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Sample records for polymicrobial otitis media

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

    PubMed

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

    2015-07-01

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

  2. Otitis media with effusion

    MedlinePlus

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

  3. Otitis Media

    PubMed Central

    Bain, John

    1992-01-01

    Otitis media remains one of the least understood conditions seen by a family physician. More attention to follow up instead of widespread use of antibiotics and decongestant mixtures could improve family practice care of children with middle ear disorders. Greater selection in resorting to surgical management would be helpful. Unnecessary interference is unlikely to be of long-term benefit to either children or their families. ImagesFigures 1-3Figures 4-5 PMID:21221314

  4. Otitis media.

    PubMed

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

    2016-01-01

    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. PMID:27604644

  5. Chronic silent otitis media.

    PubMed

    Paparella, Michael M; Schachern, Patricia A; Cureoglu, Sebahattin

    2002-01-01

    Otitis media occurs along a continuum. For example, otitis media with effusion characterized by fluid pathology can lead to chronic otitis media plus chronic mastoiditis, characterized by the presence of intractable tissue pathology such as cholesteatoma, cholesterol granuloma or granulation tissue. The literature defines chronic otitis media as having a tympanic membrane perforation and otorrhea. Amongst many other sequelae, which can result from the continuum, an important common one is chronic silent otitis media. This overlooked entity which includes pathology beneath an intact tympanic membrane is commonly seen in our human temporal bone laboratory and in patients. The clinical pathological correlates of this important disease are discussed herein. PMID:12021496

  6. Update on Otitis Media in Children.

    ERIC Educational Resources Information Center

    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,…

  7. Bacterial agents causing chronic suppurative otitis media.

    PubMed

    Obi, C L; Enweani, I B; Giwa, J O

    1995-06-01

    Ear swabs from 350 patients with chronic otitis media attending different orthorhinolaryngological clinics at different hospitals and health centres in Benin City and Ekpoma in Edo State were screened for the presence of bacterial agents of chronic otitis media. Results revealed the presence of 19 different species indicating polymicrobial infections. Species isolated comprised Staphylococcus aureus (33.6%), Pseudomonas aeruginosa (19.3%), Proteus mirabilis (17%), Alcaligenes faecalis (6.2%) and Klebsiella aerogenes (4.3%). Others included Escherichia coli (3.3%), Proteus rettgeri (2.8%), and Staphylococcus epidermidis (2.2%), Klebsiella pneumoniae, Proteus vulgaris, Acinetobacter spp, Proteus morgani, Haemophilus influenzae, Providencia spp, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus faecalis, non-haemolytic streptococci and Diphotheroids, each accounted for less than 2% of isolates. The study also showed a higher prevalence of chronic otitis media among males (55.7%) than females (44.3%). Cases of chronic otitis media were highest among the age groups (0-5 years) with a prevalence rate of 50% and least among the 6-10 year age group with a prevalence rate of 14.9%. Antibiogram of isolates revealed marked sensitivities (over 90% of the isolates) to ciproxin, tarivid, rocephin and fortum whereas over 70% were resistant to penicillin and ampicillin. Results have indicated that Staphylococcus aureus, Pseudomonas aeruginosa and Proteus mirabilis are leading bacterial agents of otitis media and highlights the high risk involved in the use of penicillin, ampicillin, streptomycin, tetracycline, chloramphenicol, erythromycin, cloxacillin and septrin in the management of chronic otitis media in our locality. PMID:7498006

  8. Pediatric otitis media.

    PubMed

    Julien, D K; Gricar, J A; Cave, D G

    1998-12-01

    The pediatric patients with routine, easiest-to-treat otitis media utilize 2.1 office visits during the course of a PTE. This patient group also received 0.13 tests, 0.14 laboratory and pathology services, and 0.05 medical/surgical procedures during the course of a PTE. Though 29.2% of these patients did not produce a claim for prescription drug therapy, this patient group received at least 1.53 prescriptions per PTEs. One prescription drug group was used in 39.8% of all PTEs. Of the PTEs treated with a single drug group, at least 56.4% were treated with amoxicillin. Two prescription drug groups were used in 18.1% of the PTEs. The prescribing patterns of physicians using two drug groups demonstrate a wide variety of switching patterns, some of which may have cost-of-care implications. Though surgical procedures are seldom utilized in SOI-1, approximately one-half of SOI-2 PTEs undergo some type of surgical procedure. The most common surgical procedure was myringotomy with the PE-TM tubes, which represents 82% of procedures performed on SOI-2 patients. The major cost drivers in the treatment of otitis media are clinical visits and antimicrobial drugs. PMID:10338744

  9. Genetics of otitis media.

    PubMed

    Post, J Christopher

    2011-01-01

    There is a growing body of evidence, both from animal and human studies, that host genetic factors can influence the risk of developing otitis media (OM). The role of genetics in OM has been elucidated through studies with monozygotic and dizygotic twins, analyses linking genetic polymorphisms to OM susceptibility, and genome scans. Several twin studies have shown a strong genetic component to middle ear effusion risk, with the estimate of the role of heredity for the proportion of time with middle ear effusions being around 0.7. Genetic polymorphisms in plasminogen activator inhibitor-1, interleukin-6, tumor necrosis factor-α, human leukocyte antigen, and mannose-binding lectin have been variously linked with OM and upper respiratory infection susceptibility. Several genome linkage studies have identified chromosomal regions associated with chronic OM, including 3p, 10q, 10q22.3, 17q12 and 19q. A number of candidate genes are associated with these sites. Given the current state of understanding of the role of genetics in OM, a family history of OM should be ascertained for all patients. Children with a strong family history of OM should be considered as candidates for a more aggressive early treatment of OM, particularly if other risk factors are present. These children may be earlier candidates for the placement of tympanostomy tubes and/or adenoidectomy. Existing data do not support routine genetic testing to determine a child's susceptibility to OM; however, given the advances in whole genome sequencing, such testing may someday play a role in the management of the OM patient. PMID:21358196

  10. Otitis Media, Learning and Community.

    ERIC Educational Resources Information Center

    McSwan, David; Clinch, Emma; Store, Ron

    This paper reviews selected literature on otitis media (OM) and its learning consequences in Aboriginal children in rural Australia and reports on a project to develop a community approach to the problem. Aboriginal people are the most disadvantaged group in Australia; have much poorer health and lower life expectancy than other Australians; and…

  11. Subepithelial space in otitis media.

    PubMed

    Paparella, M M; Sipilä, P; Juhn, S K; Jung, T T

    1985-04-01

    The role of the subepithelial space (SES) has not received sufficient attention in assessing pathogenesis, pathology, and therefore, clinical diagnosis and treatment of the various forms of otitis media (OM). Temporal bones from patients with OM were classified as cases of acute purulent (POM), serous (SOM), mucoid or secretory (MOM), or chronic otitis media (COM). Controlled morphometric studies were made of cellular components of the SES, along with studies of the epithelium and middle ear space. Corollary studies of biochemistry, cellular components, and prostaglandins (PGs) were done on fluid from the human middle ear. Middle ear effusions (MEE) from animal models of SOM, MOM, and POM were analyzed biochemically. Findings are surprising in that the SES was more actively involved in all forms of OM than had been thought, especially in MOM and COM. Implications are discussed. PMID:2984491

  12. Prevention of early episodes of otitis media by pneumococcal vaccines might reduce progression to complex disease.

    PubMed

    Dagan, Ron; Pelton, Stephen; Bakaletz, Lauren; Cohen, Robert

    2016-04-01

    Otitis media is a common childhood infection of the middle ear and a major cause of morbidity. This multifactorial disease manifests as a spectrum of clinical syndromes from uncomplicated acute otitis media to more complex recurrent and chronic cases (frequently polymicrobial), with the major pathogens involved being Streptococcus pneumoniae and non-typeable Haemophilus influenzae. Pneumococcal conjugate vaccines (PCVs) target only a few serotypes that cause otitis media; however, results from studies suggest that existing PCVs can prevent early episodes of disease associated with vaccine serotypes, resulting in a reduction of subsequent complex cases caused by non-vaccine serotypes and other otopathogens, which contribute considerably to the disease burden. In this Review, we discuss the role of pneumococcus in the disease continuum and assess clinical evidence showing the effect of prevention of early episodes on the complex interplay between bacterial species implicated in otitis media. PMID:27036355

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

    MedlinePlus

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

  14. Bacteriology of chronic otitis media, chronic sinusitis, and paranasal mucopyocele in Japan.

    PubMed

    Ito, K; Ito, Y; Mizuta, K; Ogawa, H; Suzuki, T; Miyata, H; Kato, N; Watanabe, K; Ueno, K

    1995-06-01

    A bacteriologic study of cases of chronic otitis media, chronic sinusitis, and paranasal mucopyocele diagnosed at Gifu University Hospital was performed between 1989 and 1992. Bacteria were isolated from all of 13 samples of discharge from the ears of patients with chronic otitis media, all of 14 mucosal biopsy specimens from patients with chronic sinusitis, 8 of 10 aspirate samples from patients with chronic sinusitis, and 9 of 15 aspirates samples from patients with mucopyocele. Cultures often yielded polymicrobial growth, with an average of 3.1, 3.8, and 4.2 species per positive specimen from chronic otitis media, chronic sinusitis, and mucopyocele, respectively. The most commonly encountered anaerobes were Peptostreptococcus, Propionibacterium, and Prevotella species; the most common aerobes were Staphylococcus and Streptococcus species. One strain of Prevotella melaninogenica highly resistant to ampicillin and two strains of Peptostreptococcus resistant to cefaclor were found. PMID:7548557

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

    MedlinePlus

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

  16. [CLINICAL APPROACH TO PEDIATRIC SEROUS OTITIS MEDIA].

    PubMed

    Gruber, Maayan; Honigman, Tal; Cohen-Kerem, Raanan

    2015-06-01

    Serous otitis media (also known as otitis media with effusion) is one of the most prevalent pediatric diagnoses. However, the recommended clinical approach and significance of this entity are controversial. Pathogenesis is usually based upon a combination of factors as overviewed in the body of the article. The cognitive and behavioral effects amongst children suffering serous otitis media were extensively studied and data points to little if any effects during long term follow-ups in otherwise healthy children. The therapeutic approach can be divided into watchful waiting, systemic drugs, topical drugs, mechanical therapies and surgical therapy (i.e. ventilation tube insertion). The reviewed literature mainly supports the effectiveness of the surgical approach in carefully selected cohorts of patients. PMID:26281082

  17. Biochemical pathology of otitis media with effusion.

    PubMed

    Juhn, S K; Sipilä, P; Jung, T T; Edlin, J

    1984-01-01

    The sequential cytologic and biochemical events of middle ear effusion (MEE) were studied in experimental models of serous otitis media (SOM) and purulent otitis media (POM) in chinchilla. In the SOM model, the initial appearance of neutrophils was followed by macrophages. In the POM model, neutrophils were the predominant cells in MEE and the number of neutrophils was about 100-fold higher than in the SOM model. The activity of lysozyme in MEE was higher in POM than in SOM and correlated with the number of neutrophils and mononuclear phagocytes. The results of the present study suggest that neutrophils and mononuclear phagocytes are one of the main sources for lysozyme levels in MEE during otitis media. PMID:6598270

  18. [The eosinophilic otitis media's research progress].

    PubMed

    Liu, Yang; Zhang, Zhiyuan

    2015-09-01

    The eosinophilic otitis media(EOM) is an intractable disease characterized by the presence of a highly viscous yellow effusion with extensive accumulation of eosinophils in the middle ear; granulation tissue can been discovered in the middle ear cavity; most of patients have association with bronchial asthma; resist to conventional treatment for otitis media; EOM patients show gradual deterioration of hearing and sometimes become deaf suddenly; effective treatment involves use of topical and oral steroids. This article summarizes the progress of the EOM's diagnosis and treatment. PMID:26647553

  19. Otitis media: the chinchilla model.

    PubMed

    Giebink, G S

    1999-01-01

    Streptococcus pneumoniae infection and disease have been modeled in several animal species including infant and adult mice, infant and adult rats, infant Rhesus monkeys, and adolescent and adult chinchillas. Most are models of sepsis arising from intravenous or intraperitoneal inoculation of bacteria, and a few were designed to study disease arising from intranasal infection. Chinchillas provide the only animal model of middle ear pneumococcal infection in which the disease can be produced by very small inocula injected into the middle ear (ME) or intranasally, and in which the disease remains localized to the ME in most cases. This model, developed at the University of Minnesota in 1975, has been used to study pneumococcal pathogenesis at a mucosal site, immunogenicity and efficacy of pneumococcal capsular polysaccharide (PS) vaccine antigens, and the kinetics and efficacy of antimicrobial drugs. Pathogenesis experiments in the chinchilla model have revealed variation in ME virulence among different pneumococcal serotypes, enhancement of ME infection during concurrent intranasal influenza A virus infections, and natural resolution of pneumococcal otitis media (OM) without intervention. Research has explored the relative contribution of pneumococcal and host products to ME inflammation. Pneumococcal cell wall components and pneumolysin have been studied in the model. Host inflammatory responses studied in the chinchilla ME include polymorphonuclear leukocyte oxidative products, hydrolytic enzymes, cytokine and eicosanoid metabolites, and ME epithelial cell adhesion and mucous glycoprotein production. Both clinical (tympanic membrane appearance) and histopathology (ME, Eustachian tube, inner ear) endpoints can be quantified. Immunologic and inflammatory studies have been facilitated by the production of affinity-purified antichinchilla immunoglobulin G (IgG), IgM, and secretory IgA polyclonal antibody reagents, and the identification of cross-reactivity between

  20. Sensorineural hearing loss in chronic otitis media.

    PubMed

    MacAndie, C; O'Reilly, B F

    1999-06-01

    Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P < 0.01) and varied from 5.24 to 9.02 dB across the frequency range. The effect of duration of disease on the degree of SNHL was also analysed but no correlation was found. The presence of cholesteatoma and/or ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss. PMID:10384849

  1. Sensorineural hearing loss in otitis media.

    PubMed

    Paparella, M M; Morizono, T; Le, C T; Mancini, F; Sipilä, P; Choo, Y B; Lidén, G; Kim, C S

    1984-01-01

    Additional evidence is presented to support the hypothesis that both acute purulent otitis media (POM) and chronic suppurative otitis media (COM) can cause high frequency sensorineural hearing loss. In selected patients and in animals (chinchillas) in a pilot study using electrophysiological methods, both temporary threshold shifts and permanent threshold shifts of basal cochlear turn involvement were demonstrated in POM. Data of cochlear involvement in 475 ears with bilateral COM, 607 ears with unilateral COM, and 607 ears serving as controls were obtained from six centers in five countries. In group 1 (15 dB or greater), 43% of ears with unilateral COM and 42% of ears with bilateral COM showed losses, for a combined odds ratio eight times that in controls. In group 2 (30 dB or greater), 16% of ears with unilateral COM and 17% of ears with bilateral COM demonstrated, respectively, seven and ten times that in controls. These statistically significant findings influence clinical considerations. PMID:6508134

  2. New Insights into Eosinophilic Otitis Media.

    PubMed

    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. PMID:26546407

  3. Epidemiology and Management of Otitis Media in Children.

    ERIC Educational Resources Information Center

    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))

  4. Interleukin-8 expression in otitis media.

    PubMed

    Maxwell, K S; Fitzgerald, J E; Burleson, J A; Leonard, G; Carpenter, R; Kreutzer, D L

    1994-08-01

    Based on recent studies in the authors' laboratory on the correlation of cytokines and inflammation in otitis media (OM), the authors hypothesized that in chronic otitis media with effusion (COME) interleukin-8 (IL-8) is responsible for 1. the accumulation of leukocytes in the middle ear cleft and 2. in situ leukocyte activation with subsequent tissue damage. Additionally, the authors hypothesized that IL-8 expression is at least in part under the control of interleukin-1 (IL-1) and tumor necrosis factor (TNF). To begin to test this hypothesis, middle ear effusions (MEE) obtained from children ages 2 to 90 months (mean age, 29 months) undergoing tympanostomy tube placement for the presence of these inflammatory cytokines were analyzed. For these studies, IL-8, interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha), and tumor necrosis factor-beta (TNF-beta) were measured in MEE by radioimmunoassay (RIA) or enzyme-linked immunoassay (ELISA). IL-8, IL-1 beta, TNF-alpha, and TNF-beta were present in 92%, 67%, 77%, and 0% of effusions, respectively. The mean (+/- SEM) values for IL-8, IL-1 beta, and TNF-alpha were 4805 (+/- 913) pg/mg, 4076 (+/- 1510) pg/mg, and 163 (+/- 90) pg/mg. Further analysis indicated that levels of IL-8 correlated with IL-1 beta (R2 = .500, P = .000) and TNF-alpha (R2 = .387, P = .023). Thus the authors' studies clearly demonstrate that IL-8 is consistently present in the MEE of children with COME and is strongly correlated with levels of IL-1 beta and TNF-alpha, both known inducers of IL-8 production. These results support the authors' hypothesis that IL-1 beta, TNF-alpha, and IL-8 are intimately involved in the inflammatory cascade in the middle ear and suggest regulation of these cytokines as possible sites of future therapeutic intervention in otitis media with effusion (OME). PMID:8052085

  5. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    PubMed

    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. PMID:27613655

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

    PubMed

    Blanchard-Rohner, Geraldine; Gervaix, Alain

    2016-02-17

    Acute otitis media (AOM) is an important reason for medical visits and antibiotic use in children, with possible complications. Pneumococcal conjugate vaccines (PCV) have been developed from 2000, with first the apparition of the 7-valent PCV (PCV7), and from 2013, of the 13-valent PCV (PCV13). First developed to prevent invasive pneumococcal infections, they have been shown to reduce the number of AOM as well. PC13 has allowed to reduce the nasopharyngeal carriage of the majority of pneumococcal serotypes found in AOM, with a reduction of 77% of pneumococcal AOM, according to one study. PMID:27039459

  7. Facial nerve canal dehiscence in chronic otitis media without cholesteatoma

    PubMed Central

    Nomiya, Shigenobu; Kariya, Shin; Nomiya, Rie; Morita, Norimasa; Nishizaki, Kazunori; Paparella, Michael M.

    2013-01-01

    The information on incidence of the facial nerve canal dehiscence in chronic otitis media is important for surgeons. The purpose of this study is to disclose the histopathologic findings of facial nerve canal dehiscence in human temporal bones with chronic otitis media. We divided the human temporal bones into two groups (age 4 years, and under 4 years of age). We evaluated the incidence and the area of the facial nerve canal dehiscence in chronic otitis media under light microscopy. Age-matched normal control temporal bones were also examined. In the age group of 4 years, 68.9 % of temporal bones with chronic otitis media and 71.9 % of controls had the facial nerve canal dehiscence. There was no significant difference between them (P = 0.61). The area of the dehiscence in temporal bones with chronic otitis media was not statistically different from controls (P = 0.53). In the age group under 4 years, 88.2 % of temporal bones with chronic otitis media and 76.5 % of controls had the dehiscence. No significant difference was found between them (P = 0.66). The area of the dehiscence in temporal bones with chronic otitis media was not statistically different from controls in the age group under 4 years (P = 0.43). In chronic otitis media, the incidence of facial nerve canal dehiscence was high and was not statistically different from controls. These results suggest that there is no association between chronic otitis media and the presence of facial nerve canal dehiscence. PMID:23483192

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

    PubMed Central

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

    2016-01-01

    Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. PMID:26559603

  9. tuberculous otitis media in a renal transplant recipient.

    PubMed

    Ergün, Ihsan; Keven, Kenan; Sengül, Sule; Kutlay, Sim; Sertcelik, Ayse; Ertürk, Sehsuvar; Erbay, Bülent

    2004-06-01

    Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and a very uncommon form of extrapulmonary tuberculosis. Although there have been several case reports in the nonimmunosuppressive population of tuberculous otitis media, it has never been reported in an immunosuppressed allograft recipient. We present a case of diagnosed tuberculous otitis media after recurrent chronic otitis media treated several times with empiric antibiotic treatment. After the patient developed postauricular fistula and underwent surgical removal of granulation tissue, the diagnosis was made on the basis of histopathology and growth in culture of Ziehl-Neelsen. Clinical response promptly followed institution of antituberculous treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide. PMID:15168420

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

    PubMed

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

    2016-09-01

    The aim of this study was to investigate the 4977 and 7400 bp deletions of mitochondrial DNA in patients with chronic suppurative otitis media and to indicate the possible association of mitochondrial DNA deletions with chronic suppurative otitis media. Thirty-six patients with chronic suppurative otitis media were randomly selected to assess the mitochondrial DNA deletions. Tympanomastoidectomy was applied for the treatment of chronic suppurative otitis media, and the curettage materials including middle ear tissues were collected. The 4977 and 7400 bp deletion regions and two control regions of mitochondrial DNA were assessed by using the four pair primers. DNA was extracted from middle ear tissues and peripheral blood samples of the patients, and then polymerase chain reactions (PCRs) were performed. PCR products were separated in 2 % agarose gel. Seventeen of 36 patients had the heterozygote 4977 bp deletion in the middle ear tissue but not in peripheral blood. There wasn't any patient who had the 7400 bp deletion in mtDNA of their middle ear tissue or peripheral blood tissue. The patients with the 4977 bp deletion had a longer duration of chronic suppurative otitis media and a higher level of hearing loss than the others (p < 0.01). Long time chronic suppurative otitis media and the reactive oxygen species can cause the mitochondrial DNA deletions and this may be a predisposing factor to sensorineural hearing loss in chronic suppurative otitis media. An antioxidant drug as a scavenger agent may be used in long-term chronic suppurative otitis media. PMID:26620342

  11. Determining otitis media severity from middle ear fluid analysis.

    PubMed

    Juhn, S K; Garvis, W J; Lees, C J; Le, C T; Kim, C S

    1994-05-01

    Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukin-1 beta and tumor necrosis factor alpha) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation. PMID:8179269

  12. Eosinophilic otitis media: a new middle ear disease entity.

    PubMed

    Iino, Yukiko

    2008-11-01

    Eosinophilic otitis media (EOM) is intractable otitis media characterized by the presence of a highly viscous yellow effusion containing eosinophils. It occurs mainly in patients with bronchial asthma and is resistant to conventional treatments for otitis media. Here we discuss the clinical features, pathogenesis, and management of EOM. EOM predominantly affects women and presents most often in patients in their 50s. The clinical features of the middle ear in EOM are roughly divided into the otitis media with effusion type and chronic otitis media type. The latter is further divided into two subtypes: simple perforation and granulation tissue formation. EOM is often complicated by rhinosinusitis (eosinophilic sinusitis). High-tone loss is more frequently found and more severe in EOM patients than in chronic otitis media control patients, and EOM patients sometimes become deaf suddenly. Systemic or topical steroid administration is the most effective treatment for patients with EOM. The instillation of triamcinolone acetonide, a suspension of steroids, into the middle ear is very effective for controlling eosinophilic inflammation. It is very important to explain to patients with EOM that the disease may last for a long period and that progressive and sudden hearing loss may occur. PMID:18940145

  13. Early acute otitis media and siblings' attendance at nursery.

    PubMed Central

    Kvaerner, K J; Nafstad, P; Hagen, J A; Mair, I W; Jaakkola, J J

    1996-01-01

    To assess the relation between early acute otitis media and exposure to respiratory pathogens mediated by siblings and other children, a prospective cohort of 3754 Norwegian children born in 1992-3 was followed up from birth to 12 months. Of these, 25% had one or more episodes of acute otitis media during the first year. Results from multiple logistic regression analysis adjusted for confounding showed that siblings' attendance at daycare is the most important risk factor for early acute otitis media (adjusted odds ratio, ORadj = 1.9). The total number of children in the daycare setting is another determinant for early acute otitis media (ORadj = 2.0 in groups of four or more other children and ORadj = 1.3 in groups of one to three other children, as compared to those who are cared for alone). Having siblings in daycare outside the home and the number of children in the daycare setting are the most important determinants for early acute otitis media. PMID:8984924

  14. Participation of mast cells in chronic otitis media.

    PubMed

    Pajor, Anna; Danilewicz, Marian; Jankowski, Andrzej; Durko, Tomasz

    2011-01-01

    In the pathogenesis of chronic otitis media (COM), much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs) may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of mast cells in chronic otitis media in relationship to different clinical courses of COM, bacterial infections and types of disease. The MCs expression was measured immunohistochemically in paraffin-embedded granulation tissue specimens taken during surgery, by staining with a monoclonal antibody against tryptase. The density of tryptase-positive mast cells was lower in tissue samples from the group with a good clinical course than in those from the group with poor healing and recurrence (p = 0.006). There were no differences between the groups of patients with granulomatous and cholesteatomatous chronic otitis media (p = 0.66) or between the groups of patients with and without bacterial infection (p = 0.30), although the density of mast cells was lower for those with Pseudomonas aeruginosa/Proteus sp./ /Staphylococcus MRSA infection. In conclusion, the expression of mast cells in chronic otitis media granulation tissue was found to differ depending on the clinical course of the disease, but not on bacterial infection or type of COM. This may suggest that mast cells contribute to the maintenance of the inflammatory process, but not to antibacterial defense in chronic otitis media. PMID:22038229

  15. Korean Clinical Practice Guidelines: Otitis Media in Children

    PubMed Central

    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

    2012-01-01

    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. PMID:22876048

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

    PubMed Central

    Chung, Won Jung; 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. PMID:22563277

  17. Clinical Practice Guideline: Otitis Media with Effusion Executive Summary (Update).

    PubMed

    Rosenfeld, Richard M; Shin, Jennifer J; Schwartz, Seth R; Coggins, Robyn; Gagnon, Lisa; Hackell, Jesse M; Hoelting, David; Hunter, Lisa L; Kummer, Ann W; Payne, Spencer C; Poe, Dennis S; Veling, Maria; Vila, Peter M; Walsh, Sandra A; Corrigan, Maureen D

    2016-02-01

    The American Academy of Otolaryngology-Head and Neck Surgery Foundation has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated "Clinical Practice Guideline: Otitis Media with Effusion." To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 18 recommendations developed emphasize diagnostic accuracy, identification of children who are most susceptible to developmental sequelae from otitis media with effusion, and education of clinicians and patients regarding the favorable natural history of most otitis media with effusion and the lack of efficacy for medical therapy (eg, steroids, antihistamines, decongestants). An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. PMID:26833645

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

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

    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…

  20. Terahertz otoscope and potential for diagnosing otitis media

    PubMed Central

    Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

    2016-01-01

    We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. PMID:27446647

  1. Otitis

    MedlinePlus

    Ear infection; Infection - ear ... affect the inner or outer parts of the ear. The condition is classified according to whether it ... long period of time (chronic). Otitis externa (swimmer's ear). Involves the outer ear and ear canal. A ...

