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Sample records for unilateral chronic otitis

  1. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

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

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

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis ... relations staff at newsroom@entnet.org . What is otitis media? Otitis media refers to inflammation of the middle ...

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

    Science.gov (United States)

    ... ENT Doctor Near You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic ... relations staff at newsroom@entnet.org . What is otitis media? Otitis media refers to inflammation of the ...

  4. Cochlear pathology in chronic suppurative otitis media.

    Science.gov (United States)

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

    1983-01-01

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

  5. 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.

  6. Recurrent otorrhea in chronic suppurative otitis media

    DEFF Research Database (Denmark)

    Jensen, Ramon Gordon; Johansen, Helle Krogh; Bjarnsholt, Thomas

    2017-01-01

    Dispersal of bacteria from a biofilm in the middle ear, serving as a bacterial reservoir, could explain the recurrent and chronic nature of chronic suppurative otitis media (CSOM). The objective of this study is to investigate if the same strains of bacteria could be detected in repeated episodes...

  7. International recognition of the Chronic Otitis Media Questionnaire 12.

    Science.gov (United States)

    Kosyakov, S I; Minavnina, J V; Phillips, J S; Yung, M W

    2017-06-01

    The Chronic Otitis Media Questionnaire 12 was developed initially in the UK to assess patient-reported health-related quality of life associated with chronic otitis media. This study aimed to determine whether this tool is applicable to the Russian population, which has a materially different healthcare system. A total of 108 patients with different forms of chronic otitis media completed the Russian Chronic Otitis Media Questionnaire 12. The average Russian Chronic Otitis Media Questionnaire 12 score was 19.4 (standard deviation = 8.3). The internal consistency of the Russian Chronic Otitis Media Questionnaire 12 was high, with a Cronbach's alpha value of 0.860. The Russian version of the Chronic Otitis Media Questionnaire 12 was found to be a reliable tool for the assessment of health-related quality of life in patients with chronic otitis media. This sets the scene for international collaboration, using this tool to assess the effectiveness of surgical treatments even amongst countries with different healthcare systems.

  8. Chronic suppurative otitis media in Gombe, Nigeria | Ahmad ...

    African Journals Online (AJOL)

    Background: Chronic suppurative otitis media is a common problem in developing countries and it is necessary to determine the local epidemiology for ... Method: A retrospective study of 206 patients with chronic suppurative otitis media (COSM). ... Children within the age group of 0 – 10 years were the most affected.

  9. Chronic suppurative otitis media: Socio-economic implications in a ...

    African Journals Online (AJOL)

    Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria. ... This paper highlights the socio-economic burden of chronic suppurative otitis media on a ... minimum wage for individuals in our environment where the cost of health care is the sole responsibility of the patient.

  10. Adenoid ciliostimulation in children with chronic otitis media.

    Science.gov (United States)

    Andreoli, Steven M; Schlosser, Rodney J; Wang, Ling-Feng; Mulligan, Ryan M; Discolo, Christopher M; White, David R

    2013-01-01

    Adenoid hypertrophy and chronic adenoiditis are associated with an increased incidence of chronic otitis media. This study intends to determine the relationship between chronic otitis media and dynamic ciliary beat frequency in children undergoing adenoidectomy. Prospective, controlled study. Pediatric tertiary care hospital. Children undergoing adenoidectomy were enrolled. Patients were stratified according to their indication for surgery, including adenotonsillar hypertrophy with obstructive sleep apnea, chronic otitis media with effusion, or recurrent episodes of acute otitis media. Adenoids were harvested using the curette. Tissue was sectioned and allowed to equilibrate in basal media for 24 hours. Cilia-bearing tissue was then stimulated using isoproterenol or methacholine. Ciliary beat frequency was serially reordered and analyzed using the Sisson-Ammons Video Analysis software program. Baseline ciliary beat frequency was similar in all groups (N = 47, total). Using isoproterenol, children with chronic otitis media with effusion demonstrated a blunted dynamic ciliary response at 2 and 3 hours relative to control (P = .0176 and P = .0282). Methacholine-stimulated ciliary beat frequency was not different between each group. At 2 and 3 hours following isoproterenol stimulation, there was a significant blunting of dynamic ciliary beat frequency in children with chronic otitis media with effusion. This ciliary dysfunction may provide a physiological explanation related to chronic adenoiditis in children with chronic otitis media.

  11. 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...

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    Babić Borivoj

    2008-01-01

    Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.

  15. Otitis media in Greenland children: acute, chronic and secretory otitis media in three- to eight-year-olds.

    Science.gov (United States)

    Pedersen, C B; Zachau-Christiansen, B

    1986-12-01

    The middle ear status was examined in 142 children aged three to eight years from Sukkertoppen and Kangamiut in Greenland. The investigation is based on social-pediatric and otologic histories and on objective examination using otomicroscopy and tympanometry. Three-fourths of the small children had a previous history of otitis, some with repeated instances. Otomicroscopic findings revealed suppurative, chronic otitis in 6% and sequelae of chronic otitis in 13%. Tympanometry disclosed a reduced middle ear pressure in another 26% of the ears examined. Comparison of children with healthy ears with the groups with affections of the middle ear showed a tendency to an increased risk of otitis in families at a low social stratum, whereas the mode of habitation seemed insignificant. Finally, a large milk intake both in connection with breast-feeding and later in life seemed to reduce the frequency of otitis. The investigation showed that acute otitis and chronic otitis media in particular are more prominent in Greenland than in Denmark. Attention is drawn to the handicap associated with a high incidence of chronic otitis media and the concomitant hearing loss to a population isolated in point of language. The successful achievements of a health information campaign and an active therapeutic program, which has reduced the prevalence of chronic otitis among the Innuit population native to Alaska and Canada, provides the rationale for an increased otologic effort in Greenland.

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

    African Journals Online (AJOL)

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

  17. 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...

  18. aerobic bacteria in safe type chronic suppurative otitis media

    African Journals Online (AJOL)

    PUBLICATIONS1

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

  19. Pathogenic agents of chronic suppurative otitis media in Ilorin, Nigeria

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  2. Management of chronic mucosal otitis media in children

    NARCIS (Netherlands)

    van der Veen, E.L.

    2010-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

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

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

    International Nuclear Information System (INIS)

    Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook; Jung, Keon Sik

    1999-01-01

    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

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

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

    1999-06-01

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

  8. Management of chronic otitis media by subtotal petrosectomy.

    Science.gov (United States)

    Altuna, Xabier; Navarro, Juan José; Goiburu, Miren; Palicio, Idoia

    2016-01-01

    Subtotal petrosectomy is the complete exenteration of all air cell tracts of the temporal bone. The isthmus of the Eustachian tube is obliterated and the external auditory canal is closed. The aim of this study was to describe the use of this technique in the management of certain cases of chronic otitis media. We conducted a retrospective revision of the patients treated in our Institution with this technique for chronic otitis media in a 5-year period (2008-2012). All charts were reviewed and data from the otomicroscopy, audiometry, radiology, surgical findings, postoperative complications and follow-up (including diffusion magnetic resonance imaging, MRI) of a minimum of 24 months were collected. In this period petrosectomy was performed on 28 patients for chronic otitis media. We treated 13 cases as primary cases, while 15 cases were secondary (patients that had already undergone another procedure in that ear). Fifteen cases had no serviceable hearing. Only 1 case had an immediate postoperative complication (infection); during the posterior follow-up, 2 cases had to be reoperated for diffusion restriction in the mastoid area revealed in the MRI 2 years after surgery. A subtotal petrosectomy is rarely performed for the treatment of chronic otitis media. However, it is a technique that we have to keep in mind for the treatment of certain cases where there is recurrence and deep hearing loss, as well as in cases with good cochlear reserve if the disease coexists with other complications. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  9. Pattern of Chronic Suppurative Otitis Media at the National Ear Care ...

    African Journals Online (AJOL)

    Pattern of Chronic Suppurative Otitis Media at the National Ear Care Centre Kaduna, Nigeria. ... Background: Chronic suppurative otitis media constitutes a major cause of otorhinolaryngological clinic visits in Nigeria, therefore it is pertinent to determine the local ... Children under 10 years constituted the majority (n=64).

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas....... MATERIALS AND METHODS: The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing...... were satisfied. There were no hearing hazards. CONCLUSIONS: The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared...

  11. Relationship between chronic otitis media with effusion and overweight or obesity in children.

    Science.gov (United States)

    Kaya, S; Selimoğlu, E; Cureoğlu, S; Selimoğlu, M A

    2017-10-01

    Otitis media with effusion and obesity are both common in childhood and might share some immunological alterations. This study aimed to investigate the relationship between chronic otitis media with effusion and childhood overweight or obesity, including the potential effects of adenoid or tonsillar hypertrophy on that relationship. This study included 60 children with chronic otitis media with effusion and 86 healthy children aged from 2 to 10 years. Measures of height and weight were used to calculate the body mass index, weight for height and weight z score. The prevalence of overweight or obesity was higher in children with chronic otitis media with effusion, according to the weight for height percentiles (p = 0.012). However, neither the presence of adenoid or tonsillar hypertrophy nor the degree of adenoid hypertrophy was associated with overweight or obesity. Overweight and obesity might be risk factors for developing chronic otitis media with effusion, or vice versa.

  12. Bacterial strain changes during chronic otitis media surgery.

    Science.gov (United States)

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

    2017-09-01

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

  13. High resolution computed tomography of chronic otitis media

    International Nuclear Information System (INIS)

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

    1986-01-01

    Seventy six patients with chronic otitis media were examined by CT. Using 3 dried skulls, the epitympanum was impacted with a piece of paraffin containing of 2 % iodine, and studied with CT-scan (Toshiba 60A-30) to clarify whether or not the paraffin could produce a soft tissue density on CT which was similar to that of cholesteatoma in the middle ear. The results showed that computed tomography was excellent in demonstrating a soft tissue mass in the middle ear with inflammatory disease. When the middle ear infection with granulation tissue or cholesteatoma existed, the resulting soft tissue mass was indistinguishable. CT scanning was useful for accurate determination of location of bone destruction in the middle ear as well as of the ossicles. (author)

  14. PSEUDOMONAS AERUGINOSA IN CHRONIC SUPPURATIVE OTITIS MEDIA- A DRUGSENSITIVITY STUDY

    Directory of Open Access Journals (Sweden)

    Anoop M

    2017-05-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2018-06-01

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

  17. Activation of NLRP3 inflammasome in human middle ear cholesteatoma and chronic otitis media.

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Zhao, Pengfei; Kataoka, Yuko; Yoshinobu, Junko; Maeda, Yukihide; Ishihara, Hisashi; Higaki, Takaya; Nishizaki, Kazunori

    2016-01-01

    The nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome plays an important role in the pathogenesis of middle ear diseases. Modulation of inflammasome-mediated inflammation may be a novel therapeutic strategy for cholesteatoma and chronic otitis media. NLRP3 inflammasome is a critical molecule mediating interleukin (IL)-1β responses. However, the expression of NLRP3 in the pathogenesis of cholesteatoma and chronic otitis media has not been fully examined. This study sought to assess the expression of NLRP3, ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain and a pyrin domain), and caspase-1 in middle ear tissues in patients with cholesteatoma or chronic otitis media. Middle ear tissue samples were obtained from patients with cholesteatoma or chronic otitis media. Control middle ear samples were collected during cochlear implant surgery of patients without middle ear inflammation. The expression of NLRP3, ASC, and caspase-1 were examined by reverse transcription polymerase chain reaction (RT-PCR) assay and immunohistochemical study. The levels of mRNA of NLRP3, ASC, and caspase-1 were significantly elevated in cholesteatoma and chronic otitis media as compared with that of normal controls. The proteins of NLRP3, ASC, and caspase-1 were observed in infiltrating inflammatory cells in cholesteatoma and chronic otitis media.

  18. Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media.

    Science.gov (United States)

    da Costa Monsanto, Rafael; Erdil, Mehmet; Pauna, Henrique F; Kwon, Geeyoun; Schachern, Patricia A; Tsuprun, Vladimir; Paparella, Michael M; Cureoglu, Sebahattin

    2016-09-01

    To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. Comparative human temporal bone study. Otopathology laboratory. To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. STUDY OF EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Sanal Mohan

    2016-10-01

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

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

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    O. Yu. Mezentseva

    2012-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

  3. Microbiomes of the normal middle ear and ears with chronic otitis media.

    Science.gov (United States)

    Minami, Shujiro B; Mutai, Hideki; Suzuki, Tomoko; Horii, Arata; Oishi, Naoki; Wasano, Koichiro; Katsura, Motoyasu; Tanaka, Fujinobu; Takiguchi, Tetsuya; Fujii, Masato; Kaga, Kimitaka

    2017-10-01

    The aim of this study was to profile and compare the middle ear microbiomes of human subjects with and without chronic otitis media. Prospective multicenter cohort study. All consecutive patients undergoing tympanoplasty surgery for chronic otitis media or ear surgery for conditions other than otitis media were recruited. Sterile swab samples were collected from the middle ear mucosa during surgery. The variable region 4 of the 16S rRNA gene in each sample were amplified using region-specific primers adapted for the Illumina MiSeq sequencer (Illumina, CA, USA)). The sequences were subjected to local blast and classified using Metagenome@KIN (World Fusion, Tokyo, Japan). In total, 155 participants were recruited from seven medical centers. Of these, 88 and 67 had chronic otitis media and normal middle ears, respectively. The most abundant bacterial phyla on the mucosal surfaces of the normal middle ears were Proteobacteria, followed by Actinobacteria, Firmicutes, and Bacteroidetes. The children and adults with normal middle ears differed significantly in terms of middle ear microbiomes. Subjects with chronic otitis media without active inflammation (dry ear) had similar middle ear microbiomes as the normal middle ears group. Subjects with chronic otitis media with active inflammation (wet ear) had a lower prevalence of Proteobacteria and a higher prevalence of Firmicutes than the normal middle ears. The human middle ear is inhabited by more diverse microbial communities than was previously thought. Alteration of the middle ear microbiome may contribute to the pathogenesis of chronic otitis media with active inflammation. 2b. Laryngoscope, 127:E371-E377, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

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

    Science.gov (United States)

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

    2017-08-01

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

  5. Acute otitis externa

    OpenAIRE

    Hui, Charles PS

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  7. HAART impact on prevalence of chronic otitis media in Brazilian HIV-infected children.

    Science.gov (United States)

    Weber, Raimar; Pinheiro Neto, Carlos Diógenes; Miziara, Ivan Dieb; Araújo Filho, Bernardo Cunha

    2006-01-01

    The advent of new antiretroviral drugs such as protease inhibitors has generated sensible changes in morbity and mortality in HIV-infected patients. To evaluate the impact of Highly Active Antiretroviral Therapy (HAART) on the prevalence of chronic otitis media in HIV-infected pediatric population. 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 CD4+ lymphocyte count were compared between groups in use of HAART and the group without HAART. Out of 459 children, 65 (14.2%) had chronic otitis media. We observed that in children aged 0 to 5 years and 11 months who were taking HAART there was significant lower prevalence of chronic otitis media (p=0.02). The use of HAART was associated to higher mean CD4+ lymphocyte count (pmedia in HIV infected children, probably due to increase in mean CD4+ lymphocyte count.

  8. A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media.

    Science.gov (United States)

    Mofatteh, M R; Shahabian Moghaddam, F; Yousefi, M; Namaei, M H

    2018-01-01

    To assess the frequency of bacterial agents in chronic suppurative otitis media and the antibiotic susceptibility patterns of isolates among patients. A total of 185 patients clinically diagnosed with chronic suppurative otitis media were interviewed and middle-ear effusion samples were collected using sterile swabs. All bacterial isolates were identified by conventional microbiological methods. Antibiotic susceptibility patterns of the isolates were determined by Kirby-Bauer disc diffusion. Staphylococci spp. (64.9 per cent) were the most prevalent bacteria isolated, followed by Klebsiella spp. (12.9 per cent) and Pseudomonas aeruginosa (10.3 per cent). The most effective antibiotic for treatment of bacterial chronic suppurative otitis media was ciprofloxacin. Statistical analysis showed no significant difference in bacterial infestations among chronic suppurative otitis media patients and the antimicrobial susceptibility patterns of the bacterial isolates based on gender and age (p > 0.05). Our findings highlight the importance of a continuous and periodic evaluation of the bacteriological profile and antibiotic susceptibility patterns in chronic suppurative otitis media patients for efficacious treatment of the infection.

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

    Directory of Open Access Journals (Sweden)

    L.A. Toropova

    2009-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  11. Alterations in the Contra lateral Ear in Chronic Otitis Media

    Directory of Open Access Journals (Sweden)

    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

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

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    Amad Meimaneh Jahromi

    2010-04-01

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  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...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    BACKGROUND:: Children in the developing parts of the world have a high prevalence of chronic suppurative otitis media (CSOM). It is estimated that 65 to 330 million people worldwide have CSOM, yet very little is known about the natural course of the disease. The Inuit population of the Arctic......-based cohort of 591 children originally examined during 1993 to 1994 at 3 to 8 years of age. Follow-up was attempted among 348 individuals still living in the areas. Video otoscopy and tympanometry were used. Data on otologic disease, ear surgery, and antibiotic use for otitis media were collected from medical...... of spontaneous healing was not influenced by the age at which CSOM was diagnosed in the initial study. Thirty-nine individuals (17%) had CSOM in either the initial study or at follow-up. Of these, 2 had never received antibiotic treatment for otitis media, and 15 had been treated less than 3 times. Eighty...

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

    Science.gov (United States)

    Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

    2017-09-28

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

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

    International Nuclear Information System (INIS)

    Tang Yong; Zhao Jun; Liu Fangying; Zhang Xuelin

    2005-01-01

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

  19. 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.

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

    DEFF Research Database (Denmark)

    Homøe, Preben; Bjarnsholt, Thomas; Wessman, Marcus

    2009-01-01

    Biofilm may explain the recurrences and recalcitrant episodes of otorrhea in chronic suppurative otitis media (CSOM). This study investigates bacterial biofilm in Greenlanders with CSOM and chronic otitis media with effusion (COME). The study is partly blinded, prospective and retrospective. Six...... were analyzed with microscopy and peptide nucleic acid fluorescence in situ hybridization (PNA-FISH). Biofilm was confirmed in 83% of CSOM smears but in none of the COME smears. Mucosal biofilm was confirmed in 80% of the biopsies from adults with CSOM. This study provides direct morphological evidence...... of biofilm in samples from human CSOM. This may help to explain the microbiological mechanisms of the disease and alter the treatment strategy in the future....

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

    Science.gov (United States)

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

    2017-08-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

    2017-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2018-03-01

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

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

    African Journals Online (AJOL)

    South African Journal of Child Health ... Background. Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic ... We discuss the case of a 14-year-old male with Lemierre's syndrome as a complication of chronic middle ear infection. Results.

  10. Unilateral Keratoconus after Chronic Eye Rubbing by the Nondominant Hand

    Directory of Open Access Journals (Sweden)

    Nathalie Bral

    2017-12-01

    Full Text Available Introduction: To report the development of unilateral keratoconus in a healthy male after persistent unilateral eye rubbing by the nondominant hand which was not needed for professional activities. Methods: Observational case report. Results: A 60-year-old male was first seen in our clinic due to decreased vision in his left eye. Slit-lamp biomicroscopy of the left eye revealed Vogt’s striae, stromal thinning, and a stromal scar. Corneal topography showed a stage 4 keratoconus. Clinical examination and corneal topography of the right eye were normal. Medical history revealed a habit of chronic eye rubbing only in the left eye because of the right hand being occupied for professional needs. During follow-up of 5 years, Scheimpflug images of the right eye stayed normal while the left eye showed a stable cone. Discussion: This case report supports the hypothesis of mechanical fatigue of the cornea due to repetitive shear stress on the surface caused by eye-rubbing.

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

    Science.gov (United States)

    Zelikovich, E I

    2005-01-01

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

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

    Science.gov (United States)

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

    2013-02-01

    The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p sensitivity (p anxiety (p social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Chronic suppurative otitis media (CSOM) is the leading cause of mild to moderate hearing impairment in children worldwide and a major public health problem in many indigenous populations. There is a lack of basic epidemiological facts and knowledge on the development of CSOM, as the disease...

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

    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...

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

    Science.gov (United States)

    Funk, Jeanne B.; Ruppert, Elizabeth S.

    1986-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-01-01

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

  17. 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...

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

    International Nuclear Information System (INIS)

    Czech, N.; Godbersen, G.S.

    2006-01-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Michael T Cheeseman

    2011-10-01

    Full Text Available Otitis media with effusion (OME is the commonest cause of hearing loss in children, yet the underlying genetic pathways and mechanisms involved are incompletely understood. Ventilation of the middle ear with tympanostomy tubes is the commonest surgical procedure in children and the best treatment for chronic OME, but the mechanism by which they work remains uncertain. As hypoxia is a common feature of inflamed microenvironments, moderation of hypoxia may be a significant contributory mechanism. We have investigated the occurrence of hypoxia and hypoxia-inducible factor (HIF mediated responses in Junbo and Jeff mouse mutant models, which develop spontaneous chronic otitis media. We found that Jeff and Junbo mice labeled in vivo with pimonidazole showed cellular hypoxia in inflammatory cells in the bulla lumen, and in Junbo the middle ear mucosa was also hypoxic. The bulla fluid inflammatory cell numbers were greater and the upregulation of inflammatory gene networks were more pronounced in Junbo than Jeff. Hif-1α gene expression was elevated in bulla fluid inflammatory cells, and there was upregulation of its target genes including Vegfa in Junbo and Jeff. We therefore investigated the effects in Junbo of small-molecule inhibitors of VEGFR signaling (PTK787, SU-11248, and BAY 43-9006 and destabilizing HIF by inhibiting its chaperone HSP90 with 17-DMAG. We found that both classes of inhibitor significantly reduced hearing loss and the occurrence of bulla fluid and that VEGFR inhibitors moderated angiogenesis and lymphangiogenesis in the inflamed middle ear mucosa. The effectiveness of HSP90 and VEGFR signaling inhibitors in suppressing OM in the Junbo model implicates HIF-mediated VEGF as playing a pivotal role in OM pathogenesis. Our analysis of the Junbo and Jeff mutants highlights the role of hypoxia and HIF-mediated pathways, and we conclude that targeting molecules in HIF-VEGF signaling pathways has therapeutic potential in the treatment of

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

    Science.gov (United States)

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

    2017-09-01

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

  2. Panel 7 : Otitis Media: Treatment and Complications

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    Full Text Available Risk factors associated with chronic otitis media (COM and recurrent otitis media (ROM have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13-1.64; P = 0.001. An upper respiratory tract infection (URTI significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13-13.89; P<0.00001. Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78-2.16; P<0.00001. A patient history of acute otitis media (AOM/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06-116.44; P = 0.04. Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02-1.89 P = 0.04. Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11-13.15; P = 0.03. Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.

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

    Science.gov (United States)

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

    2015-08-11

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

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

    Science.gov (United States)

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

    2014-01-01

    Risk factors associated with chronic otitis media (COM) and recurrent otitis media (ROM) have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database) from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs) could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13-1.64; P = 0.001). An upper respiratory tract infection (URTI) significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13-13.89; Pmedia (AOM)/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06-116.44; P = 0.04). Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02-1.89 P = 0.04). Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11-13.15; P = 0.03). Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Malakooti B

    2000-07-01

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

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

    Science.gov (United States)

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

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

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

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    Celebi Erdivanli, Ozlem; Sanli, Arif

    2015-01-01

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

  11. Otitis media.

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

    2016-09-08

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

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

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    Ulku, Cagatay Han

    2017-06-01

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

  13. 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

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

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    Julianis Loraine Quintero Noa

    2013-03-01

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

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

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    Parthapratim Laha

    2013-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

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

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

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

    2017-06-01

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

  1. Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis

    Science.gov (United States)

    2017-01-01

    Purpose The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic

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

    Science.gov (United States)

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

    2017-01-19

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

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

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    Anton Budhi Darmawan

    2018-01-01

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

  4. 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 .

