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Sample records for otitis media immuno

  1. Otitis media with effusion

    MedlinePlus

    OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... Kerschner JE, Preciado D. Otitis media. In: Kliegman RM, Stanton BF, ... Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  2. [Chronic otitis mediaChronic Otitis Media].

    PubMed

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

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

  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. 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,…

  5. 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,…

  6. Ear infections: otitis externa and otitis media.

    PubMed

    Lee, Hobart; Kim, Jeffrey; Nguyen, Van

    2013-09-01

    This article reviews the diagnosis and treatment of acute otitis externa and acute otitis media, and will be helpful to primary care physicians who diagnose and treat these common diseases in the clinic. The pathophysiology, microbiology, clinical features, diagnosis, treatment, prognosis, and complications are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Acute otitis media.

    PubMed

    Dickson, Gretchen

    2014-03-01

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

  8. Otitis media with effusion.

    PubMed

    Atkinson, Helen; Wallis, Sebastian; Coatesworth, Andrew P

    2015-05-01

    Otitis media with effusion (OME) is a common problem facing general practitioners, pediatricians and otolaryngologists. This article reviews the etiopathogenesis, epidemiology, presentation, natural history and management of OME. The literature was reviewed by using the PubMed search engine and entering a combination of terms including 'otitis media with effusion', 'epidemiology' and 'management'. Relevant articles were identified and examined for content. What is the take home message? While OME is a very common entity in the pediatric population, the majority of cases will resolve spontaneously. Surgery in the form of grommet insertion, with or without adenoidectomy is the most effective treatment in persistent symptomatic cases.

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

    MedlinePlus

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

  10. Otitis media: a review.

    PubMed

    Perriello, V A; Ford, R F; McLean, W C; Schoeny, Z G; Sande, M A

    1977-05-01

    We have presented recommendations for diagnosis and management of otitis media in children based on a comprehensive review of the pertinent medical literature. For an entity that is so common, there still remain amazingly large numbers of areas of controversy. We have also attempted to stress the importance of appropriate therapy and adequate followup as being very important in the management of otitis media. Newer concepts, particularly the use of the impedance bridge tympanogram, have been mentioned. With all the above background information in mind and with considerations for what is practical for the patient and the medical community, we would recommend the following as the acceptable minimal care for patients with otitis media. When the diagnosis of the acute otitis media is made on the basis of physical findings of myringitis, and/or middle ear fluid, and/or rupture of the tympanic membrane, the following treatment course is advisable: Neonates Culture of middle ear fluid if possible. Ampicillin 200 mg/kg/day intramuscularly. Gentamicin 3/5mg/kg/day intramuscularly. Hospitalize and treat until well and for minimum of seven days. Observe closely for meningitis and other infections and drug toxicity. These should be handled only by physicians experienced in dealing with patients in this age range. Appropriate work-up for septicemia should precede treatment. Switch to specific antibiotic when cultures and sensitivity available. Children. From 2 months to 6 years of age: Ampicillin 50mg/kg/day. Decongestant (if desired). Administer for ten days. Every patient with otorrhea, severe otitis and those not clinically well should be seen for followup ten to 14 days later. They should have a minimum of otologic evaluation including drum mobility. In persistent cases, audiometry and otologic referral are necessary. If patient is allergic to penicillin, erythromycin at 20mg/lb/day may be used. Trimethoprim sulfa may hold promise in the future. Tetracycline is never

  11. Acute otitis media.

    PubMed

    Atkinson, Helen; Wallis, Sebastian; Coatesworth, Andrew P

    2015-05-01

    Acute otitis media (AOM) is a common problem facing general practitioners, paediatricians and otolaryngologists. This article reviews the aetiopathogenesis, epidemiology, presentation, natural history, complications and management of AOM. The literature was reviewed by using the PubMed search engine and entering a combination of terms including 'AOM', 'epidemiology' and 'management'. Relevant articles were identified and examined for content. What is the take-home message? AOM is a very common problem affecting the majority of children at least once and places a large burden on health care systems throughout the world. Although symptomatic relief is often enough for most children, more severe and protracted cases require treatment with antibiotics, especially in younger children.

  12. Otoscopic diagnosis of otitis media.

    PubMed

    Isaacson, Glenn

    2016-12-01

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

  13. [Microbiology in acute otitis media].

    PubMed

    Bingen, E

    1998-04-15

    Acute otitis media is the most common bacterial infection in the child under 5 years of age and the leading reason for antibiotic prescriptions in Western countries. The choice of optimal antibiotic treatment is based essentially on microbiologic epidemiologic studies. The bacteria most often responsible for otitis belong to the commensal flora of the nasopharynx. French studies using paracentesis show that the main bacteria responsible for acute otitis media are H. influenzae, S. pneumoniae and M. catarrhalis. The epidemiology of resistance to antibiotics has recently changed, with the appearance of pneumococcal strains having reduced sensitivity to penicillin, and which have played a major role in treatment failures.

  14. Minimal Brain Dysfunction and Otitis Media.

    ERIC Educational Resources Information Center

    Hersher, Leonard

    1978-01-01

    The frequency of otitis media among 22 hyperactive children (ages 7-to-13 years) with learning disorders was compared with the frequency of otitis media in a sample of 772 normal matched-age children. (Author/PHR)

  15. Minimal Brain Dysfunction and Otitis Media.

    ERIC Educational Resources Information Center

    Hersher, Leonard

    1978-01-01

    The frequency of otitis media among 22 hyperactive children (ages 7-to-13 years) with learning disorders was compared with the frequency of otitis media in a sample of 772 normal matched-age children. (Author/PHR)

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

    PubMed

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

    2017-04-01

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

  17. Tuberculous otitis media: a resurgence?

    PubMed

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

    2017-09-01

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

  18. Otitis Media, Learning and Community.

    ERIC Educational Resources Information Center

    McSwan, David; Clinch, Emma; Store, Ron

    2001-01-01

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

  19. 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…

  20. Otitis Media, Learning and Community.

    ERIC Educational Resources Information Center

    McSwan, David; Clinch, Emma; Store, Ron

    2001-01-01

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

  1. [Muco-serous otitis media].

    PubMed

    Oberascher, G; Albegger, K

    1992-01-01

    Typical symptoms of the otitis media with effusion (OME)--synonym (secretory otitis media--SOM)--are fluid (serous/mucoid) in the middle ear space and a conductive hearing loss. Its most incidence can be found in infants and kids, during this period often bilaterally, but also in adolescents and adults. Etiopathological factors are infections of the upper respiratory tract, obstructing adenoids, tumors of the nasopharynx, cleft palate patients, allergological and immunological influences. As most important anatomical factor ventilation problems, respectively insufficiency of drainage of the eustachian tube is considered. Especially in childhood, OME reveals high spontaneous remission. Thus in many cases is no need for treatment. Persists OME over a longer period (some months) or in patients with recurrent disease, therapy is necessary: decongestant nasal drops, local heat during concomitant upper air way infections, long term application of low dose antibiotics, adenoidectomy with myringotomy, or insertion of ventilating tubes.

  2. Importance of viruses in acute otitis media.

    PubMed

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

    2015-02-01

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

  3. Surgery for otitis media among Indigenous Australians.

    PubMed

    O'Leary, Stephen J; Triolo, Ross D

    2009-11-02

    Otitis media with effusion and recurrent acute otitis media are ubiquitous among Indigenous children. Otitis media causes conductive hearing loss that may persist throughout early childhood and adversely affect social interactions, language acquisition and learning. Control of otitis media usually restores hearing to adequate levels. Surgery is to be considered when otitis media has not responded to medical treatment. In non-Indigenous populations, tympanostomy tubes ("grommets"), with or without adenoidectomy, can control otitis media; how these findings relate to Indigenous Australians is not known. Tympanic membrane perforation is a frequent sequela of early childhood otitis media among Indigenous children. It occurs as early as 12 months of age and causes conductive hearing loss. Perforation is associated with recurrent aural discharge, particularly in the tropics and in desert regions. Medical and public health management is required until a child is old enough to undergo surgical closure of the perforation, usually by an age of 7-10 years. Surgical closure of the tympanic membrane stops the aural discharge and improves the hearing sufficiently to avoid the need for hearing aids in most cases. The success rate of surgery conducted in rural and remote Australia is below urban benchmarks; improving this will probably require funding for community-based follow-up.

  4. [Drug therapy of otitis externa and otitis media].

    PubMed

    Okovityĭ, S V; Ivkin, D Iu; Malygin, S V

    2012-01-01

    The objective of the present work was to analyse the available pharmaceutical products used for treatment of otitis media. The rational application of these medications makes it possible to eliminate rapidly a variety of etiological factors, reduce the severity of inflammation, and improve the quality of life of the patients. One of the approaches to the achievement of these goals for the patients with otitis externa and otitis media consists of the use of combined preparations containing antibacterial, antimycotic, anti-inflammatory and analgetic components. Candibiotic is a four-components drug composed of chloramphenicol, clotrimazol, beclomethasone and lidocaine. The advantages of Candibiotic include high therapeutic efficacy due to its ethiotropic and pathogenetic activity and safety as its components do not have ototoxicity in the case of local application).

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

    ERIC Educational Resources Information Center

    Gdowski, Becky S.; And Others

    1986-01-01

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

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

    ERIC Educational Resources Information Center

    Gdowski, Becky S.; And Others

    1986-01-01

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

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

    ERIC Educational Resources Information Center

    Beattie, R. G. John L.

    1991-01-01

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

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

    ERIC Educational Resources Information Center

    Beattie, R. G. John L.

    1991-01-01

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

  9. Antibiotics for acute otitis media in children.

    PubMed

    Nitsche, María Pía; Carreño, Monica

    2015-10-29

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

  10. Complications of Pediatric Otitis Media.

    PubMed

    Lavin, Jennifer M; Rusher, Thomas; Shah, Rahul K

    2016-02-01

    Otitis media (OM) is a common diagnosis in the pediatric population that is usually managed on an outpatient basis. A small proportion of children are admitted due to a complex disease course. The aim of this study was to investigate the demographics of those patients and the resources utilized during their admissions. Retrospective review based on the 2009 Kids' Inpatient Database. Nationwide administrative database. A review based on the 2009 Kids' Inpatient Database was conducted. Inclusion criteria were clinical modification codes for OM (ICD-9 code 382). Data recorded included patient demographics, concurrent discharge diagnosis codes, length of stay, total charges, and frequency of procedures performed. There were 61,783 (92,548 nationally weighted) admissions with OM, which were analyzed. The average age (SD) for the patients was 2.18 (3.49) years, and the average length of stay was 2.88 days. The majority (80.75%) of patients did not have to undergo a procedure during admission, whereas a small proportion (5.4%) underwent a major operating room procedure. There were 21 deaths recorded (0.03%). A diagnosis of mastoiditis, meningitis, venous sinus thrombosis, or intracranial abscess was associated with significantly increased length of stay, incidence of procedures, and total cost of admission. Complicated pediatric OM remains of concern requiring prompt and thorough management. Major complications include mastoiditis and meningitis, and unfortunately, fatalities still occur in patients with OM. An understanding of resource utilization and socioeconomic implications can identify and drive opportunities for targeted quality improvement. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  11. Zinc supplements for preventing otitis media.

    PubMed

    Gulani, Anjana; Sachdev, Harshpal S

    2014-06-29

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

  12. Labyrinthitis secondary to experimental otitis media.

    PubMed

    Trinidad, Almudena; Ramírez-Camacho, Rafael; García-Berrocal, Jose Ramon; Verdaguer, Jose María; Daza, Rosa

    2005-01-01

    Analysis of labyrinthitis in a model of otitis media. Morphologic study in 20 Wistar rats in which otitis media was induced by transbullar inoculation of Pseudomonas aeruginosa with obstruction of the eustachian tube. Seventy percent of rats showed vestibular signs. Histologic changes ranged from nonaffected labyrinths to suppurative labyrinthitis. Dissemination of infection probably occurs through round window membrane. A thinner round window membrane typical of rodents would be the reason for a more severe clinical and morphologic picture in rats when compared to human beings.

  13. Update on otitis media – prevention and treatment

    PubMed Central

    Qureishi, Ali; Lee, Yan; Belfield, Katherine; Birchall, John P; Daniel, Matija

    2014-01-01

    Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment. PMID:24453496

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

    PubMed

    Kong, Kelvin; Coates, Harvey L C

    2009-11-02

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

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

    ERIC Educational Resources Information Center

    Reichman, Julie; Healey, William C.

    1983-01-01

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

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

    ERIC Educational Resources Information Center

    Reichman, Julie; Healey, William C.

    1983-01-01

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

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

    PubMed

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

    2017-05-31

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

  18. Otitis Media in Young Children with Disabilities.

    ERIC Educational Resources Information Center

    Zeisel, Susan A.; Roberts, Joanne E.