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

    PubMed

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

    1998-04-01

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

  3. Rare A2ML1 variants confer susceptibility to otitis media.

    PubMed

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

    2015-08-01

    A duplication variant within the middle ear-specific gene A2ML1 cosegregates with otitis media in an indigenous Filipino pedigree (LOD score = 7.5 at reduced penetrance) and lies within a founder haplotype that is also shared by 3 otitis-prone European-American and Hispanic-American children but is absent in non-otitis-prone children and >62,000 next-generation sequences. We identified seven additional A2ML1 variants in six otitis-prone children. Collectively, our studies support a role for A2ML1 in the pathophysiology of otitis media. PMID:26121085

  4. Luc abscess: an extraordinary complication of acute otitis media.

    PubMed

    Er, Anıl; Erdağ, Taner Kemal; Çağlar, Aykut; Kümüş, Özgür; Duman, Murat

    2016-01-01

    Luc abscess is an uncommon suppurative complication of otitis media. Unfamiliarity of this complication leads to delayed diagnosis and treatment. This abscess is usually benign. Infection in the middle ear spreads via anatomic preexisting pathways, and this process results with subperiosteal pus collection. Conservative treatment with drainage under empirical wide spectrum antibiotic is efficient. Here,we present a 9-year-old boy who had left facial swelling after a period of otalgia, diagnosed as Luc abscess without mastoiditis. PMID:26078258

  5. (Central) Auditory Processing: the impact of otitis media

    PubMed Central

    Borges, Leticia Reis; Paschoal, Jorge Rizzato; Colella-Santos, Maria Francisca

    2013-01-01

    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. PMID:23917659

  6. [Acute otitis media and short-term complications].

    PubMed

    Juilland, Naline; Vinckenbosch, Pauline; Richard, Céline

    2016-02-17

    Oral antibiotic have changed the incidence of otitic intracranial complications. In spite of therapeutic progress, these complications remain serious, potentially life-threatening and may result in long-life consequences. Acute otitis media diagnosis and knowledge of intracranial complications' symptoms are required for early and adapted therapeutics. Care strategies evolve with the continuously improvement of medical technologies, development of new vaccines and targeted use of antibiotics. PMID:27039457

  7. Intraoperative findings in revision chronic otitis media surgery.

    PubMed

    Faramarzi, Abolhassan; Motasaddi-Zarandy, Masoud; Khorsandi, Mohammad-Taghi

    2008-03-01

    In this study, we reviewed the surgical findings in a series of revision tympanomastoidectomy to determine the most common causes of failure in chronic otitis media surgery. The intraoperative findings at revision mastoidectomy with tympanoplasty of 116 patients were analyzed. The most common sites of pathologic tissue at revision surgery (with cholesteatoma and/ or granulation tissue) were unexenterated cells of the sinodural angle. The most common mechanical cause of retention of debris in canal wall down procedures was facial ridge. PMID:18298298

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

    PubMed

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

    2002-11-01

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

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

    PubMed

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

    2010-10-01

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

  10. Immunologic characteristics of cytokines in otitis media with effusion.

    PubMed

    Himi, T; Suzuki, T; Kodama, H; Takezawa, H; Kataura, A

    1992-10-01

    Levels of cytokines, interleukin (IL)-1 alpha, IL-1 beta, tumor necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were investigated in samples of the middle ear effusions (MEEs) from 144 ears with otitis media with effusion (OME) by enzyme-linked immunosorbent assay, followed by cytologic analysis. Middle ear effusions of the acute purulent type contained a significantly higher concentration of cytokines compared with normal control sera (p < .001). Cytokines were observed at lower levels in MEE in adults than in children. Tests of children at the chronic stage of MEE showed higher levels of TNF than IL-1 and GM-CSF. Meanwhile, IL-1 beta showed significantly higher concentrations in acute purulent types than in serous and mucoid types (p < .01). In cytologic analysis, the mean level of IL-1 beta was significantly higher in the neutrophil-rich group than in other groups (p < .05). Cytokines possess several biologic properties, some of which are associated not only with acute otitis media but also with chronic otitis media. This study showed that cytokines, especially IL-1 beta, contribute to infiltration into the middle ear by inflammatory cells. This implies that the persistent presence of cytokines in MEE could be a factor in prolonged OME. PMID:1416648

  11. Human evolutionary history: Consequences for the pathogenesis of otitis media

    PubMed Central

    Bluestone, Charles D.; Swarts, J. Douglas

    2010-01-01

    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 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. PMID:21109071

  12. Tuberculous Otitis Media Leading to Sequentialib Bilateral Facial Nerve Paralysis

    PubMed Central

    Gupta, Nitin; Dass, Arjun; Goel, Neha; Tiwari, Sandeep

    2015-01-01

    Introduction: Tuberculous otitis media (TOM) is an uncommon, insidious, and frequently misdiagnosed form of tuberculosis (TB). In particular, TOM is usually secondary to direct transmission from adjacent organs, while the primary form has been rarely reported. The main aim of treatment is to start the patient on an antitubercular regime and early surgical intervention to decompress the facial nerve if involved. Case Report: The case report of a twenty year-old male with bilateral tuberculous otitis media, who presented himself with fever followed by sequential bilateral facial nerve paralysis, bilateral profound hearing loss, and abdominal tuberculosis leading to intestinal perforation, is presented. To the best available knowledge and after researching literature, no such case depicting the extensive otological complications of tuberculosis has been reported till date. Conclusion: Tuberculosis of the ear is a rare entity and in most cases the clinical features resemble that of chronic otitis media. The diagnosis is often delayed due to varied clinical presentations and this can lead to irreversible complications. Early diagnosis is essential for prompt administration of antitubercular therapy and to prevent complications. PMID:26082906

  13. Middle ear fluid bacteriology of acute otitis media in neonates and very young infants.

    PubMed

    Karma, P H; Pukander, J S; Sipilä, M M; Vesikari, T H; Grönroos, P W

    1987-12-01

    The middle ear fluid (MEF) bacteriology of 107 attacks of acute otitis media (AOM) in 101 infants less than 3 months old was analyzed. A total of 108 bacteria were isolated from 85 attacks. Major AOM-pathogens, S. pneumoniae (19%), H. influenzae (9%) or B. catarrhalis (7%) were cultured in approximately one-third of all the attacks. S. aureus (17%) and coagulase-negative staphylococci (22%) without the above pathogens were commonly found, whereas gram-negative enteric bacteria were culturable from only 5 attacks. Only 8% of the MEFs were polymicrobial. More than half of all the bacterial strains produced beta-lactamase. The bacteriology of those younger than one month was not different from that of the others. The same was true with attacks of out-patients and in-patients, except for a larger proportion of beta-lactamase producing strains in in-patients. Nasal-nasopharyngeal and MEF samples showed the same bacteriology in only 20% of cases. Two-thirds of AOM attacks were present in infants with perinatal or other concomitant morbidity, but their bacteriology was not different from those without other morbidity. In addition to the examination of ears in infants presenting with any illness before the age of 3 months, the study stresses the importance of bacteriological analysis of MEF in all cases of AOM at this age. PMID:3125118

  14. C-reactive protein in acute otitis media.

    PubMed

    Karma, P; Sipilä, M; Koskela, M; Peltola, H

    1987-01-01

    Serum C-reactive protein (CRP) levels were studied in 79 children with acute otitis media (AOM), aged from 4 months to 5 years. The CRP was less than 10 mg/l in 27 children, greater than or equal to 20 mg/l in 34, and greater than or equal to 40 mg/l in 17 children, 25 of the 41 attacks caused by S. pneumoniae or H. influenzae showed a CRP of greater than or equal to 20 mg/l and 15 CRP greater than or equal to 40 mg/l, in 38 cases without major otitis pathogens, the respective figures were 9 (p less than 0.01) and 2 (p less than 0.001). Although statistically significant correlations between otitis-related clinical parameters and CRP levels were rare, there was a tendency toward higher CRP values among those with a more severe clinical picture. All five attacks with CRP greater than or equal to 100 mg/l were bilateral, caused by major pathogens, and preceded by a respiratory infection. They also tended to have high fever and a large amount of fluid in myringotomy. However, even in these the general course of AOM and other morbidity was not different from the others. PMID:3618166

  15. Pediatricians' Opinions about Otitis Media and Speech-Language-Hearing Development

    ERIC Educational Resources Information Center

    Sonnenschein, Esther; Cascella, Paul W.

    2004-01-01

    Twenty-five pediatricians responded to a confidential survey about their opinions on the relationship between otitis media and children's speech-language-hearing status. Results found that pediatricians did not necessarily agree that otitis media has an impact on speech-language-hearing development. Pediatricians reported that an early otitis…

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

    PubMed

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

    2013-05-01

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

  17. New Paradigms in the Pathogenesis of Otitis Media in Children

    PubMed Central

    Coticchia, James Mark; Chen, Michael; Sachdeva, Livjot; Mutchnick, Sean

    2013-01-01

    Acute otitis media (AOM) is a multifactorial disease with a significant socioeconomic impact. The pathogenesis of AOM is attributed to a variety of well-established internal and extrinsic factors. Recent evidence strongly points to bacterial biofilm formation as an important contributor to this disease entity. The nasopharynx is a likely reservoir for infection with subsequent seeding of pathogens to the middle ear via planktonic shedding. Various modalities have been used to directly detect biofilm formation in the middle ear mucosa of children with AOM. Further insights into this disease may lead to new strategies for prevention and treatment. PMID:24400296

  18. Otitis media in a mouse model for Down syndrome

    PubMed Central

    Han, Fengchan; Yu, Heping; Zhang, Jiangping; Tian, Cong; Schmidt, Cecilia; Nava, Casey; Davisson, Muriel T; Zheng, Qing Y

    2009-01-01

    The Ts65Dn mouse shares many phenotypic characteristics of human Down syndrome. Here, we report that otitis media, characterized by effusion in the middle ear and hearing loss, was prevalent in Ts65Dn mice. Of the 53 Ts65Dn mice tested, 81.1% had high auditory-evoked brainstem response (ABR) thresholds for at least one of the stimulus frequencies (click, 8 kHz, 16 kHz and 32 kHz), in at least one ear. The ABR thresholds were variable and showed no tendency toward increase with age, from 2 to 7 months of age. Observation of pathology in mice, aged 3–4 months, revealed middle ear effusion in 11 of 15 Ts65Dn mice examined, but only in two of 11 wild-type mice. The effusion in each mouse varied substantially in volume and inflammatory cell content. The middle ear mucosae were generally thickened and goblet cells were distributed with higher density in the epithelium of the middle ear cavity of Ts65Dn mice as compared with those of wild-type controls. Bacteria of pathogenic importance to humans also were identified in the Ts65Dn mice. This is the first report of otitis media in the Ts65Dn mouse as a model characteristic of human Down syndrome. PMID:19765102

  19. Defective immunoregulation in children with chronic otitis media with effusion.

    PubMed

    Bernstein, J M; Park, B H

    1986-03-01

    Otitis media and middle ear effusions (MEE) are most common clinical problems in early childhood, for which an estimated one million tympanostomies are performed each year in the United States. Although many factors have been associated with MEE (age, sex, genetics, otitis media, socioeconomic status, feeding style, atopy or hypersensitivity, certain bacteria and viruses), a defective immunoregulatory mechanism in the host may also contribute to the pathogenesis. During the past 2 years, we have evaluated immune function in 90 randomly selected children who underwent repeated tympanostomy for persistent MEE. The T-cell subset ratio (OKT-4/OKT-8) was reduced (below 1.25) in 16%. In 33 children, generation of T-cell growth factor (IL-2) by peripheral blood lymphocytes (PBL) was evaluated and found to be decreased in 11. The mitogenic response of PBL to phytohemagglutinin (PHA) and pokeweed mitogen (PWM) stimulation was abnormal in almost half of the cases. Imbalance of T-cell subsets and decreased production of IL-2 indicate defective immunoregulatory function in some of these children, which may play a role in the pathogenesis of persistent MEE. PMID:2938056

  20. Middle ear cleft in chronic otitis media: a clinicohistopathological study.

    PubMed

    Sharma, Karan; Manjari, Mridu; Salaria, Neha

    2013-12-01

    Chronic mucosal diseases of middle ear cleft or chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. The present prospective study was conducted to evaluate the clinical, intraoperative and histopathological changes in middle ear cleft. 100 patients diagnosed with CSOM who underwent surgery were taken. The mucosa and granulation tissue was removed along with ossicles wherever indicated and sent for histopathological examination. On clinical examination, 72 cases were found to be of tubotympanic type and 28 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases 8 were found to be of unsafe type which was also proven histologically. Stratified squamous epithelium was revealed in most of the cases accompanied by changes in the submucosa. Ossicular chain was involved in 40 cases with incus being the commonest bone to be eroded. PMID:24427703

  1. Identification of bacteria causing acute otitis media using Raman microspectroscopy

    NASA Astrophysics Data System (ADS)

    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.

  2. Xylitol Syrup for the Prevention of Acute Otitis Media

    PubMed Central

    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

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

    PubMed Central

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

    2016-01-01

    Background 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. Methods 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. Findings 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. Interpretation The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~ 64% to 80%) using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations. PMID:27077122

  4. Otitis Media and Related Complications Among Children with Autism Spectrum Disorders.

    PubMed

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

    2016-05-01

    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 without ASD. Children with ASD had a significantly increased rate of AOM, otitis media with effusion, otorrhea, and PE tube placement. Children with ASD were more than twice as likely to develop mastoiditis, and to undergo mastoidectomy and tympanoplasty. Children with ASD are more likely to have middle ear infections and otitis-related complications, highlighting the importance of routine middle ear examinations and close attention to hearing impairment in this population. PMID:26739355

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

    PubMed

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

    2016-01-01

    Recently, reduced Nasal nitric oxide (nNO) nNO levels have been reported in children with adenoidal hypertrophy predisposing to chronic nasosinusal inflammation. Given the strict anatomic and physiopathologic link between the nasopharyngeal and middle ear compartments, and considering the high prevalence of otitis prone children among those affected with chronic adenoiditis, we designed a study aimed to test any possible difference in nNO levels between non-allergic children with and without recurrent acute otitis media (RAOM) associated with chronic adenoiditis. The study involved 54 children with RAOM (44.4% males; mean age= 7.5±3.5 years) and 51 children without RAOM (47.4% males; mean age= 7.0±3.8 years). nNO levels were significantly reduced in children with RAOM compared to children without RAOM (676.9±250.7 ppb vs 831.8±320.4 ppb, respectively; p= 0.02). Our results could be related to reduced NO production by the ciliated paranasal, nasopharyngeal and middle ear epithelium and the impaired sinusal ostial and Eustachian tube patency due to chronic inflammation, and seem to confirm the involvement of NO pathway in recurrent upper airway infections related to impaired ciliated respiratory mucosa. PMID:27049104

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

    PubMed Central

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

    2013-01-01

    Acute otitis media is a very common disease in children. Most children recover with symptomatic therapy like potent analgesics, but occasionally serious complications occur. We present a 3-year-old girl who suffered from acute otitis media for already 2 weeks and presented with fever, abducens nerve palsy of her left eye and vomiting. She was finally diagnosed with an acute otitis media complicated by a mastoiditis, sinus thrombosis, meningitis and cerebellar empyema. Fusobacterium necrophorum was cultured from cerebrospinal fluid. The girl recovered following appropriate antibiotic and anticoagulation treatment. PMID:23486343

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

    PubMed

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

    2014-05-01

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

  8. A case of direct intracranial extension of tuberculous otitis media.

    PubMed

    Kim, Dong-Kee; Park, Shi-Nae; Park, Kyung-Ho; Yeo, Sang Won

    2014-02-01

    We describe a very rare case of tuberculous otitis media (TOM) with direct intracranial extension. The patient was a 55-year-old man who presented to our ENT clinic for evaluation of severe headaches and right-sided otorrhea. A biopsy of granulation tissue obtained from the right external auditory canal demonstrated chronic inflammation that was suggestive of mycobacterial infection. Magnetic resonance imaging of the brain indicated intracranial extension of TOM through a destroyed tegmen mastoideum. After 2 months of antituberculous medication, the headaches and otorrhea were controlled, and the swelling in the external ear canal subsided greatly. Rarely does TOM spread intracranially. In most such cases, intracranial extension of tuberculosis occurs as the result of hematogenous or lymphogenous spread. In rare cases, direct spread through destroyed bone can occur, as it did in our patient. PMID:24526478

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

    PubMed

    Depreux, Frederic F S; Darrow, Keith; Conner, David A; Eavey, Roland D; Liberman, M Charles; Seidman, Christine E; Seidman, J G

    2008-02-01

    Otitis media is an extremely common pediatric inflammation of the middle ear that often causes pain and diminishes hearing. Vulnerability to otitis media is due to eustachian tube dysfunction as well as other poorly understood factors, including genetic susceptibility. As EYA4 mutations cause sensorineural hearing loss in humans, we produced and characterized Eya4-deficient (Eya4(-/-)) mice, which had severe hearing deficits. In addition, all Eya4(-/-) mice developed otitis media with effusion. Anatomic studies revealed abnormal middle ear cavity and eustachian tube dysmorphology; thus, Eya4 regulation is critical for the development and function of these structures. We suggest that some human otitis media susceptibility reflects underlying genetic predisposition in genes like EYA4 that regulate middle ear and eustachian tube anatomy. PMID:18219393

  10. Early exposure to otitis media: a preliminary investigation of behavioral outcome.

    PubMed

    Black, M M; Sonnenschein, S

    1993-06-01

    Factors that contribute to developmental vulnerability were examined in a 4-year follow-up of 31 children who, as infants, had participated in an investigation of the relationship between recurrent otitis media and developmental status. The children in this inner-city sample experienced significant decline in their language and developmental status regardless of their history with otitis media. Findings support a threshold model of risk, suggesting that otitis media does not necessarily pose an additional stress to the language and cognitive development of low-income, inner-city children. In keeping with theoretical models by Vygotsky and Rutter, maternal cognitive growth fostering facilitated children's language development by serving as a compensatory factor, counteracting the potential impact of recurrent otitis media. PMID:7688005

  11. Otitis media in the Republic of Palau. A case-series study.

    PubMed

    Chan, K H; Swarts, J D; Rudoy, R; Dever, G J; Mesubed, Y

    1993-04-01

    Race is a known epidemiologic determinant for the development of otitis media. This study assessed the severity of otitis media in a subpopulation (N = 73; mean age, 13.2 years) receiving care from the ear clinic in the Republic of Palau, a US Trust Territory, through a questionnaire and an otologic examination. The mean age of patients with otorrhea (2.5 years) was found to be significantly different from the mean age at which they began to swim (4 years). Otitis media-related sequelae were found to involve more than half of ears or subjects examined. No statistical difference was noted when various patient characteristics were compared with the severity of disease. Our clinical impression is that this subpopulation is severely affected by otitis media and its sequelae. Prospective studies are required to identify risk factors present in the population at large. PMID:8457305

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

    PubMed Central

    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

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

    SciTech Connect

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

    1991-03-01

    This case-control study investigated the possible association between home environmental air pollutants and their effect on otitis media and asthma in children. Patients with physician-diagnosed otitis (n = 125, 74% response), with asthma (n = 137, 80% response), and controls (n = 237, 72% response) from a private pediatric practice seen between October 1986 and May 1987 were studied. A questionnaire inquired about housing characteristics (i.e., age, insulation, heating system) and sources of indoor air pollution such as cigarette smoking, use of woodburning stoves, household pets, etc. Analysis of the responses confirmed previous findings of significant relationships between maternal smoking (P = .021), and the presence of pets (P = .034) and the occurrence of asthma. A newly reported relationship between exposure to woodburning stoves and the occurrence of otitis (P less than .05) was reported. This implicates yet another risk factor (wood burning) in the etiology of otitis media.

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

    PubMed

    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 < 0.05. After adjusting for adult age, sex and socio-economic status, the odds ratios were 2.1 [95 % confidence interval (CI): 1.4-3.3] and 1.3 (95 % CI: 1.0-1.5), respectively. This longitudinal cohort study suggests that childhood chronic suppurative 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. PMID:26335289

  15. The clinical course of bronchiolitis associated with acute otitis media

    PubMed Central

    Shazberg, G.; Revel-Vilk, S.; Shoseyov, D.; Ben-Ami, A.; Klar, A.; Hurvitz, H.

    2000-01-01

    BACKGROUND—Acute otitis media (AOM) is the most common bacterial co-infection of viral bronchiolitis.
AIMS—To evaluate the influence of AOM on the clinical course of bronchiolitis.
SUBJECTS—150 children younger than 24 months old, diagnosed with bronchiolitis, hospitalised between December 1997 and May 1999.
METHODS—Body temperature, respiratory rate, oxygen saturation, and the need for oxygen supplementation were recorded on admission and daily throughout hospitalisation. Complete blood count, erythrocyte sedimentation rate, and assay for respiratory syncytial virus were performed on admission. All children were examined daily for the appearance of AOM. The clinical course of children with bronchiolitis and AOM was compared to those without AOM.
RESULTS—AOM was diagnosed in 79/150 (53%) children with bronchiolitis. Most were diagnosed within the first two days of hospitalisation. No significant difference was found in the clinical and laboratory findings on admission and on daily follow up between children with and without AOM.
CONCLUSIONS—This 2.5 year prospective study showed no difference in the course of bronchiolitis, whether an ear infection was present or not.

 PMID:10999866

  16. Elimination diets in the treatment of secretory otitis media.

    PubMed

    Ruokonen, J; Paganus, A; Lehti, H

    1982-03-01

    The significance of elimination diets in the treatment of secretory otitis media (SOM) and the usefulness of the cytotoxic leucocyte test (CLT) in the planning of elimination diets were investigated. Sixty-seven children with SOM were tested with CLT and treated with or without elimination diets in addition to the established SOM-treatment. After two years of observation in patients with multiple CLT-reactions (50) there was an almost significant difference (P less than 0.06) in the cure rates and a significant difference (P less than 0.02) in the percentages of therapeutic failures between those treated with (32) and those treated without (18) elimination diets. No marked difference was found between patients, who did not have multiple CLT-reactions (17) and were treated without diets and patients who were treated with diets for multiple CLT-reactions (32). It was concluded that elimination diets are needed in the treatment of SOM for those patients who have multiple reactions in the CLT and that the CLT is useful in the planning of these elimination diets. PMID:7201458

  17. Complementary and Alternative Medicine Treatment Options for Otitis Media

    PubMed Central

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

    2016-01-01

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

  18. Tympanic membrane perforation descriptors and hearing levels in otitis media.

    PubMed

    Prasansuk, S; Hinchcliffe, R

    1982-01-01

    The air conduction threshold of hearing was determined at 0.5,1 and 2 kHz by manual audiometry on a consecutive series of young Thai adults with bilateral chronic suppurative otitis media. At the same time, after visual inspection of each tympanic membrane, the perforation was drawn, as faithfully as possible in respect of both shape and relative size, on a 40-mm diagram of a tympanic membrane. A study of the shapes of perforations showed that they could be described as elliptical, reniform or cardioid. For the purposes of calculating the area of a perforation, a reniform perforation was considered to be the result of substracting a smaller ellipse from a larger ellipse, which ellipses were in contact at the point of least curvature. The hearing threshold level was found to be a function of the size of the perforation. A power function best described this relationship. The relationship was such that a total perforation would be associated with a hearing loss of about 60 dB HL over the frequency range 0.5-2 kHz. PMID:7055479

  19. Histopathology of Ossicular Grafts and Implants in Chronic Otitis Media

    PubMed Central

    Bahmad, Fayez; Merchant, Saumil N.