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

    Science.gov (United States)

    Kurien, Regi; Chrisolyte, Shipra; Rupa, V

    2009-09-01

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

  6. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    International Nuclear Information System (INIS)

    Kroepelin, T.; Ziupa, J.; Wimmer, B.

    1983-01-01

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

  7. Determinants of chronic otitis media with effusion in preschool children: a case-control study.

    Science.gov (United States)

    Walker, Rebecca E; Bartley, Jim; Flint, David; Thompson, John M D; Mitchell, Edwin A

    2017-01-06

    Chronic otitis media with effusion (COME) is a prevalent upper airway infection resulting in hearing loss. The aim of this research was to determine risk factors for COME in preschool children. A case-control design was conducted in Auckland, New Zealand from May 2011 until November 2013. The cases were children aged 3 and 4 years referred for tympanostomy tube placement due to a diagnosis of COME (n = 178). The controls were a random sample of healthy children aged 3 and 4 years from primary care practices (n = 209). The children's guardians completed an interviewer-administered questionnaire that covered topics including socio-demographic information, pregnancy and birth, infant feeding practices, home environment, and respiratory health. In addition, skin prick tests for atopy were performed. Odds ratios (OR) estimating the risk of COME independently associated with the exposures were calculated using a logistic regression model. Children with COME frequently had nasal obstruction (OR: 4.38 [95% CI: 2.37-8.28]), always snored (OR: 3.64 [95% CI: 1.51-9.15]) or often snored (OR: 2.45 [95% CI: 1.04-5.96]), spent more hours per week in daycare (OR per hour/week: 1.03 [95% CI: 1.00-1.05]), had frequent colds (OR: 2.67 [95% CI: 1.59-4.53]), had siblings who had undergone tympanostomy tube placement (OR: 2.68 [95% CI: 1.22-6.02]), underwent long labour (OR: 2.59 [95% CI: 1.03-6.79]), and had early introduction of cow's milk (OR: 1.76 [95% CI: 1.05-2.97]). Asian ethnicity (OR: 0.20 [95% CI: 0.07-0.53]) and having older siblings (OR: 0.54 [95% CI: 0.31-0.93]) were inversely associated with COME. COME in preschool children was associated with pathogen exposure, respiratory infection, and nasal obstruction. Strategies to prevent pathogen transmission warrant investigation. The novel findings of long labour and early cow's milk introduction require replication in future studies.

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

    Science.gov (United States)

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

    2016-04-01

    Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements. We investigated the prevalence of chronic suppurative otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds. In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane sequelae of OM. The median pure tone average in low-frequencies/high-frequencies were: CSOM: 34.2/31.3dB, OME: 23.3/22.5dB, Sequelae of OM: 13.3/15dB and normal ears: 11.7/12.5dB. We found a significant difference (pchildren a HL>15dB in any frequency was found, while 6.5% suffered from a bilateral low-frequency HL>25dB. The severity of OM significantly corresponded to increased HL. The burden of CSOM and HL remains high in young Greenlandic children. Aggressive treatment with antibiotics, improved hearing rehabilitation, sound field amplification in classrooms and otosurgical capacity should be further promoted in Greenland. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. 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...

  10. Sinusitis with eosinophilic otitis media

    International Nuclear Information System (INIS)

    Kawano, Toshiro; Ishitoya, Junichi; Tsukuda, Mamoru

    2007-01-01

    Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

  11. Sinusitis with eosinophilic otitis media

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

    Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

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

    Directory of Open Access Journals (Sweden)

    M.T. Goodarzi

    2013-07-01

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

  13. Panel 7: Otitis Media: Treatment and Complications.

    Science.gov (United States)

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

    2017-04-01

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

  14. Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache

    Directory of Open Access Journals (Sweden)

    Dhaval Shukla

    2016-01-01

    Full Text Available Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP. Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache.

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ercan Akbay

    2014-04-01

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

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

    Science.gov (United States)

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

    1975-07-01

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

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

    Science.gov (United States)

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

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

  19. Computed tomography study of otitis media

    International Nuclear Information System (INIS)

    Bahia, Paulo Roberto Valle; Marchiori, Edson

    1997-01-01

    The findings of computed tomography (CT) of 89 patients clinically suspected of having otitis media were studied in this work. Such results were compared to clinical diagnosis, otoscopy, surgical findings and previous data. Among the results of our analysis, we studied seven patients with acute otitis media and 83 patients with chronic otitis media. The patients with acute otitis media have undergone CT examinations to evaluate possible spread to central nervous system. The diagnosis of cholesteatoma, its extension and complications were the main indication. for chronic otitis media study. The main findings of the cholesteatomatous otitis were the occupation of the epitympanun, the bony wall destruction and the ossicular chain erosion. The CT demonstrated a great sensibility to diagnose the cholesteatoma. (author)

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

    Directory of Open Access Journals (Sweden)

    Sami Ullah

    2016-12-01

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

  1. Proteomic Characterization of Middle Ear Fluid Confirms Neutrophil Extracellular Traps as a Predominant Innate Immune Response in Chronic Otitis Media.

    Directory of Open Access Journals (Sweden)

    Stephanie Val

    Full Text Available Chronic Otitis Media (COM is characterized by middle ear effusion (MEE and conductive hearing loss. MEE reflect mucus hypersecretion, but global proteomic profiling of the mucosal components are limited.This study aimed at characterizing the proteome of MEEs from children with COM with the goal of elucidating important innate immune responses.MEEs were collected from children (n = 49 with COM undergoing myringotomy. Mass spectrometry was employed for proteomic profiling in nine samples. Independent samples were further analyzed by cytokine multiplex assay, immunoblotting, neutrophil elastase activity, next generation DNA sequencing, and/or immunofluorescence analysis.109 unique and common proteins were identified by MS. A majority were innate immune molecules, along with typically intracellular proteins such as histones and actin. 19.5% percent of all mapped peptide counts were from proteins known to be released by neutrophils. Immunofluorescence and immunoblotting demonstrated the presence of neutrophil extracellular traps (NETs in every MEE, along with MUC5B colocalization. DNA found in effusions revealed unfragmented DNA of human origin.Proteomic analysis of MEEs revealed a predominantly neutrophilic innate mucosal response in which MUC5B is associated with NET DNA. NETs are a primary macromolecular constituent of human COM middle ear effusions.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2017-12-01

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-03-15

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

  7. Bilateral Neuropathy of Primary Sensory Neurons by the Chronic Compression of Multiple Unilateral DRGs

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    Ya-Bin Xie

    2016-01-01

    Full Text Available To mimic multilevel nerve root compression and intervertebral foramina stenosis in human, we established a new animal model of the chronic compression of unilateral multiple lumbar DRGs (mCCD in the rat. A higher occurrence of signs of spontaneous pain behaviors, such as wet-dog shaking and spontaneous hind paw shrinking behaviors, was firstly observed from day 1 onward. In the meantime, the unilateral mCCD rat exhibited significant bilateral hind paw mechanical and cold allodynia and hyperalgesia, as well as a thermal preference to 30°C plate between 30 and 35°C. The expression of activating transcription factor 3 (ATF3 was significantly increased in the ipsilateral and contralateral all-sized DRG neurons after the mCCD. And the expression of CGRP was significantly increased in the ipsilateral and contralateral large- and medium-sized DRG neurons. ATF3 and CGRP expressions correlated to evoked pain hypersensitivities such as mechanical and cold allodynia on postoperative day 1. The results suggested that bilateral neuropathy of primary sensory neurons might contribute to bilateral hypersensitivity in the mCCD rat.

  8. Bilateral Changes of Spontaneous Activity Within the Central Auditory Pathway Upon Chronic Unilateral Intracochlear Electrical Stimulation.

    Science.gov (United States)

    Basta, Dietmar; Götze, Romy; Gröschel, Moritz; Jansen, Sebastian; Janke, Oliver; Tzschentke, Barbara; Boyle, Patrick; Ernst, Arne

    2015-12-01

    In recent years, cochlear implants have been applied successfully for the treatment of unilateral hearing loss with quite surprising benefit. One reason for this successful treatment, including the relief from tinnitus, could be the normalization of spontaneous activity in the central auditory pathway because of the electrical stimulation. The present study, therefore, investigated at a cellular level, the effect of a unilateral chronic intracochlear stimulation on key structures of the central auditory pathway. Normal-hearing guinea pigs were mechanically single-sided deafened through a standard HiFocus1j electrode array (on a HiRes 90k cochlear implant) being inserted into the first turn of the cochlea. Four to five electrode contacts could be used for the stimulation. Six weeks after surgery, the speech processor (Auria) was fitted, based on tNRI values and mounted on the animal's back. The two experimental groups were stimulated 16 hours per day for 90 days, using a HiRes strategy based on different stimulation rates (low rate (275 pps/ch), high rate (5000 pps/ch)). The results were compared with those of unilateral deafened controls (implanted but not stimulated), as well as between the treatment groups. All animals experienced a standardized free field auditory environment. The low-rate group showed a significantly lower average spontaneous activity bilaterally in the dorsal cochlear nucleus and the medial geniculate body than the controls. However, there was no difference in the inferior colliculus and the primary auditory cortex. Spontaneous activity of the high-rate group was also reduced bilaterally in the dorsal cochlear nucleus and in the primary auditory cortex. No differences could be observed between the high-rate group and the controls in the contra-lateral inferior colliculus and medial geniculate body. The high-rate group showed bilaterally a higher activity in the CN and the MGB compared with the low-rate group, whereas in the IC and in the

  9. Eyelid Molluscum Contagiosum Lesions in Two Patients with Unilateral Chronic Conjunctivitis

    Directory of Open Access Journals (Sweden)

    Şule Serin

    2017-08-01

    Full Text Available Molluscum contagiosum (MC is a viral infection of the skin and mucosal tissues characterized by skin-colored or transparent round nodules with a dimple or pit in the center. The infection is caused by a DNA poxvirus called the MC virus. Although MC generally occurs in children, it has also been reported in immunocompromised and atopic patients. The virus is transmitted by skin contact or sexual intercourse. The lesions disappear spontaneously within several months in most cases. However, excision, cryotherapy, cauterization, topical chemical and antiviral agents, and/or oral cimetidine are used in refractory cases or to accelerate the healing process. Herein, we discussed the clinical findings and our treatment of two patients with unilateral chronic conjunctivitis associated with eyelid MC lesions in light of the literature.

  10. A historical vignette (20). A royal otitis.

    Science.gov (United States)

    Tainmont, J

    2010-01-01

    A royal otitis. The young king of France, Francis II, the eldest son of Henry II and Catherine de Medici, died in Orleans from the effects of the complications of a chronic otitis on 6 December 1560. Based on texts of the time, the paper discusses the nature of the illness, the treatment, and the medical and political entourage of the king.

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

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    Tashneem Harris

    2016-12-01

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

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

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    Krishnamurti M A Sarmento

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

  13. Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole.

    Science.gov (United States)

    Morgand, Marjolaine; Rammaert, Blandine; Poirée, Sylvain; Bougnoux, Marie-Elisabeth; Tran, Hugo; Kania, Romain; Chrétien, Fabrice; Jouvion, Gregory; Lortholary, Olivier

    2015-12-01

    Invasive aspergillosis (IA) is a severe disseminated fungal disease that occurs mostly in immunocompromised patients. However, central nervous system IA, combining meningitis and skull base involvement, does not occur only in groups with classic risk factors for IA; patients with chronic renal failure and diabetes mellitus are also at risk for more chronic forms. In both of our proven IA cases, voriconazole monotherapy was effective without surgery, and cerebrospinal fluid and serum 1,3-β-d-glucan test results were initially positive, in contrast to galactomannan antigen results. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

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    Olufemi Emmanuel Idowu

    2014-01-01

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

  15. 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.

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

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    Salem Muftah

    2015-09-01

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

  17. Otitis media

    NARCIS (Netherlands)

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

    2004-01-01

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

  18. External Otitis (Swimmer's Ear)

    Science.gov (United States)

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

  19. Otitis media with effusion

    Science.gov (United States)

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

  20. Prevalence and Risk Factors of Chronic Otitis Media: The Korean National Health and Nutrition Examination Survey 2010–2012

    Science.gov (United States)

    Park, Mina; Lee, Ji Sung; Lee, Jun Ho; Oh, Seung Ha; Park, Moo Kyun

    2015-01-01

    Background 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. Methods 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. Results 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). Conclusions Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and

  1. Clinical results of sacral neuromodulation for chronic voiding dysfunction using unilateral sacral foramen electrodes.

    Science.gov (United States)

    Weil, E H; Ruiz-Cerdá, J L; Eerdmans, P H; Janknegt, R A; Van Kerrebroeck, P E

    1998-01-01

    The aim of this study was to determine the long-term clinical efficacy and complications of neuromodulation with a unilateral sacral foramen electrode in 36 patients with chronic voiding dysfunction. Following a positive effect of a percutaneous nerve evaluation test, patients underwent open surgery. A permanent electrode was implanted in 24 patients with urge incontinence, in 6 with urgency-frequency syndrome, and in 6 with nonobstructive urinary retention. After an average follow-up period of 37.8 months, 19 patients (52.8%) continue to benefit from the neuromodulation with a significant improvement of symptoms and urodynamic parameters. The median duration of the therapeutic effect for the total study population was longer than 60 months. No significant difference in the median duration of therapeutic effect with regard to sex, the type of voiding disorder, or the implant pulse generator was found. However, in patients with previous psychological disorders the median duration of therapeutic effect was only 12 months (P = 0.008). Complications were mild. In the group of patients in whom the therapeutic effect remains, 37 reoperations have had to be performed. We conclude that although reoperations were needed to overcome technical problems, patients can achieve lasting symptomatic improvement. Since technical changes in the equipment have reduced the number of complications, even better results can be expected in terms of the reoperation rate.

  2. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

    Science.gov (United States)

    Zavarella, Matthew M; Leblebicioglu, Binnaz; Claman, Lewis J; Tatakis, Dimitris N

    2006-01-01

    The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.

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

    International Nuclear Information System (INIS)

    Naghibi, Saeed; Seifirad, Sirous; Adami Dehkordi, Mahboobeh; Einolghozati, Sasan; Ghaffarian Eidgahi Moghadam, Nafiseh; Akhavan Rezayat, Amir; Seifirad, Soroush

    2016-01-01

    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. 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. 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. 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. 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

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

    Science.gov (United States)

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

    2017-05-01

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

  5. 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.

  6. Individuals with chronic ankle instability exhibit dynamic postural stability deficits and altered unilateral landing biomechanics: A systematic review.

    Science.gov (United States)

    Simpson, Jeffrey D; Stewart, Ethan M; Macias, David M; Chander, Harish; Knight, Adam C

    2018-06-13

    To evaluate the literature regarding unilateral landing biomechanics and dynamic postural stability in individuals with and without chronic ankle instability (CAI). Four online databases (PubMed, ScienceDirect, Scopus, and SportDiscus) were searched from the earliest records to 31 January 2018, as well as reference sections of related journal articles, to complete the systematic search. Studies investigating the influence of CAI on unilateral landing biomechanics and dynamic postural stability were systematically reviewed and evaluated. Twenty articles met the criteria and were included in the systematic review. Individuals with CAI were found to have deficits in dynamic postural stability on the affected limb with medium to large effect sizes and altered lower extremity kinematics, most notably in the ankle and knee, with medium to large effect sizes. Additionally, greater loading rates and peak ground reaction forces, in addition to reductions in ankle muscle activity were also found in individuals with CAI during unilateral jump-landing tasks. Individuals with CAI demonstrate dynamic postural stability deficits, lower extremity kinematic alterations, and reduced neuromuscular control during unilateral jump-landings. These are likely factors that contribute recurrent lateral ankle sprain injuries during dynamic activity in individuals with CAI. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction.

    Science.gov (United States)

    Verdecchia, Daniel H; Mendoza, Marcela; Sanguineti, Florencia; Binetti, Ana C

    2014-01-01

    Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

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

    Science.gov (United States)

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

    2017-10-23

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

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

    Science.gov (United States)

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

    2017-05-31

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

  10. A Pilot Study to Assess the Vestibular Apparatus Function with Videonystagmography During Chronic Otitis Media with Effusion.

    Science.gov (United States)

    Saliba, Issam; Dagher, Chady; El-Zir, Elie; Yammine, Fady G

    2015-01-01

    To assess the effect of chronic middle ear effusion (CMEE) on balance and equilibrium. Prospective study controlling two groups of children. The active arm consisted of children having a unilateral or bilateral CMEE that persisted for at least 3 months. The control group consisted of children presenting with normal middle ear. Children and parents in both groups were questioned about any symptom of vertigo, dizziness, disequilibrium or child's tendency to fall. ENT exam included an assessment with pneumatic and microscopic otoscopy, evaluation of the vestibular system with the Romberg test, the Fukuda test, the head-shaking test and the Starwalk test. The study group consisted of 15 children (mean = 6.5 years, SD = 2; 10 females and 5 males). The control group consisted also of 15 children (mean = 7.2 years, SD = 1.8; 8 females and 7 males). The duration of MEE was between 3 and 12 months (mean = 8 months). Three children (20%) in the study group had a history of vertigo, imbalance, disequilibrium and/or tendency to fall. None of the children in the control group had such a history (p = 0.22); Five children in the study group had abnormal head-shaking test, Fukuda and/or Starwalk tests (33.33%). Two children in the control group had such a finding (13.33%) (p = 0.39). Romberg test was normal in all children in both groups. In the study group, one child showed positional and spontaneous nystagmus on VNG testing. Another one showed positional nystagmus. Hence, 2 children had abnormal findings on VNG (13.33%). In the control group, VNG was normal in all children (p = 0.46). Tympanometry showed a type B curve in 26 ears, a type C curve in 3 ears and type A in one ear. In the control group all patients presented a type A curve. This paper describes the first study using VNG in a population of children with CMEE. The presence of balance disturbances associated or not with hearing loss is of paramount importance to the clinician as to the indications of myringotomy with a

  11. Effects of listening to pleasant music on chronic unilateral neglect: a single-subject study.

    Science.gov (United States)

    Tsai, Pei-Luen; Chen, Mei-Ching; Huang, Yu-Ting; Lin, Keh-Chung

    2013-01-01

    Recent studies suggest that the positive emotion induced by pleasant music may improve cognitive functions. We used the single-subject design to study whether listening to preferred music may reduce unilateral neglect in two participants with post-stroke neglect. These participants were instructed to listen to their preferred music every day for 5 weeks, followed by 2 weeks of follow-up assessment. Outcome measures involved the Star Cancellation Test, the Line Bisection Test, and the visual exploration task. A combination of visual analysis and the two-standard-deviation band method was used for data analysis. Both participants showed significant intervention-related improvements on all outcome measures except the Line Bisection Test, on which one participant showed no improvement. The therapeutic effects were maintained during the follow-up phase. The findings suggest that positive emotion, evoked by preferred music, may be used to ameliorate unilateral neglect. Further research using controlled trials is warranted to validate the findings.

  12. Epidemiology of Intratemporal Complications of Otitis Media

    Directory of Open Access Journals (Sweden)

    Maranhão, André

    2014-01-01

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

  13. Bacteriology and Antimicrobial Susceptibility of Otitis Media at ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

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

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

    Science.gov (United States)

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

    2015-11-01

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

  15. Aspergillus otitis in small animals--a retrospective study of 17 cases.

    Science.gov (United States)

    Goodale, Elizabeth C; Outerbridge, Catherine A; White, Stephen D

    2016-02-01

    Aspergillus spp. are saprophytic opportunistic fungal organisms and are a common cause of otomycosis in humans. Although there have been case reports of Aspergillus otitis externa in dogs, to the best of the authors' knowledge, this is the first retrospective case series describing Aspergillus otitis in dogs and cats. To characterize signalment, putative risk factors, treatments and outcomes of a case series of dogs and cats with Aspergillus otitis. Eight dogs and nine cats diagnosed with Aspergillus otitis. A retrospective review of medical records from 1989 to 2014 identified animals diagnosed with Aspergillus otitis based on culture. All dogs weighed greater than 23 kg. The most common putative risk factors identified in this study were concurrent diseases, therapy causing immunosuppression or a history of an otic foreign body. Aspergillus otitis was unilateral in all study dogs and most cats. Concurrent otitis media was confirmed in three dogs and one cat, and suspected in two additional cats. Aspergillus fumigatus was the most common isolate overall and was the dominant isolate in cats. Aspergillus niger and A. terreus were more commonly isolated from dogs. Animals received various topical and systemic antifungal medications; however, otic lavage under anaesthesia and/or surgical intervention increased the likelihood of resolution of the fungal infection. Aspergillus otitis is uncommon, typically seen as unilateral otitis externa in cats and larger breed dogs with possible risk factors that include immunosuppression and otic foreign bodies; previous antibiotic usage was common. © 2015 ESVD and ACVD.

  16. Medical management of otitis externa.

    Science.gov (United States)

    Chester, D K

    1988-07-01

    Successful medical management of otitis externa requires attention to all of the following points: 1. Diagnose and treat systemic or underlying disease(s). 2. Carefully clean and examine the entire ear canal before starting therapy. This includes removal of foreign bodies, parasites, hair, and other obstructions. 3. Apply carefully chosen topical preparations based on gross and microscopic examination. 4. Educate clients as to the causes of the otitis externa and their role in treating the disease. 5. Schedule regular follow-up examinations until the disease is completely cured. 6. Recommend preventive procedures such as drying ears after swimming, corrective surgery, and so on. 7. Use systemic treatment when indicated by chronicity of disease or the owner's inability to treat the patient.

  17. The role of readability in effective health communication: an experiment using a Japanese health information text on chronic suppurative otitis media.

    Science.gov (United States)

    Sakai, Yukiko

    2013-09-01

    This study identifies the most significant readability factors and examines ways of improving and evaluating Japanese health information text in terms of ease of reading and understanding. Six different Japanese texts were prepared based on an original short text written by a medical doctor for a hospital web site intended for laypersons regarding chronic suppurative otitis media. Four were revised for single readability factor (syntax, vocabulary, or text structure) and two were modified in all three factors. Using a web-based survey, 270 high school students read one of the seven texts, including the original, completed two kinds of comprehension tests, and answered questions on their impressions of the text's readability. Significantly higher comprehension test scores were shown in the true or false test for a mixed text that presented important information first for better text structure. They were also found in the cloze test for a text using common vocabulary and a cohesive mixed text. Vocabulary could be a critical single readability factor when presumably combined with better text structure. Using multiple evaluation methods can help assess comprehensive readability. The findings on improvement and evaluation methods of readability can be applied to support effective health communication. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information and Libraries Journal.

