs in one dog with unsatisfactory results showed complete bulla reformation with no increase in lumen opacity. The proliferative bony response obliterating the middle ear previously reported in normal dogs after ventral bulla osteotomy was not seen in any of these patients

  1. Nuclear scanning in necrotizing progressive ''malignant'' external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Parisier, S.C.; Lucente, F.E.; Som, P.M.; Hirschman, S.Z.; Arnold, L.M.; Roffman, J.D.

    1982-09-01

    The usefulness of radionuclear scanning in the treatment of 18 patients with necrotizing progressive ''malignant'' external otitis is discussed. A Tc 99-m bone scan, a valuable test since results are positive in early cases of osteomyelitis of the temporal bone and base of skull, showed increased uptake in all 18 patients. In 6 patients, Ga-67 citrate scans were obtained at the start of therapy and at 5-6 week intervals thereafter. The serial gallium scans were useful in evaluating the effectiveness of therapy since the uptake decrease with control of infection.

  2. Peripheral facial paralysis as a complication of a secretory otitis in children, a case report

    Directory of Open Access Journals (Sweden)

    Macías-Rodríguez DH, Batuecas-Caletrío A, Martín-Hernández R, Cordero-Civantos C, Sánchez-Blanco C, Yáñez-González R.

    2012-10-01

    Full Text Available There are different reports in the literature about the complications of Secretory Otitis (SO in childhood but few of them relating to peripheral facial paralysis (PFP. We describe a case of PFP secondary to an ipsilateral SO in a child under 2 years old admitted to our service. The patient was treated with medical treatment and surgical transtympanic tube placement with subsequent resolution of the process and favorable outcome. We report the symptoms, physical examination findings, laboratory tests, management and evolution, performing a literature review.

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

    Institute of Scientific and Technical Information of China (English)

    Paul O Dienye; Geraldine U Ndukwu

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-01-01

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

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

    Science.gov (United States)

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

    2004-01-01

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

  6. Incidence of Otitis Media in a Contemporary Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Todberg, Tanja; Koch, Anders; Andersson, Mikael;

    2014-01-01

    OBJECTIVES: In recent years welfare in Denmark has increased which might be expected to reduce otitis media (OM) incidence. We examined the age-specific incidence of OM in a nation-wide cohort of children aged 0-7 years born in 1996-2003 (Danish National Birth Cohort, DNBC). Only selection...... recordings in the Danish National Patient Registry to be gold standard, maternal self-reportings in DNBC of insertion of VT showed high sensitivity (96.4%), specificity (98.2%), and positive (94.8%) and negative predictive values (98.8%). CONCLUSION: OM affects nearly 2/3 of preschool children in Denmark...

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

    Science.gov (United States)

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

    2015-09-01

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

  8. Hearing gain in different types of tympanoplasties

    Directory of Open Access Journals (Sweden)

    Sachin Gupta

    2013-01-01

    Full Text Available Aims: The aim of the present study was to find out the hearing improvement in different types of tympanoplasties. Settings and Design: Prospective, hospital-based. Subjects and Methods : A total of 50 patients were included who were 12 years old and above, of both sexes with conductive hearing loss due chronic otitis media with or without perforation. Results: The ratio of males (28 was more as compared with females (22. Maximum number of patients belonged to the age group of 10-20 years (34%, followed by 20-30 years (30%, whereas least number of cases was found in the age group of > 50 years. Hearing loss and otorrhea were present in majority of the cases (100% and 72%, respectively. A total of 18 of the cases had cholesteatomatous chronic suppurative otitis media, while 32 ears were observed to be noncholesteatomatous chronic suppurative otitis media. The average preoperative air conduction (AC in the present study was found to be 46.6 dB ranging from 20 dB to 112.5 dB, while the average postoperative AC was found to be 39 dB with an average gain of 7.6 dB. The four frequency average preoperative and postoperative air-bone gap (ABG were found to be 26.48 dB and 20.17 dB respectively, with the average gain of 6.3 dB. The average ABG closure within 0-30 dB was seen in 33 (82% of the cases. Social hearing was achieved in 86% of the cases in type I, 46% in type II, and 40% in type III tympanoplasty. Conclusions: Tympanoplasty as a procedure when indicated without compromising for the disease, can be effectively used to improve hearing in chronic suppurative otitis media, and other types of conductive hearing losses.