    2003-01-01

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

  19. Otitis Media in Young Children with Disabilities.

    ERIC Educational Resources Information Center

    Zeisel, Susan A.; Roberts, Joanne E.

    2003-01-01

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

  20. The microbiome of otitis media with effusion.

    PubMed

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

    2016-12-01

    The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P < .001). However, the otitis media with effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Otitis Media and Language Development at 1 Year of Age.

    ERIC Educational Resources Information Center

    Wallace, Ina F.; And Others

    1988-01-01

    Fifteen 1-year-olds without otitis media were compared to 12 babies who were otitis positive. No significant differences were detected on the Bayley Scales of Infant Development or the Sequenced Inventory of Communication Development (SICD) Receptive scale. However, the otitis-positive group exhibited lower SICD Expressive scores than the…

  2. Otitis Media and Language Development at 1 Year of Age.

    ERIC Educational Resources Information Center

    Wallace, Ina F.; And Others

    1988-01-01

    Fifteen 1-year-olds without otitis media were compared to 12 babies who were otitis positive. No significant differences were detected on the Bayley Scales of Infant Development or the Sequenced Inventory of Communication Development (SICD) Receptive scale. However, the otitis-positive group exhibited lower SICD Expressive scores than the…

  3. Acute otitis media and acute bacterial sinusitis.

    PubMed

    Wald, Ellen R

    2011-05-01

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

  4. Epidemiology of otitis media in children.

    PubMed

    Teele, D W; Klein, J O; Rosner, B A

    1980-01-01

    To determine the epidemiology of otitis media (OM) during the first three years of life, physicians participating in the Greater Boston Collaborative Otitis Media Program followed prospectively from birth 2,565 children. At every visit we recorded results of pneumatic otoscopy and epidemiology data. By three years of age 71% of the children had had one or more episodes of acute otitis media including 33% who had three or more episodes. Features associated significantly with first episode of OM were: sibling with recurrent OM, race (white > black), and sex (male > female). Having a sibling with allergy disposed propositi to first episode. Features associated significantly with recurrent OM (greater than or equal to three episodes) were those noted above. A parent with recurrent OM disposed propositi to recurrent OM. Middle ear effusion (MEE) persisted for prolonged periods after OM; after the first episode of OM, 70% of children still had MEE at two weeks, 40% had fluid at one month, 20% had fluid at two months, and 10% had fluid at three months. The sole feature associated significantly with persistent effusion in the middle ear after the first episode of OM was the practice of giving a child a bottle in bed.

  5. 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.

  6. Automated Diagnosis of Otitis Media: Vocabulary and Grammar

    PubMed Central

    Kuruvilla, Anupama; Hoberman, Alejandro; Kovačević, Jelena

    2013-01-01

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

  7. 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))

  8. 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))

  9. Recurrent Otitis Media and Attachment Security: A Path Model.

    ERIC Educational Resources Information Center

    McCallum, Michelle S.; McKim, Margaret K.

    1999-01-01

    Used regular telephone interviews over six months to examine processes through which recurrent episodes of otitis media influence children's attachment security. Found that recurrent otitis media negatively affected attachment security by increasing mothers' perceptions of their children as behaving more negatively. Parenting stress was not…

  10. Otitis Media and Disordered Phonologies: Some Concerns and Cautions.

    ERIC Educational Resources Information Center

    Paden, Elaine Pagel

    1994-01-01

    This article reviews problems faced by researchers in the association between otitis media with effusion and phonological impairment and then summarizes currently established findings concerning otitis media and its effects on phonological acquisition. Professionals are cautioned to neither ignore nor exaggerate the possible influence of otitis…

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

    ERIC Educational Resources Information Center

    Davis, Dorinne S.

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

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

    ERIC Educational Resources Information Center

    Davis, Dorinne S.

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

  13. Otitis Media and Disordered Phonologies: Some Concerns and Cautions.

    ERIC Educational Resources Information Center

    Paden, Elaine Pagel

    1994-01-01

    This article reviews problems faced by researchers in the association between otitis media with effusion and phonological impairment and then summarizes currently established findings concerning otitis media and its effects on phonological acquisition. Professionals are cautioned to neither ignore nor exaggerate the possible influence of otitis…

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

    PubMed

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

    2017-06-01

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

  15. Recurrent Otitis Media and Attachment Security: A Path Model.

    ERIC Educational Resources Information Center

    McCallum, Michelle S.; McKim, Margaret K.

    1999-01-01

    Used regular telephone interviews over six months to examine processes through which recurrent episodes of otitis media influence children's attachment security. Found that recurrent otitis media negatively affected attachment security by increasing mothers' perceptions of their children as behaving more negatively. Parenting stress was not…

  16. [Relationship between adenoids hypertrophy and secretory otitis media].

    PubMed

    Liu, Yangyun; Sun, Zhengliang; Li, Zhengxian; Jiang, Wen

    2004-01-01

    To investigae the cause of secretory otitis media resulting from adenoids hypertrophy and the relationship between adenoids hypertrophy and secretory otitis media. According to the grades of adenoids hypertrophy, 140 children were divided into two groups: the group of middle-grade and the group of pathological hypertrophy. The effect about the degree of adenoids hypertrophy resulted in the descendent of middle ear function and the difference of incidence of secretory otitis media were analyzed. The incidence of secretory otitis media and the pattern of tympanic press were distinct difference in two groups. The results suggested that there was a positive correlation among the grades of adenoids hypertrophy, the descendent degree of middle ear function and the incidence of secretory otitis media.

  17. 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.

  18. Managing otitis media: a time for change.

    PubMed

    Paradise, J L

    1995-10-01

    Given the increasing prevalence of multiply resistant pneumococcal infection and the heightened risks associated with antimicrobial usage, antimicrobial treatment of otitis media in children should be restricted generally to the extent possible without compromising individual children's well-being and without subjecting them to risks potentially greater than the risks associated with antimicrobial usage. Not infrequently the decisions required will be difficult and matters of judgment. However, in most cases the indications for initiating or prolonging antimicrobial treatment will be either straightforward, calling for a decision to proceed, or marginal, in which case the decision not to proceed should be clear.

  19. Importance of Viruses in Acute Otitis Media

    PubMed Central

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

    2015-01-01

    Purpose of review Acute otitis media (AOM) occurs as a complication of viral upper respiratory tract infection (URI). Bacterial otopathogens and respiratory viruses interact and play important roles in AOM development. Better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. Recent findings There has been increasing evidence that AOM occurs during URI, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with AOM, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in AOM development, but symptomatic URI (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related health care use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Summary Progress has been made towards reduction of the burden of AOM in the last decade. Success in reducing AOM incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral URI. PMID:25514574

  20. [Incidence of complications of otitis media].

    PubMed

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

    2005-02-01

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

  1. Allergic rhinitis and chronic suppurative otitis media.

    PubMed

    Bakhshaee, Mehdi; Rajati, Mohsen; Fereidouni, Mohammad; Khadivi, Ehsan; Varasteh, Abdolreza

    2011-01-01

    Allergic inflammation in upper airways can act as a predisposing factor for infectious ear diseases. There are some evidences about the role of allergic rhinitis in chronic otitis media with effusion, but its role in establishing chronic suppurative otitis media (CSOM) has not been clearly shown. 68 adult patients with established CSOM, who were candidates for ear surgery, and 184 age- and sex-matched controls were evaluated for the presence of allergic rhinitis. Standard questionnaire was filled out for all participants. All patients and controls underwent skin prick test for 28 common regional aeroallergens, and serum total IgE was measured by means of ELISA method. Allergic rhinitis were defined as a positive responses to the questionnaire, positive skin prick test to at least one allergen, and/or high level of serum total IgE. Allergic rhinitis was diagnosed in 20 (29.41%) and 41 (22.28%) of patients and controls, respectively (P = 0.241) (OR = 1.28, CI = 0.69-2.36). Outdoor allergens, especially grass pollen, were the most prevalent allergens among both groups, but indoor allergens like mites and molds have a low prevalence. The study did not show a significant difference in the prevalence of AR in the CSOM patients compared to the controls. The intermittent nature of allergy and other less known intervening factors in the etiopathogenesis of CSOM make such a conclusion difficult.

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

    PubMed

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

    2017-04-01

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

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

    PubMed

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

    2014-03-01

    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.

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

    PubMed

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

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. [Language delay in children with chronic suppurative otitis media].

    PubMed

    Biurrún Unzué, Oscar; Biurrún Unzué, Ana; Villacorta Labairu, Begoña; Andrade Arriaga, Marcela

    2003-01-01

    The chronic serous otitis media is a well known cause of fluctuant moderated conduction deafness in childhood but not well studied in Castillian speaking areas, as a cause of alterations in the acquisition of language. In the present study we evaluate the chronic serous otitis media as a cause of alterations in the development of the language in childhood. We studied the semantic development level in a group of 18 four years old children affected of chronic serous otitis media of more than one year evolution. The incidence of alterations was of 27.7%. We discuss the results obtained and we propose a management for this pathology.

  6. Prevention of otitis media: now a reality?

    PubMed

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

    2009-09-25

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

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

    PubMed

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

    2015-04-03

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

  8. Prospects for prevention of otitis media.

    PubMed

    Pelton, Stephen I

    2007-10-01

    Understanding the pathogenesis of acute otitis media provides insight into strategies for immunoprophylaxis. This article evaluates the interactions between pathogen and host defense, and identifies potential bacterial and viral vaccine targets. Discussed in detail are the attributes for a candidate antigen necessary to achieve a greater reduction in the burden of middle ear disease. These include: (1) the need to target a broad spectrum of otopathogens; (2) antigens need to be shared across all (or most) isolates within a bacterial species; (3) antigens need to be surface exposed during middle ear infection; and (4) preferred antigens have an essential function such that nonexpressing bacterial mutants have reduced virulence. A vaccine candidate (Pnc-PD) that encompasses these "attributes" is discussed from the perspective of how it may provide additional protection from middle ear disease if further studies confirm initial data on efficacy.

  9. Acute otitis media and respiratory viruses.

    PubMed

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

    2007-03-01

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

  10. Gradenigo Syndrome: Unusual Consequence of Otitis Media

    PubMed Central

    Valles, Jennie M.; Fekete, Robert

    2014-01-01

    Introduction In 1904, Giuseppe Gradenigo published his case series on the triad of ipsilateral abducens nerve palsy, facial pain in the trigeminal nerve distribution, and suppurative otitis media, which would subsequently be referred to as Gradenigo syndrome. Case Report Our patient was a 36-year-old female, 23 weeks pregnant, with a 6-day history of right-sided otalgia and hearing loss and a 4-day history of purulent otorrhea, who presented with severe, holocephalic headache, meningeal signs, fever, photophobia, and mental status decline. Lumbar puncture yielded a white blood cell count of 1,559 cells/mm3 with 95% polymorphonuclear leukocytes, a red blood cell count of 111 cells/mm3, a protein level of 61 mg/dl, and a glucose level of <40 mg/dl. Cerebrospinal fluid Gram stain showed Gram-positive diplococci, which were subsequently identified as Streptococcus pneumoniae and treated with ceftriaxone. On the second hospital day, she developed horizontal diplopia due to right abducens nerve palsy and right mydriasis. Both symptoms resolved on the third hospital day. Erosion of temporal bone and opacification of mastoid air cells was shown on CT scan. A CT venogram showed an irregularity of the left transverse and superior sagittal sinuses. She was treated with enoxaparin for possible sinus thrombosis. Discussion This case demonstrates rare but serious sequelae of otitis media and Gradenigo syndrome. Holocephalic headache from meningitis masked trigeminal pain. Involvement of the ipsilateral petrous apex and surrounding structures on imaging and clinical improvement with antibiotic treatment supports Gradenigo syndrome over intracranial hypertension due to venous sinus thrombosis as the cause of the abducens nerve palsy. PMID:25232331

  11. 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.

  12. Bilateral promontory fistula due to noncholesteatomatous chronic otitis media.

    PubMed

    Lee, Jun Ho; Jung, Sang Ho; Park, Chan Hum; Hong, Seok Min

    2009-06-01

    The authors describe a case of bilateral promontory fistula due to noncholesteatomatous chronic otitis media in a 46-year-old male. We performed both open cavity mastoidectomy and left staged ossiculoplasty. One year postoperatively, the audiogram showed an improved left air conduction threshold and maintenance of bone conduction. We suggest that noncholesteatomatous chronic otitis media can induce various destructive changes via the chronic inflammatory reaction.

  13. Endoscopic management of chronic otitis media and tympanoplasty.

    PubMed

    Tarabichi, Muaaz; Ayache, Stéphane; Nogueira, João Flávio; Al Qahtani, Munahi; Pothier, David D

    2013-04-01

    The endoscope allows for better inspection for cholesteatoma in cases with chronic otitis media, better access to selective epitympanic poor ventilation and secondary selective chronic otitis media, better visualization of anterior poor ventilation of the mesotympanum (reestablishing adequate ventilation to the mesotympanum), better visualization and reconstruction of anterior tympanic membrane perforations, allows use of Sheehy's lateral graft tympanoplasty through a transcanal approach, and increases the odds of preoperative detection of ossicular chain disruption associated with perforations.