  18. Perda auditiva sensório-neural na otite média crônica supurativa em pacientes com e sem colesteatoma Sensorineural hearing loss in chronic suppurative otitis media with and without cholesteatoma

    Directory of Open Access Journals (Sweden)

    Alexandre Fernandes de Azevedo

    2007-10-01

    Full Text Available Perda auditiva sensório-neural (PASN relacionada a otite média crônica supurativa (OMCS foi estudada para esclarecer a participação do colesteatoma nesse contexto. OBJETIVO: Avaliar ocorrência de PASN na OMCS, correlacionando com colesteatoma, duração da doença e idade. CASUÍSTICA E MÉTODOS: Estudo retrospectivo de 115 pacientes com OMCS com e sem colesteatoma submetidos à cirurgia. Incluíram-se pacientes com doença unilateral, orelha contralateral normal e idade inferior a 60 anos. RESULTADOS: Idade média foi de 26 anos, sendo 58 homens e 57 mulheres. Tempo médio de duração da doença otológica de 12,4 anos. Limiar auditivo médio foi de 40 dB na orelha com OMCS e 22dB na orelha normal (P=0,002. Observou-se colesteatoma em 78 dos 115 casos. Na orelha com OMCS, ocorreram 15 (13% casos de PASN, sendo 7 associadas à colesteatoma e 8 não associadas. Seis casos de PASN foram severa/profunda, correlacionando-se com idade ajustada (P=0,003, ausência de colesteatoma (P=0,01, mas não com duração da doença (P=0,458. CONCLUSÃO: PASN ocorreu em 13% dos pacientes com OMCS, correlacionando-se com o aumento da idade, mas não com a presença de colesteatoma ou com maior duração da doença otológica.Sensorineural hearing loss (SNHL related to chronic suppurative otitis media (CSOM was studied to clarify the involvement of cholesteatomas in this context. AIM: to evaluate SNHL related to CSOM and its association with cholesteatomas, disease duration and patients’ ages. METHODS: Retrospective analysis of 115 patients with CSOM with and without cholesteatoma submitted to surgical treatment. Inclusion criteria were active unilateral disease, normal contralateral ear and age below 60 years. RESULTS: The average age was 26.3 years, 58 males and 57 females. The duration of ear disease was, in average, 12.4 years. The average threshold of hearing was 40 dB in CSOM ear and 22 dB in the normal contralateral ear (P=0.002. CSOM with

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

    African Journals Online (AJOL)

    2011-03-05

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

  20. Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by {sup 99m}Tc-HMPAO SPECT

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    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru [Kushiro Neurosurgical Hospital, Hokkaido (Japan); Aburano, Tamio

    2000-02-01

    Cerebral blood flow (CBF) measured by {sup 99m}Tc-HMPAO SPECT before operation was studied in 60 patients with unilateral chronic subdural hematoma. The regional CBF was measured in 26 regions of the fronto-occipital 10 cortices, putamen, thalamus and cerebellar hemisphere on both sides. Sixty cases with unilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 17 cases with headache (headache group), 34 cases with hemiparesis (hemiparesis group) and 9 cases with consciousness disturbance or dementia (consciousness disturbance group), and into three groups on the basis of the degree of midline brain shift on MRI: 7 cases of mild shift group, 24 cases of moderate shift group and 29 cases of severe shift group. The average CBF in 60 patients in each region indicated that the regional CBF was reduced in frontal, occipital cortices and cerebellum on the non-hematoma side, and in putamen and thalamus on the hematoma side. In the headache group, the regional CBF reduction on the non-hematoma side was found in only frontal and occipital cortices compared with the corresponding regions on the hematoma side. In the hemiparesis group, the regional CBF was reduced in frontal and occipital cortices on the non-hematoma side and in putamen and thalamus on the hematoma side. The part of CBF reduction in both hemispheres was also noted in the hemiparesis group. In the consciousness disturbance group, the CBF reduction was markedly noted in whole brain. The CBF reductions in frontal and occipital cortices on the non-hematoma side and in putamen, thalamus and cerebellum on the hematoma side was not mutually related with the degree of midline brain shift. We concluded that the disturbance of CBF in chronic subdural hematoma was started from frontal and occipital cortices on the non-hematoma side observed in the headache group, and which was extended to putamen and thalamus on the hematoma side and a part of both hemispheres observed in

  1. Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru; Aburano, Tamio

    2000-01-01

    Cerebral blood flow (CBF) measured by 99m Tc-HMPAO SPECT before operation was studied in 60 patients with unilateral chronic subdural hematoma. The regional CBF was measured in 26 regions of the fronto-occipital 10 cortices, putamen, thalamus and cerebellar hemisphere on both sides. Sixty cases with unilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 17 cases with headache (headache group), 34 cases with hemiparesis (hemiparesis group) and 9 cases with consciousness disturbance or dementia (consciousness disturbance group), and into three groups on the basis of the degree of midline brain shift on MRI: 7 cases of mild shift group, 24 cases of moderate shift group and 29 cases of severe shift group. The average CBF in 60 patients in each region indicated that the regional CBF was reduced in frontal, occipital cortices and cerebellum on the non-hematoma side, and in putamen and thalamus on the hematoma side. In the headache group, the regional CBF reduction on the non-hematoma side was found in only frontal and occipital cortices compared with the corresponding regions on the hematoma side. In the hemiparesis group, the regional CBF was reduced in frontal and occipital cortices on the non-hematoma side and in putamen and thalamus on the hematoma side. The part of CBF reduction in both hemispheres was also noted in the hemiparesis group. In the consciousness disturbance group, the CBF reduction was markedly noted in whole brain. The CBF reductions in frontal and occipital cortices on the non-hematoma side and in putamen, thalamus and cerebellum on the hematoma side was not mutually related with the degree of midline brain shift. We concluded that the disturbance of CBF in chronic subdural hematoma was started from frontal and occipital cortices on the non-hematoma side observed in the headache group, and which was extended to putamen and thalamus on the hematoma side and a part of both hemispheres observed in the

  2. Unilateral Renal Ischemia-Reperfusion as a Robust Model for Acute to Chronic Kidney Injury in Mice.

    Directory of Open Access Journals (Sweden)

    Nathalie Le Clef

    Full Text Available Acute kidney injury (AKI is an underestimated, yet important risk factor for development of chronic kidney disease (CKD. Even after initial total recovery of renal function, some patients develop progressive and persistent deterioration of renal function and these patients are more likely to progress to end-stage renal disease (ESRD. Animal models are indispensable for unravelling the mechanisms underlying this progression towards CKD and ESRD and for the development of new therapeutic strategies in its prevention or treatment. Ischemia (i.e. hypoperfusion after surgery, bleeding, dehydration, shock, or sepsis is a major aetiology in human AKI, yet unilateral ischemia-reperfusion is a rarely used animal model for research on CKD and fibrosis. Here, we demonstrate in C57Bl/6J mice, by both histology and gene expression, that unilateral ischemia-reperfusion without contralateral nephrectomy is a very robust model to study the progression from acute renal injury to long-term tubulo-interstitial fibrosis, i.e. the histopathological hallmark of CKD. Furthermore, we report that the extent of renal fibrosis, in terms of Col I, TGFβ, CCN2 and CCN3 expression and collagen I immunostaining, increases with increasing body temperature during ischemia and ischemia-time. Thus, varying these two main determinants of ischemic injury allows tuning the extent of the long-term fibrotic outcome in this model. Finally, in order to cover the whole practical finesse of ischemia-reperfusion and allow model and data transfer, we provide a referenced overview on crucial technical issues (incl. anaesthesia, analgesia, and pre- and post-operative care with the specific aim of putting starters in the right direction of implementing ischemia in their research and stimulate them, as well as the community, to have a critical view on ischemic literature data.

  3. Chronic intrastriatal dopamine infusions in rats with unilateral lesions of the substantia nigra

    International Nuclear Information System (INIS)

    Hargraves, R.; Freed, W.J.

    1987-01-01

    This study examined the effects of continuously supplied dopamine delivered directly into the dopamine-deficient striatum. Rats received unilateral lesions of the substantia nigra by stereotaxic administration of 6-hydroxydopamine and were tested for apomorphine-induced rotational behavior and general activity. Osmotic mini-pumps were filled with dopamine in various concentrations, implanted subcutaneously and connected to a cannula implanted directly into the striatum. The system delivered solution at a rate of .5 μl/hr for two weeks. Dopamine in a dosage of 0.5 μg/per hour reduced apomorphine-induced rotational behavior by a mean of 52 +/- 5.8% (mean +/- SEM n=20) with a maximal individual decrease of 99%. There was no change in general activity or increase in stereotype behavior. Infusions of vehicle solutions did not decrease rotational behavior. Spread of the infused dopamine and its metabolites was estimated by adding 3 H-dopamine to the pumps in tracer quantities. Radioactivity was highly concentrated at the infusion site and decreased rapidly within a few mm from the infusion site. Continuous infusion methods may eventually prove to be effective in the treatment of nigro-striatal degenerative disease. 12 references, 4 figures

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

    Directory of Open Access Journals (Sweden)

    Renata Cantisani Di Francesco

    2016-06-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  6. Cervical spinal tuberculosis with tuberculous otitis media ...

    African Journals Online (AJOL)

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

  7. Cervical spinal tuberculosis with tuberculous otitis media ...

    African Journals Online (AJOL)

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

  8. Neurological Assessment Using a Quantitative Sensory Test in Patients with Chronic Unilateral Orofacial Pain.

    Science.gov (United States)

    Salame, Talal H; Blinkhorn, Antony; Karami, Zahra

    2018-01-01

    Quantitative Sensory Testing (QST) has been used in clinical and experimental settings to establish sensory assessment for different types of pains, and may be a useful tool for the assessment of orofacial pain, but this premise needs to be tested. The aim of the study was to evaluate responses to thermal stimuli between painful and non-painful facial sites in subjects with orofacial pain using QST. A total of 60 participants (5o females: 28-83 years; 10 males: 44-81 years) with unilateral orofacial pain were recruited from the Orofacial Pain Clinic at the Pain Management and Research Centre, Royal North Shore Hospital, Sydney, Australia. The study followed the methods of limits of the German Research Network testing four modalities of thermal thresholds, the Warm Sensation, the Cold Sensation, the Heat Pain and the Cold Pain using a TSA-II Neurosensory Analyser. The results were compared to the results from the unaffected side of the same patient on the same area and a single t test statistical analysis was performed, where a p value of less than 0.05 was considered significant. The Mean Difference for Cold Sensation between the pain side and the non-pain side was 0.48 °C ± 1.5 (t= 2.466, p=0.017), 0.68 °C ± 2.04 for Warm Sensation (t= -2.573, p= 0.013), 2.56 °C ± 2.74 for Cold Pain (t= 7.238, pPain (t= -3.639, p=0.001). The study showed that QST methods using thermal stimuli could be used to evaluate sensory dysfunction in orofacial pain patients using the specific parameters of cool and warm sensation, and cold and hot pain.

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

    Science.gov (United States)

    Wasson, J D; Yung, M W

    2015-02-01

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

  10. Contingency learning deficits and generalization in chronic unilateral hand pain patients.

    Science.gov (United States)

    Meulders, Ann; Harvie, Daniel S; Bowering, Jane K; Caragianis, Suzanne; Vlaeyen, Johan W S; Moseley, G Lorimer

    2014-10-01

    Contingency learning, in particular the formation of danger beliefs, underpins conditioned fear and avoidance behavior, yet equally important is the formation of safety beliefs. That is, when threat beliefs and accompanying fear/avoidance spread to technically safe cues, it might cause disability. Indeed, such over generalization has been advanced as a trans-diagnostic pathologic marker, but it has not been investigated in chronic pain. Using a novel hand pain scenario contingency learning task, we tested the hypotheses that chronic hand pain patients demonstrate less differential pain expectancy judgments because of poor safety learning and demonstrate broader generalization gradients than healthy controls. Participants viewed digitized 3-dimensional hands in different postures presented in random order (conditioned stimulus [CS]) and rated the likelihood that a fictive patient would feel pain when moving the hand into that posture. Subsequently, the outcome (pain/no pain) was presented on the screen. One hand posture was followed by pain (CS+), another was not (CS-). Generalization was tested using novel hand postures (generalization stimuli) that varied in how similar they were to the original conditioned stimuli. Patients, but not healthy controls, demonstrated a contingency learning deficit determined by impaired safety learning, but not by exaggerated pain expectancy toward the CS+. Patients showed flatter, asymmetric generalization gradients than the healthy controls did, with higher pain expectancy for novel postures that were more similar to the original CS-. The results clearly uphold our hypotheses and suggest that contingency learning deficits might be important in the development and maintenance of the chronic pain-related disability. Chronic hand pain patients demonstrate 1) reduced differential contingency learning determined by a lack of safety belief formation, but not by exaggerated threat belief formation, and 2) flatter, asymmetric

  11. The microbiome of otitis media with effusion.

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    1995-01-01

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

  13. Three cases of tuberculous otitis media

    International Nuclear Information System (INIS)

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

    1998-01-01

    We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis

  14. Three cases of tuberculous otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)

    1998-07-01

    We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis.

  15. Laser treatment of otitis media in children

    Energy Technology Data Exchange (ETDEWEB)

    Podoynitsyna, L.F.

    1984-08-01

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

  16. A rare life-threatening disease: unilateral kidney compressed by huge chronic spontaneous retroperitoneal hemorrhage

    Directory of Open Access Journals (Sweden)

    Lu HY

    2018-03-01

    Full Text Available Hao-Yuan Lu,1,* Wei Wei,2,* Qi-Wei Chen,1,* Qing-Gui Meng,1 Gao-Hua Hu,1 Xian-Lin Yi,1,3 Xian-Zhong Bai1 1Department of Urology, Tumor Hospital of Guangxi Medical University and Guangxi Cancer Research Institute, Nanning 530021, China; 2Department of Radiology, Tumor Hospital of Guangxi Medical University and Guangxi Cancer Research Institute, Nanning 530021,China; 3Hubei Engineering Laboratory for Synthetic Microbiology, Wuhan Institute of Biotechnology, Wuhan 430075, China *These authors contributed equally to this work Objectives: To study an uncommon life-threatening disease, spontaneous retroperitoneal and perirenal hemorrhage. Case descriptions: A 69-year-old male presented with pain in the left waist and back of 1 month duration. The renal abscess was suspected by magnetic resonance imaging before operation. The perirenal hematoma was cleaned by operation. In another case, the patient had a functional solitary left kidney compressed by a huge retroperitoneal mass and uropenia appeared. Results: The first patient died of adult respiratory distress syndrome after surgery. The second patient died of cardiac insufficiency and pulmonary embolism on the second day after evacuation of retroperitoneal hematoma. Conclusion: Conservative surgery, such as selective arterial embolization, is a reasonable approach in patients with chronic spontaneous retroperitoneal and perirenal space hemorrhage and with poor general condition. We strongly recommend drainage or interventional therapy, but not a major surgery, in patients with poor condition. Keywords: kidney, spontaneous, retroperitoneal, hemorrhage, surgery

  17. 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,…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-06-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  20. 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.

  1. The transcriptome of a complete episode of acute otitis media.

    Science.gov (United States)

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

    2015-04-03

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

  2. Establishment of a rhesus monkey model of chronic temporal lobe epilepsy using repetitive unilateral intra-amygdala kainic acid injections.

    Science.gov (United States)

    Chi, Yajie; Wu, Bolin; Guan, Jianwei; Xiao, Kuntai; Lu, Ziming; Li, Xiao; Xu, Yuting; Xue, Shan; Xu, Qiang; Rao, Junhua; Guo, Yanwu

    2017-09-01

    Temporal lobe epilepsy (TLE) is a common type of acquired epilepsy refractory to medical treatment. As such, establishing animal models of this disease is critical to developing new and effective treatment modalities. Because of their small head size, rodents are not suitable for comprehensive electroencephalography (EEG) evaluation via scalp or subdural electrodes. Therefore, a larger primate model that closely recapitulates signs of TLE is needed; here we describe a rhesus monkey model resembling chronic TLE. Eight monkeys were divided into two groups: kainic acid (KA) group (n=6) and saline control group (n=2). Intra-amygdala KA injections were performed biweekly via an Ommaya device until obvious epileptiform discharges were recorded. Video-EEG recording was conducted intermittently throughout the experiment using both scalp and subdural electrodes. Brains were then analyzed for Nissl and glial fibrillary acid protein (GFAP) immunostaining. After 2-4 injections of KA (approximately 1.2-2.4mg, 0.12-0.24mg/kg), interictal epileptiform discharges (IEDs) were recorded in all KA-treated animals. Spontaneous recurrent seizures (SRSs) accompanied by symptoms mimicking temporal lobe absence (undetectable without EEG recording), but few mild motor signs, were recorded in 66.7% (four of six) KA-treated animals. Both IEDs and seizures indicated a primary epileptic zone in the right temporal region and contralateral discharges were later detected. Segmental pyramidal cell loss and gliosis were detected in the brain of a KA-treated monkey. Through a modified protocol of unilateral repetitive intra-amygdala KA injections, a rhesus monkey model with similar behavioral and brain electrical features as TLE was developed. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Recovery of cerebral blood flow in unilateral chronic subdural hematoma. The correlation with cerebral re-expansion in elders

    International Nuclear Information System (INIS)

    Nemoto, Akio

    2003-01-01

    CT and SPECT were used to investigate the relationship between cerebral re-expansion and changes in cerebral blood flow underneath hematoma in elderly patients after surgery for chronic unilateral subdural hematoma. I studied 22 patients with mild hematoma, aged 43 to 82 years (mean 67 years). The patients were placed in either Group A (under 70 years) or Group B (70 years or over) to observe postoperative changes. CT and SPECT examinations were conducted before surgery and 1, 7 and 30 days after surgery, 4 times in total. Cerebral re-expansion was represented by the re-expansion rate (PER) comparing the pre- and postoperative thickness of the maximal hematoma in CT images. The rate of cerebral re-expansion was slowed in Group B (p<0.01). Cerebral re-expansion was characterized by biphasic, rapid or gradual re-expansion on postoperative day 1 with a significant difference between groups (p<0.01). Before surgery, cerebral blood flow on the affected side correlated with age (p<0.01), thougn blood flow was diminished in both groups. After surgery, cerebral blood flow on the affected side exceeded that on the unaffected side in Group A and transiently increased on postoperative day 1. Cerebral blood flow improved after surgery in both groups, with a significant difference in those changes over time (p<0.01). In both groups, cerebral re-expansion on postoperative days 7 and 30 correlated with cerebral blood flow on the affected side (p<0.05). The present results suggest that improvement in cerebral blood flow on the affected side is delayed in elderly patients, due to slower postoperative cerebral re-expansion. (author)

  4. 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)

    Jung, Cheol Kyu; Park, Dong Woo; Seong, Jin Yong; Lee, Kak Soo; Park Choong Ki; Lee, Seung Ro; Hahm, Chang Kok

    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 flaccida (35

  5. 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

  6. "Swimmer's Ear" (Otitis Externa) Prevention

    Science.gov (United States)

    ... infections, swimmer’s ear, and healthy swimming. "Swimmer's Ear" (Otitis Externa) What are the symptoms of swimmer's ear? ... Healthy page. Reference CDC. Estimated burden of acute otitis externa —United States, 2003–2007 . MMWR Morb Mortal ...

  7. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Danish guidelines on management of otitis media in preschool children

    DEFF Research Database (Denmark)

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

    2016-01-01

    Introduction: Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment...... for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update...... the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. Methods: The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation...

  10. Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

    Directory of Open Access Journals (Sweden)

    Stefaan Van Damme

    2018-01-01

    Full Text Available Background Patients with chronic orofacial pain due to temporomandibular disorders (TMD display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. Methods TMD patients with chronic unilateral orofacial pain (n = 20 and matched healthy volunteers (n = 20 performed a temporal order judgment (TOJ task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. Results TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance (p = .07. In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. Discussion The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a

  11. Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

    Science.gov (United States)

    Van Damme, Stefaan; Vanden Bulcke, Charlotte; Van Den Berghe, Linda; Poppe, Louise; Crombez, Geert

    2018-01-01

    Patients with chronic orofacial pain due to temporomandibular disorders (TMD) display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. TMD patients with chronic unilateral orofacial pain ( n  = 20) and matched healthy volunteers ( n  = 20) performed a temporal order judgment (TOJ) task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance ( p  = .07). In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a reason for this. The findings are discussed within

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

    Azadarmaki, Roya; Westra, William; Prasad, Sanjay

    2015-09-01

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

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

    Science.gov (United States)

    Vernon-Feagans, Lynne; And Others

    1996-01-01

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

  15. Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2.

    Science.gov (United States)

    Hall, A; Wills, A K; Mahmoud, O; Sell, D; Waylen, A; Grewal, S; Sandy, J R; Ness, A R

    2017-06-01

    To explore centre-level variation in otitis media with effusion (OME), hearing loss and treatments in children in Cleft Care UK (CCUK) and to examine the association between OME, hearing loss and developmental outcomes at 5 and 7 years. Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK. Children had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as >20 dB in the better ear and history of OME and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self-confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression. There was centre-level variation in early grommet placement (variance partition coefficient (VPC) 18%, P=.001) and fitting of hearing aids (VPC 8%, P=.03). A history of OME and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% CI 1.42-5.77) and aspects of educational attainment. Hearing loss is an important determinant of poor speech and treatment variation across centres suggest management of OME and hearing loss could be improved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Acute otitis media.

    Science.gov (United States)

    Dickson, Gretchen

    2014-03-01

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

  17. Manejo clinicoquirúrgico de la otitis media crónica colesteatomatosa en el niño Clinical and surgical management of cholesteatomatous chronic otitis media in children

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa

    2007-12-01

    Full Text Available El tratamiento de la otitis media crónica colesteatomatosa en los niños es controversial y difícil. Nos propusimos caracterizar a pacientes pediátricos con colesteatomas extensos e infección activa, así como identificar hallazgos otoscópicos y quirúrgicos, complicaciones, microbiología, eficacia del tratamiento antimicrobiano y afectaciones funcionales auditivas. Se realizó un estudio descriptivo prospectivo con 12 pacientes, en edades entre 4 y 15 años, operados mediante técnica abierta combinada con timpanoplastia y osiculoplastia entre el 2001 y el 2004. La evolución de los pacientes fue seguida hasta los 3 años después de la cirugía. Los hallazgos más frecuentes fueron la perforación epitimpánica posterior marginal (41,6 %, lesión osicular total (50 %, facial timpánico dehiscente y erosión del canal semicircular horizontal (45,4 %. Las complicaciones intratemporales fueron las más frecuentes (50 %. Se realizó reconstrucción tímpano-osicular a 8 pacientes y los resultados auditivos fueron satisfactorios en el 66,6 %, mientras que la respuesta al antimicrobiano utilizado fue eficaz en el 100 %. El uso de la técnica quirúrgica abierta unida a una correcta estrategia antibiótica es lo indicado en los niños con colesteatomas extensos y con infección activa.The treatment of in children is controversial and difficult. We proposed ourselves to characterize pediatric patients with extensive cholesteatomas and active infection, as well as to identify otoscopic and surgical findings, complications, microbiology, efficiency of the antimicrobial treatment and functional auditive affections. A descriptive and prospective study was conducted among 12 patients aged 4-15 that were operated on by open technique combined with tympanoplasty and ossiculoplasty from 2001 to 2004. The evolution of the patients was followed during 3 years after surgery. The most common findings were posterior marginal epytimpanic perforation (41

  18. Unilateral initiatives

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    This paper reports on arms control which is generally thought of in terms of formal negotiations with an opponent, with the resulting agreements embodied in a treaty. This is not surprising, since arms control discussions between opponents are both important and politically visible. There are, however, strong reasons for countries to consider and frequently take unilateral initiatives. To do so is entirely consistent with the established major precepts of arms control which state that arms control is designed to reduce the risk of war, the costs of preparing for war, and the death and destruction if war should come. Unilateral initiatives on what weapons are purchased, which ones are eliminated and how forces are deployed can all relate to these objectives. There are two main categories of motives for unilateral initiatives in arms control. In one category, internal national objectives are the dominant, often sole, driving force; the initiative is undertaken for our own good

  19. Acute otitis media in children

    OpenAIRE

    Cherpillod, Jacques

    2011-01-01

    Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

  20. 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

  1. A case report of bicornis bicollis uterus with unilateral cervical atresia: an unusual aetiology of chronic debilitating pelvic pain in a Cameroonian teenager.

    Science.gov (United States)

    Dohbit, Julius Sama; Meka, Esther; Tochie, Joel Noutakdie; Kamla, Igor; Mwadjie, Darolles; Foumane, Pascal

    2017-06-02

    Congenital uterine anomalies like bicornis or bicornuate uterus are relatively rare in sub-Saharan Africa. They are associated with an increased rate of spontaneous abortion, preterm delivery, and infertility. The occurrence of bicornis bicollis uterus with unilateral cervical atresia is exceptional and its management is controversial. We hereby report a rare cause of chronic pelvic pain in a Cameroonian teenager due to unilateral obstructive hematometra and hematosalpinx in the non-communicating horn of a bicornis bicollis uterus. A 13-year-old premenarchal non-virgin female presented with chronic and severe cyclical crampy pelvic pain. On clinical examination, she had a perforated hymen, a single vagina, and one uterine cervix. A two-dimensional pelvic ultrasonography revealed hematometra but missed out the underlying anomaly. Failure to drain the hematometra by serial cervical dilatations prompted an exploratory laparotomy which revealed: bicornis bicollis uterus with a right rudimentary uterine horn communicating with the vagina and a left non-communicating uterine horn distended by hematometra due to a homolateral cervical atresia. She underwent utero-vaginal canalization and a left hemi-hysterotomy with drainage of the hematometra. The postoperative period was uneventful. Regular cyclic menses occurred thereafter beginning at the first postoperative month. She had complete resolution of symptoms without recurrence after six months. Due to the risk of compromised fertility from bicornis uterus and the diagnostic challenges akin to resource-limited settings, we highlight the need for a high index of suspicion by healthcare providers when faced with chronic pelvic pain in premenarchal adolescents.