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Acute postsurgical suppurative parotitis: current prevalence at Hospital das Clínicas, São Paulo University Medical School Parotidite aguda pós-cirúgica: prevalência atual no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

    Directory of Open Access Journals (Sweden)

    Sergio Quilici Belczak

    2008-10-01

    Full Text Available Postsurgical acute suppurative parotitis is a bacterial gland infection that occurs from a few days up to some weeks after abdominal surgical procedures. In this study, the authors analyze the prevalence of this complication in Hospital das Clínicas/São Paulo University Medical School by prospectively reviewing the charts of patients who underwent surgeries performed by the gastroenterological and general surgery staff from 1980 to 2005. Diagnosis of parotitis or sialoadenitis was analyzed. Sialolithiasis and chronic parotitis previous to hospitalization were exclusion criteria. In a total of 100,679 surgeries, 256 patients were diagnosed with parotitis or sialoadenitis. Nevertheless, only three cases of acute postsurgical suppurative parotitis associated with the surgery were identified giving an incidence of 0.0028%. All patients presented with risk factors such as malnutrition, immunosuppression, prolonged immobilization and dehydration. In the past, acute postsurgical suppurative parotitis was a relatively common complication after major abdominal surgeries. Its incidence decreased as a consequence of the improvement of perioperative antibiotic therapy and postoperative support. In spite of the current low incidence, we believe it is important to identify risks and diagnose as quick as possible, in order to introduce prompt and appropriate therapeutic measures and avoid potentially fatal complications with the evolution of the disease.A parotidite supurativa pós-cirúrgica é infecção bacteriana da glândula que ocorre poucos dias até algumas semanas após procedimento cirúrgico. Os autores analisam a prevalência desta complicação cirúrgica nos últimos 25 anos do Hospital das Clínicas de São Paulo. Foram analisados os prontuários das cirurgias realizadas pelos serviços de Cirurgia do Aparelho Digestivo e Cirurgia Geral da Faculdade de Medicina da Universidade de São Paulo no período de 1980 a 2005, num total de 106790

  11. Estimated cost-effectiveness of active middle-ear implantation in hearing-impaired patients with severe external otitis.

    NARCIS (Netherlands)

    Snik, A.F.M.; Duijnhoven, N.T.L.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2006-01-01

    OBJECTIVE: To determine the cost-effectiveness of middle-ear implantations in hearing-impaired patients with severe external otitis in the Netherlands. DESIGN: Cost-effectiveness analysis, using single-subject repeated measures of quality of life and total cost determinations. SETTING: Hospital base

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    OpenAIRE

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

    1982-01-01

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

  15. The effect of otitis media in childhood on the development of middle ear admittance on reaching adulthood.

    NARCIS (Netherlands)

    Beer, B.A. de; Snik, A.F.M.; Schilder, A.G.M.; Graamans, K.; Zielhuis, G.A.

    2005-01-01

    OBJECTIVES: To determine the long-term change in static admittance values of subjects with a positive or negative history of otitis media (OM) and ventilation tube (VT) insertion; and to investigate the association between static admittance values and tympanic membrane abnormalities. DESIGN: Prospec

  16. Natural course of tympanic membrane pathology related to otitis media and ventilation tubes between ages 8 and 18 years.

    NARCIS (Netherlands)

    Beer, B.A. de; Schilder, A.G.M.; Zielhuis, G.A.; Graamans, K.

    2005-01-01

    OBJECTIVE: To present the course of tympanic membrane pathology in childhood and young adulthood after otitis media (OM) in early life. STUDY DESIGN: Prospective follow-up study. SETTING: Community study of a birth cohort. PATIENTS: Three hundred fifty-eight subjects with a positive and negative his

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  18. In vitro evaluation of the synergistic activity of neomycin-polymyxin B association against pathogens responsible for otitis externa.