  14. Innate Immunity and the Role of Defensins in Otitis Media

    PubMed Central

    Underwood, Mark; Bakaletz, Lauren

    2011-01-01

    Otitis media is the most common pediatric disease in developed countries and a significant cause of morbidity and hearing loss in developing countries. The innate immune system is essential to protecting the middle ear from infection. Defensins, broad-spectrum cationic antimicrobial peptides, have been implicated in prevention of and the early response to acute otitis media; however, the mechanisms by which defensins and other antimicrobial molecules mediate this protection have not been completely elucidated. In both animal otitis media models and human middle ear epithelial cell culture models, β-defensins are highly induced and effectively kill the common pathogens associated with otitis media. We review the importance of innate immunity in protecting the middle ear and recent advances in understanding the roles of defensins and other antimicrobial molecules in the prevention and treatment of otitis media. The extremely high prevalence of otitis media, in spite of sophisticated innate and adaptive immune systems, is a vexing problem for clinicians and scientists. We therefore also review mechanisms by which bacteria evade innate immune defenses. PMID:21901304

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2016-10-01

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

  17. Upper airway obstructions and chronic otitis media: a clinical study.

    PubMed

    Ural, Ahmet; Minovi, Amir; Çobanoğlu, Bengü

    2014-01-01

    To investigate if pathologies causing upper airway obstructions are correlated with chronic otitis media. One hundred fourteen patients with chronic otitis media and 114 healthy controls were enrolled in this study. Nasal septal deviation, Friedman and Mallampati scores were assessed for upper airway obstructions. Chronic suppurative otitis media was classified into tubotypmanic (n=80) and atticoantral (n=34) subtypes. Number of patients with septal deviation with a convexity to the same side as the affected ear in each CSOM subgroup was compared with chi-square test. The mean Mallampati and Friedman scores in tubotympanic disease group, atticoantral disease group and healthy controls were compared using Kruskal-Wallis test. Septal deviation occurred more frequently on the same side of ear pathology in patients with tubotympanic chronic suppurative otitis media (p=0.0005). Such a difference was not observed between the controls and patients with atticoantral chronic suppurative otitis media (p=0.718). No significant difference was noted between patients and controls in terms of Mallampati and Friedman scores (p=0.602 and p=0.836, respectively). Subtypes of chronic suppurative otitis media were not different from each other in terms of Mallampati and Friedman scores either (p=0.718 and p=0.708). Our results indicate that septal deviations may commonly occur on the same side with chronic otitis media. Therefore, septal deviations must be carefully investigated during the preoperative assessment of patients with CSOM. Elucidation of any possible causal relationship calls for further trials in larger series. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Cytokine responses in the common cold and otitis media.

    PubMed

    Wine, Todd M; Alper, Cuneyt M

    2012-12-01

    Cytokines are a group of diverse molecules that influence the function of every organ system. They are most well studied in their effects on the immune system and their integral role in mediating inflammation. The common cold and otitis media are two such disease states, and much has been learned about the various effects of cytokines in each disease. Most often the viruses isolated include rhinovirus (RV), respiratory syncytial virus (RSV), adenovirus, coronavirus, and picornavirus. Otitis media, sinusitis, bronchiolitis, pneumonia, and asthma exacerbation are commonly accepted as complications of viral upper respiratory tract infections. Furthermore, otitis media and upper respiratory infections are inextricably linked in that the majority (>70 %) of cases of acute otitis media occur as complications of the common cold. Cytokine polymorphisms have been associated with the severity of colds as well as the frequency of otitis media. This article attempts to update the reader on various studies that have recently been published regarding the role of cytokines in these two disease entities.

  19. Korean clinical practice guidelines: otitis media in children.

    PubMed

    Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

    2012-08-01

    Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

  20. 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

  1. Etiologic agents of otitis media in Benin city, Nigeria

    PubMed Central

    Osazuwa, Favour; Osazuwa, Emmanuel; Osime, Clement; Igharo, Esohe Amanda; Imade, Paul Erhumwunse; Lofor, Patrick; Momoh, Moses; Omoregie, Richard; Dirisu, John

    2011-01-01

    Background: Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim: This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods: Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result: Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0 - 5 years, and lowest among aged 18 - 23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion: The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent. PMID:22540074

  2. The importance of right otitis media in childhood language disorders.

    PubMed

    Uclés, Paulino; Alonso, María Francisca; Aznar, Elena; Lapresta, Carlos

    2012-01-01

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

  3. A case of chronic suppurative otitis media caused by Kerstersia gyiorum.

    PubMed

    Uysal, Elif B; Çelik, Cem; Tuzcu, Nevin; Can, Fevzi; Doğan, Mansur; Ertürk, Rahşan; Bakici, Mustafa Z

    2015-11-01

    Chronic suppurative otitis media is inflammation of the middle ear and mastoid that involves discharge and hearing loss. Kerstersia gyiorum is a member of the Alcaligenaceae family that who could not be treated with classical treatments such as patients with chronic otitis media, neck abscesses. K. gyiorum strain isolated from a patient with chronic suppurative otitis media.

  4. Rhinosinusitis and otitis media: the link with adenoids.

    PubMed

    Pagella, F; Colombo, A; Gatti, O; Giourgos, G; Matti, E

    2010-01-01

    Rhinosinusitis and otitis media are very common diseases observed in pediatric patients. A clear association has been reported in literature between these two conditions. Even concordance in the microbiologic findings has been reported. These findings lead to a discussion in regard to a possible relationship between the two diseases and an eventual interference of another concomitant condition promoting this association. A key role in the linkage between rhinosinusitis and otitis media has been attributed to hypertrophic adenoidal tissue because of its mechanical obstruction of both choanae and Eustachian tube orifices. Recently some works in literature evidenced the presence of bacterial biofilms on adenoids and suggested a responsibility of bacterial biofilms in both chronic rhinosinusitis and otitis media. The debate is still active and more investigations are needed to clarify these topics.

  5. Cholesterol granuloma associated with otitis media in a cat.

    PubMed

    Ilha, Marcia R S; Wisell, Carie

    2013-07-01

    An 8-year-old, male neutered Siamese cat was presented with Horner syndrome and right head tilt. A soft tissue mass was observed in the right tympanic cavity, and bulla osteotomy was performed. Tissue samples retrieved from the tympanic cavity were sent for histology, and a middle ear fluid swab was sent for bacterial culture and sensitivity. Histologic diagnosis was of otitis media associated with cholesterol granuloma (CG). Bacterial culture yielded Pasteurella multocida and Leifsonia (Corynebacterium) aquaticum. Middle ear CG is frequently seen in human beings and is associated with a variety of middle ear diseases including otitis media. Cholesterol granuloma of the middle ear has been experimentally induced in cats. The clinical and pathological findings of a spontaneous case of CG in the tympanic cavity of a cat with otitis media are described herein.

  6. 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.

  7. What is new in otitis media?

    PubMed Central

    2007-01-01

    The “wait and see” approach in acute otitis media (AOM), consisting of postponing the antibiotic administration for a few days, has been advocated mainly to counteract the increased bacterial resistance in respiratory infections. This approach is not justified in children less than 2 years of age and this for several reasons. First, AOM is an acute inflammation of the middle ear caused in about 70% of cases by bacteria. Redness and bulging of the tympanic membrane are characteristic findings in bacterial AOM. Second, AOM is associated with long-term dysfunction of the inflamed eustachian tube (ET), particularly in children less than 2 years of age. In this age group, the small calibre of the ET together with its horizontal direction result in impaired clearance, ventilation and protection of the middle ear. Third, recent prospective studies have shown poor long-term prognosis of AOM in children below 2 years with at least 50% of recurrences and persisting otitis media with effusion (OME) in about 35% 6 months after AOM. Viruses elicit AOM in about 30% of children. A prolonged course of AOM has been observed when bacterial and viral infections are combined because viral infection is also associated with ET dysfunction in young children. Bacterial and viral testing of the nasopharyngeal aspirate is an excellent tool both for initial treatment and recurrence of AOM. Antibiotic treatment of AOM is mandatory in children less than 2 years of age to decrease inflammation in the middle ear but also of the ET particularly during the first episode. The best choice is amoxicillin because of its superior penetration in the middle ear. Streptococci pneumoniae with intermediary bacterial resistance to penicillin are particularly associated with recurrent AOM. Therefore the dosage of amoxicillin should be 90 mg/kg per day in three doses. In recurrent AOM with β-lactamase-producing bacilli, amoxicillin should be associated with clavulanic acid at a dose of 6.4

  8. Otitis media and its consequences: beyond the earache.

    PubMed

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

    2010-03-01

    An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger spectrum of professionals with complementary expertise in middle-ear disease. Acute otitis media is a very common bacterial infection in children worldwide, leading to excessive antibiotic consumption in children in most countries and to a substantial burden of deafness and suppurative complications in developing countries. The group attempted to move beyond the existing controversies surrounding guidelines on acute otitis media, and to propose to clinicians and public health officials their views on the actions needed to be taken to reduce the disease burden caused by acute otitis media and the microbial antibiotic resistance from the resulting use of antibiotics. Definition of acute otitis media and diagnostic accuracy are crucial steps to identify children who will potentially benefit from treatment with antibiotics and to eliminate unnecessary prescribing. Although the group agreed that antibiotics are distributed indiscriminately, even to children who do not seem to have the disease, no consensus could be reached on whether antibiotics should be given to all appropriately diagnosed children, reflecting the wide range of practices and lack of convincing evidence from observational studies. The major unanimous concern was an urgent need to reduce unnecessary prescribing of antibiotics to prevent further increases in antibiotic resistance. Prevention of acute otitis media with existing and future viral and bacterial vaccines seems the most promising approach to affect disease burden and consequences, both in developed and developing countries.

  9. Early onset otitis media: risk factors and effects on the outcome of chronic suppurative otitis media.

    PubMed

    Lasisi, Akeem O; Olayemi, Oladapo; Irabor, Achiaka E

    2008-07-01

    The onset of early otitis media (EOM), in the first few months of life has been reported to predict later chronic otitis media (CSOM), although the prevalence rates are increasing little is known about specific risk factors. In this survey we examined the hypothesis that higher risk factors is associated with the development of OM within 1 year compared to later onset and early onset otitis media (OM) has potential for negative outcome of CSOM. This is a survey of the age at onset of otorrhoea and associated risk factors in children with CSOM, in five sites spread in two sub-urban cities in two states in Nigeria. Questionnaires were administered on the informants followed by examination of the children. EOM was seen in 136/189 (70%) with CSOM, the age range was 1-150 months, mean of 59.25 (SD = 44.55). Of the 85 CSOM subjects with hearing loss, EOM accounted for 49 (57.7%) while 36 (42.4%) was later onset, On multivariate analysis (OR = 0.276, CI = 0.133-0.572, P = 0.001) revealing EOM was significant in the development of hearing loss however there was no correlation with the frequency of attack of otorrhoea (OR = 1.025, CI = 0.88-1.19, P = 0.75). Low socioeconomic status seen in 110/136 EOM (P = 0.000), allergy (P = 0.030) and number of people >10 in household (OR = 4.13, CI = 1.81-9.39, P = 0.001) constituted the significant risk for EOM compared to later onset. Bottlefeeding, adenoiditis/adenoid hypertrophy, indoor cooking and upper respiratory infection were not found to have statistical significance in early onset OM compared to later onset OM. This study found correlation between EOM and hearing loss and identified allergy, low social status and chronic exposure to overcrowding through increased number of children in the household significant risk factors for future research focus. This may help in controlling the prevalence of hearing loss accompanying CSOM.

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

    PubMed

    Rettig, Eleni; Tunkel, David E

    2014-10-01

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

  11. Early otitis media among Minnesota American Indians: the Little Ears Study.

    PubMed

    Daly, Kathleen A; Pirie, Phyllis L; Rhodes, Kristine L; Hunter, Lisa L; Davey, Cynthia S

    2007-02-01

    We examined relationships between otitis media risk factors, sociodemographic characteristics, and maternal knowledge and attitudes and early onset of otitis media. Pregnant women from Minnesota American Indian reservations and an urban clinic were enrolled in our study between 1998 and 2001. Follow-up was performed on enrollees' infants until the children were 2 years old. Research nurses collected data by ear examination, from interviews and questionnaires given to enrolled mothers, and otitis media episodes that were abstracted from medical records. Sixty-three percent of infants had experienced an otitis media episode by 6 months of age. Logistic regression analyses showed that maternal otitis media history, infant history of upper respiratory infection, and compliance with study visits were significantly related to early otitis media onset. Although high percentages of infants were exposed to cigarette smoke and other children and were formula fed, these factors were not related to otitis media. Mothers' prenatal awareness of otitis media risks associated with environmental tobacco smoke exposure and formula feeding did not predict their postpartum behaviors. We found that infant history of upper respiratory infection and maternal otitis media history are risk factors for early otitis media in American Indian infants. Mothers' prepartum knowledge and attitudes regarding otitis media did not predict their postpartum avoidance of risk behaviors.