  2. CT of malignant otitis externa

    International Nuclear Information System (INIS)

    Klose, K.C.; Elies, W.; Technische Hochschule Aachen

    1991-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  4. Malignant external otitis

    International Nuclear Information System (INIS)

    Dupuch, K.M.; Iryboz, T.; Firat, M.; Levy, C.; Tubiana, J.M.

    1991-01-01

    This paper illustrates the value of CT and MR in early diagnosis and spread of malignant external otitis. The authors retrospectively analyzed 15 patients with proved malignant external otitis examined with postcontrast high-resolution CT (15/15) and MR (6/15) (T1- and T2-weighting). Gallium studies were done in 6/15 patients. Early diagnosis was made when CT demonstrated a soft-tissue mass of the external auditory canal associated with scattered zones of cortical bone erosions (13/15). Spread of the disease was better delineated by MR than CT, especially skull base extension (6/15). Temporomandibular joint involvement with extension into parotid or/and masticator spaces 6/15 was as well detected with CT as with MR. If CT remains the first and best procedure for diagnosis, MR - despite its cost - appears a good procedure to depict exact anatomic spread, allowing therapeutic management

  5. 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...

  6. 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...

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

    Science.gov (United States)

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

    2016-10-01

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

  8. [Surgical treatment of patients with exudative otitis media].

    Science.gov (United States)

    Dmitriev, N S; Mileshina, N A

    2003-01-01

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

  9. Contemporary concepts in management of acute otitis media in children.

    Science.gov (United States)

    Rettig, Eleni; Tunkel, David E

    2014-10-01

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

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

    Science.gov (United States)

    Juhn, Young J.; Wi, Chung-Il

    2014-01-01

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

  11. 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.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    1983-02-10

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

  14. 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

    International Nuclear Information System (INIS)

    Guo, Yong; Liu, Yang; Lu, Qiao-hui; Zheng, Kui-hong; Shi, Li-jing; Wang, Qing-jun

    2013-01-01

    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

  15. Comparison between the angle of Eustachian tube in patients with chronic suppurative otitis media and normal ears based on computed tomography scan of temporal bones in Haji Adam Malik general hospital Medan

    Science.gov (United States)

    Masita, S.; Zahara, D.; Aboet, A.

    2018-03-01

    The function of the Eustachian tube plays a significant role in increased risk chronic suppurative otitis media (CSOM). The angle of the Eustachian tube is a predisposing factor for Eustachian tube dysfunction and clearance disorder of the middle ear. The aim of this study was to compare the mean angle of a Eustachian tube of CSOM ears and normal ears. This research was a cross-sectional study consisting of 19 patients of CSOM without cholesteatoma, 19 patients of CSOM with cholesteatoma and 19 patients with normal ears. All patients were examined using CT Temporal, and the angle of the eustachian tube was measured using multiplanar reconstruction technique. The mean angle of Eustachian tube in CSOM patients without cholesteatoma was 32.82° (SD=3.82), in CSOM with cholesteatoma was 27.74° (SD=4.44) and in normal ears was 33.61° (SD=3.83). Based on Kruskal-Wallis test, there was a significant difference in the angle of a Eustachian tube of these three groups (p<0.001). There was a significant difference between the mean angle of the Eustachian tube in CSOM ears and normal ears.

  16. 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.

  17. KRITERIA DIAGNOSIS DAN PENATALAKSANAAN OTITIS MEDIA SUPURATIF KRONIS

    Directory of Open Access Journals (Sweden)

    Fairuziah Bader Alkatiri

    2016-03-01

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

  18. Malignant Otitis Externa and Stroke

    Directory of Open Access Journals (Sweden)

    Marta Catarino Manso

    2016-06-01

    Full Text Available Malignant otitis externa (MOE is an aggressive but benign entity which evolves into skull base osteomyelitis. An 81-year-old female patient was admitted for left hemiparesis and homonymous hemianopia. She complained of headache radiating to the right cervical area. A recent history of recurrent otitis media was present. Head and neck imaging showed an ischemic infarction (right temporo-occipital and a parapharyngeal soft tissue mass originating in an external and medial ear infection. Culture samples revealed Pseudomonas aeruginosa infection leading to the diagnosis of Malignant otitis externa (MOE. Parenteral antibacterial therapy and hyperbaric oxygen therapy resulted in improvement.

  19. Short-term effects of whole-body vibration on postural control in unilateral chronic stroke patients: preliminary evidence.

    NARCIS (Netherlands)

    Nes, I.J.W. van; Geurts, A.C.H.; Hendricks, H.T.; Duysens, J.E.J.

    2004-01-01

    The short-term effects of whole-body vibration as a novel method of somatosensory stimulation on postural control were investigated in 23 chronic stroke patients. While standing on a commercial platform, patients received 30-Hz oscillations at 3 mm of amplitude in the frontal plane. Balance was

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

    Directory of Open Access Journals (Sweden)

    M. Faruk Oktay

    2007-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  2. Otoscopic diagnosis of otitis media.

    Science.gov (United States)

    Isaacson, Glenn

    2016-12-01

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

  3. Malignant external otitis: CT evaluation

    International Nuclear Information System (INIS)

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-01-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  5. Acute Otitis Media in Children.

    Science.gov (United States)

    Leung, Alexander K C; Wong, Alex H C

    2017-01-01

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

  6. Otitis media in indonesian urban and rural school children.

    Science.gov (United States)

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

    2014-10-01

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

  7. Pulmonary histoplasmosis presenting as chronic productive cough, fever, and massive unilateral consolidation in a 15-year-old immune-competent boy: a case report

    Directory of Open Access Journals (Sweden)

    Mshana Stephen E

    2011-08-01

    Full Text Available Abstract Introduction Severe histoplasmosis is known to be among the AIDS-defining opportunistic infections affecting patients with very low CD4 cell counts in histoplasmosis-endemic areas. Histoplasma capsulatum var. duboisii is common in West and Central Africa, where it occurs in both HIV/AIDS and non-HIV patients. Few cases of life-threatening histoplasmosis in immune-competent individuals have been reported worldwide. Case report We describe a case of pulmonary histoplasmosis diagnosed on the basis of autopsy and histological investigations. A 15-year old East African immune-competent boy with a history of smear-positive tuberculosis and a two-year history of rock cutting presented to our hospital with chronic productive cough, fever, and massive unilateral consolidation. At the time of presentation to our hospital, this patient was empirically treated for recurrent tuberculosis without success, and he died on the seventh day after admission. The autopsy revealed a huge granulomatous lesion with caseation, but no acid-fast bacilli were detected on several Ziehl-Neelsen stains. However, periodic acid-Schiff staining was positive, and the histological examination revealed features suggestive of Histoplasma yeast cells. Conclusion Severe pulmonary histoplasmosis should be considered in evaluating immune-competent patients with risk factors for the disease who present with pulmonary symptoms mimicking tuberculosis.

  8. Electrical stimulation of motor cortex in the uninjured hemisphere after chronic unilateral injury promotes recovery of skilled locomotion through ipsilateral control.

    Science.gov (United States)

    Carmel, Jason B; Kimura, Hiroki; Martin, John H

    2014-01-08

    Partial injury to the corticospinal tract (CST) causes sprouting of intact axons at their targets, and this sprouting correlates with functional improvement. Electrical stimulation of motor cortex augments sprouting of intact CST axons and promotes functional recovery when applied soon after injury. We hypothesized that electrical stimulation of motor cortex in the intact hemisphere after chronic lesion of the CST in the other hemisphere would restore function through ipsilateral control. To test motor skill, rats were trained and tested to walk on a horizontal ladder with irregularly spaced rungs. Eight weeks after injury, produced by pyramidal tract transection, half of the rats received forelimb motor cortex stimulation of the intact hemisphere. Rats with injury and stimulation had significantly improved forelimb control compared with rats with injury alone and achieved a level of proficiency similar to uninjured rats. To test whether recovery of forelimb function was attributable to ipsilateral control, we selectively inactivated the stimulated motor cortex using the GABA agonist muscimol. The dose of muscimol we used produces strong contralateral but no ipsilateral impairments in naive rats. In rats with injury and stimulation, but not those with injury alone, inactivation caused worsening of forelimb function; the initial deficit was reinstated. These results demonstrate that electrical stimulation can promote recovery of motor function when applied late after injury and that motor control can be exerted from the ipsilateral motor cortex. These results suggest that the uninjured motor cortex could be targeted for brain stimulation in people with large unilateral CST lesions.

  9. Unilateral ptosis

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-11-23

    Nov 23, 2013 ... Chronic sinusitis is an inflammatory lesion that involves the paranasal sinuses with ... nasal stuffiness, nasal discharge, postnasal drip, facial pain/pressure ... superior rami branch of the occulomotor nerve by the surrounding ...

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

    Science.gov (United States)

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

    2016-08-01

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

  11. Pediatric otitis media in Fiji: Survey findings 2015.

    Science.gov (United States)

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

    2016-06-01

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

  12. Your actions in my cerebellum: subclinical deficits in action observation in patients with unilateral chronic cerebellar stroke.

    Science.gov (United States)

    Cattaneo, Luigi; Fasanelli, Monica; Andreatta, Olaf; Bonifati, Domenico Marco; Barchiesi, Guido; Caruana, Fausto

    2012-03-01

    Empirical evidence indicates that cognitive consequences of cerebellar lesions tend to be mild and less important than the symptoms due to lesions to cerebral areas. By contrast, imaging studies consistently report strong cerebellar activity during tasks of action observation and action understanding. This has been interpreted as part of the automatic motor simulation process that takes place in the context of action observation. The function of the cerebellum as a sequencer during executed movements makes it a good candidate, within the framework of embodied cognition, for a pivotal role in understanding the timing of action sequences. Here, we investigated a cohort of eight patients with chronic, first-ever, isolated, ischemic lesions of the cerebellum. The experimental task consisted in identifying a plausible sequence of pictures from a randomly ordered group of still frames extracted from (a) a complex action performed by a human actor ("biological action" test) or (b) a complex physical event occurring to an inanimate object ("folk physics" test). A group of 16 healthy participants was used as control. The main result showed that cerebellar patients performed significantly worse than controls in both sequencing tasks, but performed much worse in the "biological action" test than in the "folk physics" test. The dissociation described here suggests that observed sequences of simple motor acts seem to be represented differentially from other sequences in the cerebellum.

  13. Acute otitis media with spontaneous tympanic membrane perforation.

    Science.gov (United States)

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

    2017-01-01

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

  14. Danish guidelines on management of otitis media in preschool children.

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2007-11-01

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

  16. Tuberculous otitis media: a resurgence?

    Science.gov (United States)

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

    2017-09-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

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

  19. Bone scanning in severe external otitis

    International Nuclear Information System (INIS)

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

    1986-01-01

    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

  20. Otitis Media, Learning and Community.

    Science.gov (United States)

    McSwan, David; Clinch, Emma; Store, Ron

    2001-01-01

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

  1. Different mechanisms of contralateral- or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain: a pilot fMRI study

    Directory of Open Access Journals (Sweden)

    Zhang S

    2018-03-01

    Full Text Available Shuai Zhang,1,* Xu Wang,2,* Chao-Qun Yan,1 Shang-Qing Hu,3 Jian-Wei Huo,4 Zhong-Yan Wang,4 Ping Zhou,1 Chun-Hong Liu,1 Cun-Zhi Liu3 1Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, 2School of Life Sciences, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 3Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Fengtai District, Beijing, 4Department of Medical Imaging, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Chronic shoulder pain (CSP is a common disease causing pain and functional limitation, which is highly prevalent and has substantial negative effects on the quality of life. Acupuncture has gained popularity and has been accepted gradually by many countries because it can successfully treat patients with chronic pain, but the specific brain mechanisms under acupuncture treatment for CSP remain unclear. Therefore, in this study, we aimed to 1 compare the clinical effects between acupuncture at the contralateral and ipsilateral Tiaokou (ST 38 point in patients with unilateral shoulder pain and 2 explore how contralateral- and ipsilateral-acupuncture modulates the regional homogeneity (ReHo of patients with CSP.Patients and methods: This was a pilot functional magnetic resonance imaging (fMRI trial. Twenty-four patients with CSP were recruited and randomized to the contralateral acupuncture group (contra-group and the ipsilateral acupuncture group (ipsi-group. All patients completed resting-state functional magnetic resonance imaging (fMRI scans before and after acupuncture treatment. Shoulder pain intensity (visual analog scale [VAS] and shoulder joint function (Constant–Murley score [CMS] were used

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

    Science.gov (United States)

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

    2016-06-01

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

  3. 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

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

    Science.gov (United States)

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

    2017-10-01

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

  5. Bilateral elevation of interleukin-6 protein and mRNA in both lumbar and cervical dorsal root ganglia following unilateral chronic compression injury of the sciatic nerve

    Czech Academy of Sciences Publication Activity Database

    Dubový, P.; Brázda, Václav; Klusáková, I.; Hradilová-Svíženská, I.

    2013-01-01

    Roč. 10, č. 55 (2013) E-ISSN 1742-2094 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081707 Keywords : Unilateral nerve injury * Contralateral reaction * Remote ganglia Subject RIV: BO - Biophysics Impact factor: 4.902, year: 2013

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

    Science.gov (United States)

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

    2017-08-01

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

  7. 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...

  8. Serous otitis media and immunological reactions in the middle ear mucosa

    NARCIS (Netherlands)

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

    1988-01-01

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

  9. Importance of viruses in acute otitis media.

    Science.gov (United States)

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

    2015-02-01

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

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

    Science.gov (United States)

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

    2009-11-02

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

  11. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

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

    2009-01-01

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

  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.......The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...... and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate...

  13. Treatment of Recurrent Eczematous External Otitis with Honey Eardrops: A Proof-of-Concept Study.

    Science.gov (United States)

    Henatsch, Darius; Nabuurs, Cindy H; van de Goor, Rens M; Wolffs, Petra F; Stokroos, Robert J

    2017-10-01

    Eczematous external otitis is a chronic inflammatory disease and often difficult to treat. Our objective was to investigate the clinical effect and in vitro antibacterial potential of medical honey eardrops as treatment of eczematous external otitis. In a prospective study, 15 patients diagnosed with recurrent eczematous external otitis were treated with medical honey eardrops for 2 weeks. The following clinical outcomes were evaluated: visual analog scale of ear complaints, score of eczema, and eradication of bacterial infection. Furthermore, the antibacterial effect of honey eardrops against different bacterial strains was tested in vitro. Treatment resulted in less discomfort and itching and decreased signs of eczema, with high patient satisfaction and without adverse reactions. Honey eardrops showed a strong in vitro inhibitory activity against all tested strains but did not eradicate Staphylococcus aureus infection in vivo. The results of this preliminary study indicate a possible role of honey eardrops in eczematous ear disease.

  14. Evaluación clínicoinmunológica de la otitis media crónica en niños

    Directory of Open Access Journals (Sweden)

    Miriam Zaldívar Ochoa

    2003-10-01

    Full Text Available Se estudiaron las alteraciones clínicas inmunológicas en niños que presentan otitis media crónica (OMC, cuyo síntoma fundamental es la otorrea persistente, uni o bilateral, que tuvo sus comienzos en la mayoría de los casos en sus primeros años de vida. Se aplicaron métodos coherentes de investigación, lo que permitió llegar a algunos resultados como que el 52 % del universo estudiado presentaban déficit inmunológico, y de ellos el 76,9 % correspondió a inmunidad de tipo humoral. Estos resultados se utilizaron para orientar la acción terapéutica, y se encontraron diferencias significativas entre aquellos pacientes a los que se les aplicó tratamiento de su déficit inmunológico con alta respuesta satisfactoria, y a los que no, se les fue modificado su trastorno inmunológico.Clinical and immunological disturbances in children with chronic otitis media, whose fundamental symptom is persistent bilateral or unilateral otorrhea that mostly occured in the first years of life, were studied. Coherent research methods were implemented; this allowed achieving some results such as 52% of the studied universe had immunological deficit and 76,9% presented with humoral immunology. These results served to guide the therapeutical action. Significant differences between patients who had been applied treatment for their immune deficit with highly satisfactory response and those with immune disorder that was not solved.

  15. Otitis Media: Beyond the Examining Room.

    Science.gov (United States)

    Welling, Deborah R; Ukstins, Carol A

    2018-02-01

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

  16. Infant otitis media and the use of secondary heating sources.

    Science.gov (United States)

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

    2004-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  18. Unilateralism in International Law

    DEFF Research Database (Denmark)

    Hartmann, Jacques

    2015-01-01

    or foreign territory. Many States, however, viewed the EU’s initiative as a unilateral act in violation of their sovereignty. The EU has since suspended the application of the ETS to foreign aircraft. Even so, this incident raises important questions concerning the legality of unilateral acts under...... Union (EU) decided to act unilaterally to reduce emission from aviation, by including aviation within its Emission Trading System (ETS). Initially, the EU set out to include in the ETS emissions from all major aircraft flying to or from European airports, even when these fly over the high seas...

  19. Otitis Media: Effect on a Child's Learning.

    Science.gov (United States)

    Gdowski, Becky S.; And Others

    1986-01-01

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

  20. The external otitis necrotizing about 45 cases

    International Nuclear Information System (INIS)

    Chnitri, Sana

    2005-01-01

    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 .

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

    Science.gov (United States)

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

    2018-01-31

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

  2. Otitis and autism spectrum disorders

    Science.gov (United States)

    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 occurrences of misdiagnosis of PDD, which can occur when an adequate screening of the autistic syndrome is not realised. The result of the surgery was an improvement in autistic behaviours, despite the persistence of less severe autistic traits that may be more closely related to Asperger’s syndrome. PMID:22736729

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

  4. Otitis Media and Its Sequelae in Kenyan Schoolchildren.

    Science.gov (United States)

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

    2016-12-01

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

  5. 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....

  6. Computed tomography in diagnostics of effluent otitis media

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ana Rita Lameiras

    2017-05-01

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

  8. Apparent brain temperature imaging with multi-voxel proton magnetic resonance spectroscopy compared with cerebral blood flow and metabolism imaging on positron emission tomography in patients with unilateral chronic major cerebral artery steno-occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Nanba, Takamasa; Nishimoto, Hideaki; Murakami, Toshiyuki; Fujiwara, Shunrou; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Open and Transdisciplinary Research Initiatives, Osaka (Japan); Sasaki, Makoto; Uwano, Ikuko [Iwate Medical University, Institute for Biomedical Science, Iwate (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Iwate (Japan)

    2017-09-15

    The purpose of the present study was to determine whether apparent brain temperature imaging using multi-voxel proton magnetic resonance (MR) spectroscopy correlates with cerebral blood flow (CBF) and metabolism imaging in the deep white matter of patients with unilateral chronic major cerebral artery steno-occlusive disease. Apparent brain temperature and CBF and metabolism imaging were measured using proton MR spectroscopy and {sup 15}O-positron emission tomography (PET), respectively, in 35 patients. A set of regions of interest (ROIs) of 5 x 5 voxels was placed on an MR image so that the voxel row at each edge was located in the deep white matter of the centrum semiovale in each cerebral hemisphere. PET images were co-registered with MR images with these ROIs and were re-sliced automatically using image analysis software. In 175 voxel pairs located in the deep white matter, the brain temperature difference (affected hemisphere - contralateral hemisphere: ΔBT) was correlated with cerebral blood volume (CBV) (r = 0.570) and oxygen extraction fraction (OEF) ratios (affected hemisphere/contralateral hemisphere) (r = 0.641). We excluded voxels that contained ischemic lesions or cerebrospinal fluid and calculated the mean values of voxel pairs in each patient. The mean ΔBT was correlated with the mean CBF (r = - 0.376), mean CBV (r = 0.702), and mean OEF ratio (r = 0.774). Apparent brain temperature imaging using multi-voxel proton MR spectroscopy was correlated with CBF and metabolism imaging in the deep white matter of patients with unilateral major cerebral artery steno-occlusive disease. (orig.)

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

    Science.gov (United States)

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

    2017-06-01

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

  10. Learning Disabilities and Conductive Hearing Loss Involving Otitis Media.

    Science.gov (United States)

    Reichman, Julie; Healey, William C.

    1983-01-01

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

  11. Otitis Media and Children with Hearing Impairments: A Sequela.

    Science.gov (United States)

    Beattie, R. G. John L.

    1991-01-01

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

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

    NARCIS (Netherlands)

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

    1988-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Wong-Kein Low

    2018-01-01

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

  15. Electrical Stimulation of Motor Cortex in the Uninjured Hemisphere after Chronic Unilateral Injury Promotes Recovery of Skilled Locomotion through Ipsilateral Control

    OpenAIRE

    Carmel, Jason B.; Kimura, Hiroki; Martin, John H.

    2014-01-01

    Partial injury to the corticospinal tract (CST) causes sprouting of intact axons at their targets, and this sprouting correlates with functional improvement. Electrical stimulation of motor cortex augments sprouting of intact CST axons and promotes functional recovery when applied soon after injury. We hypothesized that electrical stimulation of motor cortex in the intact hemisphere after chronic lesion of the CST in the other hemisphere would restore function through ipsilateral control. To ...

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

    Science.gov (United States)

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

    2011-01-01

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

  17. Otitis media with effusion:diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-04-01

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

  18. 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...

  19. Bacteriology of chronic discharging ears in Port Harcourt, Nigeria

    African Journals Online (AJOL)

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

  20. Unilateral CHARGE association

    NARCIS (Netherlands)

    Trip, J; van Stuijvenberg, M; Dikkers, FG; Pijnenburg, MWH

    A case with a predominantly unilateral CHARGE association is reported. The CHARGE association refers to a combination of congenital malformations. This boy had left-sided anomalies consisting of choanal atresia. coloboma and peripheral facial palsy. The infant had a frontal encephalocele. an anomaly

  1. Unilateral hyperhidrosis and hypothermia

    DEFF Research Database (Denmark)

    Dyring-Andersen, B; Kamp, S; Madelung, A

    2016-01-01

    A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left...

  2. Zinc supplements for preventing otitis media.

    Science.gov (United States)

    Gulani, Anjana; Sachdev, Harshpal S

    2014-06-29

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

  3. Management of radiation-induced otitis externa

    International Nuclear Information System (INIS)

    Robinson, A.C.