    Science.gov (United States)

    Tempera, G; Mangiafico, A; Genovese, C; Giudice, E; Mastrojeni, S; Nicolosi, D; Ferneri, P M

    2009-01-01

    The most recent guidelines recommend, for otitis externa antibiotic therapy, the use of topical formulations in that they are very safe, have a quicker effect and do not induce bacterial resistance compared to systemic therapy. The choice of the class of antibiotics in empiric therapy of otitis externa must take into consideration the polymicrobic nature of the infection that includes both bacteria (Grampositive and Gram-negative) and mycetes. For this reason, in this study we evaluated the synergic activity of neomycin in association with polymyxin B against the pathogens commonly responsible for otitis externa, compared to that of a single antibiotic (ciprofloxacin). The polymyxinB/neomycin association shows clear synergic effects with values of both Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) reduced by 3-4 times with respect to the single antibiotic; and in P. aeruginosa the synergistic effect of the neomycin/polymyxin B association with respect to neomycin was more evident (5-6 times), with an intrinsic in vitro activity constantly higher than that of ciprofloxacin alone or in association with hydrocortisone. From the analysis of the data obtained in vitro, we can conclude that the possibility of using a topical formulation containing a synergistic association of antibiotics, such as neomycin-polymyxin B, in such a way as to obtain the maximum effect in the minimum time with an increase in the spectrum of action of non-bacterial pathogens, is an optimal choice for the clinician for the empiric therapy of otitis externa.

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gambler Angela S

    2009-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2015-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1982-06-10

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

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

    Science.gov (United States)

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

    2014-04-01

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

  9. Temporal Bone Osteomyelitis: The Relationship with Malignant Otitis Externa, the Diagnostic Dilemma, and Changing Trends

    Directory of Open Access Journals (Sweden)

    Jia-Cheng Chen

    2014-01-01

    Full Text Available Fifty-five patients hospitalized for osteomyelitis of the temporal bone between 1990 and 2011 were divided into two study groups: group 1 was patients collected from 1990 to 2001 and group 2 was composed of patients between 2002 and 2011. Clinical diagnostic criteria and epidemiologic data were analyzed to illustrate the altering features of osteomyelitis of the temporal bone. Group 1 patients were characterized by high prevalence of diabetes and more commonly suffered from otalgia, otitis externa and granulation tissue in the external auditory canal and higher positive culture for Pseudomonas aeruginosa. Noticeable changing trends were found between both groups, including declining prevalence of diabetes, fewer patients complaining of pain or presenting with otitis externa, and canal granulation, and increased variety of pathogens in group 2. We should highlight the index of clinical suspicion for osteomyelitis of the temporal bone, even in nondiabetic or immunocompetent patients. Painless otorrhea patients were also at risk of osteomyelitis of the temporal bone, especially patients with previous otologic operation. Increased multiplicity of pathogens amplified the difficulty of diagnosis for osteomyelitis of the temporal bone.

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

    Science.gov (United States)

    McCracken, George H

    2002-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Avinash

    2014-06-01

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

  12. Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion.

    Science.gov (United States)

    Nourizadeh, Navid; Ghazvini, Kiarash; Gharavi, Vahideh; Nourizadeh, Niloufar; Movahed, Rahman

    2016-04-01

    Acute otitis media and otitis media with effusion (OME) are the main causes of hearing impairment in children which require proper treatment, mainly antibiotic therapy. Patients whom were appropriate candidates for adenoidectomy were divided into two groups regarding the presence of middle ear effusion. Adenoid tissue specimens were cultured in both groups and the bacterial flora and anti-microbial resistance pattern were determined. 72 patients were studied, 42 % had OME while 58 % did not. The following bacteria were isolated and cultured from both groups with no meaningful difference in prevalence: Streptococcus viridans (p = 0.265), Staphylococcus aureus (p = 0.72), H. influenza (p = 0.806), Entrococcus. spp (0.391), Streptococcus pneumonia (p = 0.391), nonhemolytic Streptococcus (p = 0.230). Bacterial sensitivity was similar for Amoxicillin-clavulanate (p = 0.935), Amoxicillin (p = 0.935), Cephalexin (p = 0.806), Cefixime (p = 0.391) and Azithromycin in both groups. The two groups showed no meaningful difference considering the bacterial flora of nasopharynx and their sensitivity. Bacteria in both groups were sensitive to Amoxicillin and Amoxicillin-clavulanate and resistant to Azithromycin, Cefixime and Cephalexin. PMID:25929414