  12. Early Otitis Media Among Minnesota American Indians: The Little Ears Study

    PubMed Central

    Daly, Kathleen A.; Pirie, Phyllis L.; Rhodes, Kristine L.; Hunter, Lisa L.; Davey, Cynthia S.

    2007-01-01

    Objectives. We examined relationships between otitis media risk factors, sociodemographic characteristics, and maternal knowledge and attitudes and early onset of otitis media. Methods. Pregnant women from Minnesota American Indian reservations and an urban clinic were enrolled in our study between 1998 and 2001. Follow-up was performed on enrollees’ infants until the children were 2 years old. Research nurses collected data by ear examination, from interviews and questionnaires given to enrolled mothers, and otitis media episodes that were abstracted from medical records. Results. Sixty-three percent of infants had experienced an otitis media episode by 6 months of age. Logistic regression analyses showed that maternal otitis media history, infant history of upper respiratory infection, and compliance with study visits were significantly related to early otitis media onset. Although high percentages of infants were exposed to cigarette smoke and other children and were formula fed, these factors were not related to otitis media. Mothers’ prenatal awareness of otitis media risks associated with environmental tobacco smoke exposure and formula feeding did not predict their postpartum behaviors. Conclusions. We found that infant history of upper respiratory infection and maternal otitis media history are risk factors for early otitis media in American Indian infants. Mothers’ prepartum knowledge and attitudes regarding otitis media did not predict their postpartum avoidance of risk behaviors. PMID:17194873

  13. 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…

  14. 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…

  15. Efficacy of Linezolid in Experimental Otitis Media

    PubMed Central

    Pelton, S. I.; Figueira, M.; Albut, R.; Stalker, D.

    2000-01-01

    Therapy for otitis media (OM) due to resistant Streptococcus pneumoniae (MIC of penicillin, ≥2.0 μg/ml) is challenging. Linezolid, an oxazolidinone, represent a new class of antimicrobial agents with excellent in vitro activity against penicillin-resistant S. pneumoniae; however, in vitro activity against nontypeable Haemophilus influenzae (NTHI) is limited. We evaluated its efficacy against experimental acute OM due to a multidrug-resistant S. pneumoniae isolate and two isolates of NTHI. The chinchilla model was utilized to evaluate the efficacy of linezolid against experimental infection due to S. pneumoniae or NTHI. Serum and middle ear antibiotic concentrations were determined, and sterilization of experimental OM was evaluated. Chinchillas were inoculated directly with S. pneumoniae into the superior bulla. Twenty-four hours after inoculation, all animals had positive middle ear and nasopharyngeal cultures. Animals were given linezolid at 25 mg/kg/dose twice a day (b.i.d.) by orogastric feeding tube or amoxicillin at 40 mg/kg/dose b.i.d. intramuscularly for 5 days. By day 5, all animals in the linezolid group had sterile middle ear cultures and eradication of S. pneumoniae from the nasopharynx. In the amoxicillin group, all nine animals remained middle ear and nasopharynx positive (P < 0.01). In animals inoculated with NTHI, 25 and 37.5 mg/kg b.i.d. failed to sterilize middle ear infection or eradicate colonization. Mean levels in middle ear fluid measured during experimental infection were 12.8 μg/ml at 2 to 6 h and 4.1 μg/ml at 16 to 17 h after orogastric dosing at 25 mg/kg. Linezolid achieved a high concentration in the middle ear during experimental OM. Linezolid eradicated multidrug-resistant S. pneumoniae from the middle ear and nasopharynx. Experimental infection and nasopharyngeal colonization due to NTHI persisted despite achievement of concentrations in the middle ear that were above the MIC (for NTHI). PMID:10681334

  16. Zinc supplements for preventing otitis media.

    PubMed

    Gulani, Anjana; Sachdev, Harshpal S

    2012-04-18

    Otitis media (OM) is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent OM. To evaluate whether zinc supplements prevent OM in adults and children of different ages. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2012, Issue 1) which includes the Cochrane Acute Respiratory Infections Groups' Specialised Register, MEDLINE (1950 to February week 1, 2012) and EMBASE (1974 to February 2012). Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing OM. Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There was a total of 6820 participants. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc supplemented and placebo groups in the numbers of participants experiencing an episode of definite OM during follow-up (3191 participants); another trial showed a significantly lower incidence rate of OM in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of OM (mean difference (MD) -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause

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

    PubMed

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

    2017-07-26

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

  18. Terahertz otoscope and potential for diagnosing otitis media.

    PubMed

    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

    2016-04-01

    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.

  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. [Candida arthritis of the TM joint complicating chronic otitis media].

    PubMed

    Semlali, S; Nassar, I; Fikri, M; El Quessar, A; El Hassani, Mr; Chakir, N; Jiddane, M

    2004-11-01

    Infectious arthritis of the temporomandibular joint is very uncommon, and arthritis of the TM joint as a result of candida albicans infection has not previously been reported. The authors describe a patient treated for chronic otitis media complicated by arthritis of the temporomandibular joint. The diagnosis was made using CT scan and bacteriologic sampling.

  2. Otitis Media: Occurrence and Effect on Child Development.

    ERIC Educational Resources Information Center

    Jessen, B. A.; Beattie, R. G.

    1990-01-01

    This article reviews literature and research on otitis media, focusing on definitions; occurrence, including such influences as age, socioeconomic status, genetics, child care situation, feeding techniques, and sex; fluctuating hearing loss; psychological, linguistic, and cognitive development; and developmental deficits in speech, language,…

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

    ERIC Educational Resources Information Center

    Berwick, Donald M.; Thibodeau, Lawrence A.

    1980-01-01

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

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

    ERIC Educational Resources Information Center

    Quick, Carol; Mandell, Colleen

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

  5. Developmental and Psychoeducational Sequelae of Chronic Otitis Media.

    ERIC Educational Resources Information Center

    Zinkus, Peter W.; And Others

    1978-01-01

    American Medical Association, 535 N. Dearborn Street, Chicago, Illinois 60610. The developmental, psychological, and educational sequelae of chronic otitis media (a middle ear disease) occurring during the first 3 years of life were investigated in a group of children (ages 6-11 years) with educational difficulties. (Author/DLS)

  6. Otitis Media in Early Childhood and Later Language.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; And Others

    1991-01-01

    The relationship between early otitis media with effusion (OME) and later language development was examined in a prospective cohort of 30 children from middle class families and 33 children from low income families. Findings suggested no reliable relationship between early OME experience and later language development. (Author/DB)

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

    ERIC Educational Resources Information Center

    Gunnarson, Adele D.; And Others

    1990-01-01

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

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

    ERIC Educational Resources Information Center

    Gunnarson, Adele D.; And Others

    1990-01-01

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

  9. Otitis Media in Early Childhood and Later Language.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; And Others

    1991-01-01

    The relationship between early otitis media with effusion (OME) and later language development was examined in a prospective cohort of 30 children from middle class families and 33 children from low income families. Findings suggested no reliable relationship between early OME experience and later language development. (Author/DB)

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

    ERIC Educational Resources Information Center

    Quick, Carol; Mandell, Colleen

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

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

    PubMed

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

    2016-08-01

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

  12. Developmental and Psychoeducational Sequelae of Chronic Otitis Media.

    ERIC Educational Resources Information Center

    Zinkus, Peter W.; And Others

    1978-01-01

    American Medical Association, 535 N. Dearborn Street, Chicago, Illinois 60610. The developmental, psychological, and educational sequelae of chronic otitis media (a middle ear disease) occurring during the first 3 years of life were investigated in a group of children (ages 6-11 years) with educational difficulties. (Author/DLS)

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

    PubMed

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

    2017-07-01

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

  14. Otitis Media: Occurrence and Effect on Child Development.

    ERIC Educational Resources Information Center

    Jessen, B. A.; Beattie, R. G.

    1990-01-01

    This article reviews literature and research on otitis media, focusing on definitions; occurrence, including such influences as age, socioeconomic status, genetics, child care situation, feeding techniques, and sex; fluctuating hearing loss; psychological, linguistic, and cognitive development; and developmental deficits in speech, language,…

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

    ERIC Educational Resources Information Center

    Berwick, Donald M.; Thibodeau, Lawrence A.

    1980-01-01

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

  16. 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…

  17. Serous otitis media revealing temporal en plaque meningioma.

    PubMed

    Ayache, Denis; Trabalzini, Franco; Bordure, Philippe; Gratacap, Benoit; Darrouzet, Vincent; Schmerber, Sébastien; Lavieille, Jean-Pierre; Williams, Marc; Lescanne, Emmanuel

    2006-10-01

    To present a series of temporal en plaque meningiomas involving the middle ear or mastoid, whose main symptoms suggested a serous otitis media. Multicentric retrospective study reviewing clinical records originating from eight tertiary referral centers. The clinical records of 10 patients presenting with signs and symptoms suggesting serous otitis media and whose neuroimaging studies revealed a temporal en plaque meningioma involving the middle ear or mastoid are reported. All the patients were women, ranging from 49 to 71 years old. The delay between the onset of symptoms and the diagnosis of meningioma varied from 1 to 10 years. All the patients underwent various procedures usually applied for the treatment of serous otitis media, which failed in all the cases, particularly ventilating tube placement, which was followed by severe episodes of discharge. In all cases, the computed tomographic scans showed three imaging signs: soft tissue mass filling the middle ear or mastoid, hyperostosis of the petrous bone, and hairy aspect of the intracranial margins of the affected bone. This imaging triad must alert the otologist of the possibility of intracranial meningioma. Magnetic resonance imaging was the method of choice to assess the diagnosis of intracranial meningioma involving the middle ear or mastoid. When analyzing management options, it appeared that conventional middle ear procedures were inefficient. Temporal en plaque meningioma involving the middle ear or mastoid can mimic a serous otitis media. A computed tomographic scan is recommended for cases of atypical or prolonged unilateral serous otitis media to investigate indirect signs of a meningioma, which has to be confirmed with magnetic resonance imaging.

  18. Frequency of Serous Otitis Media in Children without Otolaryngological Symptoms

    PubMed Central

    Kocyigit, Murat; Ortekin, Safiye Giran; Cakabay, Taliye; Ozkaya, Guven; Bezgin, Selin Ustun; Adali, Mustafa Kemal

    2016-01-01

    Introduction Otitis media with effusion is the fluid in the middle ear with no signs or symptoms of acute ear infection. Objective This study aims to research the frequency of serous otitis media in patients referred to the pediatric clinic between 3–16 years of age without any active ear, nose, and throat complaints. Methods This study included 589 children patients (280 boys, 309 girls; mean age: 9.42; range 3–16) who were administered to the pediatric clinic without otolaryngologic complaints. Patients underwent examination with flexible nasopharyngoscopy for adenoid hypertrophy. An otorhinolaryngologist examined all children on both ears using an otoscope and tested with tympanometry. We used tympanometry results to diagnose SOM. Results The study included 589 patients that underwent fiber optic examination of the nasopharynx with an endoscope. Adenoid vegetation was present in 58 patients (9.8%) and was not detected in 531 patients (90.2%). We found serous otitis media in 94 (15.9%) patients. We obtained Type A tympanogram in 47 (81%) of 58 patients with adenoid vegetation, 6 (10.3%) Type B, and 5 (8.6%) Type C. When comparing 58 patients with adenoid vegetation with 538 patients without adenoid vegetation for serous otitis media, the frequency was not statistically significant (p > 0.05). Conclusion We believe that in children without any ear, nose, and throat complaints, it is possible to detect serous otitis media with adenoid vegetation. Thus, pediatric patients should undergo screening at regular intervals. PMID:28382124