    1990-01-01

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

  4. Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yoshiyasu; Ogasawara, Kuniaki; Saito, Hideo; Takahashi, Yoshihiro; Ogasawara, Yasushi; Kobayashi, Masakazu; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Yoshida, Kenji; Beppu, Takaaki; Kubo, Yoshitaka; Fujiwara, Shunrou [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Tsushima, Eiki [Hirosaki University, Graduate School of Health Sciences, Hirosaki (Japan)

    2013-10-15

    In patients with unilateral internal carotid or middle cerebral artery (ICA or MCA) occlusive disease, the degree of crossed cerebellar hypoperfusion that is evident within a few months after the onset of stroke may reflect cerebral metabolic rate of oxygen in the affected cerebral hemisphere relative to that in the contralateral cerebral hemisphere. The aim of the present study was to determine whether the ratio of blood flow asymmetry in the cerebellar hemisphere to blood flow asymmetry in the cerebral hemisphere on positron emission tomography (PET) and single photon emission computed tomography (SPECT) correlates with oxygen extraction fraction (OEF) asymmetry in the cerebral hemisphere on PET in patients with chronic unilateral ICA or MCA occlusive disease and whether this blood flow ratio on SPECT detects misery perfusion in the affected cerebral hemisphere in such patients. Brain blood flow and OEF were assessed using {sup 15}O-PET and N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) SPECT, respectively. All images were anatomically standardized using SPM2. A region of interest (ROI) was automatically placed in the bilateral MCA territories and in the bilateral cerebellar hemispheres using a three-dimensional stereotaxic ROI template, and affected-to-contralateral asymmetry in the MCA territory or contralateral-to-affected asymmetry in the cerebellar hemisphere was calculated. Sixty-three patients with reduced blood flow in the affected cerebral hemisphere on {sup 123}I-IMP SPECT were enrolled in this study. A significant correlation was observed between MCA ROI asymmetry of PET OEF and the ratio of cerebellar hemisphere asymmetry of blood flow to MCA ROI asymmetry of blood flow on PET (r = 0.381, p = 0.0019) or SPECT (r = 0.459, p = 0.0001). The correlation coefficient was higher when reanalyzed in a subgroup of 43 patients undergoing a PET study within 3 months after the last ischemic event (r = 0.541, p = 0.0001 for PET; r = 0.609, p < 0

  5. Molecular analysis of bacterial pathogens in otitis media with effusion.

    Science.gov (United States)

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

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

  6. Antibiotics for acute otitis media in children

    NARCIS (Netherlands)

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

    2013-01-01

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

  7. 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

  8. [Erespal effectiveness in exudative otitis media].

    Science.gov (United States)

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

    2003-01-01

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

  9. Malignant external otitis: early scintigraphic detection

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  10. Otitis Media in Young Children with Disabilities.

    Science.gov (United States)

    Zeisel, Susan A.; Roberts, Joanne E.

    2003-01-01

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

  11. 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

  12. Unilateral Hemispheric Encephalitis

    Directory of Open Access Journals (Sweden)

    Mohan Leslie Noone

    2014-10-01

    Full Text Available A 10 year old boy presented with history of mild fever and upper respiratory symptoms followed by recurrent seizures and loss of consciousness on the next day. Normal blood counts and abnormal hepatic transaminases were noted. MRI of the brain, done on the fourth day of illness, showed extensive involvement of the cortex in the right hemisphere. Lumbar CSF was normal. The EEG showed bilateral slowing with frontal sharp wave discharges and marked attenuation over the entire right hemisphere. The patient succumbed to the illness on the ninth day. A similar pattern of acute unilateral hemispheric cortical involvement is described in the hemiconvulsion-hemiplegia-epilepsy (HHE syndrome, which is typically described to occur in children below 4 years of age. This case of fulminant acute unilateral encaphilitic illness could represent the acute phase of HHE syndrome.

  13. 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.

  14. 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.

  15. Comportamiento de la otitis media aguda

    Directory of Open Access Journals (Sweden)

    Gladys Fuentes Fernández

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

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

    Science.gov (United States)

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

    2017-05-01

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

  17. Necrotising otitis externa in the immunocompetent patient: case series.

    Science.gov (United States)

    Unadkat, S; Kanzara, T; Watters, G

    2018-01-01

    Necrotising otitis externa can be a devastating form of otitis externa. It typically tends to affect patients who are immunocompromised or diabetic. To date, there is very little in the literature about necrotising otitis externa in the immunocompetent patient population. The present paper discusses both the clinical and radiological findings in three cases of necrotising otitis externa in an immunocompetent patient cohort. The common factor among all three patients was their advanced age. Diagnosing necrotising otitis externa can be challenging because of the potentially non-specific symptoms and the absence of early radiological signs, particularly if patients are neither immunocompromised nor diabetic. Elderly patients should be considered in the same light as immunocompromised and diabetic patients in the context of necrotising otitis externa.

  18. Automated Diagnosis of Otitis Media: Vocabulary and Grammar

    Science.gov (United States)

    Kuruvilla, Anupama; Hoberman, Alejandro; Kovačević, Jelena

    2013-01-01

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

  19. Epidemiology and Management of Otitis Media in Children.

    Science.gov (United States)

    Giebink, G. Scott; Daly, Kathy

    1990-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Norma de Oliveira Penido

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

  1. Congenital unilateral hydrocephalus - CT findings

    International Nuclear Information System (INIS)

    Schulman, H.; Landau, D.; Schulman, P.; Hertzanu, Y.

    2000-01-01

    Congenital unilateral hydrocephalus is extremely uncommon with 18 cases previously reported in the English literature. Two additional newborns with unilateral hydrocephalus are presented. The second baby also presented a mega cisterna magna. This unusual association between Dandy-Walker variant and unilateral hydrocephalus has not been previously reported. Following ventriculo-peritoneal shunt, the babies had a normal cognitive neurodevelopment. The role of cranial computed tomography (CT) in diagnosis and follow-up is emphasized

  2. Unilateral retinitis pigmentosa sine pigmento.

    Science.gov (United States)

    Pearlman, J T; Saxton, J; Hoffman, G

    1976-05-01

    A patient presented with unilateral findings of night blindness shown by impaired rod function and dark adaptation, constricted visual fields with good central acuity, a barely recordable electro-retinographic b-wave, and a unilaterally impaired electro-oculogram. There were none of the pigmentary changes usually associated with retinitis pigmentosa. The unaffected right eye was normal in all respects. Therefore the case is most probably one of unilateral retinitis pigmentosa sine pigmento.

  3. Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy

    International Nuclear Information System (INIS)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Gupta, Ashok Kumar; Panda, Naresh Kumar; Das, Ashim; Mittal, Bhagwant Rai

    2013-01-01

    Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa

  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. Otitis Media and Caregiver Quality of Life

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  6. Unilateral removable partial dentures.

    Science.gov (United States)

    Goodall, W A; Greer, A C; Martin, N

    2017-01-27

    Removable partial dentures (RPDs) are widely used to replace missing teeth in order to restore both function and aesthetics for the partially dentate patient. Conventional RPD design is frequently bilateral and consists of a major connector that bridges both sides of the arch. Some patients cannot and will not tolerate such an extensive appliance. For these patients, bridgework may not be a predictable option and it is not always possible to provide implant-retained restorations. This article presents unilateral RPDs as a potential treatment modality for such patients and explores indications and contraindications for their use, including factors relating to patient history, clinical presentation and patient wishes. Through case examples, design, material and fabrication considerations will be discussed. While their use is not widespread, there are a number of patients who benefit from the provision of unilateral RPDs. They are a useful treatment to have in the clinician's armamentarium, but a highly-skilled dental team and a specific patient presentation is required in order for them to be a reasonable and predictable prosthetic option.

  7. New Insights into Eosinophilic Otitis Media.

    Science.gov (United States)

    Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

    2015-12-01

    Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM.

  8. A case of unilateral dysmenorrhea

    Directory of Open Access Journals (Sweden)

    Tulon Borah

    2010-01-01

    Full Text Available Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Otitis Media: Coping with the Effects in the Classroom.

    Science.gov (United States)

    Davis, Dorinne S.

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

  11. THE TREATMENT OF AERO-OTITIS MEDIA BY REDECOMPRESSION,

    Science.gov (United States)

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

  12. 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...

  13. Traffic-related air pollution and otitis media

    NARCIS (Netherlands)

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

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

  14. Eustachian tube three-dimensional reconstruction of secretory otitis media

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  15. 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.

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

    Science.gov (United States)

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

    2015-11-01

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

  17. Panel 3: Genetics and Precision Medicine of Otitis Media.

    Science.gov (United States)

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

    2017-04-01

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

  18. Unilateral darier′s disease

    Directory of Open Access Journals (Sweden)

    Singh Ravi

    1996-01-01

    Full Text Available Various variations of Darier′s disease have been mentioned in the literature. Here we describe a young male with unilateral involvement with clinical and histopathological features typical of Darier′s disease.

  19. 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.

  20. Unilateral proptosis as the initial manifestation of malignancy

    Directory of Open Access Journals (Sweden)

    K. Rakul Nambiar

    2017-09-01

    Full Text Available Proptosis, a common sign with a broad differential diagnosis, is defined as anterior displacement and protrusion of one or both orbital globes. Patients can present with varying degrees of chronicity, visual loss and associated symptoms. The etiology of acquired unilateral proptosis is diverse, ranging from benign to life-threatening. The causes of unilateral proptosis include traumatic, vascular, endocrine, inflammatory, infective and malignant. Breast carcinoma is the most common metastatic cause of proptosis; however, proptosis has never been reported as the initial manifestation of breast carcinoma. Our patient presented with unilateral proptosis secondary to an intraorbital lesion and histopathology of orbital lesion was suggestive of metastatic breast adenocarcinoma. She was later diagnosed to have primary breast carcinoma. We present this unusual case of a 56-year-old woman who presented with proptosis as the initial manifestation of a metastatic breast malignancy.

  1. Unilateral proptosis as the initial manifestation of malignancy.

    Science.gov (United States)

    Rakul Nambiar, K; Ajith, P S; Arjunan, Asha

    2017-09-01

    Proptosis, a common sign with a broad differential diagnosis, is defined as anterior displacement and protrusion of one or both orbital globes. Patients can present with varying degrees of chronicity, visual loss and associated symptoms. The etiology of acquired unilateral proptosis is diverse, ranging from benign to life-threatening. The causes of unilateral proptosis include traumatic, vascular, endocrine, inflammatory, infective and malignant. Breast carcinoma is the most common metastatic cause of proptosis; however, proptosis has never been reported as the initial manifestation of breast carcinoma. Our patient presented with unilateral proptosis secondary to an intraorbital lesion and histopathology of orbital lesion was suggestive of metastatic breast adenocarcinoma. She was later diagnosed to have primary breast carcinoma. We present this unusual case of a 56-year-old woman who presented with proptosis as the initial manifestation of a metastatic breast malignancy. Copyright © 2017 National Cancer Institute, Cairo University. Production and hosting by Elsevier B.V. All rights reserved.

  2. Utility and limitations of CT in otitis media

    International Nuclear Information System (INIS)

    Asensio, J.; Lopez-Rios, J.

    1998-01-01

    To assess the degree of reliability of computed tomography (CT) and the agreement between the imaging studies and intraoperative findings in chronic otitis media (COM) with cholesteatoma. We studied 51 patients diagnosed clinically as having inflammatory disease of the middle ear. All the patients under-went high-resolution Ct of temporal bone in axial and coronal planes. The imaging studies were retrospectively correlated with the intraoperative findings and the sensitivity of CT in the detection of erosive cholesteatoma was determined. Open radical mastoidectomy is the surgical technique most frequently used to treat cholesteatoma in our center. The greatest radio-surgical correlation was achieved in the detection of masses presenting soft tissue attenuation in air-filled cavities in middle ear (100%) and in bone erosion (87.5%). The 20 patients (39%) who were diagnosed as having COM with cholesteatoma underwent surgical treatment in our center. CT is the technique of choice in the study of COM with cholesteatoma, providing basic and necessary information for the image-based diagnosis of this disease, the detection of masses presenting soft tissue attenuation and bone erosion. We also point out the role of CT as an intraoperative guide and discuss its low sensitivity for the detection of small areas of dura mater exposure, ossicular luxation and facial canal dehiscence. (Author) 8 refs

  3. Three-dimensional multislice CT imaging of otitis media

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  4. Three-dimensional multislice CT imaging of otitis media

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. 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.

  8. [Incidence of complications of otitis media].

    Science.gov (United States)

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

    2005-02-01

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

  9. Peripheral blood antigen presenting cell responses in otitis-prone and non-otitis-prone infants.

    Science.gov (United States)

    Surendran, Naveen; Nicolosi, Ted; Kaur, Ravinder; Pichichero, Michael E

    2016-01-01

    Stringently defined otitis-prone (sOP) children represent a new classification of the otitis-prone condition. Previous studies showed dysfunction in Ab, B-cell memory and T-cell memory responses. We sought to determine whether there are defects in numbers, phenotype and/or function of professional APC in the peripheral blood of sOP infants. APC phenotypic counts, MHC II expression and intracellular cytokine levels were determined in response to TLR7/8 (R848) stimulation by flow cytometry. Innate immune mRNA expression was measured using RT-PCR and cytokines were measured using Luminex technology. Significant (P otitis-prone (NOP) age-matched infants. No significant differences in APC activation or function were observed. Expression of various TLRs, intracellular signaling molecules and downstream cytokines was also not found to be significantly different between sOP and NOP infants. Higher numbers of APCs in sOP infants suggest the possibility of a persistent mucosal inflammatory status. Transcriptional and cytokine profiles of PBMCs among sOP infants suggest their systemic innate responses are not different compared to NOP infants. © The Author(s) 2015.

  10. 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...

  11. Enlarged thalamostriate vein causing unilateral Monro foramen obstruction. Case report.

    Science.gov (United States)

    Leonardo, Jody; Grand, Walter

    2009-06-01

    Causes of unilateral hydrocephalus resulting from an obstruction at the Monro foramen include foraminal atresia, tumors, gliosis, contralateral shunting, and infectious and inflammatory conditions. However, few reports in the literature cite vascular lesions as the cause of the obstruction. To their knowledge, the authors present the first report of unilateral hydrocephalus occurring due to an abnormally enlarged thalamostriate vein independent of an arteriovenous malformation or developmental venous angioma. The condition was treated successfully by endoscopic septum pellucidum fenestration. A 28-year-old man was referred for evaluation due to a 10-year history of chronic headaches that worsened in severity over the past year. A CT scan of the head revealed unilateral right ventricular dilation. Cranial MR imaging with and without contrast administration showed a dilated right thalamostriate-internal vein complex without any evidence of associated arteriovenous malformation or venous angioma. Endoscopic exploration of the right lateral ventricle showed an enlarged subependymal thalamostriate vein obstructing the Monro foramen. An endoscopic fenestration of the septum pellucidum was performed, resulting in alleviation of the patient's symptoms. Abnormally enlarged venous structures may cause obstructive unilateral hydrocephalus and can be a rare cause of chronic, intermittent headaches in adults. Endoscopic fenestration of the septum pellucidum is an effective treatment.

  12. 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

  13. Vestibular evaluation in children with otitis media with effusion.

    Science.gov (United States)

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

    2015-04-01

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

  14. Values Range of Tympanometric Gradient in Otitis Media With Effusion.

    Science.gov (United States)

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

    2017-05-01

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

  15. Isolated unilateral pulmonary artery hypoplasia with accompanying pulmonary parenchymal findings on CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Surin; Cha, Yoon Ki; Kim, Jeung Sook; Kwon, Jae Hyun; Jeong, Yun Jeong [Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of); Kim, Seon Jeong [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of)

    2017-05-15

    Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia.

  16. Isolated unilateral pulmonary artery hypoplasia with accompanying pulmonary parenchymal findings on CT: A case report

    International Nuclear Information System (INIS)

    Park, Surin; Cha, Yoon Ki; Kim, Jeung Sook; Kwon, Jae Hyun; Jeong, Yun Jeong; Kim, Seon Jeong

    2017-01-01

    Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia

  17. Radionuclide evaluation in malignant external otitis

    International Nuclear Information System (INIS)

    Wolosker, Sara; Penha Costa Marques, Marise da; Fonseca, Lea Miriam Barbosa da; Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ

    1996-01-01

    Malignant external otitis (MEO) is a severe infection of the external auditory canal that can result in osteomyelitis of the skull base. Twenty-eight patients with MEO (19 diabetics, 8 with AIDS and 1 with acute mielogenous leukemia) were evaluated using 99m Tc-MDP bone scintigraphy. 67 Ga citrate and computed tomography (CT) at the time of diagnosis for establishing the MEO extent. 67 Ga scans were obtained periodically in order to assess the evolution of the treatment. 99m Tc scans had shown high sensitivity and specificity in assessing the bone disease. Serial 67 Ga scans had shown to be valuable indicators of infection remission. CT scans provided poor diagnosis of early bone involvement. (author). 26 refs., 4 figs

  18. Efficacy of amoxicillin with and without decongestant-antihistamine for otitis media with effusion in children. Results of a double-blind, randomized trial.

    Science.gov (United States)

    Mandel, E M; Rockette, H E; Bluestone, C D; Paradise, J L; Nozza, R J

    1987-02-19

    In a randomized, double-blind, placebo-controlled trial involving 518 infants and children who had otitis media with effusion ("secretory" otitis media), we evaluated the efficacy of a two-week course of amoxicillin (40 mg per kilogram of body weight per day) with and without a four-week course of an oral decongestant-antihistamine combination. Among the 474 subjects who were evaluated at the four-week end point, the rate of resolution of middle-ear effusion was twice as high in those treated with amoxicillin, either with or without the decongestant-antihistamine, as in those who received placebo (P less than 0.001), but 69.8 percent of the amoxicillin-treated subjects still had effusion. Among both the amoxicillin-treated subjects and the placebo-treated subjects, resolution was more likely in those with initially unilateral effusion, in those who had had effusion for eight weeks or less, and in those without an upper respiratory tract infection at the four-week end point. Side effects were reported more often in subjects who received decongestant-antihistamine than in those who did not. Among the subjects without effusion at the four-week end point, recurrent effusion developed in approximately half those in both the amoxicillin and placebo groups during the subsequent three months. We conclude that in infants and children with otitis media with effusion, amoxicillin treatment increases to some extent the likelihood of resolution.

  19. Gradenigo Syndrome: Unusual Consequence of Otitis Media

    Directory of Open Access Journals (Sweden)

    Jennie M. Valles

    2014-07-01

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

  20. Primary unilateral cleft lip repair

    OpenAIRE

    Adenwalla, H. S.; Narayanan, P. V.

    2009-01-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform clos...

  1. 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.

  2. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

    Directory of Open Access Journals (Sweden)

    Adriana Maria Drummond Brandão

    2008-04-01

    Full Text Available OBJETIVO: Analisar os resultados visuais de uma série de crianças operadas de catarata unilateral. MÉTODOS: Um estudo retrospectivo foi realizado através da análise de 35 prontuários médicos do Serviço de Catarata Congênita da UNIFESP/EPM. RESULTADOS: Quanto à etiologia, a primeira causa de catarata foi idiopática, a segunda causa foi o trauma e a terceira foi a rubéola congênita. Em 51,4% dos olhos tinham acuidade visual pré-operatória de ausência de fixação. E em 42,8% dos casos operados a acuidade visual final foi igual ou melhor que 20/200. DISCUSSÃO: Embora a cirurgia em catarata unilateral seja motivo de controvérsias entre os oftalmologistas, obteve-se melhora de acuidade visual em número significativo de casos.PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow, and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

  3. 191 bacterial agents of otitis media and their sensitivity to some ...

    African Journals Online (AJOL)

    DR. AMINU

    2010-06-01

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

  4. 6. Bacteriology of Chronic Suppurative Otitis Media among Children ...

    African Journals Online (AJOL)

    46987.2

    Keywords: CSOM, Children, antimicrobial sensitivity. Medical Journal of Zambia, Vol. 43, No. 1: 36 - 40 (2016) ... antimicrobial disc susceptibility tests, M100.S22,. CLSI volume 32 NO.3, January 2012. A desk review of the .... The study had limitations posed by challenges in record-keeping, the consistency of taking swabs,.

  5. CHRONIC OTITIS MEDIA WITH MIDDLE EAR CHOLESTEATOMA – CASEREPORT

    Directory of Open Access Journals (Sweden)

    Marko Četina

    2008-02-01

    The case is interesting because in one patient three different complications are present(labyrinth fistula, destruction of facial nerve bony canal and skull base with dura exposure.There are also some data about surgery approaches, hearing results and discussionabout complications

  6. aerobic bacteria in safe type chronic suppurative otitis media

    African Journals Online (AJOL)

    PUBLICATIONS1

    2016 Kwame Nkrumah University of Science and Technology (KNUST). Journal of Science .... tic n. (%. ) Resistan t to. 2 an tib io tics n. (%. ) Resistan t to. 3 an tib io tics n. (%. ) Resistan t to. 4 an .... tions in Children. Advances in Pediatrics, 55:.

  7. Bacteriology of Chronic Suppurative Otitis Media among Children at ...

    African Journals Online (AJOL)

    The common organisms isolated included; Staphylococcus species (36%), Proteus vulgaris species (35%), Pseudomonas species (15%), Streptococcus species (7%), E. coli species (3%), Enterobacter species (2%) and Serratia marcens species (2%). Antimicrobial sensitivity tests showed that Ciprofloxacin was more ...

  8. Unilateral anterior ischemic optic neuropathy

    DEFF Research Database (Denmark)

    Herbst, Kristina; Sander, Birgit; Lund-Andersen, Henrik

    2013-01-01

    of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

  9. Transdermal hyoscine induced unilateral mydriasis.

    LENUS (Irish Health Repository)

    Hannon, Breffni

    2012-03-20

    The authors present a case of unilateral mydriasis in a teenager prescribed transdermal hyoscine hydrobromide (scopolamine) for chemotherapy induced nausea and vomiting. The authors discuss the ocular side-effects associated with this particular drug and delivery system and the potential use of transdermal hyoscine as an antiemetic agent in this group.

  10. Chronic Conductive Hearing Loss Leads to Cochlear Degeneration.

    Science.gov (United States)

    Liberman, M Charles; Liberman, Leslie D; Maison, Stéphane F

    2015-01-01

    Synapses between cochlear nerve terminals and hair cells are the most vulnerable elements in the inner ear in both noise-induced and age-related hearing loss, and this neuropathy is exacerbated in the absence of efferent feedback from the olivocochlear bundle. If age-related loss is dominated by a lifetime of exposure to environmental sounds, reduction of acoustic drive to the inner ear might improve cochlear preservation throughout life. To test this, we removed the tympanic membrane unilaterally in one group of young adult mice, removed the olivocochlear bundle in another group and compared their cochlear function and innervation to age-matched controls one year later. Results showed that tympanic membrane removal, and the associated threshold elevation, was counterproductive: cochlear efferent innervation was dramatically reduced, especially the lateral olivocochlear terminals to the inner hair cell area, and there was a corresponding reduction in the number of cochlear nerve synapses. This loss led to a decrease in the amplitude of the suprathreshold cochlear neural responses. Similar results were seen in two cases with conductive hearing loss due to chronic otitis media. Outer hair cell death was increased only in ears lacking medial olivocochlear innervation following olivocochlear bundle cuts. Results suggest the novel ideas that 1) the olivocochlear efferent pathway has a dramatic use-dependent plasticity even in the adult ear and 2) a component of the lingering auditory processing disorder seen in humans after persistent middle-ear infections is cochlear in origin.

  11. 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…

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

    Science.gov (United States)

    2013-10-01

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

  13. 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. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    1987-01-01

    Ten guinea pigs were irradiated with 30 Gy of x-radiation. Five were killed on the eighth day after irradiation, and the remainder were killed at the sixteenth day after irradiation. At the time of death, examination was made of the ciliary activity and the fine structure of the middle ear mucosa. Serous effusion was found in each tympanic cavity of all animals. It was shown also that the guinea pig, when irradiated with 30 Gy of x-radiation, exhibits pathologic abnormalities similar to those in humans with otitis media with effusion: degeneration of cilia or ciliated cells and changes in the vascular system (capillary injury and increased capillary permeability). Functional examinations showed that x-ray irradiation has delayed effects on ciliary activity, and the effects are much greater at the sixteenth day than at the eighth day. We speculate that the accumulation of effusion can be, at least partially, a consequence of ciliary dysfunction. The induction of sterile effusion by the use of x-ray irradiation provides a unique animal model for chronic otitis media with effusion of the serous type

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

    Science.gov (United States)

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

    2015-11-15

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

  16. 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.

  17. Rare A2ML1 variants confer susceptibility to otitis media

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R.