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

    Directory of Open Access Journals (Sweden)

    Pereira, Agnes de Fátima Faustino

    2009-03-01

    Full Text Available Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM. Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles selected by means of the medical databases: MEDLINE, Cochrane, PubMed (MeSH and Web of Science. Results: Studies have demonstrated the efficacy of xylitol to prevent the AOM, when it is administered five times a day in chewing gum. However, this sugar is not so effective in the prevention of AOM during upper airways infections. Final Comments: Xylitol seems to be an effective strategy in prevention of acute otitis media. However, new studies are necessary to establish ideal doses, frequencies and vehicles for the correct administration of the sugar, which allows for its utilization in the public health system.

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

    Science.gov (United States)

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

    1997-01-01

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

  15. A Suspicious Pancreatic Mass in Chronic Pancreatitis: Pancreatic Actinomycosis

    Directory of Open Access Journals (Sweden)

    F. de Clerck

    2015-01-01

    Full Text Available Introduction. Pancreatic actinomycosis is a chronic infection of the pancreas caused by the suppurative Gram-positive bacterium Actinomyces. It has mostly been described in patients following repeated main pancreatic duct stenting in the context of chronic pancreatitis or following pancreatic surgery. This type of pancreatitis is often erroneously interpreted as pancreatic malignancy due to the specific invasive characteristics of Actinomyces. Case. A 64-year-old male with a history of chronic pancreatitis and repeated main pancreatic duct stenting presented with weight loss, fever, night sweats, and abdominal pain. CT imaging revealed a mass in the pancreatic tail, invading the surrounding tissue and resulting in splenic vein thrombosis. Resectable pancreatic cancer was suspected, and pancreatic tail resection was performed. Postoperative findings revealed pancreatic actinomycosis instead of neoplasia. Conclusion. Pancreatic actinomycosis is a rare type of infectious pancreatitis that should be included in the differential diagnosis when a pancreatic mass is discovered in a patient with chronic pancreatitis and prior main pancreatic duct stenting. Our case emphasizes the importance of pursuing a histomorphological confirmation.

  16. Risk Factors for Refractory Secretory Otitis Media%难治性分泌性中耳炎危险因素分析

    Institute of Scientific and Technical Information of China (English)

    冯晓华; 龙孝斌; 汪建; 陈勇挺

    2013-01-01

    Objective To identify the risk factors of refractory secretory otitis and analyse the results .Meth-ods The study subjects were 42 patients(56 ears) with secretory secretory otitis media from June 2003 to June 2011 ,all patients were performed with ears ,nose ,pharynx and throat routine inspection and mastoid HRCT .All patients were retrospectively analyzed possible risk factors :suchas history ,infection ,eustachian tube dysfunction , chronic sinusitis ,deflection of nasal septum ,nose pharynx ministry malignant tumor ,tonsillitis ,adenoid hypertro-phy ,allergic rhinitis ,etc .Results In the multivariate analysis of 42 patients(56 ears) with refractory secretory oti-tis media and the control group of 50 patients(66 ears) ,statistically significant in the history (χ2 = 9 .814 ,P<0 .01) ,mastoid pneumatization adverse (χ2 =15 .301 ,P<0 .01) ,and allergic rhinitis (χ2 =32 .614 ,P<0 .01)were observed .Two of them were found to be significant in the logistic regression model :mastoid pneumatization adverse (OR=4 .44) ,and allergic rhinitis(OR = 15 .13) .Patients of mastoid pneumatization adverse with refractory otitis media is 4 .164 times (95% CI ,1 .903 ~9 .112);patients of allergic rhinitis was 17 .192 times higher than that of in no allergic patients (95% CI ,5 .850 ~ 50 .524) .Conclusion Mastoid pneumatization adverse and allergic rhinitis are the risk factors for refractory secretory otitis media .%目的探讨难治性分泌性中耳炎的危险致病因素。方法回顾性分析2003年6月~2011年6月收治的难治性分泌性中耳炎患者42例(56耳,病例组)和50例(66耳)非难治性分泌性中耳炎患者(对照组)的临床资料,对两组患者的病程、上呼吸道感染、咽鼓管功能障碍、慢性鼻窦炎、鼻中隔偏曲、鼻咽部恶性肿瘤、扁桃体炎症、腺样体肥大、变应性鼻炎、乳突气化不良、年龄、性别、急性中耳炎治疗不当、腭裂、中耳气压损伤等15种因素进行