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

    PubMed

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

    2016-06-01

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

  20. Acute otitis media with spontaneous tympanic membrane perforation.

    PubMed

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

    2017-01-01

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

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

    PubMed Central

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

    2011-01-01

    Background Streptococcus pneumoniae (Spn) is one of the common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (otitis-prone) and AOM treatment failure (AOMTF) in children. Objective From a population of 268 children we sought to compare the serum IgG antibody titers to five different Spn proteins (PhtD, LytB, PcpA, PhtE and Ply) that are vaccine candidates in children with episodic AOM (n=34), who were otitis prone (n=35), and who had AOMTF (n=25) caused by Spn. Methods Antibody was quantitated by ELISA. Results At their acute AOM visit, anti-PhtD, -LytB, -PhtE and −Ply IgG antibody titers in otitis-prone children were significantly lower compared to non-otitis prone children (p <0.05) and children with AOMTF (p <0.05). Comparing acute to convalescent titers of antibody after AOM we found that otitis-prone, AOMTF and non-otitis prone children had no significant change in geometric mean IgG antibody titers against the five proteins (except for PhtE in children with AOMTF), but detailed analysis showed that about one-third of the children in each cohort had a 2-fold rise in antibody to the studied antigens. While non-otitis prone children had significant increases (p <0.001) between 6 and 24 months of age in anti-PhtD, PcpA, PhtE and Ply IgG antibody titers as a consequence of nasopharyngeal colonization and AOM, otitis-prone children either failed to show rises or the rises were significantly less than the non-otitis prone children. Conclusion Otitis-prone and AOMTF children mount less of an IgG serum antibody response than non-otitis prone children to Spn proteins following AOM and nasopharyngeal colonization. PMID:21487325

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

    PubMed

    Wasson, J D; Yung, M W

    2015-02-01

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

  3. A case series of complicated infective otitis media requiring surgery in adults.

    PubMed

    Heah, Harold; Soon, Sue Rene; Yuen, Heng-Wai

    2016-12-01

    With the advent of antibiotics, complications of otitis media have become less common. It is crucial for physicians to recognise otitis media and treat its complications early. Herein, we present our institution's experience with patients who required emergency surgical intervention for complications of otitis media. Data on patients who underwent emergency surgery for complications of otitis media from 2004 to 2011 was retrieved from the archives of the Department of Otolaryngology, Changi General Hospital, Singapore. A total of 12 patients (10 male, two female) underwent emergency surgery for complications of otitis media. The median age of the patients was 25 years. Otalgia, otorrhoea, headache and fever were the main presenting symptoms. Extracranial complications were observed in 11 patients, and six patients had associated intracranial complications. The primary otologic disease was acute otitis media in six patients, chronic otitis media without cholesteatoma in three patients and chronic otitis media with cholesteatoma in three patients. Mastoidectomy and drainage of abscess through the mastoid, with insertion of grommet tube, was the main surgical approach. Two patients required craniotomy. The mean length of hospital stay was 16.2 days and the mean follow-up period was 16.3 months. Five patients had residual conductive hearing loss; two patients with facial palsy had full recovery. Otitis media can still result in serious complications in the post-antibiotic era. Patients with otitis media should be monitored, and prompt surgical intervention should be performed when necessary to attain good outcomes.

  4. A case series of complicated infective otitis media requiring surgery in adults

    PubMed Central

    Heah, Harold; Soon, Sue Rene; Yuen, Heng-Wai

    2016-01-01

    INTRODUCTION With the advent of antibiotics, complications of otitis media have become less common. It is crucial for physicians to recognise otitis media and treat its complications early. Herein, we present our institution’s experience with patients who required emergency surgical intervention for complications of otitis media. METHODS Data on patients who underwent emergency surgery for complications of otitis media from 2004 to 2011 was retrieved from the archives of the Department of Otolaryngology, Changi General Hospital, Singapore. RESULTS A total of 12 patients (10 male, two female) underwent emergency surgery for complications of otitis media. The median age of the patients was 25 years. Otalgia, otorrhoea, headache and fever were the main presenting symptoms. Extracranial complications were observed in 11 patients, and six patients had associated intracranial complications. The primary otologic disease was acute otitis media in six patients, chronic otitis media without cholesteatoma in three patients and chronic otitis media with cholesteatoma in three patients. Mastoidectomy and drainage of abscess through the mastoid, with insertion of grommet tube, was the main surgical approach. Two patients required craniotomy. The mean length of hospital stay was 16.2 days and the mean follow-up period was 16.3 months. Five patients had residual conductive hearing loss; two patients with facial palsy had full recovery. CONCLUSION Otitis media can still result in serious complications in the post-antibiotic era. Patients with otitis media should be monitored, and prompt surgical intervention should be performed when necessary to attain good outcomes. PMID:26843060

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

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

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

  6. Listening and Language at 4 Years of Age: Effects of Early Otitis Media.

    ERIC Educational Resources Information Center

    Gravel, Judith S.; Wallace, Ina F.

    1992-01-01

    Examination of 23 4-year-old children classified otitis media negative or positive during their first year of life indicated that otitis positive children required a more advantageous signal-to-competition ratio for sentence intelligibility, compared to otitis-negative peers. No intergroup differences were found in receptive or expressive language…

  7. Listening and Language at 4 Years of Age: Effects of Early Otitis Media.

    ERIC Educational Resources Information Center

    Gravel, Judith S.; Wallace, Ina F.

    1992-01-01

    Examination of 23 4-year-old children classified otitis media negative or positive during their first year of life indicated that otitis positive children required a more advantageous signal-to-competition ratio for sentence intelligibility, compared to otitis-negative peers. No intergroup differences were found in receptive or expressive language…

  8. Mouse models of otitis media: strengths and limitations.

    PubMed

    Bhutta, Mahmood Fazal

    2012-10-01

    There has been a rapid rise in the use of the mouse to investigate pathobiology of otitis media. This is for good reason, including easy husbandry, but also capacity for genetic manipulation of the mouse. Insights into human disease have been gleaned from mouse models, but there are limitations of the mouse-to-man approach. First, important differences exist between mouse and man, particularly in immune function. Second, functional equivalence of genes in the 2 species is not ensured. Third, laboratory mice of a uniform genetic background and environment are an inadequate model of the plethora of factors affecting complex disease in humans. Finally, gene function in mouse models is often obliterated using gene knockout technology, but this is a poor mimic of normal gene variation in man. These drawbacks of the mouse may in the future limit its usefulness in otitis media research.

  9. Rare A2ML1 variants confer susceptibility to otitis media

    PubMed Central

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

    2015-01-01

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

  10. 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.

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

    PubMed

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

    2011-07-01

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

  12. Management of chronic otitis media by subtotal petrosectomy.

    PubMed

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

    2016-01-01

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

  13. (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

  14. Otitis media in Australian Aboriginal children: an overview.

    PubMed

    Leach, A J

    1999-10-05

    Remote and rural Australian Aboriginal children achieve lower standards of numeracy and literacy than their non-Aboriginal peers. The reasons are complex, but extraordinarily high rates of conductive hearing loss (> 50%) are, in part, responsible for poor classroom success. In addition to the burden of acute bacterial respiratory illness (highest rates of invasive pneumococcal disease in the literature), chronic disease affects virtually every young child. In the Aboriginal community studied, otitis media commenced within 3 months of birth for all infants, progressed to chronic suppurative otitis media in 60% and did not resolve throughout early childhood. Our findings, supported by mathematical modelling, show that the vicious cycle of endemic chronic otitis media is perpetuated by high carriage rates of multiple species and multiple types of respiratory bacterial pathogens, by high cross-infection rates and thus, by early age of pathogen acquisition and prolonged carriage. Long-term damage to respiratory mucosa, possibly linked to later chronic bronchitis and bronchiectasis, follows a constant series of infections by each of the concurrently held pathogens, without periods of recovery. Overcrowding and poor hygiene promote this vicious cycle. Medical and social options for intervention are limited by poor resources, low expectations for health and a complex biology that includes antibiotic resistant pneumococci.

  15. Subacute tuberculous otitis media complicated by petrositis and meningitis.

    PubMed

    Dumas, G; Schmerber, S; Atallah, I; Brion, J-P; Righini, C A

    2012-01-01

    The aim of our case study is to illustrate diagnostic and therapeutic difficulties as well as gravity related to tuberculous otitis media with intracranial complications. A diabetic male patient of 65 years old was treated for subacute otitis media with mixed hearing loss. Early bacteriologic samples from ear exudates revealed opportunistic pathogens. Clinical evolution after four months was marked by the appearance of mastoiditis with facial paralysis. The patient presented petrositis and bilateral laryngeal paralysis with lymphocytic meningitis after six and eight months respectively. Tuberculosis was suspected after a positive ELlspot tests with appearance of biologic markers of hepatic dysfunction like cholestasis and hepatic cytolysis. Although antituberculous treatment was instaured even without isolation of acid fast bacilli, the patient died after ten months. Subacute otitis media complicated by labyrinthitis, early onset of facial paralysis or any other oranial nerve palsy should raise suspicion of tuberculosis. The prognosis depends on early diagnosis which remains difficult despite morphological and metabolic imaging. The diagnostic workup should include histological and bacteriologic samples, liver markers of intacellular damage as well as ELlspot test. The prognosis remains poor especially in immunocompromised patients despite appropriate treatment.

  16. Human evolutionary history: consequences for the pathogenesis of otitis media.

    PubMed

    Bluestone, Charles D; Swarts, J Douglas

    2010-12-01

    The pathogenesis of otitis media is multifactorial, but the role of evolution on its development has not been addressed. We posit that the high prevalence of middle-ear disease is most likely restricted to humans, in contrast to other wild species, because the associated hearing loss would have reduced the fitness of affected individuals as a result of predation. We present here the possible consequences of two human adaptations that may have resulted in ubiquitous otitis media: the interaction of bipedalism and increased brain size, and the loss of facial prognathism resulting from speech or cooking. As a consequence of our adaptation for bipedalism, the female pelvic outlet is constricted, which, in the context of a rapidly enlarging brain, results in humans being born 12 months too soon. Significantly, immature eustachian tube structure and function, in conjunction with an immature immune system, helps to explain the high incidence of otitis media in the first year of life. But the persistence of middle-ear disease beyond this stage is not explained by "immaturity." The morphology of the palate changed with the adaptations that produced facial flattening, with concomitant effects on eustachian tube function. These changes resulted in relatively poor human physiologic tubal function in comparison to the nonhuman primate.

  17. PROPER USE OF ANTIBIOTICS IN TREATMENT OF ACUTE OTITIS MEDIA

    PubMed Central

    Rutherford, Miriam H.

    1951-01-01

    The problem of preventing loss of hearing following acute otitis media has been made more complex by the use of penicillin and other antibiotic agents which may apparently cure yet leave dangerous residual disease. The causes of loss of hearing must be recognized early if remedial treatment is to be effective. In children particularly, loss of hearing may go unnoticed for some time. Physicians who treat otitis media should feel the responsibility not only of bringing an acutely ill child back to health but of preserving the function of the hearing mechanism. Careful examination of the ear after apparent subsidence of infection is mandatory. It is of the utmost importance to be able to recognize the ear drum in its normal state and its various pathological states and to be alert to the early signs of changes associated with loss of hearing. Antibiotics should not be expected to do more than help combat the acute infection in otitis media. Adequate follow-up demands strong suspicion of residual pathologic process in the ear. The prevention of loss of hearing still requires knowledge of the established clinical facts and therapeutic procedures and the application of this knowledge to treatment of acute infections of the middle ear. PMID:14848731

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

    PubMed

    Maranhão, André Souza de Albuquerque; Godofredo, Valeria Romero; Penido, Norma de Oliveira

    2016-01-01

    Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. We identified 14 patients, eight (57%) of whom were females and six (43%) males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%), acute suppurative otitis media in six (43%), and chronic otitis media without cholesteatoma was diagnosed in two patients (14%). Besides labyrinthitis, 24 concomitant complications were identified: six cases (25%) of labyrinthine fistula, five cases (21%) of meningitis, five cases (21%) of facial paralysis, five cases (21%) of mastoiditis, two cases (8%) of cerebellar abscess, and one case (4%) of temporal abscess. There was one death. Eight (57%) individuals became deaf, while six (43%) acquired mixed hearing loss. Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. 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

  20. [Correlation analysis of bacterial biofilm formation and bacterial culture in chronic otitis media].

    PubMed

    Gu, Xingzhi; Tuoheti, Abulajiang; Keyoumu, Youledusi; Cheng, Xiuqing; Tang, Yuanyuan; Shi, Dongmei; Zhang, Hua

    2014-07-01

    To study the correlation between the bacterial biofilm formation and bacterial culture in chronic otitis media. As a prospective reserch, we used scanning electron microscopy to examinate patients samples which collected from 32 cases of patients with chronic suppurative otitis media and middle ear cholesteatoma in the operations, and performed the middle ear secretions bacterial culture. According to the different types of chronic otitis media group, we analysised the relationship between chronic otitis media bacterial biofilm formation and the bacterial culture results. Chronic suppurative otitis media (activity) and middle ear cholesteatoma bacterial biofilm formation rate were 87.5%, 81.3%, chi-square (P > 0.05). Compared bacterial biofilm results with the results of bacterial cultured in chronic otitis media, sensitivity was 70.37%, specificity was 60.00%, the misdiagnosis rate was 40.00%, the missed diagnosis was 29.63%, positive predictive value was 90. 46%, negative predictive value was 27.27%, accuracy was 68.75%. Youden index was 30. 37%, and Pearson correlation coefficient was 0.232 (P > 0.05). Chronic suppurative otitis media (activity) and middle ear cholesteatoma bacteria had a higher biofilm formation rate. The routine bacterial culture results can't reflecte bacterial biofilm formation in chronic otitis media. We need to explore more reliable experimental methods to accurately reveal the infection status of chronic otitis media.