    1991-01-01

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

  19. Treatment options in otitis media with effusion.

    Science.gov (United States)

    Upadhya, Ila; Datar, J

    2014-01-01

    Secretary Otitis media with effusion (OME) is the accumulation of mucus in the middle ear and sometimes in the mastoid air cell system. The main etiological factor is alteration in mucociliary system of middle ear secondary to ET malfunction which may be primary or secondary. OME is the cause of concern due to its occurance in paediatric age group, highest at 2 years of age, presenting as impairment of hearing leading to delayed speech and language development, poor academic performance and behavioral problems. In spite of this there are no confirmed guidelines of treatment to overcome. Many treatment options are available medical as well as surgical. Prospective study conducted to evaluate various treatment options revealed that auto inflation of ET is the main stay of treatment. If the ET malfunction is due to any reasons like adenoids, deviated nasal septum, hypertrophied turbinates or any other cause surgical intervention of the same gives 100% results. Medical management gives good results but recurrence is equally common.

  20. Otitis Media Supuratif Kronik pada Anak

    Directory of Open Access Journals (Sweden)

    Muhamad Faris Pasyah

    2016-02-01

    Otitis media supuratif kronik (OMSK merupakan masalah pada anak dan remaja yang berdampak pada fisik, sosial serta psikologis dan mempunyai prevalensi yang tinggi. Kondisi ini merupakan proses peradangan akibat infeksi mukoperiosteum rongga telinga tengah yang ditandai oleh perforasi membran timpani dan keluar sekret yang terus menerus atau hilang timbul selama 3 bulan, serta dapat menyebabkan perubahan patologik yang permanen. Tujuan penelitian mengetahui gambaran OMSK pada anak. Penelitian dilakukan secara deskriptif retrospektif di poliklinik Otologi Departemen Ilmu Kesehatan Telinga Hidung Tenggorokan-Kepala Leher (THT-KL RS Dr. Hasan Sadikin Bandung periode Januari 2012–Desember 2013. Diagnosis ditegakkan berdasarkan anamnesis dan pemeriksaan fisis. Didapatkan pasien OMSK anak laki-laki 53% dan pasien anak perempuan 47%. Jumlah OMSK tipe benigna 83% dan tipe maligna 17%. Komplikasi terbanyak OMSK pada anak adalah mastoiditis 32%. Angka putus berobat pada pasien anak dengan OMSK sebesar 60%. Simpulan, penderita OMSK pada anak lebih banyak pada laki-laki tipe benigna dan angka pasien putus berobat masih banyak ditemukan.

  1. Primary unilateral cleft lip repair.

    Science.gov (United States)

    Adenwalla, H S; Narayanan, P V

    2009-10-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

  2. Primary unilateral cleft lip repair

    Directory of Open Access Journals (Sweden)

    Adenwalla H

    2009-10-01

    Full Text Available The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

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

    Science.gov (United States)

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

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

  4. Preliminary results on scintigraphic evaluation of malignant external otitis

    International Nuclear Information System (INIS)

    Malamitsi, J.; Maragoudakis, P.; Papafragou, K.; Koukouliou, V.; Kalatzis, Y.; Adamopoulos, G.; Proukakis, C.

    1993-01-01

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

  5. Evaluation of the Efficacy and Tolerability of Oral Ciprofloxacin used in the Comprehensive Treatment of External Bacterial Otitis: An Observational Prospective Study.

    Science.gov (United States)

    Gurov, Alexander Vladimirovich; Kriukov, Andrey Ivanovich; Kunelskaya, Vera Yakovlevna; Isotova, Galina Nikolaevna; Shadrin, Georgiy Borisovich; Luchsheva, Yuliya Vladislavovna; Yakimov, Vladislav Olegovich; Garg, Amit; Akku, Shyam Prasad; Gupta, Namita

    2017-10-01

    Introduction  Otitis Externa is common ear infection with a prevalence of 1%. Objective  The objective of this study is to evaluate the clinical and microbiological efficacy and safety profile with oral ciprofloxacin in the external bacterial otitis (EBO) management. Methods  This is a prospective observational study conducted with EBO outpatients referred to the otorhinolaryngology center in Moscow between March and August 2013. Our study included patients from two cohorts, acute external bacterial otitis (AEBO) - Group 1 - and exacerbation of chronic otitis externa (CEBO) - Group 2. We administered Ciprofloxacin 500 mg twice daily with standard topical EBO treatment for up to 10 days. Patients underwent evaluation on study visit days 1, 3, 5, and 10 for the severity. Bacteriological examination of ear canal cultures took place on Day 1 and Day 10. Results  We collected data from 60 EBO outpatients (AEBO: N  = 30 and CEBO: N  = 30). Swimming was the major risk factor associated with the disease in addition to the most common pathogenic organisms - Staphylococcus aureus and Pseudomonas aeruginosa . was We attained complete resolution of the inflammatory process in 28 (93%) and 27 (90%) patients in the AEBO and CEBO group, respectively. We confirmed this by microbiological test with almost complete eradication of the causative organisms. Overall, we observed good positive dynamics of ear canal with no major side effects. Conclusion  We found that Ciprofloxacin 500 mg, when administered orally twice daily for 7 to 10 days in otitis externa patients is clinically and microbiologically effective and comparatively safer than other antimicrobials.

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

    Science.gov (United States)

    Principi, Nicola; Marchisio, Paola; Esposito, Susanna

    2016-01-01

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

  7. Unilateral corneal leukoplakia without limbal involvement

    Directory of Open Access Journals (Sweden)

    Hirano K

    2015-05-01

    .0. Conclusion: Our case of unilateral corneal leukoplakia without limbal involvement was most likely caused by chronic irritation of the cornea by the eyelashes. Although it was totally removed with good recovery of vision, we continue to follow the patient because of the potential of malignant transformation. Keywords: corneal leukoplakia, hyperkeratosis, eyelashes, chronic friction

  8. Antibiotics for acute otitis media in children.

    Science.gov (United States)

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

    2015-06-23

    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 and previously updated in 1999, 2005, 2009 and 2013. To assess the effects of antibiotics for children with AOM. We searched CENTRAL (2015, Issue 3), MEDLINE (1966 to April week 3, 2015), OLDMEDLINE (1958 to 1965), EMBASE (January 1990 to April 2015), Current Contents (1966 to April 2015), CINAHL (2008 to April 2015) and LILACS (2008 to April 2015). Randomised controlled trials (RCTs) comparing 1) antimicrobial drugs with placebo and 2) immediate antibiotic treatment with expectant observation (including delayed antibiotic prescribing) in children with AOM. Two review authors independently assessed trial quality and extracted data. For the review of antibiotics against placebo, 13 RCTs (3401 children and 3938 AOM episodes) from high-income countries were eligible and had generally low risk of bias. The combined results of the trials revealed that by 24 hours from the start of treatment, 60% of the children had recovered whether or not they had placebo or antibiotics. Pain was not reduced by antibiotics at 24 hours (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.78 to 1.01) but almost a third fewer had residual pain at two to three days (RR 0.70, 95% CI 0.57 to 0.86; number needed to treat for an additional beneficial outcome (NNTB) 20). A quarter fewer had pain at four to seven days (RR 0.76, 95% CI 0.63 to 0.91; NNTB 16) and two-thirds fewer had pain at 10 to 12 days (RR 0.33, 95% CI 0.17 to 0.66; NNTB 7) compared with placebo. Antibiotics did reduce the number of children with abnormal tympanometry findings at two to four weeks (RR 0.82, 95% CI 0.74 to 0.90; NNTB 11), at six to eight weeks (RR 0.88, 95% CI 0.78 to 1.00; NNTB 16) and the number of children with tympanic

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

    Science.gov (United States)

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

    2015-12-01

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

  10. Antibiotics for otitis media with effusion in children

    NARCIS (Netherlands)

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

    2016-01-01

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

  11. Microbiology of otitis media in Indigenous Australian children: review.

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

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

  13. Complications of otitis media - The importance of early recognition

    NARCIS (Netherlands)

    Albers, FWJ

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

  14. 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...

  15. FREQUENCY OF MALASSEZIA SPP. IN DOGS PRESENTING EXTERNAL OTITIS

    Directory of Open Access Journals (Sweden)

    N. R. Magalhães

    2017-12-01

    Full Text Available The external otitis is defined as an inflammation of the dog external ear canal and it is considered a common disease in dogs. It is a disease of multifactorial etiology, where one of the main microrganisms associated to the illness is the Malassezia ssp. Therefore, this work aimed to determine the frequency of Malassezia spp. by auricular cytology in dogs that present clinical signs of external otitis. Were used 23 dogs attended in a veterinary clinic located in Sinop-MT. The material was collected using a dry swab, where each extremity was inserted in one of the auditory canal (right and left, which was rotated, removed from the ear and rolled on the glass slide. First the glass slide was microscopically observed (objective 4X, for viewing mites, and then, the sample was fixed by heat and stained with Panoptic. Once stained, the glass slide was examined (objective 40X and 100X. Among the 23 dogs evaluated, 60.9% were positive for Malassezia spp., 8.7% were positive for the Otodectes cynotis mite, and also 30,4% of the animals showed mixed infection with Malassezia ssp. and bacteria. With this study, it can be concluded that Malassezia ssp. was found more frequently in at the auditory canal of dogs with that presents external otitis, associated or acting alone, indicating the importance of this yeast in cases of otitis.

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

    Science.gov (United States)

    Caramia, G; Serafini, V; Loggi, A

    2013-01-01

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

  17. Evidence-based treatment of acute otitis externa

    African Journals Online (AJOL)

    its management, especially in general practice.1,5 In particular, there appears to be confusion over the ... between the use of eardrops and recurrent disease, but a definite increase in the incidence of recurrent .... Pabla L, Jindal M, Latif K. The management of otitis externa in UK general practice. Eur Arch Otorhinolaryngol.

  18. The Effect of Breastfeeding on Childhood Otitis Media

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  19. Otitis Media and Learning Disabilities: More Than a Relationship?

    Science.gov (United States)

    Quick, Carol; Mandell, Colleen

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

  20. Human Immunodeficiency virus and invasive external otitis- A case ...

    African Journals Online (AJOL)

    Acute invasive external otitis is an uncommon life-threatening infection of the exteernal auditory canal (EAC), most often affecting the elderly diabetic patients. Although few reports have been made in HIV-positive/Aids patients among the caucasians. We present here a 25 year old nursing mother with a month history of ...

  1. 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)

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2018-06-01

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

  4. Unilateral antler combs from Romuliana

    Directory of Open Access Journals (Sweden)

    Petković Sofija

    2006-01-01

    Full Text Available In the course of investigations at Romuliana nine antler three-partite combs with a single row of teeth were found in the Late Roman horizons dating from the late 4th - mid 5th century. They were found in Tower 19, in the Palace II sector and in the Thermae sector. The combs can be classified as two types: three-partite unilateral combs with semicircular handle (Petković comb type VII and three-partite unilateral combs with triangular handle decorated with horse protomes (Petković comb type VI. Two groups of these finds were distinguished after more detailed analysis; the earlier one including specimens originating from the Chernyahov-Sîntana de Mureº culture and later one including specimens made under "barbarian"influence and produced in Romuliana. These finds confirm the continuity of settlement at Romuliana in the Late Roman period, from the final quarter of the 4th until the end of the 5th century and open up the question of the character of the settlement.

  5. Nasal nitric oxide in unilateral sinus disease.

    Directory of Open Access Journals (Sweden)

    Chia-Hsiang Fu

    Full Text Available Unilateral sinus disease (USD can sometimes be difficult to accurately diagnose before surgery. The application of nasal nitric oxide (nNO for USD diagnosis and its surgical outcome in USD has not been reported in the literature. We prospectively enrolled sixty-six USD patients who underwent endoscopic sinus surgery for fungal rhinosinusitis (n = 19, chronic rhinosinusitis (CRS without nasal polyps (n = 13, CRS with nasal polyps (n = 12 and sinonasal mass lesions (n = 22. nNO levels were measured preoperatively and at three and six months postoperatively. Correlations between nNO levels and potential clinical parameters, type of disease, disease severity, and disease-related quality of life (QOL were assessed. Unlike bilateral CRS, in USD, nNO levels did not correlate with disease severity or postoperative QOL improvements. Except for fungus group, there were no differences in nNO levels between lesion and non-lesion sides in all the other groups. nNO levels on both sides were significantly elevated six months postoperatively in all groups. Fungal rhinosinusitis patients had the lowest preoperative nNO levels, and a cutoff of 239.3 ppb had the best sensitivity (79.0% and specificity (87.2% for preoperative diagnosis. While preoperative nNO levels cannot serve as an alternative marker for disease severity of USD, they were lower in fungal rhinosinusitis patients than in other USD patients and may be useful for more accurate diagnosis prior to surgery.

  6. Risk of childhood otitis media with focus on potentially modifiable factors

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  7. 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.

  8. Impact of respiratory disease, diarrhea, otitis and arthritis on mortality and carcass traits in white veal calves.

    Science.gov (United States)

    Pardon, Bart; Hostens, Miel; Duchateau, Luc; Dewulf, Jeroen; De Bleecker, Koen; Deprez, Piet

    2013-04-15

    average and decreased carcass quality. Despite the massive use of group and individual treatments to alleviate the most prevalent health issues at the fattening period, the effects of BRD, diarrhea, otitis and arthritis on survival and performance are still considerable, especially in cases of chronic pneumonia with or without arthritis. Controlling calf health by effective preventive and therapeutic strategies and in particular the prevention of chronic BRD is key for the profitability of veal operations.

  9. Clinical and surgical management of unilateral prepubertal gynecomastia

    Directory of Open Access Journals (Sweden)

    Giuseppe Andrea Ferraro

    2014-01-01

    CONCLUSION: The exact mechanism of unilateral gynecomastia formation in our case is unclear. The evaluation of unilateral gynecomastia can therefore be complex. In conclusion, the surgical treatment of unilateral gynecomastia requires an individual approach, based on an appropriate diagnostic algorithm.

  10. Comparison of Microbiological Flora in the External Auditory Canal of Normal Ear and an Ear with Acute Otitis Externa.

    Science.gov (United States)

    Ghanpur, Asheesh Dora; Nayak, Dipak Ranjan; Chawla, Kiran; Shashidhar, V; Singh, Rohit

    2017-09-01

    Acute Otitis Externa (AOE) is also known as swimmer's ear. Investigations initiated during World War II firmly established the role of bacteria in the aetiology of Acute Otitis Externa. To culture the microbiological flora of the normal ear and compare it with the flora causing AOE and to know the role of normal ear canal flora and anaerobes in the aetiology. A prospective observational study was conducted on 64 patients clinically diagnosed with unilateral AOE. Ear swabs were taken from both the ears. Microbiological flora was studied considering diseased ear as test ear and the normal ear as the control. Aerobic and anaerobic cultures were done. Severity of the disease was assessed by subjective and objective scores. Effect of topical treatment with ichthammol glycerine pack was assessed after 48 hours and scores were calculated again. Patients with scores < 4 after pack removal were started on systemic antibiotics and were assessed after seven days of antibiotics course. Data was analysed using Paired t-test, Wilcoxon signed ranks test and Chi-square test. A p-value < 0.05 was considered significant. Pseudomonas aeruginosa (33%) was the most common bacteria cultured from the ear followed by Methicillin Resistant Staphylococcus aureus (MRSA) (18%). Patients with anaerobic organism in the test ear had severe symptoms and needed systemic antibiotic therapy. Most of the cases may respond to empirical antibiotic therapy. In cases with severe symptoms and the ones refractory to empirical treatment, a culture from the ear canal will not be a tax on the patient. This helps in giving a better understanding about the disease, causative organisms and helps in avoiding the use of inappropriate antibiotics that usually result in developing resistant strains of bacteria.

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

    Science.gov (United States)

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

    2007-12-01

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

  12. Unilateral hearing during development: hemispheric specificity in plastic reorganizations

    Directory of Open Access Journals (Sweden)

    Andrej eKral

    2013-11-01

    Full Text Available The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness. The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. The data revealed that effects of hearing experience were more pronounced when stimulating the hearing ear. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive

  13. Unilateral hearing during development: hemispheric specificity in plastic reorganizations.

    Science.gov (United States)

    Kral, Andrej; Heid, Silvia; Hubka, Peter; Tillein, Jochen

    2013-01-01

    The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness). The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs) were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory) mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive periods involved.

  14. Complementary and alternative medicine for pediatric otitis media.

    Science.gov (United States)

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

    2013-06-01

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

  15. Unilateral exophthalmos in primary hyperthyroidism

    International Nuclear Information System (INIS)

    Park, C. Y.; Kim, Y. J.; Choi, K. O.

    1980-01-01

    The exophthalmos of Graves' disease remains a pathophysiologic and therapeutic puzzle. Its relation to the hyperthyroidism of Grave's disease is far from clarified. It is a common clinical observation that exophthalmos does not often relate temporally with the onset of hyperthyroidism. Furthermore, exophthalmos may occur in patients who have no evidence of thyroid disease. Pathologically, exophthalmos is characterized by marked lymphocytic infiltration of the retro-orbital muscles, with edema and mucopolysaccharide deposition. Recently, cellular immunity in response to retro-orbital antigens and abnormal humoral immunity are suggested for the pathogenesis of exophthalmos. We experienced 2 patients with hyperthyroidism and unilateral exophthalmos. The clinical and laboratory features of the patients are presented with review of articles, with emphasis on pathogenesis.

  16. Radiographic and computed tomographic evaluation of otitis media in the dog

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  17. No evidence of cholesteatoma in untreated otitis media with effusion in children with primary ciliary dyskinesia.

    Science.gov (United States)

    Ghedia, Reshma; Ahmed, Jahangir; Navaratnam, Annakan; Harcourt, Jonny

    2018-02-01

    Primary Ciliary Dyskinesia (PCD) describes a group of inherited disorders that result in abnormal ciliary motion leading to mucous stasis. Clinical features include almost universally otitis media with effusion (OME), particularly in infants. PCD patients provide us with a cohort of patients with OME that is not treated with ventilatory tube (VT) insertion as these have been shown to result in frequent complications including chronic otorrhoea, early extrusion and persistent perforation without significant improvement to hearing in the long term. This cohort was used to investigate whether children with PCD and OME not treated with VT were predisposed to cholesteatoma formation in the setting of a paediatric quaternary referral centre. A retrospective chart review was performed of all the children attending a multi-disciplinary PCD clinic at a national quaternary referral centre with a diagnosis of OME. We reviewed otoscopic findings, and audiometry and tympanometry results. We assessed the children in four groups: Watchful waiting, hearing aids, VT, and VT and hearing aids. One-hundred-and-one of 107 patients included in the study had a diagnosis of otitis media with effusion. No child with OME and PCD was diagnosed with a cholesteatoma during the follow up period. The only children who had insertion of a ventilatory tube were those who had the procedure prior to the formal diagnosis of PCD. We found a significant complication rate in the children with VT insertion. Hearing improved over time. The prevalence of retraction pockets in untreated OME was 1.72% (3 out of 174 ears). In children with PCD, OME is an almost universal finding in younger children, but not in adolescents. The study supports the current preference to avoid VT insertion in children with PCD as it confers a significantly higher rate of complications. No cases of cholesteatoma were found in this cohort of PCD children with OME managed without VTs. Crown Copyright © 2017. Published by Elsevier B

  18. Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation

    NARCIS (Netherlands)

    Staal, M. J.; Holm, A. F.; Mooij, J. J. A.; Albers, F. W. J.; Bartels, H.

    2007-01-01

    Objective: Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by means of chronic electrical stimulation of the vestibulocochlear nerve. Patients: Inclusion criteria were severe, chronic, therapeutically refractory, unilateral tinnitus and severe hearing loss at the

  19. 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.

  20. 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.

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

    International Nuclear Information System (INIS)

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

    1993-01-01

    We describe two cases of tuberculous otitis media studied with high-resolution computed tomography (CT). Findings included extensive soft tissue densities with fluid levels in the tympanic cavity, the antrum, the mastoid and petrous air cells. Multifocal bony erosions and reactive bone sclerosis were seen as well. CT proved valuable for planning therapy by accurately displaying the involvement of the various structures of the middle and inner ear. However, the specific nature of the disease could only be presumed. (orig.)

  2. (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.

  3. A mutation in Nischarin causes otitis media via LIMK1 and NF-κB pathways.

    Directory of Open Access Journals (Sweden)

    Michael Crompton

    2017-08-01

    Full Text Available Otitis media (OM, inflammation of the middle ear (ME, is a common cause of conductive hearing impairment. Despite the importance of the disease, the aetiology of chronic and recurrent forms of middle ear inflammatory disease remains poorly understood. Studies of the human population suggest that there is a significant genetic component predisposing to the development of chronic OM, although the underlying genes are largely unknown. Using N-ethyl-N-nitrosourea mutagenesis we identified a recessive mouse mutant, edison, that spontaneously develops a conductive hearing loss due to chronic OM. The causal mutation was identified as a missense change, L972P, in the Nischarin (NISCH gene. edison mice develop a serous or granulocytic effusion, increasingly macrophage and neutrophil rich with age, along with a thickened, inflamed mucoperiosteum. We also identified a second hypomorphic allele, V33A, with only modest increases in auditory thresholds and reduced incidence of OM. NISCH interacts with several proteins, including ITGA5 that is thought to have a role in modulating VEGF-induced angiogenesis and vascularization. We identified a significant genetic interaction between Nisch and Itga5; mice heterozygous for Itga5-null and homozygous for edison mutations display a significantly increased penetrance and severity of chronic OM. In order to understand the pathological mechanisms underlying the OM phenotype, we studied interacting partners to NISCH along with downstream signalling molecules in the middle ear epithelia of edison mouse. Our analysis implicates PAK1 and RAC1, and downstream signalling in LIMK1 and NF-κB pathways in the development of chronic OM.

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

    Science.gov (United States)

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

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

  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.

  6. 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.

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

    Science.gov (United States)

    Bluestone, Charles D; Swarts, J Douglas

    2010-12-01

    The pathogenesis of otitis media is multifactorial, but the role of evolution on its development has not been addressed. We posit that the high prevalence of middle-ear disease is most likely restricted to humans, in contrast to other wild species, because the associated hearing loss would have reduced the fitness of affected individuals as a result of predation. We present here the possible consequences of two human adaptations that may have resulted in ubiquitous otitis media: the interaction of bipedalism and increased brain size, and the loss of facial prognathism resulting from speech or cooking. As a consequence of our adaptation for bipedalism, the female pelvic outlet is constricted, which, in the context of a rapidly enlarging brain, results in humans being born 12 months too soon. Significantly, immature eustachian tube structure and function, in conjunction with an immature immune system, helps to explain the high incidence of otitis media in the first year of life. But the persistence of middle-ear disease beyond this stage is not explained by "immaturity." The morphology of the palate changed with the adaptations that produced facial flattening, with concomitant effects on eustachian tube function. These changes resulted in relatively poor human physiologic tubal function in comparison to the nonhuman primate. Copyright © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  8. Prepubertal Unilateral Gynecomastia: Report of 2 Cases

    Science.gov (United States)

    Demirbilek, Hüseyin; Bacak, Gökhan; Baran, Rıza Taner; Avcı, Yahya; Baran, Ahmet; Keleş, Ayşenur; Özbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-01-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign fibroglandular gynecomastia and intensive (3+) estrogen receptor expression in 100% of periductal epithelial cells. Although an extremely rare and generally benign condition, patients with prepubertal unilateral gynecomastia should have a full endocrine and oncologic work-up. PMID:25541897

  9. Prepubertal unilateral gynecomastia: report of 2 cases.

    Science.gov (United States)

    Demirbilek, Hüseyin; Bacak, Gökhan; Baran, Rıza Taner; Avcı, Yahya; Baran, Ahmet; Keleş, Ayşenur; Özbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-12-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign fibroglandular gynecomastia and intensive (3+) estrogen receptor expression in 100% of periductal epithelial cells. Although an extremely rare and generally benign condition, patients with prepubertal unilateral gynecomastia should have a full endocrine and oncologic work-up.