    2008-01-01

    Objectives We describe the histopathology of ossicular grafts and implants so as to provide insight into factors that may influence functional results after surgery for chronic otitis media. Methods Histopathologic observations were made on 56 cases: 50 surgical specimens and 6 temporal bone cases in which the graft was sectioned in situ. Results and Conclusions Autogenous malleus, incus, and cortical bone grafts behaved in a similar manner and maintained their morphological size, shape, and contour for extended periods of time, at least up to 30 years. These histopathologic observations support the continued use of autograft ossicular and cortical bone grafts for middle ear reconstruction. Cartilage grafts developed chondromalacia with resulting loss of stiffness and showed a tendency to undergo resorption. Synthetic prostheses made of porous plastic (Plastipore, Polycel) elicited foreign body giant cell reactions with various degrees of biodegradation of the implants. Prostheses made of hydroxyapatite and Bioglass were enveloped by a lining of connective tissue and mucosal epithelium. The Bioglass material was broken down into small fragments and partially resorbed by a host response within the middle ear. These results warrant caution in the use of prostheses made of porous plastic or Bioglass. PMID:17419521

  20. Influenza-induced inflammation drives pneumococcal otitis media.

    PubMed

    Short, Kirsty R; Reading, Patrick C; Brown, Lorena E; Pedersen, John; Gilbertson, Brad; Job, Emma R; Edenborough, Kathryn M; Habets, Marrit N; Zomer, Aldert; Hermans, Peter W M; Diavatopoulos, Dimitri A; Wijburg, Odilia L

    2013-03-01

    Influenza A virus (IAV) predisposes individuals to secondary infections with the bacterium Streptococcus pneumoniae (the pneumococcus). Infections may manifest as pneumonia, sepsis, meningitis, or otitis media (OM). It remains controversial as to whether secondary pneumococcal disease is due to the induction of an aberrant immune response or IAV-induced immunosuppression. Moreover, as the majority of studies have been performed in the context of pneumococcal pneumonia, it remains unclear how far these findings can be extrapolated to other pneumococcal disease phenotypes such as OM. Here, we used an infant mouse model, human middle ear epithelial cells, and a series of reverse-engineered influenza viruses to investigate how IAV promotes bacterial OM. Our data suggest that the influenza virus HA facilitates disease by inducing a proinflammatory response in the middle ear cavity in a replication-dependent manner. Importantly, our findings suggest that it is the inflammatory response to IAV infection that mediates pneumococcal replication. This study thus provides the first evidence that inflammation drives pneumococcal replication in the middle ear cavity, which may have important implications for the treatment of pneumococcal OM. PMID:23319557

  1. Inflammatory mediators in chronic otitis media with effusion.

    PubMed

    Skoner, D P; Stillwagon, P K; Casselbrandt, M L; Tanner, E P; Doyle, W J; Fireman, P

    1988-10-01

    Otitis media with effusion (OME) is a common middle ear inflammatory disease in the pediatric population. This article determines concentrations of three functionally and metabolically distinct inflammatory mediators in middle ear effusions (MEE) and corresponding plasma of children with OME. One hundred two patients (mean age, 4.9 years) with persistent OME were studied. Middle ear effusions were collected from all subjects and plasma from a subset at the time of tympanostomy tube insertion. Histamine was assayed radioisotopically, 13,14-dihydro-15-keto-prostaglandin F2 alpha (stable PGF2 alpha metabolite) by radioimmunoassay, and neutrophil chemotactic factor of anaphylaxis by modified Boyden chamber. Mean MEE levels of the mediators (39 +/- 13 ng/mL, 462 +/- 179 pg/mL, and 264% +/- 57% positive control, respectively) were markedly higher than those of corresponding plasma (0.5 +/- 0.1 ng/mL, 285 +/- 127 pg/mL, and 47% +/- 5% positive control, respectively). The mean histamine content of mucoid effusions (43.2 +/- 56.9 ng/mL) was significantly higher than that of purulent (22.5 +/- 10.5 ng/mL) and serous (17.9 +/- 16.8 ng/mL) effusions. Higher histamine levels were observed in effusions positive for Haemophilus influenzae when compared with those with other pathogenic isolates. The high concentrations of these mediators in MEE and their potential for inducing or sustaining the inflammatory process supports a role in the pathogenesis of OME. PMID:3046637

  2. Intracranial abscesses associated with chronic suppurative otitis media.

    PubMed

    Seven, Huseyin; Coskun, Berna Uslu; Calis, Asli B; Sayin, Ibrahim; Turgut, Suat

    2005-10-01

    Intracranial abscesses are serious complications of chronic suppurative otitis media (COM). This study included 32 patients presenting with intracranial abscesses from 780 patients hospitalized for treatment of COM. The 32 patients had 59 intracranial complications. Perisinus abscess (13 of 32) was the most common intracranial abscess, followed by temporal lobe abscess (8 of 32), epidural abscess (7 of 32), cerebellar abscess (6 of 32) and subdural empyema (2 of 32). Headache (93%), fever (87%) and altered mental status (62%) were the most common presenting symptoms and signs, along with symptoms of COM. All patients were treated with intravenous antibiotics and canal wall down mastoidectomy. Cholesteatoma with granulation tissue and bony defects at the sinus plate and/or dural plate were seen in most of the patients. Gram negative bacilli and anaerobes were the most common organisms cultured from the abscesses. Three patients had neurological sequels. One patient died. The early diagnosis of these complications requires a high index of suspicion and imaging studies. A multidisciplinary and coordinated approach is important for the management of these patients. PMID:15959795

  3. A case of chronic otitis media caused by Mycobacterium abscessus.

    PubMed

    Sugimoto, Hisashi; Ito, Makoto; Hatano, Miyako; Nakanishi, Yosuke; Maruyama, Yumiko; Yoshizaki, Tomokazu

    2010-10-01

    Although it appears very uncommon in adult COM, Mycobacterium abscessus should be considered as a possible cause of a chronically draining ear. Multi-antibiotic chemotherapy including high-dose clarithromycin can effectively treat adult COM cased by M. abscessus. The first case report of adult chronic otitis media (COM) caused by M. abscessus is described here. A 61-year-old woman presented persistent otorrhea for 2 months, despite treatment with standard antimicrobial drugs. Physical examination revealed a small perforation of the tympanic membrane and edematous middle ear mucosa. Mycobacterial cultures and PCR yielded non-tuberculous mycobacteria (NTM); M. abscessus. Intravenous panipenem/betamipron and amikacin and oral clarithromycin were administered for 36 days. Computed tomography of the temporal bone showed improved aeration in the tympanic cavity, but soft tissue shadow remained unchanged in the mastoid 31 days after starting medication. She therefore underwent tympano-mastoidectomy at 36 days. At surgery, inflammation remained in the middle ear, and edematous pale mucosal tissue was noted around the stapes and ossicular chain. Histopathologic examination showed inflammation and granulation tissue, but no caseating necrosis or acid-fast bacilli. After surgery the symptoms resolved and remained well without evidence of infection recurrence 12 months after the operation. PMID:20206453

  4. Xylitol as a prophylaxis for acute otitis media: systematic review.

    PubMed

    Danhauer, Jeffrey L; Johnson, Carole E; Corbin, Nicole E; Bruccheri, Kaitlyn G

    2010-10-01

    A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects. PMID:20874048

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

    PubMed Central

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

    2015-01-01

    Summary Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects. PMID:25447732

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

    PubMed

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

    2014-11-01

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

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

    PubMed

    Yoshida, Naohiro; Iino, Yukiko

    2014-12-01

    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is histologically characterized by systemic necrotizing vasculitis and is clinically classified into two phases, systemic or localized. Recently, otological symptoms such as otitis media and hearing loss, not previously often associated with AAV, have been reported in AAV cases. In these cases we propose a diagnosis of otitis media with AAV (OMAAV). The ANCA titer is important for the diagnosis of OMAAV, and in most cases rapid progressive hearing loss is observed as localized AAV. Peripheral facial nerve palsy or hypertrophic pachymeningitis are coupled with 25% of cases and 18% of cases respectively. Proteinase 3-ANCA (PR3-ANCA) positive otitis media causes granulomatous formation or middle ear effusion in the middle ear, on the other hand myeloperoxidase-ANCA (MPO-ANCA) positive otitis media predominantly presents as otitis media with effusion. The early diagnosed case and the sensorineural hearing loss not progressed deaf could be recovered by the immunosuppressive therapy. Delayed diagnosis of AAV occasionally leads to progression to the irreversible phase; therefore, diagnosis at the early-localized stage is important for treating AAV. In this review, we discuss the current understanding of this newly proposed concept of OMAAV. PMID:25339433

  8. Sh3pxd2b Mice Are a Model for Craniofacial Dysmorphology and Otitis Media

    PubMed Central

    Yang, Bin; Tian, Cong; Zhang, Zhi-guang; Han, Feng-chan; Azem, Rami; Yu, Heping; Zheng, Ye; Jin, Ge; Arnold, James E.; Zheng, Qing Y.

    2011-01-01

    Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2bnee mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2bnee mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) mirrors craniofacial dysmorphology and otitis media in humans. PMID:21818352

  9. Sh3pxd2b mice are a model for craniofacial dysmorphology and otitis media.

    PubMed

    Yang, Bin; Tian, Cong; Zhang, Zhi-guang; Han, Feng-chan; Azem, Rami; Yu, Heping; Zheng, Ye; Jin, Ge; Arnold, James E; Zheng, Qing Y

    2011-01-01

    Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2b(nee)) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2b(nee) mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2b(nee) mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2b(nee)) mirrors craniofacial dysmorphology and otitis media in humans. PMID:21818352

  10. TLR4-mediated induction of TLR2 signaling is critical in the pathogenesis and resolution of otitis media.

    PubMed

    Leichtle, Anke; Hernandez, Michelle; Pak, Kwang; Yamasaki, Kenshi; Cheng, Chun-Fang; Webster, Nicholas J; Ryan, Allen F; Wasserman, Stephen I

    2009-08-01

    Otitis media is the most prevalent childhood disease in developed countries. The involvement of Toll-like receptors (TLRs) in otitis media pathophysiology has been implicated by studies in cell lines and association studies of TLR gene polymorphisms. However, precise functions of TLRs in the etiology of otitis media in vivo have not been examined. We investigated the inflammatory response to nontypeable Haemophilus influenzae using a model of otitis media in wild-type, TLR2(- /-) and TLR4(-/ -) mice by gene microarray, qPCR, immunohistochemistry, Western blot analysis and histopathology. Toll-like receptor-2(- /-) and TLR4(- /-) mice exhibited a more profound, persistent inflammation with impaired bacterial clearance compared to controls. While wild-type mice induced tumor necrosis factor-a (TNF) after non-typeable H. influenzae challenge, TLR2(-/-) and TLR4(-/-) mice lack TNF induction in the early phase of otitis media. Moreover, lack of TLR2 resulted in a late increase in IL-10 expression and prolonged failure to clear bacteria. Toll-like receptor-4(-/- ) mice showed impaired early bacterial clearance and loss of TLR2 induction in early otitis media. Our results demonstrate that both TLR2 and TLR4 signalling are critical to the regulation of infection in non-typeable H. influenzae-induced otitis media. Toll-like receptor-4 signalling appears to induce TLR2 expression, and TLR2 activation is critical for bacterial clearance and timely resolution of otitis media. PMID:19586996

  11. [Evaluation of intensity of angiogenesis in granulation tissue in chronic otitis media--preliminary report].

    PubMed

    Pajor, Anna; Jankowski, Andrzej; Danilewicz, Marian; Durko, Tomasz

    2006-01-01

    In chronic otitis media molecular pathogenetic mechanisms are still unknown, however, angiogenesis may play a role. The aim of the study was to determine the intensity of angiogenesis in granulation tissue in chronic otitis media of different clinical course. Twenty six granulation tissue specimens (twenty two--from chronic otitis media, four--from prolongated otitis externa) taken during surgery were analyzed. The angiogenesis (microvessel density) was measured in paraffin-embedded tissue by an immunohistochemical method, by staining for endothelial cells with a monoclonal antibody against CD 34. The presence of CD 34 was found in all specimens. The expression was more intense in tissue samples from the group with good clinical course (good healing and without recurrence) than those in the group with poor healing and recurrence (mean number of dots for mm2 589,2 vs 533,3, respectively) and from the group without bacterial infection by Pseudomonas aeruginosa than those with this infection (mean number of dots for mm2 645,5 vs 440,8, respectively), but differences were not significant. In conclusion it is suggested that angiogenesis may contribute to different clinical course of chronic otitis media. PMID:17152811

  12. Complications of chronic suppurative otitis media: a retrospective review.

    PubMed

    Yorgancılar, E; Yildirim, M; Gun, R; Bakir, S; Tekin, R; Gocmez, C; Meric, F; Topcu, I

    2013-01-01

    The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach. PMID:22249835

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

    PubMed Central

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

    2016-01-01

    Background/Aims To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. Methods Children aged 7–10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3–5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. Results Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. Conclusions LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease. PMID:27193974

  14. Childhood Otitis Media: A Cohort Study with 30-year Follow-Up of Hearing (The HUNT study)

    PubMed Central

    Aarhus, Lisa; Tambs, Kristian; Kvestad, Ellen; Engdahl, Bo

    2014-01-01

    Objectives To study the extent to which otitis media in childhood is associated with adult hearing thresholds. Furthermore, to study if the effects of otitis media on adult hearing thresholds are moderated by age or noise exposure. Design Population-based cohort study of 32,786 participants who had their hearing tested by pure-tone audiometry in primary school and again at ages ranging from 20–56 years. 3066 children were diagnosed with hearing loss, the remaining sample had normal childhood hearing. Results Compared to participants with normal childhood hearing, those diagnosed with childhood hearing loss caused by otitis media with effusion (n=1255), chronic suppurative otitis media (n=108) or hearing loss after recurrent acute otitis media (n=613) had significantly reduced adult hearing thresholds in the whole frequency range (2 dB/17–20 dB/7–10 dB, respectively). The effects were adjusted for age, sex and noise exposure. Children diagnosed with hearing loss after recurrent acute otitis media had somewhat improved hearing thresholds as adults. The effects of chronic suppurative otitis media and hearing loss after recurrent acute otitis media on adult hearing thresholds were larger in participants tested in middle adulthood (ages 40 to 56 years) than in those tested in young adulthood (ages 20 to 40 years). Eardrum pathology added a marginally increased risk of adult hearing loss (1–3 dB) in children with otitis media with effusion or hearing loss after recurrent acute otitis media. Our study could not reveal significant differences in the effect of self-reported noise exposure on adult hearing thresholds between the groups with otitis media and the group with normal childhood hearing. Conclusions This cohort study indicates that chronic suppurative otitis media and recurrent acute otitis media in childhood are associated with adult hearing loss, underlining the importance of optimal treatment in these conditions. It appears that ears with a subsequent

  15. Transcription of genes encoding iron and heme acquisition proteins of Haemophilus influenzae during acute otitis media.

    PubMed Central

    Whitby, P W; Sim, K E; Morton, D J; Patel, J A; Stull, T L

    1997-01-01

    Unencapsulated Haemophilus influenzae is the second most common etiologic agent of otitis media in children. H. influenzae requires heme for aerobic growth in vitro and is able to utilize hemoglobin and complexes of heme-hemopexin, heme-albumin, and hemoglobin-haptoglobin and ferritransferrin as sources of iron and heme in vitro. Several of the acquisition mechanisms have been characterized and been shown to be heme repressible in vitro. However, little is known about the expression of heme and/or iron acquisition mechanisms during infections in the middle ear. This study was performed to determine if the genes encoding heme and iron acquisition proteins are transcribed during in vivo growth and to compare these findings with those for samples grown in vitro. Reverse transcriptase PCR (RT-PCR) was used to analyze total RNA fractions derived from in vitro- and in vivo-grown H. influenzae. Genes encoding the transferrin-binding proteins TbpA and TbpB, the 100-kDa hemopexin-binding protein HxuA, and the hemoglobin-binding protein HgpA were transcribed during otitis media. Twelve middle ear fluid samples were analyzed by blind RT-PCR to determine the transcriptional status of these genes in H. influenzae during otitis media. Five isolates had transcripts corresponding to tbpA, tbpB, and hxuA. The presence of hgpA transcripts was variable, depending on the presence of hgpA in the genome of the H. influenzae isolate. Samples without H. influenzae gene transcripts contained other etiologic agents commonly causing otitis media. These data demonstrate that H. influenzae iron and/or heme acquisition genes are transcribed during otitis media and suggest that the microenvironment during acute otitis media starves H. influenzae of heme. PMID:9353052

  16. Spontaneous otitis media in Wistar rats: an overlooked pathology in otological research.

    PubMed

    Verdaguer, José María; Trinidad, Almudena; González-García, José Angel; García-Berrocal, José Ramón; Ramírez-Camacho, Rafael

    2006-11-01

    The rat is commonly employed in otological research, but spontaneous ear infections can confound the results of experimental procedures--wasting time, money, and animals. The authors focus on the incidence of spontaneous otitis media in Wistar rats. They compare disease incidence in animals housed in standard cages with those housed in barrier units, showing that 20% of their conventionally housed animals developed spontaneous otitis media, whereas only 5% of their animals housed in isolated units were infected. These results underscore the importance of strict control of the shipping, housing conditions, and manipulation of animals to be used in otological research. PMID:17077834

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

    PubMed Central

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

    2014-01-01

    We report the imaging features of a case of a temporal bone meningioma extending into the middle ear cavity and clinically presenting as a serous otitis media. Temporal bone meningioma extending in the mastoid or the middle ear cavity, however, is very rare. In case of unexplained or therapy-resistant serous otitis media and a nasopharyngeal tumor being ruled out, a temporal bone computed tomography (CT) should be performed. If CT findings are suggestive of a temporal bone meningioma, a magnetic resonance imaging (MRI) examination with gadolinium will confirm diagnosis and show the exact extension of the lesion. PMID:25535569

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

    PubMed

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

    2015-12-01

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

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

    ERIC Educational Resources Information Center

    McSwan, David

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

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

    ERIC Educational Resources Information Center

    Denning, Jennifer; Mayberry, Wanda

    1987-01-01

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

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

    ERIC Educational Resources Information Center

    FPG Child Development Institute, University of North Carolina, 2004

    2004-01-01

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

  2. The Role of Vascular Endothelial Growth Factors and Fibroblast Growth Factors in Angiogenesis during Otitis Media

    PubMed Central

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

    2012-01-01

    The middle ear response to otitis media includes transformation and hyperplasia of the mucosal epithelium and subepithelial connective tissue. Significant neovascularization is also noted, which occurs both to support the hypertrophied mucosa and to mediate the increased trafficking of leukocytes. We investigated the role of two known potent angiogenic growth factor families, the fibroblast growth factors (FGFs) and vascular endothelial growth factors (VEGFs), in middle ear mucosal angiogenesis. DNA microarrays were used to evaluate the expression of FGFs and VEGFs, as well as their receptors and unique signaling proteins, in the middle ears of mice undergoing a complete course of acute bacterial otitis media. In addition, a member of each family was introduced to the middle ear submucosal compartment of the normal middle ears of guinea pigs, by a continuous-release osmotic minipump system over 1 week. During the course of bacterial otitis media, a significant regulation of a number of genes important for angiogenesis was identified. Histologic evaluation of middle ear mucosa following micropump infusion of both FGF1 and VEGF-A showed significant angiogenesis at the site of infusion in comparison to control saline infusion. These results support a role for FGFs and VEGFs in the neovascularization of the middle ear mucosa during otitis media, and offer a potential avenue for therapeutic intervention. PMID:22104377

  3. The Effects of Otitis Media on the Attention Skills of Day-Care-Attending Toddlers.

    ERIC Educational Resources Information Center

    Feagans, Lynne V.; And Others

    1994-01-01

    Investigated whether otitis media (OM), middle ear disease, affected toddlers' attention to language. Children were studied during a picture book-reading task at high- or low-quality day-care centers. Children with chronic OM in low-quality care showed the most negative effects on attention during episodes of OM; mothers rated children with…

  4. Therapeutic outcomes of canal wall up mastoidectomy in combination with Type I tympanoplasty in otitis media

    PubMed Central

    Zhang, Liansheng

    2016-01-01

    Objective: To evaluate the therapeutic effects in terms of disease clearance and hearing improvement of canal wall up mastoidectomy in combination with Type I tympanoplasty in otitis media. Methods: A total of 78 patients (81 ears) with otitis media were treated by canal wall up mastoidectomy in combination with Type I tympanoplasty. The postoperative tympanic membrane morphology, average of pure-tone hearing thresholds and average air-bone gap were used as the indices for evaluating therapeutic effects. Results: The patients were followed up for two years in average. All the tympanic membranes recovered, with the ear canals being dry. There were five cases (5 ears) of tympanic membrane retraction and one case of otitis media recurrence. Hearing was effectively recovered by 76.54% (62/81) after surgery. Conclusion: Combining canal wall up mastoidectomy with Type I tympanoplasty can treat otitis media safely and effectively due to high postoperative dry ear canal rate, satisfactory reconstruction of hearing and maintenance of ear morphology. PMID:27375690

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

    ERIC Educational Resources Information Center

    Winskel, Heather

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Peters, Sylvia A. F.; And Others

    1994-01-01

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

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

    PubMed

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

    1996-01-01

    One hundred sixty children with effusive otitis media who did not improve with medical treatment were reviewed. The evolution and complications observed in 294 ears treated by myringotomy and ventilation tubes (grommets) over a three-year period were analyzed. Otorrhea occurred during grommet placement in 11.6%. The disease remitted in 84%. Recurrences occurred in 15.3%: 4.8% had different degrees of tympanic atelectasia and 0.7% had perforation. Three per cent of the children were reoperated for bilateral recurrence of otitis. Younger children and those whose had delayed surgery had a worse outcome. Insertion of ear grommets improved hearing. PMID:8991399

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

    PubMed Central

    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

  9. Comparison of Local and Systemic Ciprofloxacin Ototoxicity in the Treatment of Chronic Media Otitis

    PubMed Central

    Samarei, R.

    2014-01-01

    Introduction: Chronic media otitis is a common cause of reference to ear, nose and throat clinics and the treatment is one of the health problems among ENT specialists. Ciprofloxacin drop that is of fluoroquinolone drug class due to good treatment effect is now widely used in the treatment of chronic media otitis. Due to the widespread use, it seems proper research on the human population has not been taken to ensure its non-toxicity in the inner ear, therefore comparison of local ciprofloxacin ototoxicity with systemic in chronic media otitis is investigated in this study. Materials and Methods: This study was conducted as a randomized clinical trial. Prospective methods were considered and the number of samples in the study group was 40 patients that were treated with ciprofloxacin drops. And in the control group 32 patients with chronic media otitis who were treated with ciprofloxacin tablets. The collected data was analyzed using SPSS software. Results: Statistical indicators of different frequencies in air conduction (AC) in both groups showed, there was significant improvement in hearing thresholds at frequencies of 250, 8000, 1000 in air conduction for the group receiving drops compared to the group receiving tablet. Based on statistical indicators in different frequencies of bone conduction in the two treated groups, there was significant difference in the two groups receiving tablets and drops only at a frequency of 4000Hz that drop impact improves hearing threshold and in contrast in the group receiving tablet hearing loss was seen in the frequency of 4000. Discussion: Topical ciprofloxacin is a safe and uncomplicated ototoxic drug that is an effective antibiotic used in the treatment of refractory chronic otitis those dregs such as pseudomonas aerogenusa and staphylococci resistant to methicillin are responsible for it, which in the usual doses has not harmful effects on hearing hairy cells. PMID:25363170

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

    PubMed Central

    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

  11. The immunoregulatory and allergy-associated cytokines in the aetiology of the otitis media with effusion.

    PubMed Central

    Smirnova, Marina G; Birchall, John P; Pearson, Jeffrey P

    2004-01-01

    Inflammation in the middle ear mucosa, which can be provoked by different primary factors such as bacterial and viral infection, local allergic reactions and reflux, is the crucial event in the pathogenesis of otitis media with effusion (OME). Unresolved acute inflammatory responses or defective immunoregulation of middle inflammation can promote chronic inflammatory processes and stimulate the chronic condition of OME. Cytokines are the central molecular regulators of middle ear inflammation and can switch the acute phase of inflammation in the chronic stage and induce molecular-pathological processes leading to the histopathological changes accompanying OME. In this review we present cytokines identified in otitis media, immunoregulatory [interleukin (IL)-2, IL-10, transforming growth factor-beta]) and allergy associated (IL-4, IL-5, granulocyte-macrophage colony-stimulating factor), as crucial molecular regulators, responsible for chronic inflammation in the middle ear and the chronic condition of OME. PMID:15203548

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

    PubMed

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

    2016-07-01

    Nontypeable Haemophilus influenzae (NTHi) is a predominant organism of the upper respiratory nasopharyngeal microbiota. Its disease spectrum includes otitis media, sinusitis, non-bacteremic pneumonia and invasive infections. Protein-based vaccines to prevent NTHi infections are needed to alleviate these infections in children and vulnerable populations such as the elderly and those with chronic obstructive pulmonary disease (COPD). One NTHi protein is included in a pneumococcal conjugate vaccine and has been shown to provide efficacy. Our lab has been interested in understanding the immunogenicity of NTHi vaccine candidates P6, protein D and OMP26 for preventing acute otitis media in young children. We expect that continued investigation and progress in the development of an efficacious protein based vaccine against NTHi infections is achievable in the near future. PMID:26894630

  13. Indigenous nasopharyngeal, auditory canal, and middle ear bacterial flora of gerbils: animal model for otitis media.

    PubMed Central

    Thompson, T A; Gardner, D; Fulghum, R S; Daniel, H J; Allen, W E; Worthington, J M; Williams, P P

    1981-01-01

    The indigenous microbial flora of the middle ear cavity of Mongolian gerbils, Meriones unguiculatus, was isolated, characterized, and identified, showing it to be sparse and transitory. Organisms, when found in the middle ear cavity, were most likely to be Staphylococcus epidermidis-like organisms. Cerumen from the external auditory canal of these animals yielded mostly staphylococci, coryneforms, and other gram-positive rods, including some anaerobic species. The nasopharynx supported a flora consisting mainly of staphylococci, lactobacilli, and coryneforms, with a smaller incidence and numbers of many other species. No mycoplasmas were cultured or seen in scanning electron microscope studies. None of the major pathogens of human otitis media were found; therefore, Mongolian gerbils are microbiologically acceptable candidates as a model for induced otitis media, using organisms isolated from human otitic infections. PMID:7251160

  14. The immunoregulatory and allergy-associated cytokines in the aetiology of the otitis media with effusion.

    PubMed

    Smirnova, Marina G; Birchall, John P; Pearson, Jeffrey P

    2004-04-01

    Inflammation in the middle ear mucosa, which can be provoked by different primary factors such as bacterial and viral infection, local allergic reactions and reflux, is the crucial event in the pathogenesis of otitis media with effusion (OME). Unresolved acute inflammatory responses or defective immunoregulation of middle inflammation can promote chronic inflammatory processes and stimulate the chronic condition of OME. Cytokines are the central molecular regulators of middle ear inflammation and can switch the acute phase of inflammation in the chronic stage and induce molecular-pathological processes leading to the histopathological changes accompanying OME. In this review we present cytokines identified in otitis media, immunoregulatory [interleukin (IL)-2, IL-10, transforming growth factor-beta]) and allergy associated (IL-4, IL-5, granulocyte-macrophage colony-stimulating factor), as crucial molecular regulators, responsible for chronic inflammation in the middle ear and the chronic condition of OME. PMID:15203548

  15. Murine model of otitis media with effusion: immunohistochemical demonstration of IL-1 alpha antigen expression.

    PubMed

    Johnson, M D; Contrino, A; Contrino, J; Maxwell, K; Leonard, G; Kreutzer, D

    1994-09-01

    Recent studies have suggested that cytokines likely play a central role in the formation and maintenance of otitis media with effusion (OME). Currently, there is no immunologically defined animal model for the study of cytokines as they contribute to the formation of OME. In the present study, a murine model of OME, using eustachian tube blockage via an external surgical approach, was developed. The murine model temporal bone histology appears to mimic the histology found in chronic otitis media with effusion in humans. Additionally, using this murine model, interleukin-1 alpha (IL-1 alpha) expression was detected in the middle ear using standard immunohistochemical techniques. IL-1 alpha seemed localized to the epithelial lining of the middle ear as well as 5% to 10% of inflammatory cells. This model should provide the necessary tool to further study the immunologic aspects of OME. PMID:8072363

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Adhami, Maya; Tohme, Souheil

    2010-01-01

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

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

    PubMed

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

    2014-08-01

    The variability in the recovery of otitis media (OM) is not well understood. Recent data have shown a critical role for toll-like receptors (TLRs) in inflammatory responses to bacteria. It remains unclear whether TLRs-mediated mucosal immunity plays a role in the OM recovery. The etiology, pathological profile, expression levels of TLR2, TLR4, TLR5, TLR9 and proinflammatory cytokines were measured in human middle-ear mucosae sampled from three subject groups: non-OM group, chronic otitis-media (COM) group, and chronic suppurative otitis-media (CSOM) group. Of the 72 ears, 86.11% CSOM patients were positive for bacteria. The cellular makeup of the middle ear mucosa differs among the three groups. Mucosae from the CSOM group presented chronic inflammation or suppurative inflammation in the rudimentary stroma, mainly with infiltration of monocytes and macrophages. The mRNA and protein levels of TLR2, TLR4, and TLR5 exhibited no difference between the non-OM and COM groups but were significantly lower in the CSOM group. Conversely, there was no significant difference in the TLR9 level among the three groups. Furthermore, proinflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6 were up-regulated in the CSOM group. This study provides evidence that the variability in clinical otitis media recovery might be associated with the variability in the expression of mucosal TLRs. Reduced TLR levels in the middle-ear mucosa might cause weak host response to bacteria, persistent inflammation and susceptibility to CSOM. PMID:24882571

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  20. Trimethoprim-sulfamethoxazole v. amoxicillin in the treatment of acute otitis media.