  1. 77 FR 60126 - Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-02

    ...; Formerly 2008N-0004] Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment... Media: Developing Drugs for Treatment.'' This guidance addresses FDA's current thinking regarding the... treatment of acute bacterial otitis media (ABOM). This guidance finalizes the revised draft guidance of...

  2. Otitis media and tonsils--role of adenoidectomy in the treatment of chronic otitis media with effusion.

    PubMed

    Park, Keehyun

    2011-01-01

    Innate immunity involves the first line of the mucosal defense system. Homeostatic defense of the middle ear and Eustachian tube is maintained in part by molecules related to the innate immunity. The middle ear and tonsils are the organs related to the innate immunity. Recent attention has focused on the possibility that chronic otitis media and adenotonsillitis may represent a chronic infective state such as evidenced in conditions secondary to biofilms or small colony variants. The role of biofilms in the persistence of chronic mucosal-based ENT-related infections was first recognized in otitis media and adenotonsillitis. The efficacy of adenotonsillectomy on otitis media with effusion (OME) has been demonstrated by several randomized and controlled studies. It was speculated that tonsil and adenoid may play a role as an infectious focus to OME. In summary, patients suffering from recurrent or chronic OME may benefit from adenoidectomy due to the removal of an infectious source in the nasopharynx rather than the removal of a large adenoidal mass. Copyright © 2011 S. Karger AG, Basel.

  3. Recurrent acute otitis media detracts from health-related quality of life.

    PubMed

    Kujala, T; Alho, O-P; Kristo, A; Uhari, M; Renko, M; Pokka, T; Koivunen, P

    2017-02-01

    Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

  4. Otitis Media in Early Childhood and Its Relationship to Later Phonological Development.

    ERIC Educational Resources Information Center

    Roberts, Joanne Erwick; And Others

    1988-01-01

    Examination of 55 socioeconomically disadvantaged children found no significant relationship between otitis media in early childhood and number of common phonological processes or consonants in error used during preschool years. However, otitis media in early childhood was associated with total number of phonological processes used by children…

  5. Phonological Systems of Speech-Disordered Clients with Positive/Negative Histories of Otitis Media.

    ERIC Educational Resources Information Center

    Churchill, Janine D.; And Others

    1988-01-01

    Evaluation of object-naming utterances of articulation-disordered children (ages 3-6) found that subjects with histories of recurrent otitis media during their first 24 months evidenced stridency deletion (in consonant singletons and in consonant clusters) significantly more than did subjects with negative otitis media histories. (Author/DB)

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

    ERIC Educational Resources Information Center

    Grievink, Eefje H.; And Others

    1993-01-01

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

  7. The Role of Otitis Media in the Development of Expressive Language Disorder.

    ERIC Educational Resources Information Center

    Lonigan, C. J.; And Others

    1992-01-01

    In a study of 50 normal children and 65 children with expressive language disorder (ELD), results showed no differences in the frequency, duration, or timing of episodes of otitis media. For children with ELD, there was a relationship between otitis media and expressive language improvement. (BC)

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

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; And Others

    1996-01-01

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

  9. Functional Analysis of Episodic Self-Injury Correlated with Recurrent Otitis Media.

    ERIC Educational Resources Information Center

    O'Reilly, Mark F.

    1997-01-01

    A functional analysis examined the consequences that maintained episodic self-injury and the relationship between those consequences and otitis media for a 26-month-old child with developmental disabilities. Results indicated that self-injury occurred only during periods of otitis media and may have served as a sensory escape function. (Author/CR)

  10. The Role of Otitis Media in the Development of Expressive Language Disorder.

    ERIC Educational Resources Information Center

    Lonigan, C. J.; And Others

    1992-01-01

    In a study of 50 normal children and 65 children with expressive language disorder (ELD), results showed no differences in the frequency, duration, or timing of episodes of otitis media. For children with ELD, there was a relationship between otitis media and expressive language improvement. (BC)

  11. Functional Analysis of Episodic Self-Injury Correlated with Recurrent Otitis Media.

    ERIC Educational Resources Information Center

    O'Reilly, Mark F.

    1997-01-01

    A functional analysis examined the consequences that maintained episodic self-injury and the relationship between those consequences and otitis media for a 26-month-old child with developmental disabilities. Results indicated that self-injury occurred only during periods of otitis media and may have served as a sensory escape function. (Author/CR)

  12. Phonological Systems of Speech-Disordered Clients with Positive/Negative Histories of Otitis Media.

    ERIC Educational Resources Information Center

    Churchill, Janine D.; And Others

    1988-01-01

    Evaluation of object-naming utterances of articulation-disordered children (ages 3-6) found that subjects with histories of recurrent otitis media during their first 24 months evidenced stridency deletion (in consonant singletons and in consonant clusters) significantly more than did subjects with negative otitis media histories. (Author/DB)

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

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; And Others

    1996-01-01

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

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

    ERIC Educational Resources Information Center

    Grievink, Eefje H.; And Others

    1993-01-01

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

  15. Otitis Media in Early Childhood and Its Relationship to Later Phonological Development.

    ERIC Educational Resources Information Center

    Roberts, Joanne Erwick; And Others

    1988-01-01

    Examination of 55 socioeconomically disadvantaged children found no significant relationship between otitis media in early childhood and number of common phonological processes or consonants in error used during preschool years. However, otitis media in early childhood was associated with total number of phonological processes used by children…

  16. 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…

  17. 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…

  18. Tuberculous otitis media and lupus vulgaris of face: an unusual association.

    PubMed

    Kohli, Parvinderjit Singh; Kumar, Vipin; Nibhoria, Sarita

    2011-07-01

    Tuberculous otitis media is a rare extra-pulmonary presentation of tuberculosis. Tuberculous otitis media is usually associated with pulmonary tuberculosis or tuberculosis involving nasopharynx and oropharynx. Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis. The disease often affects the face and may be associated with nasal or nasopharyngeal tuberculosis. Lupus vulgaris associated with tuberculous otitis media is not reported in English literature. We report a case of 40 year old female patient who presented with symptoms of chronic suppurative otitis media and non-healing skin lesion of face. The biopsy of skin lesion showed granulomatous pathology and helped us to reach a diagnosis of tuberculous otitis media.

  19. Incidence of acute otitis media and sinusitis complicating upper respiratory tract infection: the effect of age.

    PubMed

    Revai, Krystal; Dobbs, Laura A; Nair, Sangeeta; Patel, Janak A; Grady, James J; Chonmaitree, Tasnee

    2007-06-01

    Infants and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications such as acute otitis media and sinusitis. We evaluated 623 upper respiratory tract infection episodes in 112 children (6-35 months of age) to determine the proportion of upper respiratory tract infection episodes that result in acute otitis media or sinusitis. Of all upper respiratory tract infections, 30% were complicated by acute otitis media and 8% were complicated by sinusitis. The rate of acute otitis media after upper respiratory tract infection declined with increasing age, whereas the rate of sinusitis after upper respiratory tract infection peaked in the second year of life. Risk for acute otitis media may be reduced substantially by avoiding frequent exposure to respiratory viruses (eg, avoidance of day care attendance) in the first year of life.

  20. Otitis media with effusion and dental occlusion: is there any relationship?

    PubMed

    Nery, C de Góis; Buranello, F Stefanato; Pereira, C; Di Francesco, R Cantisani

    2010-09-01

    Auditory tube dysfunction is one of the aetiological causes of otitis media. Studies suggest a correlation between otitis media with effusion and dental malocclusion. Our goal was to determine any correlation between dental malocclusion and otitis media with effusion in children with chronic upper airway obstruction due to tonsil and adenoid enlargement. This prospective study evaluated 52 children with otitis media with effusion and 48 without, aged 4.2 to 10.8 years. A questionnaire was answered by the parents about breast or bottle-feeding and bad oral habits. Malocclusion was diagnosed according to Angle's classification for molar relationships in Classes I, II and III, posterior and anterior cross bite, open and deep bite, and overjet. The results suggested no correlation between dental malocclusion and otitis media with effusion. Other potential confounders, such as breast or bottle- feeding and oral habits were also not correlated.

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

    PubMed

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

    2012-01-01

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

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

    PubMed

    Azadarmaki, Roya; Westra, William; Prasad, Sanjay

    2015-09-01

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

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

    PubMed

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

    2017-10-01

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

  4. Otitis Media and Its Sequelae in Kenyan Schoolchildren.

    PubMed

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

    2016-12-01

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

  5. Familial link of otitis media requiring tympanostomy tubes.

    PubMed

    Padia, Reema; Alt, Jeremiah A; Curtin, Karen; Muntz, Harlan R; Orlandi, Richard R; Berger, Justin; Meier, Jeremy D

    2017-04-01

    Placement of tympanostomy tubes for recurrent or chronic otitis media is the most commonly performed ambulatory procedure in the United States. Etiologies have been speculated to be environmentally based, and studies have suggested a genetic component to the disease. However, no large-scale studies have attempted to define a familial component. The objective of this study was to determine the familial risk of otitis media requiring tympanostomy tubes (OMwTT) in a statewide population. Retrospective observational cohort study with population-based matched controls. Using an extensive genealogical database linked to medical records, the familial risk of OMwTT was calculated for relatives of probands (46,249 patients diagnosed with OMwTT from 1996-2013) compared to random population controls matched 5:1 on sex and birth year from logistic regression models. The median age at time of tympanostomy tube placement was 1 year (interquartile range, 0-2 years). First-degree relatives of patients with OMwTT, primarily siblings, had a 5-fold increased risk of OMwTT (P < 10(-16) ). Second-degree relatives were at a 1.5-fold increased risk (P < 10(-15) ). More extended relatives (third, fourth and fifth degree) showed a 1.4-fold increased risk (P < 10(-15) ). In the largest population-based study to date, a significant familial risk is confirmed in OMwTT, suggesting otitis media may have a significant genetic component given the increased risk found in close as well as distant relatives. This could be influenced by shared environments given a five-times risk observed in siblings. Further understanding the genetic basis of OMwTT and its interplay with environmental factors may clarify the etiology and lead to better detection of disease and treatments. 3b. Laryngoscope, 127:962-966, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  6. 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

  7. Middle ear pressures of children with otitis media with effusion.

    PubMed

    Takahashi, H; Honjo, I; Hayashi, M; Fujita, A; Kurata, K

    1991-06-01

    Middle ear (ME) pressures were measured in 30 children with chronic otitis media with effusion (OME) transtubally with the use of a catheter pressure transducer (Mikro-tip, PC-330F). They were found to range from 40 to -185 mm H2O, the average being mildly negative (-54.33 +/- 59.04 mm H2O). About two thirds of these children had pulsating changes of ME pressure; the range of the pressure change was between 10 and 50 mm H2O. The ME pressure tended to be lower in ears with serous effusion than in those with mucoid effusion, but there was no significant difference between them.

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

    PubMed Central

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

    2016-01-01

    Objective To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population Study Design Cross-sectional study Setting Indigenous Filipino community Subjects and Methods Clinical history and information on breastfeeding, tobacco smoke exposure and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for presence and character of perforation or discharge. An A2ML1 duplication variant that confers otitis media susceptibility was Sanger-sequenced in all DNA samples. Co-occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to A2ML1 genotype and social cluster. Results The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; p=0.004), however age was non-significant as a bi-stratal or continuous variable. There was no association between otitis media and gender, body mass index, breastfeeding, tobacco exposure or deep swimming. In multivariate analyses, A2ML1 genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95%CI: 1.3, 10.8; p=0.005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life and chronic otitis media persisted up to adulthood, particularly in A2ML1 variant carriers. Conclusion Among indigenous Filipinos, A2ML1 genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome and social clusters might modulate the effect of the A2ML1 genotype. PMID:27484237

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

    PubMed

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

    2016-11-01

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

  10. Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis?

    PubMed

    Laulajainen-Hongisto, Anu; Saat, Riste; Lempinen, Laura; Aarnisalo, Antti A; Jero, Jussi

    2015-09-01

    To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis. A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time. The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis. Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media

  11. 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.