  10. Hearing aids for otitis media with effusion: Do children use them?

    Science.gov (United States)

    Gan, Richard Wei Chern; Overton, Parisa; Benton, Claire; Daniel, Matija

    2017-08-01

    ENT surgeons may refer children with otitis media with effusion (OME) to audiology for consideration of hearing aids. They are an option for the treatment of OME, but are only effective if the child actually wears them. Our study investigated what proportion of children referred for hearing aids actually receive them, and whether children use them. Retrospective study of children referred to audiology from November 2013 to August 2014, including 70 children referred by ENT for hearing aids for OME, plus a further 5 children with OME given hearing aids through direct access audiology service. During the study period, there were 202 referrals of children to audiology, of which 70 (34.7%) were for consideration of hearing aids for OME. Of these 70 referred children, 37 (52.9%) were not fitted with hearing aids due to normal audiometry (23), asymptomatic mild hearing loss (7), nonattendance (3), clinical decision to just monitor hearing (1), parental decline (2), and unrecorded reason (1). A total of 38 children (including direct access patients) were fitted with hearing aids for OME. Majority (36/38) of children issued aids used them, 16 all day, 7 only at school, 1 only at home, 3 only when needed, and 9 used them for an unspecified duration; 1 child's use of hearing aids was unrecorded, and 1 child refused to use it. 21 were fitted bilaterally and 17 unilaterally. 37 were behind the ear aids and 1 a BAHA softband. A third of referrals to paediatric audiology by ENT are for consideration of hearing aids for OME. Only about half of children referred to audiology for hearing aids for OME actually receive them, as by the time they see audiology the hearing loss has frequently resolved or is asymptomatic so that aiding is unwarranted. Once fitted, they appear to be well accepted. Hearing aids have fair utilization in children fitted with them for OME. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. 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

  12. 76 FR 39883 - Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis...

    Science.gov (United States)

    2011-07-07

    ...] Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis Media... Clinical Trials for Systemic Antibacterial Agents for the Treatment of Acute Otitis Media. This public... the treatment of acute otitis media (middle ear infection). Discussions will focus on [[Page 39884...

  13. 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

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

    African Journals Online (AJOL)

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

  15. Observations on the Current Bacteriological Profile of Chronic ...

    African Journals Online (AJOL)

    Department of Otolaryngology,. University of Nigeria Teaching. Hospital, Enugu, Nigeria. E‑mail: tochiorji@yahoo.com. Introduction. Chronic suppurative otitis media (CSOM) is the most common infection of the ear characterized by persistent or recurrent purulent drainage from the middle ear through a persistent nonintact ...

  16. Unilateral traumatic oculomotor nerve paralysis

    International Nuclear Information System (INIS)

    Asari, Syoji; Satoh, Toru; Yamamoto, Yuji

    1982-01-01

    The present authors report a case of unilateral traumatic oculomotor nerve paralysis which shows interesting CT findings which suggest its mechanism. A 60-year-old woman was admitted to our hospital with a cerebral concussion soon after a traffic accident. A CT scan was performed soon after admission. A high-density spot was noted at the medial aspect of the left cerebral peduncle, where the oculomotor nerve emerged from the midbrain, and an irregular, slender, high-density area was delineated in the right dorsolateral surface of the midbrain. Although the right hemiparesis had already improved by the next morning, the function of the left oculomotor nerve has been completely disturbed for the three months since the injury. In our case, it is speculated that an avulsion of the left oculomotor nerve rootlet occurred at the time of impact as the mechanism of the oculomotor nerve paralysis. A CT taken soon after the head injury showed a high-density spot; this was considered to be a hemorrhage occurring because of the avulsion of the nerve rootlet at the medial surface of the cerebral peduncle. (J.P.N.)

  17. United Nations and Multilateralism: Appraising USA's Unilateralism ...

    African Journals Online (AJOL)

    DrNneka

    global peace and security, as well as the survival of the United Nations. This is because ... Key Words: United Nations, multilateralism, United States, unilateralism, national interest, UN Charter ..... Lebanon, Iraq, Turkey, Egypt, Jordan, etc.

  18. 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.

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

    Science.gov (United States)

    Subbotina, M V

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

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

    Science.gov (United States)

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

    2017-02-01

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

  1. 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.

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

    Science.gov (United States)

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

    2008-12-01

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

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

    Science.gov (United States)

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

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

  4. Unilateral Condylar Hyperplasia of the Mandible

    Directory of Open Access Journals (Sweden)

    Malachovsky I

    2015-12-01

    Full Text Available Condylar hyperplasia (CH of the mandible is a rare pathology that occurs at the head of the condyle and can lead to facial asymmetry affecting occlusion and possible association with pain and dysfunction. Unilateral condylar hyperplasia is an uncommon condition of unknown aetiology, proper diagnosis of which has to be established, as the patients may look for surgical help. A rare case of unilateral condylar hyperplasia of the mandible is reported here.

  5. Prepubertal Unilateral Gynecomastia: Report of 2 Cases

    OpenAIRE

    Demirbilek, H?seyin; Bacak, G?khan; Baran, R?za Taner; Avc?, Yahya; Baran, Ahmet; Kele?, Ay?enur; ?zbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-01-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign ...

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

    Science.gov (United States)

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

    2015-09-01

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

  7. 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

  8. Laser Myringotomy Versus Ventilation Tubes In Otitis Media With Effusion.

    Science.gov (United States)

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

    2016-01-01

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

  9. Primary secretory otitis media in Cavalier King Charles spaniels.

    Science.gov (United States)

    Cole, Lynette K

    2012-11-01

    Primary secretory otitis media (PSOM) is a disease that has been described in the Cavalier King Charles spaniel (CKCS). A large, bulging pars flaccida identified on otoscopic examination confirms the diagnosis. However, in many CKCS with PSOM the pars flaccida is flat, and radiographic imaging is needed to confirm the diagnosis. Current treatment for PSOM includes performing a myringotomy into the caudal-ventral quadrant of the pars tensa with subsequent flushing of the mucus out of the bulla using a video otoscope. Repeat myringotomies and flushing of the middle ear are necessary to keep the middle ear free of mucus. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Radiographic imaging of otitis media and interna in pigs

    International Nuclear Information System (INIS)

    Harlizius, J.; Kluczniok, C.; Bollwahn, W.

    1997-01-01

    Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations

  11. Transverse sinus thrombosis associated with otitis media and mastoiditis

    International Nuclear Information System (INIS)

    Santos, V.M.; Figueiredo, N.C.; Santos, F.H.B.

    2012-01-01

    A case of transverse sinus thrombosis is described in an adolescent male with antecedent meningomyelocele corrected by surgery, and ventriclo-peritoneal derivation. Four months before the occurrence of thrombosis, he presented with bilateral otitis media and mastoiditis, and was treated with antibiotic. Magnetic resonance images were not obtained before referral to our hospital. The patient received full anticoagulation and his clinical course was uneventful. He remains asymptomatic under outpatient surveillance till this report. The aim of reporting the case is to emphasize the role of otologic infections in the origin of intracranial thrombotic phenomena, and highlights the findings of magnetic resonance venography for characterization of intracranial sinus thrombosis. (author)

  12. [Efficiency of combination therapy for acute otitis media].

    Science.gov (United States)

    Poliakova, S D; Nekrasova, E A

    2010-01-01

    The clinical efficiency of treatment was evaluated in 60 patients aged 18 to 60 years with protracted acute otitis media (AOM) who had residual tympanic membrane inflammation and exudates in the tympanic cavity. The patients were divided into 2 groups of 30 each, who received equal basic medical treatment; Group 1 patients were additionally given eurespal (fenspiride) 80 mg thrice daily for 2 weeks. The patients were examined by clinical, endoscopic, and audiometric studies; the transport function of the nasal ciliated epithelium was also explored. The findings suggest the benefits of the additional use of eurespal in the treatment of the catarrhal stage of AOM.

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

    International Nuclear Information System (INIS)

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

    1982-01-01

    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

  14. Malignant external otitis: The diagnostic value of bone scintigraphy

    International Nuclear Information System (INIS)

    Ostfeld, E.; Aviel, A.; Pelet, D.

    1981-01-01

    Technetium99m Methylene Diphosphate bone scintigraphy (BS) of the skull was performed in three patients with malignant external otitis (MEO). Pathological uptake of the radioisotope in the mastoid region was found during the early stages of MEO updating radiologic findings. The extent of the radioisotope accumulation during the early stages of MEO indicates that the actual tissue damage exceeds the clinical estimation. The follow-up BS findings correlate well with the clinical course of MEO indicating either healing or extension to the base of skull

  15. Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma.

    Science.gov (United States)

    Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

    2017-01-01

    Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer-specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer-specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p =0.11). Bilateral mastectomy did not provide a clinically or statistically significant breast cancer-specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy.

  16. Functional significance of ipsilesional motor deficits after unilateral stroke.

    Science.gov (United States)

    Chestnut, Caitilin; Haaland, Kathleen Y

    2008-01-01

    To determine whether ipsilesional motor skills, which have been related to independent functioning, are present chronically after unilateral stroke and are more common in people with apraxia than in those without apraxia. Observational cohort comparing the performance of an able-bodied control group, stroke patients with left- or right-hemisphere damage matched for lesion volume, and left-hemisphere stroke patients with and without ideomotor limb apraxia. Primary care Veterans Affairs and private medical center. Volunteer right-handed sample; stroke patients with left- or right-hemisphere damage about 4 years poststroke; a control group of demographically matched, able-bodied adults. Not applicable. Total time to perform the (1) Williams doors test and the (2) timed manual performance test (TMPT), which includes parts of the Jebsen-Taylor Hand Function Test. Ipsilesional motor deficits were present after left- or right-hemisphere stroke when using both measures, but deficits were consistently more common in patients with limb apraxia only for the TMPT. These findings add to a growing literature that suggests that ipsilesional motor deficits may have a functional impact in unilateral stroke patients, especially in patients with ideomotor limb apraxia.

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

    Science.gov (United States)

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

    2016-03-01

    Otitis media is one of the most common childhood diseases worldwide, but because of lack of doctors and health personnel in developing countries it is often misdiagnosed or not diagnosed at all. This may lead to serious, and life-threatening complications. There is, thus a need for an automated computer based image-analyzing system that could assist in making accurate otitis media diagnoses anywhere. A method for automated diagnosis of otitis media is proposed. The method uses image-processing techniques to classify otitis media. The system is trained using high quality pre-assessed images of tympanic membranes, captured by digital video-otoscopes, and classifies undiagnosed images into five otitis media categories based on predefined signs. Several verification tests analyzed the classification capability of the method. An accuracy of 80.6% was achieved for images taken with commercial video-otoscopes, while an accuracy of 78.7% was achieved for images captured on-site with a low cost custom-made video-otoscope. The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~64% to 80%) using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.

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

    Science.gov (United States)

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

    2014-10-01

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

  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

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

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

    Directory of Open Access Journals (Sweden)

    Jing Chen

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

  1. [Comparison of four different staining methods for ear cytology of dogs with otitis externa].

    Science.gov (United States)

    Bouassiba, C; Osthold, W; Mueller, R S

    2013-01-01

    Cytological examination is crucial for the diagnosis and classification of canine otitis externa. Staining should reveal micro-organisms as perpetuating factors of otitis externa. The aim of the study was to compare four different staining methods (Diff-Quik®, Diff-Quik® after dipping in acetone, Gram Quick stain® and a commercial rapid stain for otitis externa) for ear cytology of dogs with otitis externa and to investigate the agreement of cytology and culture. In a study evaluating dogs with otitis externa, five ear swabs (one for culture and four for cytology) were taken from the horizontal part of the external auditory canal of 224 affected ears and compared semi-quantitatively. Diff-Quik® with and without prior dipping in acetone as well as the Gram Quick stain® displayed a high degree of agreement in the detection of micro-organisms (cocci p = 0.2366; rods p = 0.4832; yeasts p = 0.1574), while the commercial otitis rapid stain revealed significantly less micro-organisms (p stains corresponded to the culture results by >  70%; the agreement was lower with the commercial otitis rapid stain. The quickest and easiest method was staining with Diff-Quik®. Diff-Quik® with or without prior dipping in acetone and the Gram Quick stain® had a high agreement in the detection of microorganisms and can thus be considered nearly equivalent for the diagnosis of otitis externa infectiosa. The commercial otitis rapid stain is less reliable. Based on this study Diff-Quik® can be recommended for the routine cytology of ear swabs. Additionally, a culture may be indicated and must be interpreted in the context of the cytology.

  2. An exercise in preferential unilateral breathing

    International Nuclear Information System (INIS)

    Cheong, D.; Tucker, B.; Jenkins, S.; Robinson, P.; Curtin University, Shenton Park, WA

    1999-01-01

    Full text: In preparation for major thoracic surgery, physiotherapists have traditionally taught unilateral breathing exercises. There are no studies that prove that these exercises are effective This study was undertaken to demonstrate the effects of unilateral thoracic expansion exercises (TEE) using 99 Tc m -Technegas Ten physiotherapists were taught unilateral TEE to increase ventilation to the right lower lobe. Each subject underwent two separate Technegas ventilation studies using a single-breath technique, one with normal deep inspiration and the other during a right TEE. Dynamic and static images were acquired in the seated position for each ventilation study. Analysis was undertaken by dividing the lungs into 6 zones of equal height and calculating the relative ventilation of each zone and each lung. Seven subjects (70%) achieved significantly increased ventilation to the right lower zone, while 9 (90%) achieved greater ventilation to the right lung. Total lung ventilation was reduced during right TEE when compared with normal deep inspiration

  3. Acute external otitis as debut of acute myeloid leukemia - A case and review of the literature.

    Science.gov (United States)

    Slengerik-Hansen, Joachim; Ovesen, Therese

    2018-03-01

    Acute leukemia is a well known childhood cancer. The relation between leukemia and otological symptoms has long been established but is highly rare as a debut symptom of leukemia. External otitis is a common condition affecting many children, and most cases are successively treated with topical medicine. Here we present a child with acute external otitis later shown to be the debut symptom of acute myeloid leukemia, to our knowledge the first specific case described. We have reviewed the literature to find red flags for suspicion of severe disease in case of acute external otitis. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate.

    Science.gov (United States)

    Tengroth, Birgitta; Hederstierna, Christina; Neovius, Erik; Flynn, Traci

    2017-06-01

    Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT treatments) during childhood in a group of children with cleft lip and palate. A retrospective medical chart review of 33 children (25 boys and 8 girls) born with unilateral cleft lip and palate (UCLP) was completed. Audiological data (results of hearing sensitivity tests, the total number of hearing tests, and number of VT treatments) were extracted from medical records from when the children were 4-7 and >7-10 years of age. The hearing thresholds in the speech frequencies improved with age (p 7-10 years of age. There were no significant correlations between number of VT treatments and hearing thresholds at >7-10 years. Four of the 33 children presented with complications: two children exhibited perforations of the ear drum (6.1%) and two children developed unilateral cholesteatoma (6.1%). In the current study, the hearing sensitivity of children with cleft lip and palate improved with age. However, this improvement was not seen in the higher frequencies. Twelve percent of the children experienced complications following VT treatments. Due to these complications, it is recommended that all children with cleft palate should have routine follow-ups by an ENT doctor and audiologist. As part of the routine follow-up care, hearing assessments should be performed before and after VT treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Haemophilus parainfluenzae Strain ATCC 33392 Forms Biofilms In Vitro and during Experimental Otitis Media Infections.

    Science.gov (United States)

    Pang, Bing; Swords, W Edward

    2017-09-01

    Haemophilus parainfluenzae is a nutritionally fastidious, Gram-negative bacterium with an oropharyngeal/nasopharyngeal carriage niche that is associated with a range of opportunistic infections, including infectious endocarditis and otitis media (OM). These infections are often chronic/recurrent in nature and typically involve bacterial persistence within biofilm communities that are highly resistant to host clearance. This study addresses the primary hypothesis that H. parainfluenzae forms biofilm communities that are important determinants of persistence in vivo The results from in vitro biofilm studies confirmed that H. parainfluenzae formed biofilm communities within which the polymeric matrix was mainly composed of extracellular DNA and proteins. Using a chinchilla OM infection model, we demonstrated that H. parainfluenzae formed surface-associated biofilm communities containing bacterial and host components that included neutrophil extracellular trap (NET) structures and that the bacteria mainly persisted in these biofilm communities. We also used this model to examine the possible interaction between H. parainfluenzae and its close relative Haemophilus influenzae , which is also commonly carried within the same host environments and can cause OM. The results showed that coinfection with H. influenzae promoted clearance of H. parainfluenzae from biofilm communities during OM infection. The underlying mechanisms for bacterial persistence and biofilm formation by H. parainfluenzae and knowledge about the survival defects of H. parainfluenzae during coinfection with H. influenzae are topics for future work. Copyright © 2017 American Society for Microbiology.

  6. Presengical CT assessment of cholesteatomaclronic otitis media: review of 116 cases

    International Nuclear Information System (INIS)

    Lazaro, A.; Navarro, M.; Beams, B.; Fernandez, F.; Mas, F.; Domenech, A.; Moreno, A.; Bordon, F.

    1995-01-01

    We assess the utility of CT in the diagnosis of the sped of and complications associated with cholesteatomas of middle ear. We review retrospectively the CT studies of 116 patients who underwent surgical treatment after a preoperative diagnosis of cholesteatoma between 1988 and 1992. We compare the findings at CT and surgery, taking into account the site, extension, complications and noteworthly surgical aspects. In our study, CT disclosed the presence of a mass within the tympanic cavity in all cases (100%). Among the entire study population, there were 103 cases of cholesteatoma and 13 of chronic otitis media (COM). CT revealed signs compatible with cholesteatoma in 99 cases, 3 of which were classified as COM and 14 in which it was impossible to distinguish between COM and cholesteatoma. CT discolsed a high correlation coefficient for the detection of erosion of the ossicular chain (sensitivity, 94.4%; specificity, 63.6%) and a moderate coefficient for fistula in lateral semicircular canal (75.0% and 97.0%), rupture of the tegmen tympani (76.9% and 96.1%) and dehiscence of the osseous portion of the facial nerve canal (66.6% and 95.6%). In our experience, wich coincides with reports in the literature, we conclude that CT is currebtly an excellent imaging method for the presurgical assessment of cholesteatoma. Additional explorations are usually unneccessary. 12 refs

  7. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids.

    Science.gov (United States)

    Lack, Gideon; Caulfield, Helen; Penagos, Martin

    2011-05-01

    We reviewed the evidence linking otitis media with effusion (OME) and atopy, with the goal of clarifying the possible role of intranasal corticosteroids (INSs) in OME treatment. In August 2009, the MEDLINE database was searched for primary studies on OME epidemiology, pathophysiology, and treatment. Relevant clinical guidelines were obtained. Interpreting OME research is complicated by variable disease definitions, patient populations, methodologies, and outcomes assessments, along with the possibility of spontaneous resolution. However, evidence links OME with atopic conditions including allergic rhinitis; observed prevalence of allergic rhinitis in patients with chronic or recurrent OME ranges from 24% to 89%. Such findings have prompted evaluations of common allergy medications for OME treatment. While short-term use of INSs alone or combined with antibiotics has shown benefit in some studies, more prolonged treatment protocols and long-term clinical outcomes will require critical assessment. Evidence suggesting epidemiologic and pathophysiologic links between allergy and OME has prompted investigation into a potential role for INSs in OME management, with promising initial results. Benefits of considering medical treatment in patients with OME prior to surgery include both the potential reductions in allergic inflammation and the naturally occurring spontaneous resolution of OME in these patients. © 2011 John Wiley & Sons A/S.

  8. The impact of unilateral divorce on crime

    OpenAIRE

    Cáceres-Delpiano, Julio; Giolito, Eugenio P.

    2008-01-01

    In this paper, we evaluate the impact of unilateral divorce on crime. First, using crime rates from the FBI's Uniform Crime Report program for the period 1965-1998 and differences in the timing in the introduction of the reform, we find that unilateral divorce has a positive impact on violent crime rates, with an 8% to 12% average increase for the period under consideration. Second, arrest data not only confirms the findings of a positive impact on violent crime but also shows that this impac...

  9. Trilateral retinoblastoma with unilateral eye involvement

    Directory of Open Access Journals (Sweden)

    Gabriel Costa de Andrade

    2015-08-01

    Full Text Available SummaryRetinoblastomas (RB are the main forms of intraocular tumor in childhood, with a worldwide incidence of 1 case per 15,000 to 20,000 live births. Trilateral RB (RBT is a rare combination of unilateral or bilateral RB with a midline intracranial neoplasm of neuroblastic origin, usually found in the pineal region or the suprasellar region, presenting variable incidence of 0.5% up to 6% among patients with RB. The article reports a case of unilateral RBT in a patient treated at Hospital A.C.Camargo.

  10. Recurrent Unilateral Vulval Elephantiasis: A Case Report

    Science.gov (United States)

    G., Sampath Kumar; Venkatesh, Shreedhar

    2014-01-01

    Genital elephantiasis is caused by a variety of infective and non infective causes leading to blockage of lymphatic. We are presenting a rare case of recurrent unilateral vulval elephantiasis which has recurred after initial reconstructive surgery. A 38 year old female presented with vulval swelling and on examination there was gross unilateral vulval enlargement. FNAC (Fine needle aspiration cytology) and biopsy were contributory for diagnosis. Patient was started with antibiotics and daily dressing was done till the infection was subsided and the patient was planned for reconstructive surgery. PMID:24971141

  11. Recurrent unilateral vulval elephantiasis: a case report.

    Directory of Open Access Journals (Sweden)

    Lakshmidevi Muralidhar

    2014-06-01

    Full Text Available Genital elephantiasis is caused by a variety of infective and non infective causes leading to blockage of lymphatic. We are presenting a rare case of recurrent unilateral vulval elephantiasis which has recurred after initial reconstructive surgery. A 38 year old female presented with vulval swelling and on examination there was gross unilateral vulval enlargement. FNAC (Fine needle aspiration cytology and biopsy were contributory for diagnosis. Patient was started with antibiotics and daily dressing was done till the infection was subsided and the patient was planned for reconstructive surgery.

  12. Mandibular unilateral fusion in primary dentition

    Directory of Open Access Journals (Sweden)

    Neena Eregowda

    2017-01-01

    Full Text Available Fusion is a developmental anomaly which occurs due to a union of one or more adjacent teeth during morphodifferentiation of the dental germs. The prevalence of tooth fusion is estimated at 0.5%–2.5% in the primary dentition. These anomalies may be unilateral or bilateral and may affect either dentition although the deciduous teeth are more commonly affected. Early diagnosis of such condition is important because it may cause clinical problems, such as esthetic concerns, and caries. This report describes a case of unilateral fusion of the primary mandibular lateral incisor and canine and aims to evaluate any associated pathology.

  13. Thyrotoxicosis Presenting as Unilateral Drop Foot.

    Science.gov (United States)

    Hara, Kenju; Miyata, Hajime; Motegi, Takahide; Shibano, Ken; Ishiguro, Hideaki

    2017-01-01

    Neuromuscular disorders associated with hyperthyroidism have several variations in their clinical phenotype, such as ophthalmopathy, periodic paralysis, and thyrotoxic myopathy. We herein report an unusual case of thyrotoxic myopathy presenting as unilateral drop foot. Histopathological examinations of the left tibialis anterior muscle showed marked variation in the fiber size, mild inflammatory cell infiltration, and necrotic and regenerated muscle fibers with predominantly type 1 fiber atrophy. Medical treatment with propylthiouracil resulted in complete improvement of the left drop foot. This case expands the phenotype of thyrotoxicosis and suggests that thyrotoxicosis be considered as a possible cause of unilateral drop foot.

  14. Unusual unilateral presentation of pachydermodactyly: a case report.

    Science.gov (United States)

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions.

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

    Directory of Open Access Journals (Sweden)

    Nuriddin U. Narzullaev, PhD

    2012-09-01

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

  16. 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.

  17. Societal costs and burden of otitis media in Portugal

    Directory of Open Access Journals (Sweden)

    Speets AM

    2011-04-01

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

  18. Otitis media with effusion in children with in Down syndrome.

    Science.gov (United States)

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

    2013-08-01

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

  19. Otitis media aguda: nuevo enfoque terapéutico

    Directory of Open Access Journals (Sweden)

    Ileana Alvarez Lam

    2004-03-01

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

  20. Regulatory domain limits of unilateral agreements

    International Nuclear Information System (INIS)

    Grenier, M.