    PubMed Central

    Feldman, W; Momy, J; Dulberg, C

    1988-01-01

    Although amoxicillin has long been the preferred drug for treatment of acute otitis media, resistant strains of two relatively common causal organisms have emerged, prompting a search for other antibiotics. We performed a randomized double-blind trial comparing amoxicillin and trimethoprim-sulfamethoxazole in 221 children in whom acute otitis media was diagnosed in an outpatient setting. Diagnosis was on the basis of symptoms, otoscopic examination and acoustic reflectometry. No culture specimens were taken. A research nurse, using the same methods, evaluated patients in a follow-up home visit at around 14 days and measured compliance by examination of the medicine bottle. Equal proportions of children in the two groups were cured or improved (88% and 87%). Therapeutic efficacy was related to compliance in both groups, and there were few side effects in either group. This study had statistical power of 80% to detect a difference of 15%. We conclude that trimethoprim-sulfamethoxazole can be considered a first-line antibiotic in the treatment of acute otitis media. PMID:3052769

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

    The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in <5-year-old children decreased by 29.1% in 2011 and by 25.2% in 2012 compared to the mean rate performed in the 3 years prior to the introduction of public funding. A total of 895 myringotomies were performed for 1-year-old infants. The rate of myringotomies per child-year performed for acute otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (p<0.000001). Our results suggest a benefit of heptavalent pneumococcal conjugate vaccine for acute otitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants. PMID:26348230

  3. Vernet's syndrome caused by large mycotic aneurysm of the extracranial internal carotid artery after acute otitis media--case report.

    PubMed

    Amano, Mizuki; Ishikawa, Eiichi; Kujiraoka, Yuji; Watanabe, Shunji; Ashizawa, Kei; Oguni, Eiichi; Saito, Atsushi; Nakai, Yasunobu; Ikeda, Hiroaki; Abe, Takashi; Uekusa, Yoshinori; Matsumura, Akira

    2010-01-01

    An 85-year-old man presented with a rare large aneurysm of the extracranial internal carotid artery (ICA) due to acute otitis media manifesting as Vernet's syndrome 2 weeks after the diagnosis of right acute otitis media. Angiography of the right extracranial ICA demonstrated an irregularly shaped large aneurysm with partial thrombosis. The aneurysm was treated by proximal ICA occlusion using endovascular coils. The ICA mycotic aneurysm was triggered by acute otitis media, and induced Vernet's syndrome as a result of direct compression to the jugular foramen. Extracranial ICA aneurysms due to focal infection should be considered in the differential diagnosis of lower cranial nerve palsy, although the incidence is thought to be very low. PMID:20098025

  4. Dynamic Properties of Tympanic Membrane in a Chinchilla Otitis Media Model Measured With Acoustic Loading.

    PubMed

    Yokell, Zachary; Wang, Xuelin; Gan, Rong Z

    2015-08-01

    Otitis media is the most common infectious disease in young children, which results in changes in the thickness and mechanical properties of the tympanic membrane (TM) and induces hearing loss. However, there are no published data for the dynamic properties of the TM in otitis media ears, and it is unclear how the mechanical property changes are related to TM thickness variation. This paper reports a study of the measurement of the dynamic properties of the TM in a chinchilla acute otitis media (AOM) model using acoustic loading and laser Doppler vibrometry (LDV). AOM was created through transbullar injection of Haemophilus influenzae into the middle ear, and AOM samples were prepared 4 days after inoculation. Vibration of the TM specimen induced by acoustic loading was measured via LDV over a frequency range of 0.1-8 kHz. The experiment was then simulated in a finite element (FE) model, and the inverse-problem solving method was used to determine the complex modulus in the frequency domain. Results from 12 ears (six control and six AOM) show that the storage modulus of the TM from AOM ears was on average 53% higher than that of control ears, while the loss factor was 17.3% higher in control ears than in AOM ears at low-frequency (f < 1 kHz). At high-frequency (e.g., 8000 Hz), there was a mean 40% increase in storage modulus of the TM from AOM compared to control samples. At peak frequency (e.g., 3 kHz), there was a 19.5% increase in loss factor in control samples compared to AOM samples. These findings quantify the changes induced by AOM in the chinchilla TM, namely, a significant increase in both the storage and loss moduli. PMID:25902287

  5. Otitis media associated polymorphisms in the hemin receptor HemR of nontypeable Haemophilus influenzae

    PubMed Central

    LaCross, Nathan C.; Marrs, Carl F.; Gilsdorf, Janet R.

    2014-01-01

    Nontypeable Haemophilus influenzae (NTHi) colonize the human pharynx asymptomatically, and are also an important cause of otitis media (OM). Previous studies have demonstrated that some genes are more prevalent in OM-causing NTHi strains than in commensal strains, suggesting a role in virulence. These studies, however, are unable to investigate the possible associations between gene polymorphisms and disease. This study examined amino acid polymorphisms and sequence diversity in a potential virulence gene, the hemin receptor hemR, from a previously characterized NTHi strain collection containing both commensal and OM organisms to identify possible associations between the polymorphisms and otitis media. The full open reading frame of hemR was sequenced from a total of 146 NTHi isolates, yielding a total of 47 unique HemR amino acid sequences. The predicted structure of HemR showed substantial similarity to a class of monomeric TonB dependent, ligand-gated channels involved in iron acquisition in other gram negative bacteria. Fifteen amino acid polymorphisms were significantly more prevalent at the 90% confidence level among commensal compared to OM isolates. Upon controlling for the confounding effect of population structure, over half of the polymorphism-otitis media relationships lost statistical significance, emphasizing the importance of assessing the effect of population structure in association studies. The seven polymorphisms that retained significance were dispersed throughout the protein in various functional and structural domains, including the signal peptide, N-terminal plug domain, and intra- and extracellular loops. The alternate amino acid of only one of these seven polymorphisms was more common among OM isolates, demonstrating a strong trend toward the consensus sequence among disease causing NTHi. We hypothesize that variability at these positions in HemR may result in a reduced ability to acquire iron, rendering NTHi with such versions of the gene

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

    PubMed Central

    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. Dynamic properties of round window membrane in guinea pig otitis media model measured with electromagnetic stimulation.

    PubMed

    Gan, Rong Z; Nakmali, Don; Zhang, Xiangming

    2013-07-01

    The round window, one of two openings into the cochlea from the middle ear, plays an important role in hearing and is known to be structurally altered during otitis media. However, there have been no published studies systematically describing the changes in biomechanical properties of the round window membrane (RWM) that accompany bacterial otitis media. Here we describe the occurrence of significant changes in the dynamic properties of the RWM between normal guinea pigs and those with acute otitis media (AOM) that are detectable by electromagnetic force stimulation and laser Doppler vibrometry (LDV) measurements. AOM was induced by transbullar injection of streptococcus pneumoniae into the middle ear, and RWM specimens were prepared three days after challenge. Vibration of the RWM induced by coil-magnet coupling was measured by LDV over frequencies of 0.2-40 kHz. The experiment was then simulated in a finite element model, and the inverse-problem solving method was used to determine the complex modulus in the frequency domain and the relaxation modulus in the time domain. Results from 18 ears (9 control ears and 9 AOM ears) established that both the storage modulus and loss modulus of the RWM from ears with AOM were significantly lower than those of RWM from uninfected ears. The average decrease of the storage modulus in AOM ears ranged from 1.5 to 2.2 MPa and the average decrease of the loss modulus was 0.025-0.48 MPa. Our findings suggest that middle ear infection primarily affects the stiffness of the RWM due to the morphological changes that occur in AOM ears. We also conclude that the coil-magnet coupling method for assessment of RWM function may provide a valuable new approach to characterizing the mechanical response of the RWM when reverse driving is selected for middle ear implantable devices. This article is part of a special issue entitled "MEMRO 2012". PMID:23333258

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

    NASA Astrophysics Data System (ADS)

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

    2008-02-01

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

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

    PubMed

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

    2002-01-01

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

  10. Risk Factors for Refractory and Delayed De novo Otitis Media Requiring Pressure Equalization Tube Insertion

    PubMed Central

    Bowe, Sarah N.; Jatana, Kris R.; Kang, D. Richard

    2016-01-01

    Objective Limited data exists regarding risk factors for otitis media in older children and specifically those for which surgical intervention is performed. This study investigated potential risk factors in this older age group who required pressure equalization tube (PET) insertion. Study design Retrospective cohort study Setting Tertiary care pediatric academic medical center Subjects and methods Children 6–12 years old undergoing PET insertion between October 1, 2010 and September 30, 2011. Data was stratified into two separate age cohorts (6–7 versus 8–12-year-olds) and compared using chi-square analysis. Results A total of 263 patients met study criteria. PET insertion was most common in 6 year-olds (36%, 95/263). Presence of siblings (p=0.03) and history of recurrent upper respiratory tract infection (p<0.01), otalgia (p<0.05), otorrhea (p<0.001), and nasal discharge (p<0.001) were common in the older cohort. No statistical difference was found for history of recurrent acute otitis media, allergy, asthma, or atopy between the two groups (p=0.23–0.92), although the overall prevalence of these conditions was high in both cohorts. Conclusion The 8–12-year-olds had a history of recurrent upper respiratory tract infection and more infectious symptoms than the 6–7-year-olds. Atopy can lead to a heightened susceptibility to upper respiratory tract infections and potential increase in the relative risk of otitis media. In our patient population, while there was no statistically significant difference in history of asthma, allergy, or atopy, the overall prevalence within both cohorts was relatively high. Therefore, this study provides insight into many pertinent and potentially modifiable risk factors for older children requiring PET insertion. PMID:27175444

  11. Detoxified lipooligosaccharide from nontypeable Haemophilus influenzae conjugated to proteins confers protection against otitis media in chinchillas.

    PubMed Central

    Gu, X X; Sun, J; Jin, S; Barenkamp, S J; Lim, D J; Robbins, J B; Battey, J

    1997-01-01

    Detoxified-lipooligosaccharide (dLOS)-protein conjugates from nontypeable Haemophilus influenzae (NTHi) elicited a significant rise of anti-LOS antibodies with bactericidal activity in rabbits (X.-X. Gu, C.-M. Tsai, T. Ueyama, S. J. Barenkamp, J. B. Robbins, and D. J. Lim, Infect. Immun. 64:4047-4053, 1996). In this study, we evaluated whether vaccination with the conjugates would protect against NTHi otitis media in chinchillas. Fifty-eight chinchillas received three subcutaneous or intramuscular injections of dLOS-conjugated tetanus toxoid, dLOS-conjugated high-molecular-weight proteins from NTHi, or saline (control) in Freund's adjuvant and then were challenged by intrabullar inoculation with 140 CFU of NTHi. All vaccinated animals responded with elevated serum titers of anti-LOS antibody, and 49% (19 of 39) demonstrated bactericidal activity against the homologous strain. Otitis media with culture-positive NTHi effusions developed in all 19 controls and 56% (22 of 39) of the vaccinated animals during a period of 21 days (P < 0.001). Bacterial counts of the middle ear effusions were lower in the vaccine groups than in the controls (P < 0.01). The incidences of infection in the unchallenged ear or inner ear were 26 or 28% in the vaccine groups and 53 or 58% in the controls (P < 0.05). The signs of infection observed by otoscopy were less severe in the vaccine groups than in the controls. There was no significant difference between the two vaccine groups. These data indicate that active immunization with LOS-based conjugates reduces the incidence of NTHi-induced otitis media. PMID:9353024

  12. A case of lemierre syndrome secondary to otitis media and mastoiditis.

    PubMed

    Turan, Aynur; Cam, Harun; Dadali, Yeliz; Korkmaz, Serdar; Ozdek, Ali; Hekimoğlu, Baki

    2014-01-01

    Lemierre's syndrome is a rare clinical condition that generally develops secondary to oropharyngeal infection caused by Fusobacterium necrophorum, which is an anaerobic bacteria. A 62-year-old patient with diabetes mellitus presented with internal jugular vein and sigmoid sinus-transverse sinus thrombophlebitis, accompanying otitis media and mastoiditis that developed after an upper airway infection. Interestingly, there were air bubbles in both the internal jugular vein and transverse sinus. Vancomycin and meropenem were started and a right radical mastoidectomy was performed. The patient's clinical picture completely resolved in 14 days. High mortality and morbidity may be prevented with a prompt diagnosis of Lemierre's syndrome. PMID:25431696

  13. A Case of Lemierre Syndrome Secondary to Otitis Media and Mastoiditis

    PubMed Central

    Turan, Aynur; Cam, Harun; Dadali, Yeliz; Korkmaz, Serdar; Özdek, Ali; Hekimoğlu, Baki

    2014-01-01

    Lemierre's syndrome is a rare clinical condition that generally develops secondary to oropharyngeal infection caused by Fusobacterium necrophorum, which is an anaerobic bacteria. A 62-year-old patient with diabetes mellitus presented with internal jugular vein and sigmoid sinus-transverse sinus thrombophlebitis, accompanying otitis media and mastoiditis that developed after an upper airway infection. Interestingly, there were air bubbles in both the internal jugular vein and transverse sinus. Vancomycin and meropenem were started and a right radical mastoidectomy was performed. The patient's clinical picture completely resolved in 14 days. High mortality and morbidity may be prevented with a prompt diagnosis of Lemierre's syndrome. PMID:25431696

  14. An Antihistamine Decongestant in the Prevention of Acute Otitis Media in Children with Colds

    PubMed Central

    Brownoff, R.; Hutchison, L.J.

    1990-01-01

    Most clinical drug trials relating to acute otitis media have evaluated medications in terms of treatment. In this randomized double-blind, cross-over study, the effectiveness of an antihistamine decongestant in the prevention of AOM was investigated, rather than the treatment. The medication/placebo was started at the onset of a cold and continued throughout its duration. No treatment effect was evident in the results obtained with 308 children who completed the eight-month study. However, the results indicated a strong relationship between colds and AOM, and a trend toward higher occurrence of AOM in children under four years of age. PMID:21233997

  15. An Antihistamine Decongestant in the Prevention of Acute Otitis Media in Children with Colds

    PubMed Central

    Brownoff, R.; Hutchison, L.J.

    1988-01-01

    Most clinical drug trials relating to acute otitis media have evaluated medications in terms of treatment. In this randomized double-blind, cross-over study, the effectiveness of an antihistamine decongestant in the prevention of AOM was investigated, rather than the treatment. The medication/placebo was started at the onset of a cold and continued throughout its duration. No treatment effect was evident in the results obtained with 308 children who completed the eight-month study. However, the results indicated a strong relationship between colds and AOM, and a trend toward higher occurrence of AOM in children under four years of age. PMID:21253110

  16. Rare clinical presentation of diffuse large B-cell lymphoma as otitis media and facial palsy

    PubMed Central

    Siddiahgari, Sirisha Rani; Yerukula, Pallavi; Lingappa, Lokesh; Moodahadu, Latha S.

    2016-01-01

    Extra nodal presentation of Non Hodgkins Lymphoma (NHL) is a rare entity, and data available about the NHL that primarily involves of middle ear and mastoid is limited. We report a case of diffuse large B cell lymphoma (DLBCL), in a 2 year 8 month old boy, who developed otalgia and facial palsy. Computed tomography revealed a mass in the left mastoid. Mastoid exploration and histopathological examination revealed DLBCL. This case highlights the importance of considering malignant lymphoma as one of the differential diagnosis in persistent otitis media and/facial palsy. PMID:27195036

  17. [Pharyngolaryngeal reflux as one of the causes of chronic excretory otitis media].

    PubMed

    Petrova, L G; Chaĭkovskiĭ, V V; Rybak, P R

    2013-01-01

    The objective of the present work was to study the relationship between chronic secretory otitis media (CSOM) and pharyngolaryngeal reflux (PLR). A total of 43 patients aged between 3 to 19 years presenting with CSOM were available for the examination. PLR was confirmed in 36 (83.7%) patients. A relapse of CSOM after a course of otorhinolaryngological and gastroenterological treatment developed in 6 (14.0%) patients. It is concluded that antireflux therapy should be a constituent component of CSOM therapy concomitant with gastroesophageal reflux disease. PMID:23528458

  18. Grisel syndrome, acute otitis media, and temporo-mandibular reactive arthritis: A rare association.

    PubMed

    Martins, J; Almeida, S; Nunes, P; Prata, F; Lobo, M L; Marques, J G

    2015-08-01

    We present a case report of a four-year-old boy with torcicollis and trismus after acute otitis media. Grisel Syndrome diagnosis in association with temporo-mandibular reactive arthritis was admitted, leading to early conservative treatment. GS should be suspected in a child presenting with torticollis after an upper respiratory tract infection or an ENT surgical procedure. The association with temporo-mandibular reactive findings is somehow rarer but not impossible, due to the close vascular communication between retropharyngeal and pterigoid spaces. PMID:26060148

  19. Chronic suppurative otitis media due to nontuberculous mycobacteria: A case of successful treatment with topical boric acid.

    PubMed

    Lefebvre, Marie-Astrid; Quach, Caroline; Daniel, Sam J

    2015-07-01

    Nontuberculous mycobacteria (NTM) are an increasingly recognized cause of chronic suppurative otitis media in children with tympanostomy tubes. Treatment of this condition is difficult and typically requires a combination of systemic antibiotics and surgical debridement. We present the first case of a 2-year-old male with chronic suppurative otitis media due to NTM who failed systemic antibiotic therapy and was successfully managed with topical boric acid powder. This report highlights the challenges involved in treating this infection, and introduces boric acid as a potentially valuable component of therapy. PMID:26026892

  20. Impact of Sulphurous Water Politzer Inhalation on Audiometric Parameters in Children with Otitis Media with Effusion

    PubMed Central

    Mirandola, Prisco; Gobbi, Giuliana; Malinverno, Chiara; Carubbi, Cecilia; Ferné, Filippo M.; Artico, Marco; Vitale, Marco

    2013-01-01

    Objectives The positive effects of spa therapy on ear, nose, and throat pathology are known but robust literature in this field, is still lacking. The aim of this study was to assess through a retrospective analysis, the effects on otitis media with effusion of Politzer endotympanic inhalation of sulphurous waters in children aged 5-9 years. Methods A cohort of 95 patients was treated with Politzer insufflations of sulphurous water: 58 patients did a cycle consisting of a treatment of 12 days per year for three consecutive years; 37 patients followed the same procedure for 5 years consecutively. The control population was represented by untreated, age-matched children. A standard audiometric test was used before and after each cycle of treatment. Results One cycle of Politzer inhalation of sulphur-rich water improved the symptoms. Three cycles definitively stabilized the improvement of hearing function. Conclusion Our results show that otitis media with effusion in children can be resolved by an appropriate non-pharmacological treatment of middle ear with sulphur-rich water. PMID:23524467

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

    PubMed

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

    2016-04-01

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

  2. [Antibiotics and cortisone in the treatment of otitis media with effusion].

    PubMed

    Zocconi, E

    1994-01-01

    Persistent otitis media with effusion (OME) is a pathology very frequent in the first year of life and causes hearing loss which can be a negative factor in language and cognitive development and may result in disturbances in psychological adjustment. Generally OME has spontaneous resolution but if it persist for more than 3 months a medical or surgical treatment is compulsory. OME is frequently a result of recurrent otitis media and bacterial infection is considered to play a definitive causative role in the development of this pathology. A wide variety of medical treatments (antibiotics, aerosolized corticosteroids, oral antihistamine-decongestants, mucolytics) is indicative of lake of success. We have treated 60 children with OME with antibiotics (amoxicillin or cefaclor for 1 month) and oral steroids (prednisone for 7 days). All patients had a history for more than 3 months, without adenoid hypertrophy. Diagnosis of OME was established after pneumatic otoscopy, tympanometry and audiometry. Following the therapeutical association 53 patients showed a complete resolution of the effusion. At the follow-up after 2 months, 4 children had a recurrence of effusion. We consider this treatment with a short course of steroids and antibiotics and effective method before referral for tube placement. PMID:7971452

  3. Therapeutic Transcutaneous Immunization with a Band-Aid Vaccine Resolves Experimental Otitis Media

    PubMed Central

    Novotny, Laura A.; Clements, John D.

    2015-01-01

    Transcutaneous immunization (TCI) is a noninvasive strategy to induce protective immune responses. We describe TCI with a band-aid vaccine placed on the postauricular skin to exploit the unique organization of the stratum corneum and to promote the development of immune responses to resolve active experimental otitis media due to nontypeable Haemophilus influenzae (NTHI). This therapeutic immunization strategy induced significantly earlier resolution of middle ear fluid and rapid eradication of both planktonic and mucosal biofilm-resident NTHI within 7 days after receipt of the first immunizing band-aid vaccine. Efficacy was ascribed to the homing of immunogen-bearing cutaneous dendritic cells to the nasal-associated lymphoid tissue, induction of polyfunctional CD4+ T cells, and the presence of immunogen-specific IgM and IgG within the middle ear. TCI using band-aid vaccines could expand the use of traditional parenteral preventative vaccines to include treatment of active otitis media, in addition to other diseases of the respiratory tract due to NTHI. PMID:26018536

  4. Evaluation of Iranian pediatric specialists’ attitude and knowledge regarding approach to patients with acute otitis media

    PubMed Central

    Ghalehbaghi, Babak; Asghari, Alimohamad; Ahmadvand, Alireza; Moradi, Yasaman; Kamrava, Kamran; Motiei, Mir Abolfazl

    2012-01-01

    Background The ministry of health and medical education of Iran and many other countries advice physicians to use this guideline for diagnosis and treatment of acute otitis media (AOM), but there is not any evaluation of effectiveness and obedience of this guideline, so the aim of this study was to evaluate the attitude of pediatricians, the most important group that interfere with these patients in treatment of acute otitis media. Methods A total of 120 anonymous surveys were mailed to 120 pediatrician in Tehran (Iran) to evaluate pattern of diagnosis and treatment of AOM in these physicians. Age, gender, place of work, attitude of diagnosis and treatment were asked by anonymous survey. Results Sixty-two completed surveys were received, for a response rate of 51%. There was no significant difference between responders in these survey and scenarios, according to sex, age, practice setting, graduation year or the number of AOM patients visiting each month. Conclusion Our study seems to add new insights to the previous literature on management of AOM according to guideline. We can assess the impact of guidelines on the usual practice of practitioners in evidenced-based management of AOM. PMID:23483781

  5. New Pneumococcal Carriage Acquired in Association with Acute Respiratory Infection Is Prone to Cause Otitis Media

    PubMed Central

    Leino, Tuija; Kilpi, Terhi

    2016-01-01

    For considering vaccine-prevention of pneumococcal acute otitis media (PncAOM), relationships between pneumococcal carriage, respiratory infection and PncAOM need to be understood. We analyzed nasopharyngeal samples collected from 329 unvaccinated Finnish children aged 2–24 months at scheduled visits and at visits during respiratory infection in 1994–97. We assessed temporal associations of respiratory infection with pneumococcal acquisition and whether PncAOM hazard depends on the relative timing of acquisition and the infection onset. The data comprised 607 person-years of risk-time for acquisition, 245 person-months of concurrent respiratory infection and carriage, and 119 episodes of PncAOM. The acquisition hazard was 3-fold in the month preceding respiratory sickness (hazard ratio, HR 3.5, 90% credible interval CI 2.9, 4.1) as compared to acquisition in healthy children. Moreover, the PncAOM hazard was markedly higher (HR 3.7, 90% CI 2.4, 5.3) during the first month of carriage acquired around the acute phase of respiratory infection (between 1 month before and 1 week after the sickness onset), as compared to carriage acquired later during sickness. The high proportion (76%) of PncAOM events occurring within 1 month of acquisition was due to frequent acquisition being associated with respiratory infection as well as the susceptibility of such acquisition to cause otitis media. PMID:27257789

  6. Therapeutic Transcutaneous Immunization with a Band-Aid Vaccine Resolves Experimental Otitis Media.

    PubMed

    Novotny, Laura A; Clements, John D; Bakaletz, Lauren O

    2015-08-01

    Transcutaneous immunization (TCI) is a noninvasive strategy to induce protective immune responses. We describe TCI with a band-aid vaccine placed on the postauricular skin to exploit the unique organization of the stratum corneum and to promote the development of immune responses to resolve active experimental otitis media due to nontypeable Haemophilus influenzae (NTHI). This therapeutic immunization strategy induced significantly earlier resolution of middle ear fluid and rapid eradication of both planktonic and mucosal biofilm-resident NTHI within 7 days after receipt of the first immunizing band-aid vaccine. Efficacy was ascribed to the homing of immunogen-bearing cutaneous dendritic cells to the nasal-associated lymphoid tissue, induction of polyfunctional CD4(+) T cells, and the presence of immunogen-specific IgM and IgG within the middle ear. TCI using band-aid vaccines could expand the use of traditional parenteral preventative vaccines to include treatment of active otitis media, in addition to other diseases of the respiratory tract due to NTHI. PMID:26018536

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

    PubMed

    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 < 0.001), interpersonal sensitivity (p < 0.001), depression (p < 0.001), phobic anxiety (p < 0.001), and other subscores, and also global severity index score (p < 0.001) were significantly high in patient group when compared to the control group. The patients with COM reported significantly lower levels of QoL in terms of physical role difficulty (p < 0.001), general health perception (p < 0.004), social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests. PMID:22566178

  8. Functional Antibodies Elicited by Two Heptavalent Pneumococcal Conjugate Vaccines in the Finnish Otitis Media Vaccine Trial▿

    PubMed Central

    Ekström, Nina; Väkeväinen, Merja; Verho, Jouko; Kilpi, Terhi; Käyhty, Helena

    2007-01-01

    In the Finnish Otitis Media Vaccine Trial, the now-licensed pneumococcal conjugate vaccine containing polysaccharides conjugated to protein CRM197 (PncCRM) and the experimental pneumococcal polysaccharide-meningococcal outer membrane protein complex conjugate vaccine (PncOMPC), showed similar efficacy profiles against acute otitis media despite different antibody concentrations in sera. We now report the opsonophagocytic activities (OPA) in these sera. OPA, antibody concentration, and avidity for serotypes 6B, 19F, and 23F were determined in sera of infants who received either pneumococcal conjugate (PCV) or control vaccine at 2, 4, and 6 months of age and either the homologous or pneumococcal polysaccharide vaccine at 12 months of age. OPA varied by vaccine and serotype. The majority of PCV recipients had positive OPA after the fourth dose, while OPA was undetectable in the control group. Coinciding with the efficacy data, the concentration of antibodies required for 50% killing was low for 6B and high for 19F for both PCVs. Contradictory to the efficacy data, PncOMPC induced lower functional capacity to 23F than PncCRM. OPA correlated with antibody concentration, while avidity and functional capacity of antibodies showed no correlation. The OPA data provide valuable additional information for serotype-specific differences in protection and when evaluating serotype-specific immunogenicity and should thus be considered when defining serological correlates of protection. PMID:17261612

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

    PubMed

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

    1996-08-01

    Within a prospective group study of five practicing otorhinolaryngologists, conventional therapy of acute otitis media in children was compared with homeopathic treatments. Group A (103 children) was primarily treated with homeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea). Group B (28 children) was treated by decongestant nose-drops, antibiotics, secretolytics and/or antipyretics. Comparisons were done by symptoms, physical findings, duration of therapy and number of relapses. The children of the study were between 1 and 11 years of age. The difference in numbers was explained by the children with otitis media being primarily treated by pediatricians using conventional methods. The median duration of pain in group A was 2 days and in group B 3 days. Median therapy in group A lasted 4 days and in group B 10 days. Antibiotics were given over a period of 8-10 days, while homeopathic treatments were stopped after healing. In group A 70.7% of the patients were free of relapses within 1 years and 29.3% had a maximum of three relapses. Group B had 56.5% without relapses and 43.5% a maximum of six relapses. Five children in group A were given antibiotics and 98 responded solely to homeopathic treatments. No side effects of treatment were found in either group. PMID:8805013

  10. Long-Term Effects of Otitis Media a Ten-Year Cohort Study of Alaskan Eskimo Children

    ERIC Educational Resources Information Center

    Kaplan, Gary J.; And Others

    1973-01-01

    Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children, followed through the first 10 years of life, to determine whether otitis media (middle ear inflammation) deleteriously affected intellectual functioning and achievement in school.…

  11. Preliminary study of proinflammatory cytokines and chemokines in the middle ear of acute otitis media due to Alloiococcus otitidis.