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

    Directory of Open Access Journals (Sweden)

    Keigo Suzukawa

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

  18. 小儿急性化脓性阑尾炎150例治疗分析%Clinical Analysis of Pediatric Acute Suppurative Appendicitis of 150 Cases

    Institute of Scientific and Technical Information of China (English)

    安俊军; 张生格

    2015-01-01

    Objective To summarize diagnosis and treatment of infantile suppurative appendicitis, in order to im-prove the comprehensive understanding of infantile suppurative appendicitis,reduce the occurrence of postoperative com-plications.Methods 860 cases of appendicitis in children with clinical medical records of the statistics, of which the clinical data of 150 cases of children with purulent appendicitis were retrospectively analyzed.Results All 150 cases were performed surgical treatment, 62 cases of traditional laparotomy, laparoscopic surgery in 88 cases, 2 cases of lapa-roscopic transfer laparotomy.Preoperative diagnosis and postoperative diagnosis of 138 cases of appendicitis, coincidence rate was 92.0% .Postoperative complications in 11 cases, mergers were recovered and discharged, no deaths.Conclusions Children with acute suppurative appendicitis small age of perforation rate is high, the clinician should be detailed history, careful physical examination, reasonable use of auxiliary examination, comprehensive analy-sis, as far as possible the diagnosis of early diagnosis, timely surgical treatment, reduce the incidence rate of perforation, reduce the occurrence of postoperative complications.%目的:总结小儿化脓性阑尾炎的临床诊治,提高临床医师对于小儿化脓性阑尾炎的全面认识,做到早诊断,早治疗,并减少术后并发症的发生。方法对收治的860例阑尾炎患儿临床病历资料进行统计,其中150例化脓性阑尾炎患儿的临床资料进行回顾性分析、总结。结果本组150例均行手术治疗,行传统开腹手术62例,腹腔镜手术88例,腹腔镜中转开腹2例,术后阑尾标本行病理检查:化脓性阑尾炎150例,平均就诊时间为32.5 h,临床症状表现为:腹痛、发热、恶心与呕吐、腹泻、肠梗阻、腹部压痛等,术前诊断与术后诊断均为阑尾炎者138例,符合率为92.0%。术后合并并发症11例,均痊愈出院,

  19. Effect of pneumococcal conjugate vaccination on nasopharyngeal carriage in children with early onset of acute otitis media - a randomized controlled trial.

    OpenAIRE

    Gisselsson-Solén, Marie; Henriksson, Gunnel; Hermansson, Ann; Melhus, Åsa

    2015-01-01

    Abstract Conclusion: Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage.

  20. Biofilms in chronic infections - a matter of opportunity - monospecies biofilms in multispecies infections

    DEFF Research Database (Denmark)

    Burmølle, Mette; Thomsen, Trine Rolighed; Fazli, Mustafa;

    2010-01-01

    It has become evident that aggregation or biofilm formation is an important survival mechanism for bacteria in almost any environment. In this review, we summarize recent visualizations of bacterial aggregates in several chronic infections (chronic otitis media, cystic fibrosis, infection due...... to permanent tissue fillers and chronic wounds) both as to distribution (such as where in the wound bed) and organization (monospecies or multispecies microcolonies). We correlate these biofilm observations to observations of commensal biofilms (dental and intestine) and biofilms in natural ecosystems (soil......). The observations of the chronic biofilm infections point toward a trend of low bacterial diversity and sovereign monospecies biofilm aggregates even though the infection in which they reside are multispecies. In contrast to this, commensal and natural biofilm aggregates contain multiple species that are believed...