    1986-06-01

    Simple in its principle unilateral agreement application in practice arise nevertheless some problems, not only for international transport when interpretation is somewhat different between countries, but also in domestic transport. This report tries to determine what being misapprehension and to propose a way to solve misapprehension which does not facilitate radioactive materials transport [fr

  1. Unilateral nodular adrenal hyperplasia: Case series

    African Journals Online (AJOL)

    A.F. Kotb

    2016-07-26

    Jul 26, 2016 ... Abstract. Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 ...

  2. Prenatal diagnosis of congenital unilateral hydrocephalus

    International Nuclear Information System (INIS)

    Koga, Yasutsugn; Tahara, Yasuo; Kida, Takeshi; Matumoto, Yoshinori; Negishi, Hiroaki; Fujimoto, Seiichiro

    1997-01-01

    A case is presented in which fetal unilateral hydrocephalus that had not been definitively diagnosed by ultrasonography was confirmed by means of magnetic resonance imaging. Computed tomography performed in the neonatal period after intraventricular injection of contrast medium showed stenosis of the foramen of Monro. (orig.). With 1 fig

  3. Unilateral vestibular loss impairs external space representation.

    Directory of Open Access Journals (Sweden)

    Liliane Borel

    Full Text Available The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal and far (extrapersonal spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation, and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

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

    Directory of Open Access Journals (Sweden)

    Sriram Nathan

    2012-01-01

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

  5. [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

    acute otitis media is a frequent disease in the pediatric age. About 2 % of all cases develop intracranial complications such as meningitis. The cerebral infarction originates meningitis and usually occurs in the venous system. The presence of a cerebral artery infarction secondary to acute otitis media is a rare cause described in the literature. a girl of 12 months who presented a febrile syndrome due to acute otitis media and mental confusion. On physical examination, she appeared sleepy with anisocoria, mydriasis in the right eye and left hemiparesis. The computed tomography examination showed extensive cerebral artery infarction. The patient's parents refused the proposed surgical treatment and the girl died 48 hours later. regardless of the current technological advances, the clinical prognosis of cerebral infarction associated with acute otitis media is bad. The focused neurological signs and progressive clinical deterioration should raise suspicion that antimicrobial therapy is not effective.

  6. 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.

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

    Science.gov (United States)

    Azab, Safinaz Nagib; Rhman, Samir Shokr A

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Ruth B Thornton

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

  9. Modification of unilateral otolith responses following spaceflight.

    Science.gov (United States)

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing.

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

    Science.gov (United States)

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

    2017-10-01

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

  11. Measurement of body temperature by use of auricular thermometers versus rectal thermometers in dogs with otitis externa.

    Science.gov (United States)

    González, A Michelle; Mann, F A; Preziosi, Diane E; Meadows, Richard L; Wagner-Mann, Colette C

    2002-08-01

    To compare measurements of body temperature obtained with auricular thermometers versus rectal thermometers in dogs with otitis externa. Prospective study. 100 client-owned dogs: 50 with and 50 without clinical evidence of otitis externa. Dogs were evaluated for the presence of otitis externa on the basis of clinical signs, otoscopic examination, and cytologic evaluation of ear exudate. Auricular and rectal temperatures were obtained simultaneously in all dogs prior to and following ear examination. There was a high correlation between auricular and rectal temperatures in dogs with otitis externa both prior to and after ear manipulation. Significant differences were not detected in temperature measurements among dogs with different degrees of otitis externa. Auricular temperature readings obtained by use of an auricular thermometer in dogs with otitis externa are accurate measurements of body temperature, compared with rectal temperature measurements. Temperature measurements are reliable before and after examination of the ear canal.

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2002-07-01

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

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

    Science.gov (United States)

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

    2012-12-07

    In veterinary medicine, Staphylococcus schleiferi was previously assumed to be an inhabitant of carnivore skin, however, more recently, it has been repeatedly documented in the literature as both an inhabitant and as a pathogen. In order to determine the frequency of nasal carriage, and the methicillin susceptibility pattern of S. schleiferi from healthy dogs as well as dogs with otitis and/or pyoderma, a prospective study including 24 dogs with healthy ears and skin, 27 dogs with healthy ears and pyoderma, 15 dogs with otitis without pyoderma and 20 dogs with both otitis and pyoderma was performed. Specimens were obtained and cultured and isolates were identified as S. schleiferi based on growth and biochemical characteristics. S. schleiferi was isolated from the nares of 1 healthy dog, 3 dogs with recurrent pyoderma, 2 dogs with recurrent otitis, and 1 dog with both recurrent otitis and pyoderma. One of the S. schleiferi isolates was methicillin resistant. Nasal carriage of S. schleiferi does occur in healthy dogs as well as dogs with otitis and pyoderma. Methicillin resistant and sensitive S. schleiferi can be found in the nares of dogs with diseased ears and skin. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Unilateral Palmar Callus and Irritant Hand Eczema – Underreported Signs of Dependency on Crutches

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2018-01-01

    Full Text Available Leg amputees who can’t use prostheses and patients with arthritis are often dependent on crutches. Their chronic use can exert significant friction forces. The palmar skin will respond by forming a hyperkeratotic callus. We report for the first time unilateral palmar callus formation caused by friction from using crutches. Another possible adverse effect is the triggering of irritant contact dermatitis by the handholes of crutches. We report two cases with hand dermatitis due to the chronic dependence on crutches and discuss treatment options.

  17. Topical vs. systemic treatments for acute otitis media.

    Science.gov (United States)

    Thornton, Kathy; Parrish, Francie; Swords, Christine

    2011-01-01

    Acute otitis media (AOM) is a common condition in children that is often treated with systemic antibiotic therapy; however, research suggests that non-complicated AOM will resolve spontaneously using only eardrops. To determine best practice for the use of systematic antibiotics compared to topical treatment of AOM, a systematic review of evidence was conducted. Cochrane, Medline, CINAHL, and other databases were searched. Inclusion criteria were studies published from 1995-2010 that included children with AOM and were randomized controlled trials (RCTs). Five systematic reviews and five RCTs were included in the review. Current evidence recommends using topical and other alternative approaches for treating non-complicated AOM in children 2 years of age or older; however, many practitioners are not currently following these recommendations for various reasons. Additional research to address these reasons may help determine how to improve practitioner adherence to best practice evidence and guidelines to help reduce the unnecessary use of systemic antibiotics.

  18. Early childhood otitis media and later school performance

    DEFF Research Database (Denmark)

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

    2017-01-01

    INTRODUCTION: Otitis media (OM) is a common disease in childhood and hearing loss (HL) is the most common complication. Prolonged HL may lead to language delay and cognitive difficulties. However, the consequences of HL due to OM are not fully understood. The aim of this study was to determine...... proportional odds regression. RESULTS: Out of 94,745 successful pregnancies, 35,946 children without malformations and their parents completed a questionnaire at age 11 years. No associations were observed between number of OM episodes and school performance, even in children with ≥7 OM episodes. CONCLUSION......: This national birth-cohort study did not support the hypothesis that the number of OM episodes in childhood is associated with reduced self-reported school performance in children at 11 years of age....

  19. Tratamiento Quirúrgico de la Otitis Media y el Colesteatoma

    Directory of Open Access Journals (Sweden)

    Jorge García Gómez

    1991-06-01

    %.

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

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

    Abstract

    Surgical Treatment of Chronic Otitis Media and Cholesteatoma

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

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

  20. Valuing reduced antibiotic use for pediatric acute otitis media.

    Science.gov (United States)

    Meropol, Sharon B

    2008-04-01

    The 2004 American Academy of Pediatrics acute otitis media guidelines urge parents to weigh the benefits of reduced antibiotic use, adverse drug events, and future resistance versus risks of extra costs and sick days resulting from guideline use. The value of decreased antibiotic resistance has not been quantified. The objective was to perform cost-utility analysis, estimating the resistance value of implementing the guidelines for acute otitis media treatment for children life-day units. The minimum resistance benefit value, where the benefits of the American Academy of Pediatrics guidelines would at least balance their costs, was defined as the guidelines' incremental costs minus their other benefits. For a child 2 to benefit at 0.77 quality-adjusted life-days per antibiotic prescription avoided for the guidelines' benefits to balance their costs. For the 6- to life-days per prescription avoided. Results were sensitive to the dollar cost utility; when willingness to pay ranged from $20,000 to $200,000 per quality-adjusted life-year, results ranged from 0.36 and 0.30 quality-adjusted life-days up to 4.10 and 3.57 quality-adjusted life-days for the 2- to work days. From a societal perspective, trading 0.30 to 4 quality-adjusted life-days to avoid 1 antibiotic course might be desirable; from a parental perspective, this may not be as desirable. Parent demand for antibiotics may be rational when driven by the value of parent time. Other approaches that have the potential to reduce antibiotic use, such as wider use of influenza vaccine and improved rapid viral diagnostic techniques, might be more successful.

  1. Pediatric Acute Otitis Media in the Era of Pneumococcal Vaccination.

    Science.gov (United States)

    Tawfik, Kareem O; Ishman, Stacey L; Altaye, Mekibib; Meinzen-Derr, Jareen; Choo, Daniel I

    2017-05-01

    Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged otitis media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.

  2. Clinical and audiological findings in children with acute otitis media.

    Science.gov (United States)

    Kostić, Mirjana; Ribarić Jankes, Ksenija; Trotić, Robert; Ries, Mihael; Ledić, Branka; Bedeković, Vladimir

    2015-07-01

    It is recommended to perform follow-up tympanometry and if necessary tonal audiometry in children who have normal plain otoscopy findings after recovering from acute otitis media (AOM). Children with Type B tympanogram, 3 months following the onset of AOM, are very likely to have a conductive hearing loss. Type B tympanogram is a much better indicator of effusion in the middle ear compared to plain otoscopy. This study was undertaken to investigate the frequency and duration of middle ear effusion in children following an episode of acute otitis media, to track changes in tonal audiometry and tympanometry findings in the post-AOM period, and recognize the optimal timing for performing both tests. In this study, 125 children aged 5-7 years with bilateral AOM were randomly selected and separately followed up for 3 months. The children underwent six ear, nose, and throat (ENT 1-6) examinations, six tympanometries (TM 1-6), and three tonal audiometries (TA 1-3). Evaluation of nasopharynx was done at the ENT 1 examination. Children who received ventilation tubes were followed for 21 month altogether. At the first otoscopy, pathological findings were recorded in 250 ears/125 children (100.0%). The number of pathological otoscopy findings decreased at each subsequent examination. At ENT 6 all children had normal otoscopy findings. Type B tympanogram was detected in 49/250 (19.6%) ears at TM 6, performed 3 months following the onset of the disease. At the TA 1 conductive hearing impairment was recorded in 158/250 (63.2%) ears, at TA 2 in 66/250 (26.4%), and at TA 3 in 39/250 (15.6%). Most of them were associated with Type B tympanogram.

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

    Science.gov (United States)

    Harman, Nicola L; Bruce, Iain A; Kirkham, Jamie J; Tierney, Stephanie; Callery, Peter; O'Brien, Kevin; Bennett, Alex M D; Chorbachi, Raouf; Hall, Per N; Harding-Bell, Anne; Parfect, Victoria H; Rumsey, Nichola; Sell, Debbie; Sharma, Ravi; Williamson, Paula R

    2015-01-01

    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.

  4. 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.

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

    Science.gov (United States)

    Harman, Nicola L.; Bruce, Iain A.; Kirkham, Jamie J.; Tierney, Stephanie; Callery, Peter; O'Brien, Kevin; Williamson, Paula R.

    2015-01-01

    Background 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. Methods and Findings 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. Conclusions 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

  6. Unilateral facial pain and lung cancer

    International Nuclear Information System (INIS)

    Shakespeare, T.P.; Stevens, M.J.

    1996-01-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab

  7. Unilateral facial pain and lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shakespeare, T.P.; Stevens, M.J. [Royal North Shore Hospital, Crows Nest, NSW (Australia)

    1996-02-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab.

  8. Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome

    Science.gov (United States)

    Boto, Ana; Del Hierro, Almudena; Capote, Maria; Noval, Susana; Garcia, Amanda; Santiago, Susana

    2014-01-01

    We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature. PMID:24882965

  9. Unilateral glaucoma in Sotos syndrome (cerebral gigantism).

    Science.gov (United States)

    Yen, M T; Gedde, S J; Flynn, J T

    2000-12-01

    To report a patient with unilateral glaucoma associated with Sotos syndrome. Sotos syndrome (cerebral gigantism) is a disorder of growth and development with characteristic facial changes and normal endocrine function. Ocular manifestations may also include megalocornea, iris hypoplasia, cataracts, megalophthalmos, strabismus, nystagmus, and retinal dystrophy. Case report. A 50 year-old man with the clinical features of Sotos syndrome presented with complaints of decreased vision in the left eye. Ophthalmologic examination revealed bilateral megalocornea, megalophthalmos, iris hypoplasia and transillumination defects, cataracts, and unilateral glaucoma. Intraocular pressure was lowered, and visual field loss was stabilized with topical medications. Sotos syndrome patients should be examined routinely to allow for early detection and treatment of potential ocular problems, including glaucoma.

  10. Uterus didelphys associated with unilateral imperforate vagina.

    Science.gov (United States)

    Gilliland, B; Dyck, F

    1976-07-01

    Two cases of uterus didelphys associated with unilateral imperforate vagina are reported with a review of the literature. In all cases investigated, ipsilateral renal agenesis was found on the affected side. A summary of the embryologic development of the female reproductive tract is included, as well as a possible explanation for this rare anomaly. The authors describe their proposed method of management to achieve freedom from symptoms and maintenance of a relatively intact reproductive tract.

  11. Unilateral Congenital Cataract: Clinical Profile and Presentation.

    Science.gov (United States)

    Khokhar, Sudarshan; Jose, Cijin P; Sihota, Ramanjit; Midha, Neha

    2018-03-01

    To study the clinical profile and presentation of children with unilateral cataract. In this hospital-based, observational, cross-sectional study, patients 15 years of age or younger who presented with unilateral cataract were recruited. Cases of cataract secondary to causes such as trauma or uveitis were excluded. Age at detection and presentation, distance from the treatment center, presenting complaints, cataract morphology, and biometry were noted for each case. A total of 76 patients were recruited. Most patients presented with complaints of leukocoria. Persistent fetal vasculature accounted for 27.6% of cases and was the most common identifiable cause of cataract in this study. Subsequently, patients were divided into two groups: no persistent fetal vasculature (control) and persistent fetal vasculature. A male predominance was noted in both groups. The mean age at detection was 27.58 ± 37.02 and 6.17 ± 8.42 months and the mean age at presentation was 55.613 ± 45.21 and 14.83 ± 17.75 months in the control and persistent fetal vasculature groups, respectively. In the persistent fetal vasculature group, a significant difference was noted in the axial length, keratometry, and corneal diameter between the affected and normal eyes (P = .027, .00176, and .0114, respectively). In the control group, this difference was observed only in keratometry readings (P = .0464). The mean distance traveled by patients to reach the treatment center was 211 km. Persistent fetal vasculature is an important and less identified cause of unilateral cataract. A significant delay is noted in the detection and presentation of unilateral cataract. [J Pediatr Ophthalmol Strabismus. 2018;55(2):107-112.]. Copyright 2017, SLACK Incorporated.

  12. Unilateral regulation breaks regularity of Turing patterns

    Czech Academy of Sciences Publication Activity Database

    Vejchodský, Tomáš; Jaroš, F.; Kučera, Milan; Rybář, Vojtěch

    2017-01-01

    Roč. 96, č. 2 (2017), č. článku 022212. ISSN 2470-0045 EU Projects: European Commission(XE) 328008 - STOCHDETBIOMODEL Institutional support: RVO:67985840 Keywords : unilateral term * Turing instability * pattern Subject RIV: BA - General Mathematics OBOR OECD: Applied mathematics Impact factor: 2.366, year: 2016 https://link. aps .org/doi/10.1103/PhysRevE.96.022212

  13. Unilateral lung transplantation for pulmonary fibrosis.

    Science.gov (United States)

    1986-05-01

    Improvements in immunosuppression and surgical techniques have made unilateral lung transplantation feasible in selected patients with end-stage interstitial lung disease. We report two cases of successful unilateral lung transplantation for end-stage respiratory failure due to pulmonary fibrosis. The patients, both oxygen-dependent, had progressive disease refractory to all treatment, with an anticipated life expectancy of less than one year on the basis of the rate of progression of the disease. Both patients were discharged six weeks after transplantation and returned to normal life. They are alive and well at 26 months and 14 months after the procedure. Pulmonary-function studies have shown substantial improvement in their lung volumes and diffusing capacities. For both patients, arterial oxygen tension is now normal and there is no arterial oxygen desaturation with exercise. This experience shows that unilateral lung transplantation, for selected patients with end-stage interstitial lung disease, provides a good functional result. Moreover, it avoids the necessity for cardiac transplantation, as required by the combined heart-lung procedure, and permits the use of the donor heart for another recipient.

  14. Unilateral hallux valgus: is it true unilaterality, or does it progress to bilateral deformity?

    Science.gov (United States)

    Young, Ki Won; Park, Young Uk; Kim, Jin Su; Jegal, Hyuk; Lee, Kyung Tai

    2013-04-01

    This study was undertaken to determine whether unilateral hallux valgus progresses unilaterally and to evaluate the demographics, etiologies, and radiographic findings associated with symptomatic unilateral hallux valgus deformities. Patients treated for hallux valgus between January 2004 and December 2008 were identified, and of these, 33 patients with unilateral deformities were enrolled. Progression of deformities in normal feet were evaluated at last follow-up visit, and the clinical information and radiographic measurements of those with a deformed normal foot or an unchanged normal foot were compared. Thirty-three patients (3.4%) had a unilateral hallux valgus deformity on preoperative radiographs. The mean length of follow up was 4.7 years (range, 2.4-11). Twenty-four cases had no deformity of the normal foot at last follow-up (the unchanged group), but 15 cases had developed hallux valgus deformity (the deformed group). No significant intergroup differences were found in terms of metatarsus adductus angle (P = .412), Meary angle (P = .771), talocalcaneal angle (P = 1.000), or calcaneal pitch angle (P = .267). However, members of the deformed group were significantly younger at disease onset (P = .045), exhibited a curved first metatarsal head (P = .046), and had a larger initial hallux valgus angle (P hallux valgus was found to be over 97.3%, and significant differences were found between the deformed and unchanged groups in terms of age of onset, metatarsal head shape, and hallux valgus angle.

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

    Science.gov (United States)

    Fletcher, Mark A.; Fritzell, Bernard

    2012-01-01

    Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

  16. Otitis-Prone Children Produce Functional Antibodies to Pneumolysin and Pneumococcal Polysaccharides.

    Science.gov (United States)

    Kirkham, Lea-Ann S; Wiertsema, Selma P; Corscadden, Karli J; Mateus, Tulia; Mullaney, Gemma L; Zhang, Guicheng; Richmond, Peter C; Thornton, Ruth B

    2017-03-01

    The pneumococcus is a major otitis media (OM) pathogen, but data are conflicting regarding whether otitis-prone children have impaired humoral immunity to pneumococcal antigens. We and others have shown that otitis-prone and healthy children have similar antibody titers to pneumococcal proteins and polysaccharides (vaccine and nonvaccine types); however, the quality of antibodies from otitis-prone children has not been investigated. Antibody function, rather than titer, is considered to be a better correlate of protection from pneumococcal disease. Therefore, we compared the capacities of antibodies from otitis-prone (cases) and healthy (controls) children to neutralize pneumolysin, the pneumococcal toxin currently in development as a vaccine antigen, and to opsonize pneumococcal vaccine and nonvaccine serotypes. A pneumolysin neutralization assay was conducted on cholesterol-depleted complement-inactivated sera from 165 cases and 61 controls. A multiplex opsonophagocytosis assay (MOPA) was conducted on sera from 20 cases and 20 controls. Neutralizing and opsonizing titers were calculated with antigen-specific IgG titers to determine antibody potency for pneumolysin, pneumococcal conjugate vaccine (PCV) polysaccharides, and non-PCV polysaccharides. There was no significant difference in antibody potencies between cases and controls for the antigens tested. Antipneumolysin neutralizing titers increased with the number of episodes of acute OM, but antibody potency did not. Pneumolysin antibody potency was lower in children colonized with pneumococci than in noncarriers, and this was significant for the otitis-prone group ( P otitis-prone children demonstrates that they respond to the current PCV and are likely to respond to pneumolysin-based vaccines as effectively as healthy children. Copyright © 2017 Kirkham et al.

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

    Science.gov (United States)

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

    2014-02-01

    Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated with different factors like insertion of VT and use of antibiotics. We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental smoking were associated with the long-term HRQOL in children with otitis media. A cohort study including 397 children was carried out. The children were followed for 13 months, and symptoms, HRQOL and so on were identified by means of questionnaires. HRQOL in children with otitis media was significantly improved after 13 months. The improvement of HRQOL was significantly lower for children with sleep problems compared with children without sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work during the preceding 3 months due to the child' s otitis media compared with children with parents not being absent from their work. There were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period compared with children without a VT. HRQOL in children with otitis media was significantly improved after 13 months. The improvement in HRQOL was significantly lower for children with sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work due to the child's otitis media. There were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  19. Unilateral Macular Star in a Case of Hypertension and Retinitis Pigmentosa.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Chaudhary, Sunil; Phuljhele, Swati; Venkatesh, Pradeep

    2017-01-01

    To describe a case of hypertension and retinitis pigmentosa presenting with a unilateral macular star. Case report. A 17-year-old female with chronic kidney disease and hypertension presented with a mild blurring of vision in the left eye. There was a history of night blindness. Both eyes had optic disc pallor, arteriolar attenuation, and peripheral bony spicules suggestive of the triad of retinitis pigmentosa. Macular star was seen in the left eye alone. We ascribe the macular star to hypertension as the patient had only a mild decrease in vision, no relative afferent pupillary defect, and similar visual evoked response amplitude and latency in both eyes. Unilateral macular star may be seen in hypertension and may simulate neuroretinitis in the clinical setting.

  20. The pathology of silent otitis media: a predecessor to tympanogenic meningitis in infants.

    Science.gov (United States)

    Yildirim-Baylan, Muzeyyen; Schachern, Patricia; Tsuprun, Vladimir; Shiabata, Dai; Paparella, Michael M; Cureoglu, Sebahattin

    2014-03-01

    To determine the association of bacteria embedded within a fibrous matrix in the middle and inner ear in infants with tympanogenic meningitis. Thirty-one cases with meningitis from the human temporal bone collection at the University of Minnesota were screened to select those with tympanogenic meningitis. Inclusion criteria for tympanogenic meningitis were acute meningitis with histopathological evidence of chronic otitis media, and no other source of infection. The presence of labyrinthitis and pathologic changes such as granulation tissue, fibrosis, cholesterol granuloma, cholesteatoma, tympanic membrane perforation, tympanosclerosis, and the type of effusion were noted. The extent and location of bacteria embedded in a fibrous matrix were also explored. Seventeen temporal bones, from nine cases that included two females and seven males, ranging in age from five to twenty-three months, met our criteria of tympanogenic meningitis. Eighty two percent of these temporal bones had bacteria within the fibrous matrices (BFM). BFM were located in one anatomical region in one temporal bone and multiple anatomic regions in sixteen temporal bones. The most common locations were the areas near the oval and round windows. They were also commonly seen in the epitympanum, facial recess, and supratubal recess. BFM within the inner ear were observed in the scala tympani and modiolus in the middle and basal turns of the cochleae of nine temporal bones. In one of these temporal bones, BFM were seen in the internal auditory canal. Labyrinthitis was seen in all ears. The tympanic membrane was intact in all cases. BFM were not seen in three temporal bones from two patients. In one case only one side was available for study. Our findings show an association between the presence of BFM in the ear with chronic pathologic changes and tympanogenic meningitis. Potential pathways of bacteria from the middle ear include hematogeous spread and/or direct spread to dura through the tympanic