    PubMed

    Harimaya, Atsushi; Fujii, Nobuhiro; Himi, Tetsuo

    2009-05-01

    Alloiococcus otitidis is a newly discovered organism frequently detected in otitis media. However, the association of the organism with the development of otitis media has not been disclosed in detail yet. In the middle ear, proinflammatory cytokines and chemokines are released in association with infection by pathogens, and these cytokines contribute to the induction of an inflammatory reaction. To investigate the profile of inflammation-related cytokines in the acute phase of A. otitidis infection, we analyzed the release of proinflammatory cytokines and chemokines in middle ear effusions of acute otitis media due to A. otitidis, in comparison with acute otitis media due to the well-known Gram-positive middle ear pathogen Streptococcus pneumoniae. The amounts of proinflammatory cytokines (IL-8, IL-1beta, IL-6, TNF-alpha) and CXC chemokines (IP-10, I-TAC) were significantly increased in the A. otitidis group as well as in the S. pneumoniae group. Various inflammation-related cytokines/chemokines were induced in the A. otitidis-infected middle ear, and the profile of cytokines was very similar to that in S. pneumoniae infection. This preliminary study suggests that A. otitidis has the potential to induce these cytokines, contributing to the development of an inflammatory reaction in the middle ear cavity in a similar manner to S. pneumoniae. PMID:19185927

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  13. Otitis Media, the Quality of Child Care, and the Social/Communicative Behavior of Toddlers: A Replication and Extension

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; Manlove, Elizabeth E.

    2005-01-01

    The purpose of this study was to examine the effects of otitis media (OM) and the quality of child care on the social and communicative behaviors of toddlers, using a cumulative risk framework that included moderation. The study followed 72 children who began child care in infancy. Both process and structural aspects of the quality of 11 child…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  15. Lipopolysaccharide induces proinflammatory cytokines and chemokines in experimental otitis media through the prostaglandin D2 receptor (DP)-dependent pathway

    PubMed Central

    Eguchi, M; Kariya, S; Okano, M; Higaki, T; Makihara, S; Fujiwara, T; Nagata, K; Hirai, H; Narumiya, S; Nakamura, M; Nishizaki, K

    2011-01-01

    Otitis media is one of the most common and intractable ear diseases, and is the major cause of hearing loss, especially in children. Multiple factors affect the onset or development of otitis media. Prostaglandin D2 is the major prostanoid involved in infection and allergy. However, the role of prostaglandin D2 and prostaglandin D2 receptors on the pathogenesis of otitis media remains to be determined. Recent studies show that D prostanoid receptor (DP) and chemoattractant receptor-homologous molecule expressed on T helper type 2 (Th2) cells (CRTH2) are major prostaglandin D2 receptors. In this study, homozygous DP single gene-deficient (DP–/–) mice, CRTH2 single gene-deficient (CRTH2–/–) mice and DP/CRTH2 double gene-deficient (DP–/– CRTH2–/–) mice were used to investigate the role of prostaglandin D2 and its receptors in otitis media. We demonstrate that prostaglandin D2 is induced by lipopolysaccharide (LPS), a major component of Gram-negative bacteria, and that transtympanic injection of prostaglandin D2 up-regulates macrophage inflammatory protein 2 (MIP-2), interleukin (IL)-1β and IL-6 in the middle ear. We also show that middle ear inflammatory reactions, including infiltration of inflammatory cells and expression of MIP-2, IL-1β and IL-6 induced by LPS, are reduced significantly in DP–/– mice and DP–/– CRTH2–/– mice. CRTH2–/– mice display inflammatory reactions similar to wild-type mice. These findings indicate that prostaglandin D2 may play significant roles in LPS-induced experimental otitis media via DP. PMID:21166666

  16. Lipopolysaccharide induces proinflammatory cytokines and chemokines in experimental otitis media through the prostaglandin D2 receptor (DP)-dependent pathway.

    PubMed

    Eguchi, M; Kariya, S; Okano, M; Higaki, T; Makihara, S; Fujiwara, T; Nagata, K; Hirai, H; Narumiya, S; Nakamura, M; Nishizaki, K

    2011-02-01

    Otitis media is one of the most common and intractable ear diseases, and is the major cause of hearing loss, especially in children. Multiple factors affect the onset or development of otitis media. Prostaglandin D₂ is the major prostanoid involved in infection and allergy. However, the role of prostaglandin D₂ and prostaglandin D2 receptors on the pathogenesis of otitis media remains to be determined. Recent studies show that D prostanoid receptor (DP) and chemoattractant receptor-homologous molecule expressed on T helper type 2 (Th2) cells (CRTH2) are major prostaglandin D₂ receptors. In this study, homozygous DP single gene-deficient (DP⁻(/)⁻) mice, CRTH2 single gene-deficient (CRTH2⁻(/)⁻) mice and DP/CRTH2 double gene-deficient (DP⁻(/)⁻ CRTH2⁻(/)⁻) mice were used to investigate the role of prostaglandin D₂ and its receptors in otitis media. We demonstrate that prostaglandin D₂ is induced by lipopolysaccharide (LPS), a major component of Gram-negative bacteria, and that transtympanic injection of prostaglandin D₂ up-regulates macrophage inflammatory protein 2 (MIP-2), interleukin (IL)-1β and IL-6 in the middle ear. We also show that middle ear inflammatory reactions, including infiltration of inflammatory cells and expression of MIP-2, IL-1β and IL-6 induced by LPS, are reduced significantly in DP⁻(/)⁻ mice and DP⁻(/)⁻ CRTH2⁻(/)⁻ mice. CRTH2⁻(/)⁻ mice display inflammatory reactions similar to wild-type mice. These findings indicate that prostaglandin D₂ may play significant roles in LPS-induced experimental otitis media via DP. PMID:21166666

  17. A Mouse Model of Otitis Media Identifies HB-EGF as a Mediator of Inflammation-Induced Mucosal Proliferation

    PubMed Central

    Pak, Kwang; Chavez, Eduardo; Kurabi, Arwa; Baird, Andrew; Wasserman, Stephen I.; Ryan, Allen F.

    2014-01-01

    Objective Otitis media is one of the most common pediatric infections. While it is usually treated without difficulty, up to 20% of children may progress to long-term complications that include hearing loss, impaired speech and language development, academic underachievement, and irreversible disease. Hyperplasia of middle ear mucosa contributes to the sequelae of acute otitis media and is of important clinical significance. Understanding the role of growth factors in the mediation of mucosal hyperplasia could lead to the development of new therapeutic interventions for this disease and its sequelae. Methods From a whole genome gene array analysis of mRNA expression during acute otitis media, we identified growth factors with expression kinetics temporally related to hyperplasia. We then tested these factors for their ability to stimulate mucosal epithelial growth in vitro, and determined protein levels and histological distribution in vivo for active factors. Results From the gene array, we identified seven candidate growth factors with upregulation of mRNA expression kinetics related to mucosal hyperplasia. Of the seven, only HB-EGF (heparin-binding-epidermal growth factor) induced significant mucosal epithelial hyperplasia in vitro. Subsequent quantification of HB-EGF protein expression in vivo via Western blot analysis confirmed that the protein is highly expressed from 6 hours to 24 hours after bacterial inoculation, while immunohistochemistry revealed production by middle ear epithelial cells and infiltrating lymphocytes. Conclusion Our data suggest an active role for HB-EGF in the hyperplasia of the middle ear mucosal epithelium during otitis media. These results imply that therapies targeting HB-EGF could ameliorate mucosal growth during otitis media, and thereby reduce detrimental sequelae of this childhood disease. PMID:25033458

  18. Epidemiology and pathogenesis of otitis media: construction of a phenotype landscape.

    PubMed

    Bhutta, Mahmood F

    2014-01-01

    Otitis media (OM) represents a complex set of clinically defined disease phenotypes. Epidemiological and pathological data suggest that inflammation of the middle ear occurs on a continuum of disease. Here I review epidemiological data and apply mathematical modelling to better define the interrelation of OM phenotypes, including the relationship of upper respiratory tract infection to acute OM (AOM), of AOM to OM with effusion, and of recurrent OM to chronicity of effusion. I use these mathematical models to represent OM graphically as a 'landscape of disease'. This novel nosology may enable clinicians and researchers to better conceptualise middle ear inflammation in its various forms, although the limits of its application are also discussed. PMID:24819621

  19. Novel type of Streptococcus pneumoniae causing multidrug-resistant acute otitis media in children.

    PubMed

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

    2009-04-01

    After our recent discovery of a Streptococcus pneumoniae 19A "superbug" (Legacy strain) that is resistant to all Food and Drug Administration-approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) that expressed the 19A capsule, and 8 (88%) of the 9 multidrug-resistant strains were serotype 19A, including the Legacy strain with the new ST-2722. In genetic relatedness, ST-2722 belonged to a cluster of reported strains of S. pneumoniae in which all strains had 6 of the same alleles as ST-156. The multidrug-resistant strains related to ST-156 expressed different capsular serotypes: 9V, 14, 11A, 15C, and 19F. PMID:19331730

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

    NASA Astrophysics Data System (ADS)

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

    2011-11-01

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

  1. Can you hear me now? A genetic model of otitis media with effusion.

    PubMed

    Lazaridis, Evelyn; Saunders, James C

    2008-02-01

    Otitis media with effusion (OME) is characterized by the occurrence of fluid in the middle-ear cavity in the absence of any signs of acute ear infection and occurs most frequently in children with auditory or eustachian tube dysfunction. Its chronic form is an important clinical issue for pediatricians and otologists alike. The study by Depreux et al. in this issue of the JCI shows that absence of the transcriptional activator Eya4 in knockout mice results in abnormal structuring of the eustachian tube, thus predisposing these animals to OME (see the related article beginning on page 651). The development of this genetics-based animal model is an important advance for understanding OME and for exploring new avenues of treatment. PMID:18219392

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

    PubMed

    Yazıcı, Hasmet

    2015-12-01

    Mucociliary clearance (MCC), which exists in many systems, is the first defensive mechanism of the human body. Nasal MCC has an important role in transporting the secretions of the nasal cavity and paranasal sinuses along with the trapped inhaled pathogens to the nasopharynx. Physiologic or pathologic situations that effect nasal MCC, such as temperature, humidity, nasal obstruction, allergic rhinitis, chronic infections, etc., lead to impaired MCC and related local or circumjacent system disorders. With this perspective, when a unified airway with a multiple disease principle is considered, investigating the relationship between adenoid hypertrophy (AH), otitis media with effusion (OME) and nasal MCC is logical. In this review, histological and physiologic properties of nasal MCC and its possible role involving pathologic situations such as AH and OME is discussed together with recent literature findings. PMID:26496764

  3. [Middle ear cancer hidden by chronic otitis media--a case report].

    PubMed

    Wierzbicka, Małgorzata; Gawecki, Wojciech; Leszczyńska, Małgorzata; Kopeć, Tomasz

    2008-01-01

    The authors would like to present a rare case of the middle ear cancer which has been developed in postoperative cave in 67 years old patient operated for cholesteatoma 50 years earlier. The patient was admitted to the ENT Department of Poznań University of Medical Sciences because of the ear suppuration and headache occurring for 3 months. CT and MR images suggested granulation tissue filling the postoperative spaces with bone destruction, infiltration of the dura and temporal lobe abscess formation. Intraoperative findings allowed excluding the preliminary diagnosis of intracranial complication in the course of chronic otitis media, revealing the tissue masses resembling neoplastic infiltration. The histopathology examination confirmed the final diagnosis of squamous cell cancer. The patient was directed to radiotherapy. The authors report a case of middle ear squamous cell carcinoma and discuss its diagnostic aspect. PMID:19205537

  4. An evidence-based patient information leaflet about otitis media with effusion.

    PubMed

    Kubba, H

    2000-01-01

    Leaflets are a useful resource for information provision. Many otolaryngology patients have poor reading skills, and may have difficulty understanding medical jargon. The aim of this project was to produce a patient information leaflet on otitis media with effusion whose content is based on the best available research evidence, and which is presented in a clear format with simple language. Patients were involved at the planning stage, and in testing the final draft. The leaflet was preferred by the majority compared to existing information material and was felt to be more informative and easier to understand. The leaflet has been given the Crystal Mark for clarity of language by the Plain English Campaign. This study shows that existing guidelines can be used to improve the quality of written information provision. PMID:11184057

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

    PubMed

    Principi, Nicola; Marchisio, Paola; Esposito, Susanna

    2016-04-01

    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. PMID:26853095

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

    PubMed

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

    2016-08-01

    Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice. PMID:27409041

  7. Non typable-Haemophilus influenzae biofilm formation and acute otitis media

    PubMed Central

    2014-01-01

    Background Non-typable Haemophilus influenzae (NT-Hi) infection is frequently associated with acute otitis media (AOM) treatment failure, recurrence or chronic otitis media. Persistence of otopathogens in a biofilm-structured community was implicated in these situations. Here, we compared biofilm production by H. influenzae strains obtained by culture of middle ear fluid (MEF) from children with AOM treatment failure and by strains isolated from nasopharyngeal (NP) samples from healthy children or those with AOM (first episode or recurrence). We aimed to evaluate an association of clinical signs and in vitro biofilm formation and establish risk factors of carrying a biofilm-producing strain. Methods We used a modification of the microtiter plate assay with crystal violet staining to compare biofilm production by 216 H. influenzae strains: 41 in MEF from children with AOM treatment failure (group MEF), 43 in NP samples from healthy children (NP group 1), 88 in NP samples from children with a first AOM episode (NP group 2, n = 43) or recurrent (NP group 3, n = 45) and 44 in NP samples from children with AOM associated with conjunctivitis (NP group 4). Results At all, 106/216 (49%) H. influenzae strains produced biofilm as did 26/43 (60.5%) in NP samples from healthy children. Biofilm production in MEF samples and NP samples did not significantly differ (40.5% vs 60.5%, 55.8%, 56.8% and 31.1% for NP groups 1, 2, 3 and 4, respectively). On multivariate analysis, only presence of conjunctivitis was significantly associated with low biofilm production (OR = 0.3, CI [0.16-0.60], p = 0.001). The ampicillin resistance of H. influenzae produced by penicillin-binding protein modification was significantly associated with low biofilm production (p = 0.029). Conclusion We found no association of biofilm production and AOM treatment failure or recurrence. Biofilm production was low from H. influenzae strains associated with conjunctivitis-otitis syndrome

  8. Clinical, functional, and surgical findings in chronic bilateral otitis media with effusion in childhood.

    PubMed

    Diacova, Svetlana; McDonald, Thomas J; Ababii, Ion

    2016-08-01

    We conducted a prospective, observational study over a 3-year period to compare the clinical, functional, and surgical findings in children with chronic bilateral otitis media with effusion who underwent one of three different types of treatment. Our study population was made up of 150 patients-79 boys and 71 girls aged 24 to 84 months-who were randomly assigned to one of the three treatment groups of 50 patients each. One group was treated with myringotomy, tympanostomy tube insertion, and adenoidectomy (T+A group); another with a combination of physical conservative treatment and adenoidectomy (P+A group); and the third with physical conservative treatment alone (P-only group). Hearing levels and tympanogram trends were evaluated during a follow-up of 12 months. In the T+A group, we noted a stable normalization of hearing in 95 of the 100 ears. Treatment with the P+A combination resulted in an improvement of hearing in 79 ears, but the improvement was maintained in only 27 ears during 12 months of follow-up. In the group with the P-only regimen, an amelioration of hearing was registered in 76 ears, but it was unstable in all cases. A type A tympanogram was maintained during the follow-up period for 2 ears in the P+A group and for 4 ears in the P-only group. Myringotomy with a detailed examination of the tympanic cavity in all ears with prolonged abnormal audiologic results revealed that types C and B tympanograms, which were found in most ears in the P+A and P-only groups, corresponded to middle ear chronic inflammatory changes (retraction pockets, granulations, adhesions, etc.) Based on our findings, we conclude that the use of a physical conservative treatment with or without an adenoidectomy does not prevent the development of chronic adhesive and purulent otitis media. PMID:27551851

  9. The Efficacy of Adjuvant Intratympanic Steroid Treatment for Otitis Media with Effusion in Children

    PubMed Central

    Amer, Hazem Saeed; El-Anwar, Mohammad Waheed; Elfeky, Alaa Eldin

    2015-01-01

    Introduction  Otitis media with effusion (OME) is a leading cause of hearing impairment in children. Therefore, early and proper management is essential. Objectives  The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME). Methods  This study involved 42 children (84 ears) with bilateral OME. We used tympanometry to confirm the childreńs middle ear effusion and pure tone audiometry to determine hearing threshold. We performed myringotomy and inserted ventilation tubes (VTs) bilaterally, followed by a steroid injection of 0.4–0.6 mL methylprednisolone (40 mg/mL) into one randomly selected middle ear. This procedure was followed by once-weekly administration of steroids (0.5 mL methylprednisolone at a concentration of 40 mg/mL) into the middle ear for three consecutive weeks. Results  We found recurrent OME after VT alone in nine (21.4%) ears; whereas, after VT combined with steroid administration, we found two (4.76%), with statistically significant difference. We noted tympanosclerosis postoperatively in six (12.9%) ears and in one of the injected ears (2.3%) (p = 0.0484). Otorrhea occurred in eight (19%) ears with VT alone and in three (7.1%) injected ears, with non-significant difference. The duration between VT insertion and its extrusion was 6.6 = 1.1 months for ears with VT alone and 6.95 =1.12 months in injected ears (p = 0.1541 NS). Conclusion  IT Steroids injection for treatment of OME is a safe and simple intervention with lower incidence of symptoms recurrence and postoperative complications. Thus, its use in management of OME is recommended.

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

    PubMed

    Cheeseman, Michael T; Tyrer, Hayley E; Williams, Debbie; Hough, Tertius A; Pathak, Paras; Romero, Maria R; Hilton, Helen; Bali, Sulzhan; Parker, Andrew; Vizor, Lucie; Purnell, Tom; Vowell, Kate; Wells, Sara; Bhutta, Mahmood F; Potter, Paul K; Brown, Steve D M

    2011-10-01

    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 chronic OM. PMID

  11. Altered Expression of Middle and Inner Ear Cytokines in Mouse Otitis Media

    PubMed Central

    MacArthur, Carol J.; Pillers, De-Ann M.; Pang, Jiaqing; Kempton, J. Beth; Trune, Dennis R.

    2010-01-01

    Objectives/Hypothesis The inner ear is at risk for sensorineural hearing loss in both acute and chronic otitis media (OM), but the underlying mechanisms underlying sensorineural hearing loss are unknown. Previous gene expression array studies showed cytokine genes might be upregulated in the cochleas of mice with acute and chronic otitis media. This implies that the inner ear could manifest a direct inflammatory response to OM that may cause sensorineural damage. Therefore, to better understand inner ear cytokine gene expression during OM, quantitative RT-PCR and immunohistochemistry were performed on mouse models to evaluate middle and inner ear inflammatory and remodeling cytokines. Study Design Basic science experiment. Methods An acute OM model was created in Balb/c mice by a transtympanic injection of S. pneumoniae in one ear; the other ear used as a control. C3H/HeJ mice were screened for unilateral chronic OM with the non-infected ear serving as control. Results Both acute and chronic OM caused both the middle ear and inner tissues in these two mouse models to over express numerous cytokine genes related to tissue remodeling (TNFα, FGF, BMP) and angiogenesis (VEGF), as well as inflammatory cell proliferation (IL-1α,β, IL-2, IL-6). Immunohistochemistry confirmed that both the middle ear and inner ear tissues expressed these cytokines. Conclusion Cochlear tissues are capable of expressing cytokine mRNA that contributes to the inflammation and remodeling that occur in association with middle ear disease. This provides a potential molecular basis for the transient and permanent sensorineural hearing loss often reported with acute and chronic OM. Level of Evidence N/A PMID:21271590

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

    PubMed Central

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

    2015-01-01

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

  13. Amoxicillin/clavulanic acid is ineffective at preventing otitis media in children with presumed viral upper respiratory infection: a randomized, double-blind equivalence, placebo-controlled trial

    PubMed Central

    Autret-Leca, Elisabeth; Giraudeau, Bruno; Ployet, Marie Joseph; Jonville-Béra, Annie-Pierre

    2002-01-01

    Aims To assess the equivalence of amoxicillin/clavulanic acid and placebo in the prevention of acute otitis media in children at high risk of acute otitis media who develop upper respiratory tract infection. Methods This was a multicentre, equivalence, randomized, double-blind trial of two parallel groups comparing 5 days of amoxicillin/clavulanic acid 75 mg kg−1 day−1 (i.e. 25 mg kg−1 every 8 h) and placebo. The main outcome measure was acute otitis media occurring within 8–12 days of initiating treatment. Results Two hundred and three infants, aged 3 months−3 years with upper respiratory tract infection over 36 h and a history of recurrent acute otitis media were included over 8.5 months. Two children were lost to follow-up. Patient characteristics were similar in both groups. In the intention to treat analysis the frequency of acute otitis media was 16.2% (16/99) in the placebo group and 9.6% (10/104) in the amoxicillin/clavulanic acid group (P= 0.288). The difference between acute otitis media rates was 6.6% (one-sided 95% confidence interval of 14.3%). The occurrence of side-effects was similar in the amoxicillin/clavulanic acid and placebo groups. Conclusions The difference in effectiveness between antibiotic and placebo was not greater than 14.3%, and we calculated that 94 children would need to be exposed to antibiotics to avoid six cases of acute otitis media. In view of the risk of development of resistance due to frequent exposure to antibiotics, our study supports the need for reduction in the administration of antibiotics in upper respiratory tract infection even in children at high risk of acute otitis media. PMID:12492614

  14. Isolation of Alloiococcus otitidis from Indigenous and non-Indigenous Australian children with chronic otitis media with effusion.

    PubMed

    Ashhurst-Smith, Christopher; Hall, Sharron T; Walker, Paul; Stuart, John; Hansbro, Philip M; Blackwell, C Caroline

    2007-10-01

    During the last decade Alloiococcus otitidis has been identified in specimens from patients with chronic otitis media with effusion. Whereas most of those studies employed molecular techniques, we used minor modifications of conventional microbiological methods to isolate and identify A. otitidis in samples obtained from 20/50 (40%) children referred for myringotomy. Alloiococcus otitidis was isolated from 10/22 (45%) Indigenous and 10/28 (36%) non-Indigenous children. This is the first report of isolation of A. otitidis from Australian children with chronic otitis media. All isolates were sensitive to penicillin, but 14/20 (70%) of the isolates were resistant or partially resistant to erythromycin as assessed by the E-test. PMID:17666076

  15. Multiple Streptococcus pneumoniae Serotypes in Aural Discharge Samples from Children with Acute Otitis Media with Spontaneous Otorrhea

    PubMed Central

    Rodrigues, Fernanda; Morales-Aza, Begonia; Turner, Katy M. E.; Sikora, Paulina; Gould, Katherine; Hinds, Jason; Gonçalves, Guilherme; Januário, Luís

    2013-01-01

    Among 55 children with cultures positive for acute otitis media with spontaneous otorrhea, 28 (51%) had cultures positive for aural Streptococcus pneumoniae, and in 10 of these, two distinct strains were detected, in which 5 had pairs of strains that were both capsule-bearing serotypes. Such cases were more likely to have cultures positive for other otopathogens than those with only one pneumococcus present. PMID:23885003

  16. OTO-201: Nonclinical Assessment of a Sustained-Release Ciprofloxacin Hydrogel for the Treatment of Otitis Media

    PubMed Central

    Wang, Xiaobo; Fernandez, Rayne; Tsivkovskaia, Natalia; Harrop-Jones, Anne; Hou, Huiying J.; Dellamary, Luis; Dolan, David F.; Altschuler, Richard A.; LeBel, Carl; Piu, Fabrice

    2014-01-01

    Hypothesis OTO-201 can provide sustained release to the middle ear and effectively treat otitis media, when compared with FDA-approved ciprofloxacin otic drop formulations. Background There is an unmet medical need for antibiotic therapy that can provide a full course of treatment from a single administration by an otolaryngologist at the time of tympanostomy tube placement, obviating the need for twice daily multiday treatment with short-acting otic drops. Methods Studies in guinea pigs and chinchillas were conducted. OTO-201 was administered as a single intratympanic injection and compared with the twice daily multi-day treatment with Ciprodex or Cetraxal otic drops. Results OTO-201 demonstrated sustained release of ciprofloxacin in the middle ear compartment for days to approximately 2 weeks depending on the dose. The substantial Cmax values and steady drug exposure yielded by OTO-201 were in contrast to the pulsatile short lasting exposure seen with Ciprodex and Cetraxal. OTO-201 was also effective in a preclinical chinchilla model of Streptococcus pneumoniae–induced otitis media. The degree of cure was comparable to that afforded by Ciprodex and Cetraxal. There was no evidence of middle or inner ear pathology in guinea pigs treated with OTO-201, unlike Ciprodex and Cetraxal, which both demonstrated mild cochlear ototoxicity. No adverse effects of the poloxamer 407 vehicle were noted. Conclusion Intratympanic injection of OTO-201 constitutes an attractive treatment option to twice daily multiday dosing with ciprofloxacin ear drops for the treatment of otitis media, as evidenced by superior middle ear drug exposure, efficacy in an acute otitis media model, safety of administration, and convenience of a single dose regimen. PMID:24518407

  17. [Effect of recombinant interleukin-1 beta on microbial flora of the middle ear in patients with chronic purulent otitis media].

    PubMed

    Riazantsev, S V; Chernushevich, I I

    2000-01-01

    Betaleukin was given to 60 patients with various forms of otitis media purulenta chronica (OMPC). Symptoms of the purulent exacerbation were relieved in 43.3% of the patients, the clinical course improved in 18.3%. No response was achieved in 40% of the treated patients. Betaleukin proved highly effective in management of exacerbations of uncomplicated OMPC though it has no direct antimicrobial activity. PMID:10846490

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

    PubMed Central

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

    2015-01-01

    Background 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. Material/Methods 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. Results 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. Conclusions 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. PMID:26259623

  19. Use of Transrenal DNA for the Diagnosis of Extrapulmonary Tuberculosis in Children: a Case of Tubercular Otitis Media

    PubMed Central

    Petrucci, Roberta; Corsini, Ilaria; Visciotti, Francesca; Pirodda, Antonio; Cazzato, Salvatore; Landini, Maria Paola; Dal Monte, Paola

    2014-01-01

    The diagnosis of tuberculosis (TB) is difficult in children, especially for smear-negative pulmonary and extrapulmonary TB, which are common at this age. We report an 11-year-old girl with TB otitis media with negative smear microscopy and Xpert MTB/RIF but positive Mycobacterium tuberculosis-specific transrenal DNA (Tr-MTB-DNA) test results and culture for M. tuberculosis. PMID:25339389

  20. Formulation of Thermosensitive in situ Otic Gel for Topical Management of Otitis Media

    PubMed Central

    Shau, P. A.; Dangre, P. V.; Potnis, V. V.