  12. Bacterial isolates in chronic suppurative otitis media: a changing pattern?

    PubMed

    Adoga, A A; Bakari, A; Afolabi, O A; Kodiya, A M; Ahmad, B M

    2011-01-01

    The most frequently isolated organism in chronic suppurative otitis media from different parts of the world is Pseudomonas aeruginosa. The pattern from this bacteriological study from our region is different. This study was carried out on 97 patients presenting to the outpatient clinic of the National Ear Care Center, Kaduna. Nigeria from May 2008 to April 2009. The patients were aged between 1 year and 75 years comprising 50) males and 47 females giving a male to female ratio of 1:1. Most of the patients (n=40, 41.2%) were in the age group 1-10) years. Seventy-five (77.3%) patients had a positive culture while in 22 (22.7%) patients there was no growth. Gram-negative bacteria comprised 80% of the isolates. The predominant organisms cultured were Klebsiella sp (n=31, 41.3%), Escherichia coli (n=22, 29.3%) and Pseudomonas aeruginosa (n=6, 8%). The gram-positive isolates were Streptococcus sp (n=8, 10.8%) and Staphylococcus aureus (n=7, 9.3%). In-vitro drug sensitivity pattern of all isolates shows that they were more sensitive to Ofloxacin, ciprofloxacin and Perfloxacin. Klebsiella sp. Escherichia coli and Streptococcus sp. are the leading pathogenic organisms in chronic suppurative otitis media in our region and their ensitivity rates are highest to the quinolone antibiotics, which are relatively cheap, readily available as ototopic agents and lack ototoxic effects.

  13. Bacterial strain changes during chronic otitis media surgery.

    PubMed

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

    2017-09-01

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

  14. Mcph1-Deficient Mice Reveal a Role for MCPH1 in Otitis Media

    PubMed Central

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

    2013-01-01

    Otitis media is a common reason for hearing loss, especially in children. Otitis media is a multifactorial disease and environmental factors, anatomic dysmorphology and genetic predisposition can all contribute to its pathogenesis. However, the reasons for the variable susceptibility to otitis media are elusive. MCPH1 mutations cause primary microcephaly in humans. So far, no hearing impairment has been reported either in the MCPH1 patients or mouse models with Mcph1 deficiency. In this study, Mcph1-deficient (Mcph1tm1a/tm1a) mice were produced using embryonic stem cells with a targeted mutation by the Sanger Institute's Mouse Genetics Project. Auditory brainstem response measurements revealed that Mcph1tm1a/tm1a mice had mild to moderate hearing impairment with around 70% penetrance. We found otitis media with effusion in the hearing-impaired Mcph1tm1a/tm1a mice by anatomic and histological examinations. Expression of Mcph1 in the epithelial cells of middle ear cavities supported its involvement in the development of otitis media. Other defects of Mcph1tm1a/tm1a mice included small skull sizes, increased micronuclei in red blood cells, increased B cells and ocular abnormalities. These findings not only recapitulated the defects found in other Mcph1-deficient mice or MCPH1 patients, but also revealed an unexpected phenotype, otitis media with hearing impairment, which suggests Mcph1 is a new gene underlying genetic predisposition to otitis media. PMID:23516444

  15. Otitis media and the social behavior of day-care-attending children.

    PubMed

    Vernon-Feagans, L; Manlove, E E; Volling, B L

    1996-08-01

    Research has suggested that young children who experience chronic middle ear disease (otitis media) in early childhood may display some initial developmental delays in language development as well as later problems in school. This association between otitis media and developmental problems is hypothesized to be linked to the hearing loss that accompanies frequent or long bouts of otitis media. Recent interest has focused on whether otitis media may be linked to behavioral changes in children, making them less responsive to the environment even when well. This study examined the relation between early otitis media in day-care-attending children and their subsequent behavior in the day-care classroom when the children were well. Findings suggest that day-care-attending children with chronic otitis media in the first 3 years of life play more often alone and have fewer positive and fewer negative verbal interactions with peers than nonchronic children in day-care. There were no differences between chronic and nonchronic otitis media children in their nonverbal behavior. Results may also contribute to our understanding of the development of the socially withdrawn child.

  16. Paediatric otitis media at a primary healthcare clinic in South Africa.

    PubMed

    Biagio, L; Swanepoel, D W; Laurent, C; Lundberg, T

    2014-05-12

    No published studies on the prevalence of paediatric otitis media at primary healthcare clinics (PHCs) in South Africa (SA) are available. To examine the point prevalence of otitis media in a paediatric population in a PHC in Johannesburg, SA, using otomicroscopy. A sample of 140 children aged 2 - 16 years (mean 6.4; 44.1% females) were recruited from patients attending the PHC. Otomicroscopy was completed for each of the participants' ears by a specialist otologist using a surgical microscope. Cerumen removal was necessary in 36.0% of participants (23.5% of ears). Otitis media with effusion was the most frequent diagnosis (16.5%). Chronic suppurative otitis media (CSOM) was diagnosed in 6.6% of children and was the most common type of otitis media in participants aged 6 - 15 years. Acute otitis media was only diagnosed in the younger 2 - 5-year age group (1.7%). Otitis media was significantly more prevalent among younger (31.4%) than older children (16.7%). CSOM prevalence, as classified by the World Health Organization, was high. Consequently diagnosis, treatment and subsequent referral protocols may need to be reviewed to prevent CSOM complications.

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2016-03-01

    Otitis media is one of the most common childhood diseases worldwide, but because of lack of doctors and health personnel in developing countries it is often misdiagnosed or not diagnosed at all. This may lead to serious, and life-threatening complications. There is, thus a need for an automated computer based image-analyzing system that could assist in making accurate otitis media diagnoses anywhere. A method for automated diagnosis of otitis media is proposed. The method uses image-processing techniques to classify otitis media. The system is trained using high quality pre-assessed images of tympanic membranes, captured by digital video-otoscopes, and classifies undiagnosed images into five otitis media categories based on predefined signs. Several verification tests analyzed the classification capability of the method. An accuracy of 80.6% was achieved for images taken with commercial video-otoscopes, while an accuracy of 78.7% was achieved for images captured on-site with a low cost custom-made video-otoscope. The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~64% to 80%) using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.

  19. 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

  20. 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.

  1. [The possibilities for the treatment of exudative otitis media in the children presenting with chronic adenoiditis].

    PubMed

    Karpova, E P; Karpycheva, I E; Tulupov, D A

    2014-01-01

    The objective of the present study was to improve the effectiveness of medicamental therapy of exudative otitis media in the children with recurrent and chronic adenoiditis. It was shown that the use of fluifort (carbocysteine lysine salt) for the treatment of exudative otitis media in the children presenting with chronic adenoiditis is a more effective approach in comparison with the expectant management. It is concluded that the application of carbocysteine lysine salt in combination with the mometasone furoate nasal spray ensures the rapid elimination of the symptoms of adenoiditis and significantly accelerates the resolution of exudative otitis media compared with the monotherapeutic treatment.

  2. Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children.

    PubMed

    Hoberman, Alejandro; Paradise, Jack L; Rockette, Howard E; Kearney, Diana H; Bhatnagar, Sonika; Shope, Timothy R; Martin, Judith M; Kurs-Lasky, Marcia; Copelli, Susan J; Colborn, D Kathleen; Block, Stan L; Labella, John J; Lynch, Thomas G; Cohen, Norman L; Haralam, MaryAnn; Pope, Marcia A; Nagg, Jennifer P; Green, Michael D; Shaikh, Nader

    2016-12-22

    Background Limiting the duration of antimicrobial treatment constitutes a potential strategy to reduce the risk of antimicrobial resistance among children with acute otitis media. Methods We assigned 520 children, 6 to 23 months of age, with acute otitis media to receive amoxicillin-clavulanate either for a standard duration of 10 days or for a reduced duration of 5 days followed by placebo for 5 days. We measured rates of clinical response (in a systematic fashion, on the basis of signs and symptomatic response), recurrence, and nasopharyngeal colonization, and we analyzed episode outcomes using a noninferiority approach. Symptom scores ranged from 0 to 14, with higher numbers indicating more severe symptoms. Results Children who were treated with amoxicillin-clavulanate for 5 days were more likely than those who were treated for 10 days to have clinical failure (77 of 229 children [34%] vs. 39 of 238 [16%]; difference, 17 percentage points [based on unrounded data]; 95% confidence interval, 9 to 25). The mean symptom scores over the period from day 6 to day 14 were 1.61 in the 5-day group and 1.34 in the 10-day group (P=0.07); the mean scores at the day-12-to-14 assessment were 1.89 versus 1.20 (P=0.001). The percentage of children whose symptom scores decreased more than 50% (indicating less severe symptoms) from baseline to the end of treatment was lower in the 5-day group than in the 10-day group (181 of 227 children [80%] vs. 211 of 233 [91%], P=0.003). We found no significant between-group differences in rates of recurrence, adverse events, or nasopharyngeal colonization with penicillin-nonsusceptible pathogens. Clinical-failure rates were greater among children who had been exposed to three or more children for 10 or more hours per week than among those with less exposure (P=0.02) and were also greater among children with infection in both ears than among those with infection in one ear (P<0.001). Conclusions Among children 6 to 23 months of age with acute

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

    PubMed

    Wahl, Richard A; Aldous, Michael B; Worden, Katherine A; Grant, Kathryn L

    2008-10-02

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

  4. Gene mutations in primary ciliary dyskinesia related to otitis media.

    PubMed

    Mata, Manuel; Milian, Lara; Armengot, Miguel; Carda, Carmen

    2014-03-01

    Otitis media with effusion (OME) is the most common cause of conductive hearing loss in children and is strongly associated with primary ciliary dyskinesia (PCD). Approximately half of the children with PCD require otolaryngology care, posing a major problem in this population. Early diagnosis of PCD is critical in these patients to minimise the collateral damage related to OME. The current gold standard for PCD diagnosis requires determining ciliary structure defects by transmission electron microscopy (TEM) or clearly documenting ciliary dysfunction via digital high-speed video microscopy (DHSV). Although both techniques are useful for PCD diagnosis, they have limitations and need to be supported by new methodologies, including genetic analysis of genes related to PCD. In this article, we review classical and recently associated mutations related to ciliary alterations leading to PCD, which can be useful for early diagnosis of the disease and subsequent early management of OME.

  5. [Acute otitis media: do not hesitate to treat].

    PubMed

    Schoch, Adriaan G; van Marwijk, H W J Harm

    2012-01-01

    Recently, two randomised, double-blind, placebo-controlled trials published in The New England Journal of Medicine have stirred up discussion about the use of antibiotics in the treatment of acute otitis media (AOM). In the Netherlands, the practice guideline of the Dutch College of General Practitioners recommends withholding antibiotics in most cases and that antibiotics can be considered when a child under the age of 2 years has bilateral AOM, otorrhoea, or persistent symptoms for 3 days or more. These recommendations are mostly based on a meta-analysis published in 2006. Previous studies on AOM had important limitations such as varying diagnostic criteria and biased patient selection. The new trials, which are of high methodological quality, investigated only 'real' AOM and the results show the same efficacy as the aforementioned meta-analysis. We therefore feel it is justified to consider prescribing antibiotics for a young child with manifest symptoms and evident AOM on otoscopic examination.

  6. Intratympanic Gene Delivery of Antimicrobial Molecules in Otitis Media.

    PubMed

    Moon, Sung K; Lim, David J

    2015-04-01

    Otitis media (OM) in children is clinically important because of its detrimental effects on the development of language and motor coordination and is the most common reason for prescription of antibiotics. A recent bacteriological change in OM pathogens such as emergence of antibiotic resistance and vaccination-mediated pathogenic shift urges us to develop a new non-antibiotic strategy. The middle ear epithelium abundantly secretes a variety of antimicrobial molecules suppressing the viability of the common OM pathogens. Recently, we have demonstrated that the adenoviral vector is able to deliver the β-defensin 2 gene to the middle ear epithelial cells in vitro and in vivo, and adenovirus-mediated overexpression of β-defensin 2 is protective for experimental OM. There are many hurdles limiting successful clinical application of gene delivery to the respiratory epithelium of the tubotympanum; however, intratympanic gene therapy with β-defensin 2 is a promising alternative or adjuvant strategy for the management of OM.

  7. Silent reading and secretory otitis media in school children.

    PubMed

    Lous, J

    1993-01-01

    In an unselected cohort of 366 8-year-old children, the relationship between secretory otitis media and reading achievement was investigated. The children underwent 10 impedance audiometries and 5 pure tone audiometries during their first year at school. At the beginning of the second grade they all had a Silent Reading Word Test (OS-400). The background parameters were recorded by an interview with one of the parents. There was a significant but small correlation between type B tympanograms in the first grade and silent word reading. No association between silent reading score and otological history or pure tone screening was found. In a stepwise multiple regression model, 37% of the variance could be 'explained' by the included variables. The 'classroom factor' could 'explain' about 17% of the variance, followed by phonology at the start of school (6%), gender (5%), social group of the mother (4%), type B tympanogram (2%), absence from school (2%) and allergy (1%).

  8. [The relationship between adenoids hypertrophy and secretory otitis media].