    2015-01-01

    Antibiotics and antiinflammatory agents are the primary and main therapeutic categories in the treatment of otitis media. One of the simpler and feasible approaches of minimizing the problem of repeated use and subsequent resistance is development of sustained release formulation. Therefore, the present investigation aimed to develop a sustained release in situ gel formulation containing combination of broad spectrum antibiotic and antiinflammatory agents for the management of otits media. The prolonged release is achieved by phase transition of Poloxamer 407 (in situ) from sol to gel at a physiological temperature in combination with viscosity imparting agent Natrasol 250 and Klucel HF. The formulation P3N3 (19% w/v Poloxamer 407, 1.5% w/v Natrasol 250) and P3K3 (19% w/v Poloxamer 407, 1.5% w/v Klucel HF) showed mucoadhesive strength 37.17±0.32×103 and 38.12±0.13×103 dyne/cm2, respectively, and gel strength 2.1 and 2 cm, respectively. Both these formulations indicated good drug content and viscosity besides a good gelling ability. The in vitro diffusion has demonstrated prolongation of release of both the drugs over a period of 8 h. PMID:26997706

  1. Otitis media in a population of black American and white American infants, 0-2 years of age.

    PubMed

    Casselbrant, M L; Mandel, E M; Kurs-Lasky, M; Rockette, H E; Bluestone, C D

    1995-08-01

    To determine the incidence of otitis media (OM) and the bacteriology of acute otitis media (AOM) in a clinic population of young children in Pittsburgh, 138 black infants and 60 white infants were followed from birth to 2 years of age, examined at monthly intervals and whenever an upper respiratory tract infection (URI) or OM intervened. By 24 months of age the cumulative incidence of episodes of AOM was 43% and 42%, and of episodes of middle-ear effusion (MEE) was 86% and 85% in black and white infants, respectively. The average rate of episodes of AOM was 0.41 and 0.39 and of episodes of MEE was 1.68 and 1.70 in black and white infants, respectively. Tympanocentesis was performed for episodes of AOM and the following organisms were isolated from black and white infants, respectively: Streptococcus pneumoniae 43% and 43% of episodes; Moraxella catarrhalis 24% and 24%; non-typable Haemophilus influenzae 18% and 24%; and Haemophilus influenzae type b 5% and 0%. In both black and white infants first born children had less ear disease. We found no difference in the incidence of otitis media during the first 2 years of life between black and white infants. PMID:7558637

  2. Surgical approaches to treating otitis media in the only hearing ear of patients with contralateral hearing loss

    PubMed Central

    Tong, Jun; Chen, Wenwen; Deng, Yaxin; Cai, Xunhua; Shan, Liang; Du, Lijun

    2015-01-01

    The aim of this study was to retrospectively analyze the surgical procedures used to treat the only hearing ears of two patient cohorts diagnosed with otitis media in the last twenty years. Clinical, surgical, and follow-up data of 15 patients with otitis media in the only hearing ear who underwent middle ear surgery prior to 2000 (Cohort A) and 13 patients with a similar condition (Cohort B) who underwent middle ear surgery between 2000 and 2013 were retrospectively collected, analyzed, and compared. Mean preoperative air conduction (AC) and bone conduction of the patients in Cohort B was 61 ± 18.7 and 20 ± 15.7 dBHL, respectively. Mean preoperative and postoperative air bone gap was 43.21 ± 13.2 dBHL and 12.66 ± 3.93 dBHL, respectively. The success rate of the surgical procedures in this patient cohort was 85%. Surgery of the only hearing ear in patients with otitis media is safe and effective if performed carefully. PMID:26309687

  3. Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children?

    PubMed Central

    Tähtinen, Paula A.; Ruuskanen, Olli; Löyttyniemi, Eliisa; Ruohola, Aino

    2015-01-01

    Objective Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians’ time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spectral gradient acoustic reflectometry (SG-AR) to exclude AOM. Design Three nurses were trained, who performed examinations with tympanometry and SG-AR. Pneumatic otoscopy by the study physician served as the diagnostic standard. Setting Study clinic at primary health care level. Patients. 281 children 6–35 months of age. Main outcome measures Predictive values (with 95% confidence interval) for tympanometry and SG-AR, and the clinical usefulness, i.e. the proportion of visits where nurses obtained the exclusive test result from both ears of the child. Results At 459 visits, the negative predictive value of type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) was 94% (91–97%). Based on type A and C1 tympanograms, the nurse could exclude AOM at 94/459 (20%) of visits. The negative predictive value of SG-AR level 1 result (>95°) was 94% (89–97%). Based on the SG-AR level 1 result, the nurse could exclude AOM at 36/459 (8%) of visits. Conclusion Type A and C1 tympanograms and SG-AR level 1 results obtained by nurses are reliable test results in excluding AOM. However, the clinical usefulness of these test results is limited by their rarity. Type A and C1 tympanograms were obtained by nurses from both ears of the child only at one-fifth of the symptomatic visits.Key PointsAcute otitis media (AOM) is the most prevalent bacterial infection in young children. Nurses’ role in excluding AOM is unknown.Type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) obtained by nurses are reliable test results in excluding AOM.With type A and C1 tympanograms, nurses could exclude AOM only at one-fifth of the symptomatic visits.The clinical usefulness

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

    PubMed

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

    2015-10-01

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

  5. Characterization of the T-cell subpopulations in the granulation tissues of chronic suppurative otitis media

    PubMed Central

    WANG, BING; CHENG, YING; XU, MIN

    2016-01-01

    The present study aimed to investigate the potential involvement of specific T-cell subpopulations in granulation tissue formation in chronic suppurative otitis media (CSOM). Fifteen patients with CSOM were enrolled in this study. Granulation tissues were obtained from the middle ear cavity. Hematoxylin and eosin staining was performed for histopathological observation, and different T-cell subpopulations were characterized by immunohistochemistry. No evident association was identified between granulation tissue formation and disease course. The number of cluster of differentiation 8+ (CD8+) T cells, forkhead box P3+ (FOXP3+) regulatory T (Treg) cells and OX40+ T cells were significantly higher in granulation tissues from patients with ear discharge within the last 6 months compared to those without (P<0.05). Fresh granulation tissues had more CD8+ T cells and FOXP3+ Treg cells compared to the mature granulation tissues (P<0.05). There was a differential abundance of specific T-cell subpopulations in the granulation tissues in CSOM with different disease courses or with ear discharge, suggesting that T cell-mediated cellular immunity is involved in lesion formation of CSOM. PMID:27313854

  6. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis.

    PubMed

    Kim, Chang-Hee; Yang, Young Soo; Im, Donghyuk; Shin, Jung Eun

    2016-06-01

    Conclusion The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. Objective This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. Methods From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. Results The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment. PMID:26797398

  7. Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations.

    PubMed

    Bhutta, Mahmood F

    2015-04-01

    Otitis media (OM; inflammation of the middle ear) comprises a group of disorders that are among the most common disorders of childhood. OM is also heritable and has effects on fecundity. This means that OM is subject to evolution, yet the evolutionary forces that may determine susceptibility to OM have not been adequately explored. Here I analyze evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those affecting function of the middle ear, host immunity, or colonization by and pathogenicity of bacteria. I review existing evolutionary models of host-pathogen interaction and coevolution and apply these to better understand the complex evolutionary landscape of middle ear infection and inflammation in humans, including factors determining transition between stable evolutionary strategies for host and bacteria. This understanding is then applied to an analysis of OM in indigenous populations to devise a new theory for OM prevalence in Australian Aborigine, Native American, Inuit, and Maori populations. I suggest that high prevalence in such groups may have resulted from encounters of these previously isolated populations with European immigrants in the 15th and 16th centuries. This exposed them to new strains of bacteria to which their immune system had not evolved immunity, perturbing a previously stable host-pathogen coevolutionary state. PMID:26829293

  8. Unraveling the genetics of otitis media: from mouse to human and back again.

    PubMed

    Rye, Marie S; Bhutta, Mahmood F; Cheeseman, Michael T; Burgner, David; Blackwell, Jenefer M; Brown, Steve D M; Jamieson, Sarra E

    2011-02-01

    Otitis media (OM) is among the most common illnesses of early childhood, characterised by the presence of inflammation in the middle ear cavity. Acute OM and chronic OM with effusion (COME) affect the majority of children by school age and have heritability estimates of 40-70%. However, the majority of genes underlying this susceptibility are, as yet, unidentified. One method of identifying genes and pathways that may contribute to OM susceptibility is to look at mouse mutants displaying a comparable phenotype. Single-gene mouse mutants with OM have identified a number of genes, namely, Eya4, Tlr4, p73, MyD88, Fas, E2f4, Plg, Fbxo11, and Evi1, as potential and biologically relevant candidates for human disease. Recent studies suggest that this "mouse-to-human" approach is likely to yield relevant data, with significant associations reported between polymorphisms at the FBXO11, TLR4, and PAI1 genes and disease in humans. An association between TP73 and chronic rhinosinusitis has also been reported. In addition, the biobanks of available mouse mutants provide a powerful resource for functional studies of loci identified by future genome-wide association studies of OM in humans. Mouse models of OM therefore are an important component of current approaches attempting to understand the complex genetic susceptibility to OM in humans, and which aim to facilitate the development of preventative and therapeutic interventions for this important and common disease. PMID:21107580

  9. Complementary and Alternative Medicine Treatment Options for Otitis Media: A Systematic Review.

    PubMed

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

    2016-02-01

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

  10. The Efficacy of Nasal Steroids in Treatment of Otitis Media with Effusion: A Comparative Study

    PubMed Central

    El-Anwar, Mohammad Waheed; Nofal, Ahmad Abdel-Fattah; Khazbak, Alaa Omar; Sayed, Ahmad Ebrahim El; Hassan, Mohammad Ramadan

    2015-01-01

    Introduction Otitis media with effusion (OME) continues to be an important pediatric clinical problem, and more studies are needed to decide the proper treatment for it. Objective To assess the efficacy of nasal steroids in the management of OME by comparing its results with that of oral steroid and that of nasal saline spray as placebo. Methods This study was carried on 60 patients with OME who were divided into three groups: in group 1, 20 patients received mometasone furoate spray, one puff in each nostril daily, for 3 months; in group 2, 20 patients received oral prednisolone, 5 mg three times per day for the first 3 weeks; in group 3, 20 patients received nasal saline spray, one puff in each nostril daily for 3 months. Results A highly significant difference between systemic or topical (nasal spray) steroid therapy and saline nasal spray was detected (p < 0.001), and the difference between systemic and topical steroid was nonsignificant (p > 0.05). Conclusion Nasal steroid spray can be used as an effective treatment for OME, giving a significant result similar to systemic steroid. Further studies are needed to investigate its use for longer duration and in recurrent cases. PMID:26491474

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

    PubMed Central

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

    2016-01-01

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

  12. Ten-Year Study of Acute Otitis Media in Rochester, NY.

    PubMed

    Pichichero, Michael E

    2016-09-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, involving 760 children where virtually all clinically diagnosed acute otitis media (AOM) was confirmed by bacterial culture of middle ear fluid. This review describes detection of otopathogens in middle ear fluid, nasopharyngeal (NP) otopathogen colonization patterns, AOM risk factor analysis, biomarkers of AOM and antibody responses to NP colonization by otopathogens. After licensure of PCV13, there was an immediate drop in AOM caused by Streptococcus pneumoniae (Spn) vaccine serotypes and shortly thereafer an increase in nonvaccine types 16, 21 and 35B. When NP co-colonization occurred, nontypeable Haemophilus influenzae (NTHi) predominated over Spn to cause AOM, and NTHi and Spn both predominated over Moraxella catarrhalis. Transcriptome analysis of peripheral blood mononuclear cells identified unique signatures for NTHi AOM compared with Spn AOM. Elevation of 3 cytokines in serum (S100A12, intercellular adhesion molecule 1 and interleukin 10) accurately predicted the presence and recovery from AOM and the likely otopathogen. NP colonization was an immunizing event. PMID:27182898

  13. Microbiology of Chronic Suppurative Otitis Media in a Tertiary Care Setup of Uttarakhand State, India

    PubMed Central

    Prakash, Rajat; Juyal, Deepak; Negi, Vikrant; Pal, Shekhar; Adekhandi, Shamanth; Sharma, Munesh; Sharma, Neelam

    2013-01-01

    Background: Chronic suppurative otitis media (CSOM) is a notorious infection and a major health problem in developing countries causing serious local damage and threatening complications. Early and effective treatment based on the knowledge of causative micro-organisms and their antimicrobial sensitivity ensures prompt clinical recovery and possible complications can thus be avoided. Aims: The aim of this study was to isolate the organisms associated with CSOM and to detect the antibiogram of the aerobic isolates. Materials and Methods: A total of 204 patients clinically diagnosed of CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and cultured for microbial flora. Drug susceptibility testing for aerobic isolates was conducted using Kirby-Bauer disc diffusion method. Results: The most common causative organisms isolated were Staphylococcus aureus (48.69%) and Pseudomonas aeruginosa (19.89%) amongst the 191 aerobic isolates. Anaerobes accounted for 29.41% of the isolates while 12.25% were fungi. Antimicrobial profile of aerobic isolates revealed maximum sensitivity to amikacin (95.5%), ceftriaxone (83.4%) and gentamicin (82.7%). Conclusion: Knowing the etiological agents of CSOM and their antimicrobial susceptibility is of essential importance for an efficient treatment, prevention of both complications and development of antibiotic resistance and finally, the reduction of the treatment costs. PMID:23724403

  14. Chronic Otitis Media Resulting in Aortic Valve Replacement: A Case Report.

    PubMed

    Guler, Adem; Sahin, Mehmet Ali; Gurkan Yesil, Fahri; Yildizoglu, Uzeyir; Demirkol, Sait; Arslan, Mehmet

    2015-04-01

    The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 (°)C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16(th) postoperative day in good condition. PMID:26110009

  15. The inflammasome adaptor ASC contributes to multiple innate immune processes in the resolution of otitis media.

    PubMed

    Kurabi, Arwa; Lee, Jasmine; Wong, Chelsea; Pak, Kwang; Hoffman, Hal M; Ryan, Allen F; Wasserman, Stephen I

    2015-02-01

    This study was designed to understand the contribution of the inflammasome and IL-1β activation in otitis media (OM). We examined the middle ear (ME) response to non-typeable Haemophilus influenzae (NTHi) in wild type (WT) mice using gene microarrays and a murine model of acute OM. Expression of members of the NOD domain-like receptor family of inflammasome genes was significantly up-regulated early in NTHi infection of the ME, potentially activating specific downstream regulatory cascades that contribute to the proliferative inflammatory response observed during OM. Expression of the pro-forms of the inflammasome targets IL-1β and IL-18 were also up-regulated. To evaluate the role of inflammasome-mediated cytokine maturation, NTHi-induced OM was examined in Asc(-/-)-deficient mice and compared with that seen in WT mice. Mice lacking the Asc gene showed near absence of IL-1β maturation in the ME and a reduction in leukocyte recruitment and infiltration to the cavity, and their macrophages exhibited reduced phagocytosis of NTHi. These inflammatory defects were linked to an increase in the degree and duration of mucosal epithelial hyperplasia in the ME of Asc(-/-) mice, as well as a delay in bacterial clearance from their MEs. These data demonstrate an important role for the inflammasome and cytokine processing in the course and resolution of OM. PMID:24652041

  16. Divergent mucosal and systemic responses in children in response to acute otitis media.

    PubMed

    Verhoeven, D; Pichichero, M E

    2014-10-01

    Acute otitis media (AOM), induced by respiratory bacteria, is a significant cause of children seeking medical attention worldwide. Some children are highly prone to AOMs, suffering three to four recurrent infections per year (prone). We previously determined that this population of children could have diminished anti-bacterial immune responses in peripheral blood that could fail to limit bacterial colonization in the nasopharynx (NP). Here, we examined local NP and middle ear (ME) responses and compared them to peripheral blood to examine whether the mucosa responses were similar to the peripheral blood responses. Moreover, we examined differences in effector cytokine responses between these two populations in the NP, ME and blood compartments at the onset of an AOM caused by either Streptococcus pneumoniae or non-typeable Haemophilus influenzae. We found that plasma effector cytokines patterned antigen-recall responses of CD4 T cells, with lower responses detected in prone children. ME cytokine levels did not mirror blood, but were more similar to the NP. Interferon (IFN)-γ and interleukin (IL)-17 in the NP were similar in prone and non-prone children, while IL-2 production was higher in prone children. The immune responses diverged in the mucosal and blood compartments at the onset of a bacterial ME infection, thus highlighting differences between local and systemic immune responses that could co-ordinate anti-bacterial immune responses in young children. PMID:24889648

  17. Expression of inflammatory mediators in the otitis media induced by Helicobacter pylori antigen in mice.

    PubMed

    Kariya, S; Okano, M; Fukushima, K; Nomiya, S; Kataoka, Y; Nomiya, R; Akagi, H; Nishizaki, K

    2008-10-01

    Helicobacter pylori is a Gram-negative bacterium that is recognized as one of the key factors in gastric diseases such as gastritis, peptic ulcer and gastric cancer. Recent studies have shown relationships between H. pylori and extra-digestive diseases, and the presence of H. pylori in the middle ear and upper respiratory tract has been reported. However, the role of H. pylori in middle ear disease remains unclear. The present study demonstrated that H. pylori whole-cell protein directly induces macrophage migration inhibitory factor, macrophage inflammatory protein 2, interleukin 1 beta and tumor necrosis factor alpha in middle ear epithelium in mice, and severe proliferation of inflammatory cells was observed in middle ear cavity inoculated with H. pylori whole-cell protein. In addition, trans-tympanic injection of macrophage migration inhibitory factor up-regulated expression of macrophage inflammatory protein 2 in the middle ear. These findings indicate that H. pylori infection causes immunological inflammation in middle ear epithelium, and H. pylori may play a significant role in otitis media. PMID:18727622

  18. Polymorphisms of Immunity Genes and Susceptibility to Otitis Media in Children

    PubMed Central

    Nokso-Koivisto, Johanna; Chonmaitree, Tasnee; Jennings, Kristofer; Matalon, Reuben; Block, Stan; Patel, Janak A.

    2014-01-01

    Background Acute otitis media (OM) is a common disease which often develops through complex interactions between the host, the pathogen and environmental factors. We studied single nucleotide polymorphisms (SNPs) of genes involved in innate and adaptive immunity, and other host and environmental factors for their role in OM. Methods Using Sequenom Massarray platform, 21 SNPs were studied in 653 children from prospective (n = 202) and retrospective (n = 451) cohorts. Data were analyzed for the relationship between SNPs and upper respiratory infection (URI) frequency, risk of acute OM during URI episodes, and proneness to recurrent OM. Results Increased risk for OM proneness was associated with CX3CR1 (Thr280Met) SNP and with a jointly interactive group of IL-10 (−1082) SNP, IL-1β (−511) wild type genotype and white race. Family history of OM proneness independently increased the risk for frequent URIs, OM occurrence during URI, and OM proneness. Additionally, IL-1β (−31) SNP was associated with increased risk for frequent URIs, but IL-10 (−592), IL-1β (−511), IL-5 (−746) and IL-8 (−251) SNPs were associated with decreased risk of URI. Conclusion IL-1β (−31), CX3CR1 (Thr280Met), IL-10 (−1082) and IL-1β (−511) SNPs were associated with increased risk for frequent URIs or OM proneness. PMID:24718616

  19. Shepard grommet tympanostomy tube complications in children with chronic otitis media with effusion.

    PubMed

    Yaman, Huseyin; Yilmaz, Suleyman; Alkan, Nihal; Subasi, Bugra; Guclu, Ender; Ozturk, Ozcan

    2010-08-01

    The objective of this study was to determine tympanostomy tube complications in children with chronic otitis media with effusion who were treated with Shepard grommet tympanostomy tube insertion. This tube type was selected as it is the most commonly used one in our clinic. The medical records of 162 ears of 87 children (52 male and 35 female) were reviewed retrospectively. The children were between 3 to 16 years old (mean age = 8.1 +/- 3.1). The patients were followed up 6-66 months (mean 23.3 +/- 14.9 months) after tympanostomy tube insertion. We reviewed age, sex, time to tube extrusion and complications. In all patients the indication for surgery was chronic middle ear effusion. Otorrhea occurred in nine ears (5.6%). Granulation tissue was seen in two ears (1.2%). Complications after tympanostomy tube extrusion included myringosclerosis (34.6%), persistent perforation (5.6%), atrophy (23.5%), retraction (16.7%) and medial displacement of tubes (1.2%). The average extrusion time was 8.5 +/- 4.6 months (range 1-24) for Shepard grommet tympanostomy tubes. Complications of tympanostomy tube insertion are common. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most frequently appearing complications. But they are generally insignificant and cosmetic. Consequently, in the majority of these complications there is no need for any management. PMID:20204390

  20. Adoption of Electronic Medical Record-Based Decision Support for Otitis Media in Children

    PubMed Central

    Fiks, Alexander G; Zhang, Peixin; Localio, A Russell; Khan, Saira; Grundmeier, Robert W; Karavite, Dean J; Bailey, Charles; Alessandrini, Evaline A; Forrest, Christopher B

    2015-01-01

    Objective Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence. Study Setting A total of 41,391 OM visits with 108 clinicians at 16 pediatric practices between February 2009 and August 2010. Study Design Prospective cohort study of EHR-based CDS adoption during OM visits, comparing clinicians receiving performance feedback to none. CDS was available to all physicians; use was voluntary. Data Collection Extraction from a common EHR. Principal Findings Clinicians and practices used the CDS system for a mean of 21 percent (range: 0–85 percent) and 17 percent (0–51 percent) of eligible OM visits, respectively. Clinicians who received performance feedback reports summarizing CDS use and guideline adherence had a relative increase in CDS use of 9.0 percentage points compared to others (p = .001). CDS adoption was associated with increased OM guideline adherence. Effects were greatest among clinicians with the lowest adherence prior to the study. Conclusions Performance feedback increased CDS adoption, but additional strategies are needed to integrate CDS into primary care workflows. PMID:25287670

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

    PubMed Central

    Jacobs, Jennifer

    2014-01-01

    Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM). Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032). Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach. PMID:27335917

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

    PubMed

    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

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

  3. Mouse Models for the Study of Mucosal Vaccination Against Otitis Media

    PubMed Central

    Sabirov, Albert; Metzger, Dennis W.

    2008-01-01

    Otitis media (OM) is one of the most common infectious diseases in humans. The pathogenesis of OM involves nasopharyngeal colonization (NP) and retrograde ascension of the pathogen up the Eustachian tube into the middle ear (ME). Due to increasing rates of antibiotic resistance, there is an urgent need for vaccines to prevent infections caused by the most common causes of bacterial OM, including nontypeable Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Current vaccine strategies aim to diminish bacterial NP carriage, thereby reducing the likelihood of developing acute OM. To be effective, vaccination should induce local mucosal mmunity both in the ME and in the NP. Studies in animal models have demonstrated that the intranasal route of vaccination is particularly effective at inducing immune responses in the nasal passage and ME for protection against OM. The mouse is increasingly used in these models, because of the availability of murine reagents and the existence of technology to manipulate murine models of disease immunologically and genetically. Previous studies confirmed the suitability of the mouse as a model for inflammatory processes in acute OM. Here, we discuss various murine models of OM and review the applicability of these models to assess the efficacy of mucosal vaccination and the mechanisms responsible for protection. In addition, we discuss various mucosal vaccine antigens, mucosal adjuvants and mucosal delivery systems. PMID:18295938

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

    PubMed

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

    2012-03-01

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

  5. Payment analysis of two diagnosis and management approaches of acute otitis media.

    PubMed

    Casey, Janet R; Pichichero, Michael E

    2014-08-01

    We determined the cost of care for 2 diagnosis and management approaches for acute otitis media (AOM) among children 6 to 30 months old. A case-control design was used. Cases included 208 children diagnosed with AOM based on a bulging tympanic membrane (TM) and treated with amoxicillin/clavulanate. Controls (5:1 ratio) included 1020 children with AOM diagnosed not requiring bulging of the TM and treated with amoxicillin. Fewer cases (49%) than controls (69%) were diagnosed with AOM (P < .001), fewer were diagnosed with recurrent AOM or AOM treatment failure (0.34 vs 1.6/child; P < .0001), and fewer had insertion of tympanostomy tubes (6.3% vs 14.8%) due to recurrent AOM (P < .0001). The combined direct payments and indirect costs for management of AOM were $539/case versus $1,023/control. Using Rochester NY payments generalized to the US birth cohort, this case diagnosis and treatment strategy could save $1.008 billion per year. PMID:24817077

  6. Auditory processing abilities in children with chronic otitis media with effusion.

    PubMed

    Khavarghazalani, Bahare; Farahani, Farhad; Emadi, Maryam; Hosseni Dastgerdi, Zahra

    2016-05-01

    Conclusion The study results indicate that children with a history of otitis media with effusion (OME) suffer from auditory processing disorder to some degree. The findings support the hypothesis that fluctuating hearing loss may affect central auditory processing during critical periods. Objectives Evidence suggests that prolonged OME in children can result in an auditory processing disorder, presumably because hearing has been disrupted during an important developmental period. A lack of auditory stimulation leads to the abnormal development of the hearing pathways in the brain. The aim of the present study was to determine the effects of OME on binaural auditory function and auditory temporal processing. Method In the present study, the dichotic digit test (DDT) was used for binaural hearing, and the gap in noise (GIN) test was used to evaluate temporal hearing processing. Results The average values of GIN differed significantly between children with a history of OME and normal controls (p < 0.001). The mean values of the DDT score were significantly different between the two groups (p = 0.002). PMID:26881324

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

    PubMed Central

    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

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

  8. Quality Measures for the Care of Children With Otitis Media With Effusion

    PubMed Central

    Peterson, Laura E.; Goudie, Anthony

    2011-01-01

    BACKGROUND: Current national efforts provide an opportunity to integrate performance measures into clinical practice and improve outcomes for children. OBJECTIVE: The goal of this study was to explore issues in developing and testing measures of care for children with otitis media with effusion (OME). METHODS: We assessed compliance with diagnostic, evaluation, and treatment measures for OME adapted from preliminary work of the Physician Consortium for Performance Improvement, using chart data in a convenience sample of practices from 2 primary care networks (Cincinnati Pediatric Research Group and the American Academy of Pediatrics Quality Improvement Innovation Network). Children aged 2 months to 12 years with at least 1 visit with a specified OME code during a 1-year period were included. RESULTS: Of 23 practices, 4 could not locate eligible visits. Nineteen practices submitted 378 abstractions (range: 3–37 per practice) with 15 identifying <30 eligible visits. Performance on diagnosis (33%) and hearing evaluation (29%) measures was low but high on measures of appropriate medication use (97% decongestant/antihistamine, 87% antibiotics, and 95% corticosteroids). Thirty-five percent of records documented antibiotic use concurrent with OME; only 16% of the 94 cases that cited reason for prescribing were appropriate. Using methods that consider appropriate clinical action, a more accurate rate for appropriate use of antibiotics was 68%. CONCLUSIONS: Coding, case finding, and evaluating appropriateness of treatment are some of the issues that will need to be considered to assess the care of children with OME. This study emphasizes the importance of testing proposed quality of care measures in “real-world” settings. PMID:21606146

  9. Parental acceptability of the watchful waiting approach in pediatric acute otitis media

    PubMed Central

    Broides, Arnon; Bereza, Olga; Lavi-Givon, Noga; Fruchtman, Yariv; Gazala, Eli; Leibovitz, Eugene

    2016-01-01

    AIM: To determine parental knowledge about acute otitis media (AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting (WW) approach in primary care settings in southern Israel. METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires (20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents (150 at each centers) of children < 6 years of age. RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach. PMID:27170930

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

    PubMed Central

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

    2016-01-01

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

  11. In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media

    PubMed Central

    2014-01-01

    Background The safety and efficacy of Ciprodex® has been demonstrated for treatment of chronic suppurative otitis media (CSOM). However, symptoms fail to resolve in 9-15% of patients. The objective of this study is to evaluate the efficacy of N-acetylcysteine (NAC) on S. aureus, and planktonic and sessile (biofilm forming) P. aeruginosa in vitro using clinical isolates from patients with CSOM. Methods 1) Stability was assessed using liquid chromatography-mass spectrometry for each component in a prepared mixture of Ciprodex® and NAC over 15 days. Sterility was assessed by measuring bacterial growth on a blood agar plate. Efficacy was assessed using a disc diffusion method by inoculating plates with S. aureus ATCC 29513 and P. aeruginosa ATCC 27853, and measuring the clearance zone. 2) Fifteen P. aeruginosa strains were isolated from patients with CSOM and tested in vitro using the bioFILM PA™ antimicrobial susceptibility assay. Treatment solutions included Ciprodex® & ciprofloxacin +/- NAC, and NAC alone (0.25%, 0.5% & 1.25%). Results 1) NAC combined with Ciprodex® demonstrated stability, sterility, and efficacy over a two-week period 2) P. aeruginosa strains in the sessile (33%-40%) and planktonic (13%) state demonstrated resistance to Ciprodex® and ciprofloxacin. When NAC ≥0.5% was used in isolation or as an adjunct to either of these medications, no resistance was found in the sessile or planktonic state among all 15 strains. Conclusion 1) Ciprodex® combined with NAC has a shelf life of at least two weeks given the documented preservation of stability, sterility, and clinical efficacy of the mixed compounds. 2) P. aeruginosa strains demonstrated resistance to both Ciprodex® and ciprofloxacin. NAC ≥0.5% overcomes issues with resistance and shows promise in the treatment of CSOM. PMID:25001062

  12. Observations on the Current Bacteriological Profile of Chronic Suppurative Otitis Media in South Eastern Nigeria

    PubMed Central

    Orji, FT; Dike, BO

    2015-01-01

    Background: Chronic suppurative otitis media (CSOM) is a disease well-known for its recurrence and persistence despite treatment. The situation is compounded by the increasing resistance to antimicrobial agents by bacteria these days. Aim: This study was carried out to examine the current local bacteriological profile of CSOM and to compare the profile of either ear in bilaterally discharging ears. Materials and Methods: We carried out a retrospective analysis of ear swab cultures from 133 unilateral and 73 bilateral consecutive tubotympanic CSOM cases seen at the Ear-Nose-Throat clinics of a referral health institution during a 4 year period ending 2013. Sensitivities to eight locally available antibiotics were analyzed. Aerobic bacterial isolates were analyzed separately for the unilateral and bilateral cases. Comparison was made between the ears in the bilateral cases. Results: We analyzed 279 ear swab culture results from 206 patients with age ranging from 5 months to 86 years and a mean of 21.3 (19.5) years. Pseudomonas aeruginosa was the most common isolated bacteria (44% [109/250]) followed by Staphylococcus aureus (17% [42/250]), and Proteus Mirabilis (15% [38/250]). The most and least sensitive bacteria were Klebsiella Spp and Escherichia Coli, respectively. The most effective antibiotics were gentamicin and ciprofloxacin. The two ears differ significantly in the rates of isolation of S. aureus and E. coli (P = 0.01 and P = 0.04, respectively). Conclusion: Pseudomonas is the most common bacteria involved in CSOM in this part of the country. Ciprofloxacin as ear drops is recommended as first-line drug in the management of active CSOM as it is cheap, less ototoxic, and locally available. Separate ear swab culture should be obtained in bilateral CSOM. PMID:25861532

  13. Otitis media in the Tgif knockout mouse implicates TGFβ signalling in chronic middle ear inflammatory disease

    PubMed Central

    Tateossian, Hilda; Morse, Susan; Parker, Andrew; Mburu, Philomena; Warr, Nick; Acevedo-Arozena, Abraham; Cheeseman, Michael; Wells, Sara; Brown, Steve D.M.

    2013-01-01

    Otitis media with effusion (OME) is the most common cause of hearing loss in children and tympanostomy to alleviate the condition remains the commonest surgical intervention in children in the developed world. Chronic and recurrent forms of OM are known to have a very significant genetic component, however, until recently little was known of the underlying genes involved. The identification of mouse models of chronic OM has indicated a role of transforming growth factor beta (TGFβ) signalling and its impact on responses to hypoxia in the inflamed middle ear. We have, therefore, investigated the role of TGFβ signalling and identified and characterized a new model of chronic OM carrying a mutation in the gene for transforming growth interacting factor 1 (Tgif1). Tgif1 homozygous mutant mice have significantly raised auditory thresholds due to a conductive deafness arising from a chronic effusion starting at around 3 weeks of age. The OM is accompanied by a significant thickening of the middle ear mucosa lining, expansion of mucin-secreting goblet cell populations and raised levels of vascular endothelial growth factor, TNF-α and IL-1β in ear fluids. We also identified downstream effects on TGFβ signalling in middle ear epithelia at the time of development of chronic OM. Both phosphorylated SMAD2 and p21 levels were lowered in the homozygous mutant, demonstrating a suppression of the TGFβ pathway. The identification and characterization of the Tgif mutant supports the role of TGFβ signalling in the development of chronic OM and provides an important candidate gene for genetic studies in the human population. PMID:23459932

  14. Determinants of non-healing ear discharge in chronic suppurative otitis media in a developing country.

    PubMed

    Orji, Foster Tochukwu; Dike, Benjamin O; Oji, Onuoha

    2015-10-01

    The major burden of chronic suppurative otitis media (CSOM) is the embarrassing ear discharge which may last for few months to many years or even a lifetime with increasing risks of complications. We conducted this study to determine the risk factors for protracted non-healing ear discharge among CSOM patients. We carried out a retrospective analysis of non-cholesteatomatous CSOM patients treated in a tertiary hospital in a developing country. Comparison was made between 128 patients with ear discharge persisting beyond 24 months and 58 patients whose otorrhoea resolved within 6 months in terms of socio-demographic and other potential risk factors. Major risk factors identified by logistic regression analysis were rural residence, multidrug-resistant bacteria, and bilateral CSOM (P = <0.001, 0.001, and 0.008, respectively). Others were onset of ear discharge before the age of 10 years, diabetes mellitus, persistent rhinorrhoea, home >10 miles away from hospital, and >7 persons in a family (P = 0.012, 0.041, 0.013, 0.010, and 0.043, respectively). Age, sex, nasal allergy, and self-medication were not significant risk factors for non-healing ear discharge. Protracted non-healing ear discharge still remains a prominent feature of CSOM in our experience. Rural residence, multidrug resistance, bilateral CSOM, and long distance to health facilities are prime risk factors. Measures to address these risk factors to bring about a decline in the number of non-healing ear discharge among CSOM patients, especially in our rural communities, are urgently needed. PMID:25178414

  15. Otitis Media in Sperm-Associated Antigen 6 (Spag6)-Deficient Mice

    PubMed Central

    Li, Xiaofei; Xu, Lei; Li, Jianfeng; Li, Boqin; Bai, Xiaohui; Strauss, Jerome F.; Zhang, Zhibing; Wang, Haibo

    2014-01-01

    Mammalian SPAG6 protein is localized to the axoneme central apparatus, and it is required for normal flagella and cilia motility. Recent studies demonstrated that the protein also regulates ciliogenesis and cilia polarity in the epithelial cells of brain ventricles and trachea. Motile cilia are also present in the epithelial cells of the middle ear and Eustachian tubes, where the ciliary system participates in the movement of serous fluid and mucus in the middle ear. Cilia defects are associated with otitis media (OM), presumably due to an inability to efficiently transport fluid, mucus and particles including microorganisms. We investigated the potential role of SPAG6 in the middle ear and Eustachian tubes by studying mice with a targeted mutation in the Spag6 gene. SPAG6 is expressed in the ciliated cells of middle ear epithelial cells. The orientation of the ciliary basal feet was random in the middle ear epithelial cells of Spag6-deficient mice, and there was an associated disrupted localization of the planar cell polarity (PCP) protein, FZD6. These features are associated with disordered cilia orientation, confirmed by scanning electron microscopy, which leads to uncoordinated cilia beating. The Spag6 mutant mice were also prone to develop OM. However, there were no significant differences in bacterial populations, epithelial goblet cell density, mucin expression and Eustachian tube angle between the mutant and wild-type mice, suggesting that OM was due to accumulation of fluid and mucus secondary to the ciliary dysfunction. Our studies demonstrate a role for Spag6 in the pathogenesis of OM in mice, possibly through its role in the regulation of cilia/basal body polarity through the PCP-dependent mechanisms in the middle ear and Eustachian tubes. PMID:25393619

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

    PubMed Central

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

    2015-01-01

    Introduction: In developing countries, chronic otitis media (COM) and cholesteatoma are relatively prevalent. Within the field of otology, COM surgery remains one of the most common surgical treatments. Most recent studies evaluating the potential prognostic factors in COM surgery have addressed graft success rate and types of middle ear and mastoid pathology. There has been much controversy about this issue until the present time. This study evaluated the effect of cholesteatoma on the GSR in COM surgery. Materials and Methods: The present retrospective, case-controlled study investigated 422 ears undergoing COM surgery. The minimum and maximum postoperative follow-up periods were 6 and 48 months, respectively. The study group consisted of patients with cholesteatomatous COM, while the control group included patients with non-cholesteatomatous COM, who had undergone ear surgery. Postoperative graft success rate and audiological test results were recorded and the effect of cholesteatoma on graft success rate was investigated. Results: The overall GSR was 92.4%. In the study group (COM with cholesteatoma),the postoperative GSR, mean speech reception threshold improvement, and mean air-bone gap gain were 95.3%, 2.1 dB, and 3.2 dB, respectively. In the control group (COM without cholesteatoma), however, these measurements were 90.9%, 9.4 dB, and 9.1 dB, respectively. The difference between the two groups was not statistically significant. Conclusion: The study results suggest that cholesteatoma is not a significant prognostic factor in graft success rate. PMID:26788485

  17. Comparative Study of Two Different Myringoplasty Techniques in Mucosal Type of Chronic Otitis Media

    PubMed Central

    Murugendrappa, Mallikarjunappa Ajjampura; Siddappa, Prakash Naganahalli; Basavaraj, Girish Pattanada

    2016-01-01

    Introduction Myringoplasty is a surgical procedure used to close the perforation of pars tensa of the tympanic membrane and to improve the hearing loss. Aim To compare the two different techniques of myringoplasty- circumferential subannular grafting technique and conventional underlay technique in cases of chronic otitis media with inactive mucosal disease. Materials and Methods This is a prospective study of 12 months (July 2014 to June 2015) duration conducted in Department of Otorhinolaryngology and Head and Neck Surgery, JJM Medical College, Davanagere and data was collected from the 50 patients admitted for myringoplasty, 25 in each group. Results were calculated in terms of graft success rate and improvement in hearing after 3 months postoperatively. Results A total of 50 cases are included in this study, out of which 21 were males and 29 were females with male to female ratio of 0.72:1. The success rate of graft take up by circumferential subannular grafting technique is 96% and by conventional underlay technique is 76% respectively. In circumferential subannular grafting technique, the pre-op mean PTA was 36.92db, and the post-op mean PTA after 3 months was 25.87 db with a mean difference in PTA (dB) was 11.05 with t value of 7.74. In case of conventional underlay technique, the pre-op mean PTA was 38.24 db, and the post-op mean PTA after 3 months was 30.28 db with a mean difference in PTA (dB) was 7.96 with t-value of 14.39. Conclusion The study showed that circumferential grafting technique is superior in graft success rate and postoperative hearing improvement when compared to conventional underlay technique. PMID:27042491

  18. Development of a non-invasive murine infection model for acute otitis media.

    PubMed

    Stol, K; van Selm, S; van den Berg, S; Bootsma, H J; Blokx, W A M; Graamans, K; Tonnaer, E L G M; Hermans, P W M

    2009-12-01

    Otitis media (OM) is one of the most frequent diseases in childhood, and Streptococcus pneumoniae is among the main causative bacterial agents. Since current experimental models used to study the bacterial pathogenesis of OM have several limitations, such as the invasiveness of the experimental procedures, we developed a non-invasive murine OM model. In our model, adapted from a previously developed rat OM model, a pressure cabin is used in which a 40 kPa pressure increase is applied to translocate pneumococci from the nasopharyngeal cavity into both mouse middle ears. Wild-type pneumococci were found to persist in the middle ear cavity for 144 h after infection, with a maximum bacterial load at 96 h. Inflammation was confirmed at 96 and 144 h post-infection by IL-1beta and TNF-alpha cytokine analysis and histopathology. Subsequently, we investigated the contribution of two surface-associated pneumococcal proteins, the streptococcal lipoprotein rotamase A (SlrA) and the putative proteinase maturation protein A (PpmA), to experimental OM in our model. Pneumococci lacking the slrA gene, but not those lacking the ppmA gene, were significantly reduced in virulence in the OM model. Importantly, pneumococci lacking both genes were significantly more attenuated than the DeltaslrA single mutant. This additive effect suggests that SlrA and PpmA exert complementary functions during experimental OM. In conclusion, we have developed a highly reproducible and non-invasive murine infection model for pneumococcal OM using a pressure cabin, which is very suitable to study pneumococcal pathogenesis and virulence in vivo. PMID:19762437

  19. Reduced iNOS expression in adenoids from children with otitis media with effusion.

    PubMed

    Granath, Anna; Norrby-Teglund, Anna; Uddman, Rolf; Cardell, Lars-Olaf

    2010-12-01

    Nitric oxide (NO) is a key mediator in the local immune response of human airways. Inducible NO-synthases (iNOS), and endothelial NO-synthases (eNOS) are two enzymes known to regulate its production. The role of NO in middle ear disease is not fully known. Previous studies suggest that NO might have a dual role, both promoting and suppressing middle ear inflammation. The aim of the present study was to compare the eNOS and iNOS expression in adenoids obtained from children with otitis media with effusion (OME) with the expression seen in adenoids derived from children without middle ear disease. In addition, the expression of IL-1β and TNF-α were analyzed, because of their role in the iNOS-induction pathway. The iNOS and eNOS expression were analyzed with real-time PCR in 8 OME and 11 control adenoids. The corresponding proteins were demonstrated by immunohistochemical staining of adenoid tissue. A Luminex(®) assay was performed to analyze IL-1β and TNF-α in nasopharyngeal secretion in 10 OME and 8 controls, and immunohistochemistry was performed on adenoid tissue and imprints from the adenoid surface. Children with OME exhibited lower levels of iNOS than controls without middle ear disease. No such difference was seen for eNOS. The corresponding proteins were found mainly in conjunction with surface epithelium. No significant changes were seen among the cytokines tested. The present results indicate that local induction of iNOS in adenoids might be of importance for preventing development of OME. PMID:21073541

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

    PubMed

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

    2010-09-01

    Acute otitis media (AOM) is an inflammatory response to microbes in the middle ear, sometimes associated with rupture of the tympanic membrane. Human leukocytes produce different patterns of inflammatory mediators in vitro when stimulated with Gram-positive and Gram-negative bacteria, respectively. Here, we investigated the cytokine and prostaglandin E2 (PGE2) responses in middle ear fluids (MEFs) from children with spontaneously perforated AOM, and related the mediator levels to the presence of pathogens detected by culture (live) or PCR (live or dead). Furthermore, the in vivo cytokine pattern was compared with that induced in leukocytes stimulated by dead bacteria in vitro. MEFs with culturable pathogenic bacteria contained more interleukin (IL)-1β (median: 110 μg/L vs. <7.5 μg/L), tumour necrosis factor (TNF) (6.3 μg/L vs. <2.5 μg/L), IL-8 (410 μg/L vs. 38 μg/L) and IL-10 (0.48 μg/L vs. <0.30 μg/L) than culture-negative fluids, irrespective of PCR findings. IL-6 and PGE2 were equally abundant (69-110 μg/L) in effusions with live, dead or undetectable bacteria. Cytokine levels were unrelated to bacterial species and to the presence or absence of virus. Similar levels of TNF and IL-6 as found in the MEFs were obtained by in vitro stimulation of leukocytes, whereas 11 times more IL-1β and 3.5 times more IL-8 were produced in vivo, and 22 times more IL-10 was produced in vitro. Vigorous production of proinflammatory cytokines accompanies AOM with membrane rupture, regardless of the causative agent, but the production seems to cease rapidly once the bacteria are killed and fragmented. IL-6 and PGE2, however, remain after bacterial disintegration, and may play a role in the resolution phase. PMID:19832705

  1. The homoeopathic treatment of otitis media in children--comparisons with conventional therapy.

    PubMed

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

    1997-07-01

    In a prospective observational study carried out by 1 homoeopathic and 4 conventional ENT practitioners, the 2 methods of treating acute pediatric otitis media were compared. Group A received treatment with homoeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea), whereas group B received nasal drops, antibiotics, secretolytics and/or antipyretics. The main outcome measures were duration of pain, duration of fever, and the number of recurrences after 1 year, whereby alpha < 0.05 was taken as significance level. The secondary measures were improvement after 3 hours, results of audiometry and tympanometry, and necessity for additional therapy. These parameters were only considered descriptively. The study involved 103 children in group A and 28 children in group B, aged between 6 months and 11 years in both groups. For duration of pain, the median was 2 days in group A and 3 days in group B. For duration of therapy, the median was 4 days in group A and 10 days in group B: this is due to the fact that antibiotics are usually administered over a period of 8-10 days, whereas homoeopathics can be discontinued at an earlier stage once healing has started. Of the children treated, 70.7% were free of recurrence within a year in group A and 29.3% were found to have a maximum of 3 recurrences. In group B, 56.5% were free of recurrence, and 43.5% had a maximum of 6 recurrences. Out of the 103 children in group A, 5 subsequently received antibiotics, though homoeopathic treatment was carried through to the healing stage in the remaining 98. No permanent sequels were observed in either group. PMID:9247843

  2. Tolerability of Oral Xylitol Solution in Young Children: Implications for Otitis Media Prophylaxis

    PubMed Central

    Vernacchio, Louis; Vezina, Richard M.; Mitchell, Allen A.

    2007-01-01

    Objective. Xylitol, given as two grams orally five times-a-day, significantly reduces the incidence of acute otitis media (AOM) in children. A less frequent dosing schedule, if tolerable and efficacious, would promote the more widespread use of this treatment. We sought to determine the tolerability and acceptability in young children of oral xylitol solution at doses of 5 grams three times-a-day (TID) and 7.5 grams once daily (QD). Methods. The study was a three-month randomized placebo-controlled trial of the tolerability and acceptability of oral xylitol solution in 120 children 6-36 months of age performed in the SCOR Network. Results. Study withdrawals and unscheduled medical visits for gastrointestinal complaints did not differ significantly among the study groups. The proportions of subjects in the xylitol TID group who experienced excessive gas or diarrhea at months one, two, and three were 22.7%, 10.0%, and 14.3%, respectively, and in the xylitol QD group were 27.3%, 17.4%, and 14.3%, respectively, and these did not differ from the placebo groups. The proportions who accepted the study solution easily or with only minor difficulty at one, two, and three months in the xylitol TID group were 77.3%, 90.0%, and 90.5% and in the xylitol QD group, 77.3%, 82.6%, and 90.5%, respectively. Conclusions. Oral xylitol solution at dosages of 5 grams TID and 7.5 grams QD is well-tolerated by young children. Given the potential for xylitol as a safe, inexpensive option for AOM prophylaxis, clinical trials using these dosages of xylitol can be conducted. PMID:17097152

  3. The rationale for preventive treatments for early post-tympanostomy tube otorrhea in persistent otitis media with effusion.

    PubMed

    Faramarzi, Mohammad; Roosta, Sareh; Shishegar, Mahmood; Abbasi, Rohollah; Atighechi, Saeid

    2016-06-01

    Some studies have shown that post-tympanostomy tube otorrhea (PTTO) is a common complication after tympanostomy tube insertion. There are wide range of controversies about the incidence of PTTO and different methods of preventive treatment. The aim of this study was to determine the incidence of early PTTO in persistent otitis media with effusion in our centers. We also investigated the effect of preventive treatments on the incidence of early PTTO in children with persistent otitis media with effusion. This multi-central study comprised 536 ears belonging to children with otitis media and effusion for at least 3 months, referred for complications arising from post-tympanostomy tube insertion. The patients were randomly divided into three treatment and control groups. In the first group of patients, the middle ear cavity was irrigated with isotonic saline after myringotomy. The second group received oral amoxicillin three times a day for 7 days postoperatively. The third group had similar treatment as the second group, in addition to topical ciprofloxacin drop, 4 drops three times a day for 3 days after operation. The control group did not undergo any treatment. Early post-tympanostomy tube otorrhea was detected in 6 ears (1.1 %), including 3 (2.2 %) from the control group and 3 (2.3 %) from the first group. There was no statistically significant difference in early PTTO between integrated treatment groups and control group (P = 0.111). As the total rate of early post-tympanostomy tube otorrhea was very low, there was no significant difference between the 3 treatment groups and control group. Our study did not support the routine use of preventive therapy. A period of at least 3 months watchful waiting before tympanostomy tube insertion may help reduce the incidence of PTTO. PMID:26153378

  4. Streptococcus pneumoniae Serotype 3 among Costa Rican Children with Otitis Media: clinical, epidemiological characteristics and antimicrobial resistance patterns

    PubMed Central

    Abdelnour, Arturo; Soley, Carolina; Guevara, Silvia; Porat, Nurith; Dagan, Ron; Arguedas, Adriano

    2009-01-01

    Background After the introduction of the seven valent-pneumococcal conjugated vaccine into our National Immunization Program, it is important to establish and track local serotype distribution in order to evaluate its impact specially because serotype replacement phenomena has been described. To describe the clinical, epidemiological and antimicrobial resistance patterns of Costa Rican children with otitis media caused by Streptococcus pneumoniae serotype 3. Methods Middle ear fluid samples were obtained from Costa Rican children with otitis media who participated in various antimicrobial clinical trials between 1992 and 2007. Streptococcus pneumoniae was identified according to laboratory standard procedures. Strains were serotyped and antimicrobial susceptibility to penicillin, amoxicillin, cefuroxime, ceftriaxone, azithromycin and levofloxacin was determined by E-test. Results Throughout 1992–2007 a total of 1919 tympanocentesis were performed in children with otitis media (median age: 19 months) and yielded a total of 1208 middle ear isolates. The most common pathogens were: Streptococcus pneumoniae, 511 isolates (49%); Non-Typable Haemophilus influenzae, 386 isolates (37%); Moraxella catarrahalis, 100 isolates (9.5%); and Streptococcus pyogenes, 54 isolates (5%). Streptococcus pneumoniae serotyping was performed in 346/511 isolates (68%) recovered during years 1999–2006. The most common serotypes were 19F (101/30.0%), 14 (46/13.7%), 3 (34/10.1%), 6B (30/8.9%) and 23F (23/6.8%). Analysis performed per years showed a higher prevalence of serotype 3 Streptococcus pneumoniae during the study period 2004 and 2005. During the entire study period (1999–2006) serotype 3 was most commonly isolated in children older than 24 months (61.2% vs 40.6%;P = 0.05) and showed a lower rate of penicillin non-susceptibility (4.0% vs 18%; P = 0.003). Conclusion Streptococcus pneumoniae serotype 3 is an important pathogen in Costa Rican children with otitis media, especially in

  5. Extensive dural sinus thrombosis and bilateral lateral rectus palsy as an uncommon complication of chronic suppurative otitis media

    PubMed Central

    Balasubramanian, Anusha; Mohamad, Irfan; Sidek, Dinsuhaimi

    2013-01-01

    Dural venous sinus thrombosis, especially of the sigmoid sinus, is a known but uncommon intracranial extradural complication of chronic suppurative otitis media. Even rarer is the simultaneous occurrence of bilateral abducens palsy in the same patient. We report the case of an adolescent male who presented with signs of raised intracranial pressure, diplopia and bilateral lateral rectus palsy associated with a history of left ear discharge and neck swelling. Extensive dural sinus thrombosis extending right up to the left internal jugular vein was confirmed on CT imaging. The patient was successfully treated with thrombolytic agents and antibiotic therapy. The pathophysiology of the concurrent complications is discussed. PMID:23355565

  6. Two cases of severe head-banging parasomnias in peripubertal males resulting from otitis media in toddlerhood.

    PubMed

    Bramble, D

    1995-07-01

    The author presents two case reports of peripubertal boys with severe and chronic head-banging parasomnias, or rhythmic movement disorders (RMDs), which started de novo whilst they were suffering from recurrent and severe otitis media in toddlerhood. Treatment consisting of straightforward behaviour modification techniques and advice concerning healthy sleeping habits proved highly successful. It is proposed that these late-onset or 'acquired' forms of RMD might be distinct from those which continue from infancy which have a stronger developmental aetiology. PMID:7554105

  7. Efficacy of single-dose ceftriaxone in experimental otitis media induced by penicillin- and cephalosporin-resistant Streptococcus pneumoniae.

    PubMed Central

    Barry, B; Muffat-Joly, M; Bauchet, J; Faurisson, F; Gehanno, P; Pocidalo, J J; Carbon, C

    1996-01-01

    We used a gerbil model of otitis media to assess the efficacy of single-dose ceftriaxone against three Streptococcus pneumoniae strains highly resistant to penicillin (MICs, 4 to 8 micrograms/ml) and with various susceptibilities to ceftriaxone (MICs, 0.5, 4, and 8 micrograms/ml). Middle ear infection was induced by bilateral transbullar challenge with 10(7) bacteria per ear. Antibiotic treatment was administered subcutaneously at 2 h postinfection. Infection status was checked 2 days later by counting the bacteria in middle ear and cerebrospinal fluid samples. With the cefriaxone-susceptible strain (MIC, 0.5 microgram/ml), we tested doses of 5 to 100 mg/kg of body weight. With a dose of 50 mg/kg, treatment outcome was equivalent to that with amoxicillin, which was used as a reference (25 mg/kg, two injections); no bacteria were recovered from 82% of the middle ear samples, and the rate of cerebrospinal fluid culture positivity was significantly reduced to 6%, relative to 59% for the untreated controls. Similar efficacy was obtained with a dose of 100 mg/kg against the two ceftriaxone-resistant strains. Pharmacokinetic study indicates that the values of the parameters in plasma after the administration of a dose of 100 mg/kg (peak level of total drug, 268 +/- 33 micrograms/ml; elimination half-life, 0.8 h; area under concentration-time curve, 488 micrograms.h.ml-1) were still suboptimal compared with the values of the parameters measured in pediatric patients after intravenous or intramuscular administration of a dose of 50 mg/kg. Our results indicate the efficacy of ceftriaxone against experimental cephalosporin-resistant pneumococcal otitis and provide a basis for the clinical use of single-dose ceftriaxone against pneumococcal otitis media. PMID:8878566

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

    PubMed

    Di Pierro, Francesco; Di Pasquale, Daniele; Di Cicco, Maurizio

    2015-01-01

    Secretory otitis media (SOM) remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM), is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis(®)). After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. PMID:26396541

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

    PubMed Central

    Di Pierro, Francesco; Di Pasquale, Daniele; Di Cicco, Maurizio

    2015-01-01

    Secretory otitis media (SOM) remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM), is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®). After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. PMID:26396541

  10. Relationship of endotoxin to tumor necrosis factor-alpha and interleukin-1 beta in children with otitis media with effusion.

    PubMed

    Willett, D N; Rezaee, R P; Billy, J M; Tighe, M B; DeMaria, T F

    1998-01-01

    Sixty-five middle ear effusions and paired sera from 41 children with chronic otitis media with effusion were assayed for endotoxin and for tumor necrosis factor alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) in order to establish whether a correlation exists between the concentrations of endotoxin and of these cytokines. Endotoxin concentration was determined by means of a chromogenic limulus amebocyte lysate assay, and the cytokine concentration by means of a quantitative enzyme-linked immunosorbent assay. Forty percent of the effusions had detectable levels of endotoxin, with a mean concentration of 2.9 +/- 7.8 endotoxin units per milligram of total protein. The mean concentration of TNF-alpha was 1.24 +/- 3.1 pg/mg total protein, and that of IL-1 beta was 18.79 pg/mg total protein. A strong, statistically significant correlation exists between the concentrations of endotoxin and TNF-alpha (r = .89) and IL-1 beta (r = .72). The data indicate that endotoxin may contribute to the pathogenesis of chronic otitis media with effusion by stimulating the sustained production of TNF-alpha and IL-1 beta in the middle ear. PMID:9439385

  11. Gradenigo’s syndrome secondary to chronic otitis media on a background of previous radical mastoidectomy: a case report

    PubMed Central

    2014-01-01

    Introduction Gradenigo’s syndrome is nowadays a rare condition characterized by a triad of otorrhea, facial pain with trigeminal nerve involvement and abducens nerve palsy. Most cases are caused by medial extension of acute otitis media into a pneumatized petrous apex and surgical drainage is usually the treatment of choice. We present a case highlighting the pathological mechanism of this disease, demonstrate rare radiological findings associated with this patient, and showcase successful medical treatment without surgical intervention. Case presentation A 63-year-old Thai man presented with complete Gradenigo triad as a complication of chronic otomastoiditis in spite of clinical history of previous radical mastoidectomy and a nonpneumatization of the petrous apex. Magnetic resonance imaging showed abnormal prominent enhancement at the roof of his right temporal bone, and the dura overlying the floor of right middle cranial fossa and right cavernous sinus. Magnetic resonance imaging also detected right petrous apicitis. With the use of intravenous antibiotics and topical antibiotic eardrops, recovery was observed within 5 days with complete resolution within 2 months. Conclusions Although there is little evidence to support the use of medical therapy in the treatment of Gradenigo’s syndrome resulting from chronic ear disease, we here demonstrate successful conservative treatment of Gradenigo’s syndrome following chronic otitis media in a patient who underwent previous radical mastoidectomy. PMID:24957520

  12. Homeopathic Medications as Clinical Alternatives for Symptomatic Care of Acute Otitis Media and Upper Respiratory Infections in Children

    PubMed Central

    Boyer, Nancy N

    2013-01-01

    The public health and individual risks of inappropriate antibiotic prescribing and conventional over-the-counter symptomatic drugs in pediatric treatment of acute otitis media (AOM) and upper respiratory infections (URIs) are significant. Clinical research suggests that over-the-counter homeopathic medicines offer pragmatic treatment alternatives to conventional drugs for symptom relief in children with uncomplicated AOM or URIs. Homeopathy is a controversial but demonstrably safe and effective 200-year-old whole system of complementary and alternative medicine used worldwide. Numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches. Evidence-based advantages for homeopathy include lower antibiotic fill rates during watchful waiting in otitis media, fewer and less serious side effects, absence of drug-drug interactions, and reduced parental sick leave from work. Emerging evidence from basic and preclinical science research counter the skeptics' claims that homeopathic remedies are biologically inert placebos. Consumers already accept and use homeopathic medicines for self care, as evidenced by annual US consumer expenditures of $2.9 billion on homeopathic remedies. Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials, but additional well-designed efficacy trials are indicated. Nonetheless, the existing research evidence on safety supports pragmatic use of homeopathy in order to “first do no harm” in the early symptom management of otherwise uncomplicated AOM and URIs in children. PMID:24381823

  13. A defect in early myogenesis causes Otitis media in two mouse models of 22q11.2 Deletion Syndrome

    PubMed Central

    Fuchs, Jennifer C.; Linden, Jennifer F.; Baldini, Antonio; Tucker, Abigail S.

    2015-01-01

    Otitis media (OM), the inflammation of the middle ear, is the most common disease and cause for surgery in infants worldwide. Chronic Otitis media with effusion (OME) often leads to conductive hearing loss and is a common feature of a number of craniofacial syndromes, such as 22q11.2 Deletion Syndrome (22q11.2DS). OM is more common in children because the more horizontal position of the Eustachian tube (ET) in infants limits or delays clearance of middle ear effusions. Some mouse models with OM have shown alterations in the morphology and angle of the ET. Here, we present a novel mechanism in which OM is caused not by a defect in the ET itself but in the muscles that control its function. Our results show that in two mouse models of 22q11.2DS (Df1/+ and Tbx1+/−) presenting with bi- or unilateral OME, the fourth pharyngeal arch-derived levator veli palatini muscles were hypoplastic, which was associated with an earlier altered pattern of MyoD expression. Importantly, in mice with unilateral OME, the side with the inflammation was associated with significantly smaller muscles than the contralateral unaffected ear. Functional tests examining ET patency confirmed a reduced clearing ability in the heterozygous mice. Our findings are also of clinical relevance as targeting hypoplastic muscles might present a novel preventative measure for reducing the high rates of OM in 22q11.2DS patients. PMID:25452432

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  16. Role of group 3 innate lymphoid cells during experimental otitis media in a rat model.

    PubMed

    Cho, Chang Gun; Gong, Sung Ho; Kim, Hee-Bok; Song, Jae-Jun; Park, Joo Hyun; Lim, Yun-Sung; Park, Seok-Won

    2016-09-01

    The objective of this study was to evaluate the role of group 3 innate lymphoid cells (ILC3) in the middle ear (ME) mucosal response to bacterial infection in a rat model. To confirm the role of ILC3 in bacterially induced otitis media (OM), the serum concentrations of IL-17 and IL-22 were determined by ELISA, and the tissue expression of IL-17 and IL-22 in infected ME mucosa was assessed by immunohistochemical staining. Immunohistochemical staining of specific cell surface markers was also assessed to confirm the origin of the cells expressing IL-17 and IL-22. Twenty Sprague-Dawley rats were used in the surgically-induced animal model of OM. OM was induced by inoculation of non-typeable Haemophilus influenzae into the ME cavity of the rats. The rats were divided into four experimental groups: three infected groups and one control group. Infected groups were subdivided into sets of 5 rats, one for each of the three time points (1, 4 and 7 days post-inoculation). For determination of rat IL-17 and IL-22 levels in infected rats and control rats, infected or control ME mucosa sections were analyzed by immunohistochemistry with specific antibodies directed against IL-17 and IL-22. Immunohistochemical staining for CD3, RORγt, and NKp46 were also conducted on the samples to confirm the origin of cells expressing IL-17 and IL-22. IL-17 and IL-22 serum concentrations were significantly increased in the infected rats compared to control rats. Immunohistochemical staining revealed increased IL-17 and IL-22 expressions in all infected ME mucosae from the first day after inoculation. In addition, the results of tissue staining for the specific surface markers were negative for CD3 and NKp46, but were highly positive for RORγt. IL-17 and IL-22 revealed their association with the bacterially induced proliferative and hyperplastic responses of ME mucosa, which are characteristic features in pathogenesis of OM. Surface marker examination showed that the source cells for IL-17

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

    PubMed Central

    Todberg, Tanja; Koch, Anders; Andersson, Mikael; Olsen, Sjurdur F.; Lous, Jørgen; Homøe, Preben

    2014-01-01

    Objectives In recent years welfare in Denmark has increased which might be expected to reduce otitis media (OM) incidence. We examined the age-specific incidence of OM in a nation-wide cohort of children aged 0–7 years born in 1996–2003 (Danish National Birth Cohort, DNBC). Only selection was ability to understand and speak Danish. Methods Information of OM and ventilation tubes (VT) was collected through three maternal interviews at 6-month, 18-month and 7-years of age and based on this age-specific and cumulative incidence of OM was calculated. As different numbers of the total population answered the different interviews, the calculations are done with different denominators. The information in DNBC was validated against two population based registries containing information of VT insertions. Results Cumulative incidence of OM at 7 years was 60.6% (31,982/52,755). For children with OM, 16.2% (7143/44194) had their first OM episodes between 0–6 months of age, 44.3% (19579/44194) between 7–18 months, and 39.5% (17472/44194) between 19 months and 7 years. Four or more OM episodes before 7 years were reported by 39.5% (12620/31982) and by 64.0% (2482/3881) of those who had their OM debut between 0–6 months; by 48.2% (4998/10378) with debut between 7–18 months; and by 28.7% (4996/17344) with debut between 19 months and 7 years. These figures are essentially unchanged from earlier figures from Denmark. VT insertion at least once was reported by 26,1% in the 7-year interview. Assuming recordings in the Danish National Patient Registry to be gold standard, maternal self-reportings in DNBC of insertion of VT showed high sensitivity (96.4%), specificity (98.2%), and positive (94.8%) and negative predictive values (98.8%). Conclusion OM affects nearly 2/3 of preschool children in Denmark despite reduction in known OM risk factors. PMID:25545891

  18. Endoscopic Adenoidectomy in Children With Otitis Media With Effusion and Mild Hearing Loss

    PubMed Central

    Capaccio, Pasquale; Torretta, Sara; Marciante, Givlia Anna; Marchisio, Paola; Forti, Stella; Pignataro, Lorenzo

    2016-01-01

    Objectives Surgical management of children with chronic otitis media with effusion (OME) includes tympanostomy tube insertion or adenoidectomy, alone or with myringotomy and tube insertion. The aim of this study was to compare the effectiveness of transoral microdebrider endoscopic-assisted adenoidectomy (TOMEA) and traditional adenoidectomy in the management of children with mild hearing loss due to OME and chronic adenoiditis. Methods This prospective, double-blind and controlled study involved 120 consecutive patients aged 4–12 years, who were randomised 1:1 to undergo TOMEA or traditional adenoidectomy under general anesthesia. All the patients underwent a complete otolaryngological examination, including nasopharyngeal fibre endoscopy (NFE), pneumatic otoscopy, otomicroscopy, tympanometry and supraliminar tonal audiometry, upon enrolment, and three and nine months postoperatively. Results There were no statistically significant differences in age or gender distribution between the TOMEA group (mean age, 4.9±1.1 years; 53.3% males) and the traditional adenoidectomy group (mean age, 5.3±0.9 years; 56.7% males). Both procedures led to a significant improvement in choanal patency (P<0.01) and all of the otological and audiological parameters (P<0.01) 3 and 9 months postoperatively, although postoperative NFE showed that the mean percentage of residual choanal obstruction was significantly less in the TOMEA group (P=0.02). There was no significant between-group difference in the percentage of children with tympanic membrane changes, but the postoperative prevalence of children with a type B tympanogram was significantly lower in the TOMEA group after 3 (15.0% vs. 31.7%, P=0.05) and 9 months (18.3% vs. 38.3%, P=0.02), as was the percentage of children with mild conductive hearing loss (3.3% vs. 23.3%, P<0.01; and 8.3% vs. 28.3%, P<0.01). Conclusion Although both TOMEA and traditional adenoidectomy are effective in treating children with mild hearing loss due to

  19. Blocking macrophage migration inhibitory factor activity alleviates mouse acute otitis media in vivo.

    PubMed

    Zhang, Jin; Xu, Min; Zheng, Qingyin; Zhang, Yan; Ma, Weijun; Zhang, Zhaoqiang

    2014-11-01

    This study was to investigate the role of macrophage migration inhibitory factor (MIF) in mouse acute otitis media (AOM), we hypothesize that blocking MIF activity will relieve mouse AOM. A mouse AOM model was constructed by injecting lipopolysaccharide (LPS) into the middle ear of C57BL/6 mice through the tympanic membrane (TM). MIF levels were measured by real-time PCR (RT-PCR) and ELISA after LPS application. Normal or AOM mice were given PBS or ISO-1 (MIF antagonist) every day for 10 days and the hearing levels were determined by measuring auditory brainstem response (ABR) threshold. After the ABR test finished, H&E staining was conducted and the inflammation was also measured by detecting interleukin (IL)-1β, tumor necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF) levels with RT-PCR and ELISA. TLR-4 expression was determined by western blotting and NF-κB activation was determined by electrophoretic mobility shift assays. Compared with the normal control, MIF levels in the middle ear of LPS-induced AOM mice were significant increased. The ABR results showed that mean ABR thresholds in ISO-1 treated AOM mice were significantly reduced compared with PBS treated AOM mice since day 7, indicating that ISO-1 treatment potentially improved the hearing levels of AOM mice. H&E staining showed that ISO-1 treatment could reduce the mucosal thickness of AOM mice. In ISO-1 treated mice, TLR-4 expression and levels of IL-1β, TNF-α and VEGF were significantly lower compared with PBS treated AOM mice. ISO-1 treatment also significantly inhibited NF-κB activation in AOM mice compared with PBS treated AOM mice. These results suggested that blocking the activity of MIF by ISO-1 could reduce the inflammation in AOM mice in which process TLR-4 and NF-κB were involved. The reduction in MIF activity is conducive to alleviate mouse AOM, which may serve as a potential therapeutic target for the treatment of AOM. PMID:25108100

  20. Evidence of T-helper cell 2 cytokine regulation of chronic otitis media with effusion.

    PubMed

    Smirnova, Marina G; Birchall, John P; Pearson, Jeffrey P

    2005-10-01

    Cytokine and cellular patterns of effusions may reflect stages of middle ear inflammation. The local interplay between IL-2 and -4 is likely to play a crucial role in the switching of inflammation in the chronic stage. The T-helper cell 2 (Th2) cytokines IL-4, -5 and -13 and the Th2/Th1 cytokine granulocyte-macrophage colony-stimulating factor (GM-CSF) regulate the cellular and molecular processes of chronic inflammation in the middle ear and therefore the chronic condition of otitis media with effusion (OME). Early identification of the cytokine and cellular patterns of effusions can be helpful in directing the clinical treatment of OME.We hypothesized that IL-2 and the group of Th2 cytokines regulate chronic inflammation in the middle ear and chronic OME. Effusions from children with persistent OME were analysed to determine the presence of cytokines (the Th1 cytokine IL-2, the Th2 cytokines IL-4, -5 and -13 and the Th1/Th2 cytokine GM-CSF), inflammatory cells (CD4+ T cells, eosinophils, macrophages and neutrophils) and mucin. Cytokines were evaluated by means of a quantitative "sandwich"-type ELISA, inflammatory cells by means of alkaline phosphatase-anti-alkaline phosphatase immunocytostaining and mucin by means of a modified periodic acid-Schiff method based on a slot-blot technique. The cytokine pattern in effusions varied from patient to patient. GM-CSF correlated positively and IL-4 inversely with IL-2 and the increased level of IL-4 may have had an inhibitory effect on IL-2. IL-5 and -13 correlated with IL-4. Inflammatory cells correlated with cytokines as follows: CD4+ T cells with IL-2 and -4; macrophages and neutrophils with GM-CSF; and eosinophils with IL-5. Some cytokine-cellular correlations in effusions were reflected at the clinical level. The mucin content of effusions correlated with the concentrations of IL-4 (>10 pg/ml) and -13, suggesting involvement of IL-4 and -13 in upregulation of the middle ear mucin metabolism. PMID:16298784

  1. A Quantitative and Qualitative Assessment of Verbal Short-Term Memory and Phonological Processing in 8-Year-Olds with a History of Repetitive Otitis Media

    ERIC Educational Resources Information Center

    Majerus, Steve; Amand, Pierre; Boniver, Vincent; Demanez, Jean-Pierre; Demanez, Laurent; Van der Linden, Martial

    2005-01-01

    Language outcome in children experiencing fluctuant hearing loss due to otitis media (OME) remains highly equivocal. In the current study, we assessed performance on highly sensitive verbal short-term memory (STM), new word learning and phonological processing tasks in 8-year-old children who had suffered from recurrent OME before the age of 3.…

  2. Otitis Media with Effusion in Young Children. Clinical Practice Guideline, Quick Reference Guide for Clinicians, [and] Parent Guide, Consumer Version, Number 12.

    ERIC Educational Resources Information Center

    Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

    Otitis media with effusion and its related hearing loss have been associated with delayed language development, particularly if the disease is recurrent or of long duration, although available data are insufficient to establish a causal linkage. This guide presents recommendations based on extensive reviews of the relevant medical and…

  3. Oral Inoculation of Young Dairy Calves with Mycoplasma bovis Results in Colonization of Tonsils, Development of Otitis Media and Local Immunity

    PubMed Central

    Maunsell, Fiona; Brown, Mary B.; Powe, Joshua; Ivey, James; Woolard, Matthew; Love, Wees; Simecka, Jerry W.

    2012-01-01

    Because M. bovis otitis media is an economically important problem, there is a need to understand the pathogenesis of disease, not only to improve our understanding of the factors contributing to the development of this disease but also to inform the development of improved diagnostic tests and therapy. Oral ingestion of M. bovis-contaminated milk is linked, but not definitively proven, to development of otitis media. In the current study, we demonstrate that oral ingestion of M. bovis infected colostrum can result in an ascending infection and development of otitis media. Importantly, M. bovis was found to have a previously unrecognized tendency for colonization of the tonsils of calves, which most likely contributed to the subsequent development of otitis media. In contrast, transtracheal inoculation failed to produce clinically significant upper respiratory tract disease, although did induce lower respiratory tract disease. The upper respiratory tract was the major site of M. bovis-specific B cell and mucosal IgA responses in calves inoculated by the oral route. The oral inoculation route of infection presented here is particularly suited to the study of host-pathogen interactions during initial colonization of the tonsils, expansion of infection and dissemination to the lower respiratory tract and middle ear. In addition, it could be used to investigate potential new preventative or control strategies, especially those aimed at limiting colonization of the tonsils and/or spread to the middle ear. PMID:22970240

  4. Parent Versus Professional Views of the Developmental Impact of a Multi-Faceted Condition at School Age: Otitis Media with Effusion ("Glue Ear")

    ERIC Educational Resources Information Center

    Higgins, Josephine; Haggard, Mark

    2005-01-01

    Background: Several aspects of children's health and development are known from empirical studies to be associated with otitis media with effusion (OME; "glue ear"'). The "diffuse image" has been an obstacle to defining a core set of impacts about which inter-profession and parent-professional communication can be effective. Aims: The study…

  5. [The experience with the topical application of non-steroidal anti-inflammatory agents for the treatment of otitis media].

    PubMed

    Razvozzhaev, A A; Starodumova, T A; Nemstsveridze, E Ia

    2012-01-01

    The objective of the present study was to estimate the therapeutic efficacy and safety of the topically applied otinum ear drops. The authors present the results of the combined treatment of acute catarrhal otitis in the children with the use of choline salicilate (otinum). The study included 50 patients randomized into two identical groups. The children of group 1 received systemic therapy supplemented by the topical application of otinum, those in group 2 were prescribed a 3% alcoholic solution of boric acid. The study has demonstrated a significantly more pronounced positive dynamics of clinical conditions in the patients of group 1 compared with those of the control group. The total duration of therapy in the first group was 37.5% shorter than in the second. The results of the study confirmed the strong anti-inflammatory and analgesic action of choline salicilate. The pain was relieved within 7 minutes on the average after the application of this agent. It is concluded that otinum can be recommended for the introduction into combined therapy of acute catarrhal otitis media as an efficacious anti-inflammatory and analgetic drug. PMID:22810643

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

    PubMed

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

    2012-07-01

    The hypertrophic adenoid may promote chronic suppurative otitis media in children as it fulfills its immune function. The number of lymphocytes in the adenoid and their cooperation in the immune response depend of on their proliferation and migration to the effector sites. Interleukin 7 (IL-7) is essential for the normal development and function lymphocytes. IL-7 plays pivotal role for activation and proliferation of T and B cells. The heterodimeric interleukin-7 receptor (IL-7R) is composed of the IL-7Rα (127) and the common cytokine receptor γc (CD132). The aim of this study was to evaluate the percentage of lymphocytes T (CD4(+) and CD8(+)) with IL-7R (CD127 and CD132) expression in hypertrophic adenoid in children suffering with otitis media with effusion for a duration of 3 months. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. CD4(+) CD127(+), CD4(+)132(+), CD8(+)CD127(+) and CD8(+)CD132(+) cell subpopulations were identified using monoclonal antibodies and flow cytometry. The percentage of CD4(+) and CD8(+) T cells with CD127 receptor expression in hypertrophic adenoid of children with otitis media with effusion was statistically significantly higher than in hypertrophic adenoid group. The percentage of CD4(+) T cells with CD132 expression in the study group was statistically significantly higher than in the reference group. The percentage of CD8(+) T cells with CD132(+) expression was not statistically different in both groups. The increased percentage of T lymphocytes with IL-7R expression (CD127 and CD132) in hypertrophic adenoid seems to influence the quantity of lymphocytes and upset the immunological function of tonsils which can influence the course of otitis media with effusion. PMID:22382400

  7. Diet as a Risk Factor for Pneumococcal Carriage and Otitis Media: A Cross-Sectional Study among Children in Day Care Centers

    PubMed Central

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

    2014-01-01

    Background Pharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children. Methods Our study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother. Results The dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04). The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient −0.51, 95% CI −0.98 to −0.03, P = 0.04). A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P = 0.03) was associated with an increased risk of caries. Conclusions Diet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media. PMID:24599395

  8. Optical-fiber-coupled inferometric measurement of tympanic membrane temperature: a new diagnostic tool for acute otitis media

    NASA Astrophysics Data System (ADS)

    DeRowe, Ari; Ophir, Eyal; Sade, Sharon; Fishman, Gadi; Ophir, Dov; Grankin, Mila; Katzir, Abraham

    1998-07-01

    A novel infrared (IR) transparent optical fiber coupled to a hand held otoscope and a radiometer was constructed and used to measure the temperatures of the tympanic membrane (TM) and to distinguish between diseased and healthy middle ears. A greater temperature difference between TM readings was found when Acute Otitis Media (AOM) existed in one of the ears examined. This supports the hypothesis that acute inflammation of the middle ear will result in elevated local temperature when measured in such a way that the reading is taken only from the TM without interference of the external canal. The use of an optical fiber enabled temperature measurements of the TM with high spatial resolution eliminating the external ear canal interference. A small patient population was examined and the initial results were statistically significant. In the hands of the primary care physician, this tool would prevent misdiagnosis of AOM preventing indiscriminate use of antibiotics and avoiding complications by early diagnosis.

  9. ModA2 Phasevarion Switching in Nontypeable Haemophilus influenzae Increases the Severity of Experimental Otitis Media.

    PubMed

    Brockman, Kenneth L; Jurcisek, Joseph A; Atack, John M; Srikhanta, Yogitha N; Jennings, Michael P; Bakaletz, Lauren O

    2016-09-01

    Several human-adapted bacterial pathogens use a phasevarion (ie, a phase-variable regulon) to rapidly and reversibly regulate the expression of many genes, which include known virulence factors, yet the influence of phasevarion-mediated regulation in pathogenesis remains poorly understood. Here we examine the impact of the nontypeable Haemophilus influenzae (NTHI) ModA2 phasevarion on pathogenesis and disease severity in a chinchilla model of experimental otitis media. Chinchillas were challenged with NTHI variant populations that were either inoculated ON and remained ON, inoculated OFF and shifted ON, or inoculated OFF and remained OFF, within the middle ear. We show that populations that shift from OFF to ON within the middle ear induce significantly greater disease severity than populations that are unable to shift. These observations support the importance of phasevarion switching in NTHI pathogenesis and the necessity to considered phasevarion regulation when developing methods to treat and prevent infection. PMID:27288538

  10. Passage of albumin from the middle ear to the inner ear in otitis media in the chinchilla

    SciTech Connect

    Goldberg, B.; Goycoolea, M.V.; Schleivert, P.M.; Shea, D.; Schachern, P.; Paparella, M.M.; Carpenter, A.M.

    1981-08-01

    A study of the permeability of the middle ear-inner ear interface for macromolecules was carried out in chinchillas with open and obstructed eustachian tubes utilizing tritiated human serum albumin and immunoelectrophoresis. Tritiated albumin was placed in the round window niche area or normal animals and animals in which the eustachian tubes had been obstructed for 24 hours or 14 days. The tritiated albumin was allowed to remain in the middle ear cavity for 24 hours, Samples of middle ear effusion, perilymph, blood and cerebrospinal fluid were collected and measured for radioactivity. Radioactivity was demonstrated in the perilymph. Samples of middle ear effusions and perilymph were also studied by immunoelectrophoresis with goat antihuman albumin. Albumin placed in the round window niche of an experimental animal could be recovered unchanged in the perilymph. The results suggest a pathophysiologic explanation for the association of otitis media and sensorineural hearing loss or endolymphatic hydrops.