    PubMed

    Yin, Guiru; Yue, Zhuoli; Hu, Jiangong; Zhao, Xiaoming

    2005-07-01

    To investigate the relationship between immune status of adenoids and secretory otitis media (SOM). All the 76 cases of SOM were divided into 2 groups: recurrent group (46 cases) and control group (30 cases whose occurrence was less than 3 times). The manifestation of CD45RO, CD20, PCNA and BCL-2 in adenoids was detected with ultrasensitive (TM)S-P immunohistology. The expression of CD44Ro, CD20, PCNA and BCL-2 in recurrent group was significantly higher than that in control group (P < 0.05 or P < 0.01). In adenoid tissues of recurrent SOM patients, the activities of lymphocytes and cells in hypertrophic status increase, the adenoids enlarge and local immunity enhances. Therefore, adenoidectomy for SOM patients should be carried out as early as possible.

  9. Etiology of Acute Otitis Media in Infants and Children

    PubMed Central

    Laxdal, Oliver E.; Blake, Roy M.; Cartmill, Thomas; Robertson, H. E.

    1966-01-01

    Seventy-one children were studied intensively in an attempt to identify both bacterial and viral agents responsible for acute otitis media. Studies included processing of nasopharyngeal secretions and of fluid obtained by needle aspiration of the middle ear. Ear fluid was consistently sterile for viruses but grew bacterial pathogens in 10 of 20 specimens. Nose and throat cultures yielded bacterial pathogens in less than 40% and were of little value in predicting middle-ear flora. Influenza C was isolated from one of 48 throat washings. Viral serology was compatible with influenza A2 and adenovirus infection in two cases. Bacterial and viral agents could not be incriminated in nearly 50% of the children studied. PMID:4379067

  10. The Role of Breastfeeding in Childhood Otitis Media.

    PubMed

    Lodge, Caroline J; Bowatte, Gayan; Matheson, Melanie C; Dharmage, Shyamali C

    2016-09-01

    The purpose of this review is to summarize the recent literature, both systematic reviews and recently published original studies not included within those reviews, on the relationship between breastfeeding and childhood otitis media (OM). There is clear evidence that breastfeeding is associated with a reduced risk of OM in childhood with sound biological plausibility to support that the association is likely causal. Any breastfeeding reduces OM risk in early childhood by 40-50 %. Systematic reviews also support a further reduced risk for continued breastfeeding. Recent studies have estimated burden of disease savings if breastfeeding within countries and globally approached WHO guidelines. Cost savings per year for reduced cases of OM by increasing ever and exclusive breastfeeding rates are estimated to be millions of pounds or dollars for UK and Mexico. Breastfeeding reduces OM in children. The burden of disease and economic impact of increasing breastfeeding rates and duration would be substantial.

  11. Development of terahertz otoscope for diagnosing otitis media (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Jeon, Tae-In; Ji, Young Bin; Bark, Hyeon Sang; Noh, Sam Kyu; Oh, Seung Jae

    2017-03-01

    A novel terahertz (THz) otoscope is designed and fabricated to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. The inclusion of indium tin oxide (ITO) glass in the THz otoscope allows physicians to diagnose OM with both THz and conventional optical diagnostics. To determine THz diagnostics for OM, we observed reflection signals from samples behind a thin dielectric film and found that the presence of water behind the membrane could be distinguished based on THz pulse shape. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. The presence of water absorbed by the human membrane was easily distinguished based on differences in pulse shapes and peak-to-peak amplitudes of reflected THz pulses. The potential for early OM diagnosis using the THz otoscope was confirmed by alteration of THz pulse depending on water absorption level.

  12. [Acute otitis media in children: the strategy of patient care].

    PubMed

    Davydova, A P

    2010-01-01

    Acute otitis media in children is an emergency ENT pathology encountered not only by otorhinolaryngologists but also in the practical work of general pediatrists, infectionists, allergologists, and representatives of other medical disciplines. Retrospective analysis demonstrates a progressively increasing ENT morbidity rate, especially that of non-purulent forms. Clinical and laboratory characteristics of 130 emergency patients examined in the present study using PCR-testing and bacteriological methods provided data on the activity of Streptococci, Mycoplasmas, Chlamidiae, viruses, and other causative agents of ENT diseases. A strategy for the combined treatment of patients with ENT pathology in an infectious department under control of an otorhinolaryngologist is proposed taking into consideration etiology and pathogenesis of the disease.

  13. Pediatric Acute Otitis Media in the Era of Pneumococcal Vaccination.

    PubMed

    Tawfik, Kareem O; Ishman, Stacey L; Altaye, Mekibib; Meinzen-Derr, Jareen; Choo, Daniel I

    2017-05-01

    Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged <21 years with acute suppurative otitis media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.

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

    PubMed

    Penido, Norma de Oliveira; Chandrasekhar, Sujana Sreedevi; Borin, Andrei; Maranhão, André Souza de Albuquerque; Gurgel Testa, José Ricardo

    2016-01-01

    It is an erroneous but commonly held belief that intracranial complications (ICCs) of chronic and acute otitis media (COM and AOM) are past diseases or from developing countries. These problems remain, despite improvements in antibiotic care. This paper analyzes the occurrence and clinical characteristics and course of the main ICCs of otitis media (OM). Retrospective cohort study of 51 patients with ICCs from OM, drawn from all patients presenting with OM to the emergency room of a large inner-city tertiary care hospital over a 22-year period. 80% of cases were secondary to COM of which the incidence of ICC was 0.8%; 20% were due to AOM. The death occurrence was 7.8%, hearing loss in 90%, and permanent neurological sequelae in 29%. Patients were 61% male. In the majority, onset of ear disease had occurred during childhood. Delay of diagnosis of both the initial infection as well as the secondary ICC was significant. ICCs included brain abscess and meningitis in 78%, and lateral sinus thrombosis, empyema and otitic hydrocephalus in 13%, 8% and 1% of cases, respectively. Twenty-seven neurosurgical procedures and 43 otologic surgery procedures were performed. Two patients were too ill for surgical intervention. ICCs of OM, although uncommon, still occur. These cases require expensive, complex and long-term inpatient treatment and frequently result in hearing loss, neurological sequelae and mortality. It is important to be aware of this potentiality in children with COM, especially, and maintain a high index of suspicion in order to refer for otologic specialty care before such complications occur. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. [Acute otitis media: could it be a sentinel indicator of health care?].

    PubMed

    Cabrera-Gaytán, David Alejandro; Valle-Alvarado, Gabriel; Krug-Llamas, Ernesto; Grajales-Muñiz, Concepción

    2014-01-01

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

  16. 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.

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

    PubMed

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

    1988-02-01

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

  18. Relationship of Otitis Media and Language Impairment in Adolescents with Down's Syndrome.

    ERIC Educational Resources Information Center

    Whiteman, Barbara C.; And Others

    1986-01-01

    Results of the study of receptive and expressive language abilities of 30 Down's Syndrome adolescents suggested that early recurrent otitis media may play an important role in the language deficits commonly found among Down Syndrome persons. (Author/DB)

  19. Relationship of Otitis Media and Language Impairment in Adolescents with Down's Syndrome.

    ERIC Educational Resources Information Center

    Whiteman, Barbara C.; And Others

    1986-01-01

    Results of the study of receptive and expressive language abilities of 30 Down's Syndrome adolescents suggested that early recurrent otitis media may play an important role in the language deficits commonly found among Down Syndrome persons. (Author/DB)

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

    PubMed

    Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

    2016-01-01

    Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p<0.05); children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p<0.05). Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p<0.05); the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. Upper respiratory tract infections and otitis media are common childhood diseases strongly

  1. Genetic susceptibility to chronic otitis media with effusion: candidate gene single nucleotide polymorphisms.

    PubMed

    MacArthur, Carol J; Wilmot, Beth; Wang, Linda; Schuller, Michael; Lighthall, Jessyka; Trune, Dennis

    2014-05-01

    The genetic factors leading to a predisposition to otitis media are not well understood. The objective of the current study was to develop a tag-single nucleotide polymorphism (SNP) panel to determine if there is an association between candidate gene polymorphisms and the development of chronic otitis media with effusion. A 1:1 case/control design of 100 cases and 100 controls was used. The study was limited to the chronic otitis media with effusion phenotype to increase the population homogeneity. A panel of 192 tag-SNPs was selected. Saliva for DNA extraction was collected from 100 chronic otitis media with effusion cases and 100 controls. After quality control, 100 case and 79 control samples were available for hybridization. Genomic DNA from each subject was hybridized to the SNP probes, and genotypes were generated. Quality control across all samples and SNPs reduced the final SNPs used for analysis to 170. Each SNP was then analyzed for statistical association with chronic otitis media with effusion. Eight SNPs from four genes had an unadjusted P value of <.05 for association with the chronic otitis media with effusion phenotype (TLR4, MUC5B, SMAD2, SMAD4); five of these polymorphisms were in the TLR4 gene. Even though these results need to be replicated in a novel population, the presence of five SNPs in the TLR4 gene having association with chronic otitis media with effusion in our study population lends evidence for the possible role of this gene in the susceptibility to otitis media. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Parents' beliefs and knowledge about the management of acute otitis media: a qualitative study.

    PubMed

    Hansen, Malene Plejdrup; Howlett, Janine; Del Mar, Chris; Hoffmann, Tammy C

    2015-07-07

    Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients' (or parents') expectations of antibiotics often influence general practitioners' (GPs) decision to prescribe antibiotics, but few have explored parents' expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents' knowledge and beliefs about the management of acute otitis media in children. Individual semi-structured interviews were conducted with 15 parents of children who had recently presented to their GP with acute otitis media. Parents were recruited at childcare centres or playgroups in Brisbane, Australia. Many parents did not have an accurate understanding of what causes acute otitis media. GPs were primarily consulted for the management of symptoms such as pain and fever. Others specifically wanted reassurance or were concerned about hearing loss. Most parents assumed that antibiotics were the best treatment option. Parents' perceptions about the best treatment were mainly based on their previous experience and the advice of the GP. Pain relief medications, such as paracetamol and non-steroidal anti-inflammatory drugs, were not considered by parents to be sufficient treatment on their own. There is discrepancy between parents' beliefs and expectations of management of acute otitis media and the evidence-based recommendations. This study provides insights into parents' expectations of management of acute otitis media, which may help inform clinicians about perceptions and misperceptions that may be valuable to elicit and discuss.

  3. Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

    PubMed

    Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

    2017-06-01

    Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion.

    PubMed

    Doğru, Mehmet; Kuran, Gökhan; Haytoğlu, Süheyl; Dengiz, Ramazan; Arıkan, Osman Kürşat

    2015-04-01

    To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient's middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.

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

    PubMed

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

    2016-09-01

    To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. Comparative human temporal bone study. Otopathology laboratory. To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P < .05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

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

    PubMed

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

    2016-01-01

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

  7. Household crowding associated with childhood otitis media hospitalisations in New Zealand.

    PubMed

    Bowie, Christopher; Pearson, Amber L; Campbell, Malcolm; Barnett, Ross

    2014-06-01

    To examine the association between hospitalisations for otitis media and area-level measures of household crowding among children in New Zealand. Counts of hospital admissions for otitis media by census area unit were offset against population data from the 2006 national census. Area-level household crowding, exposure to tobacco smoke in the home, equivalised income and individual-level characteristics age and sex were adjusted for. To examine effect modification by ethnicity, three separate poisson models were examined for the total, Māori and non-Māori populations. Household crowding was significantly associated with hospital admissions for otitis media after adjustment in all three models. Neighbourhoods with the highest compared to the lowest proportion of crowded homes exhibited incidence rate ratios of 1.25 (95%CI 1.12-1.37) in the total population, 1.59 (95%CI 1.21-2.04) in the Māori restricted model and 1.17 (95%CI 1.06-1.32) in the non-Māori restricted model. Otitis media hospitalisations are associated with area-level measures of household crowding and other risk factors in this ecological study. The largest increase in otitis media incidence relative to neighbourhood rates of household crowding was exhibited among Māori cases of otitis media. This study adds weight to the growing body of literature linking infectious disease risk to overcrowding in the home. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  8. Prevalence of otitis media in school going children in Eastern Nepal.

    PubMed

    Maharjan, M; Bhandari, S; Singh, I; Mishra, S C

    2006-01-01

    To find out the prevalence of otitis media in school going children from lower socio-economic strata. This study was carried out in a government school, Shree Naragram Secondary School in Morang district, eastern Nepal, and included 1050 children aged between 5-15 years. Of the 1050 school children, 346 children were found to have various ENT related problems. Hearing assessment revealed a conductive hearing loss on one or both sides in 114 cases (87%). Various middle ear pathologies were detected in these children, out of which chronic suppurative otitis media "Tubotympanic type" was the most common, followed by otitis media with effusion. The prevalence of otitis media in these children was found to be13.2% and those with hearing loss comprised 12.47%. Prevalence of otitis media is found to be much higher in school going children as compared to adults, and is even higher amongst children belonging to the lower socio-economic strata. Conditions complicating otitis media are more common and severe in children as compared to adults. Primary ear care education to teachers, students and guardians can prevent these vulnerable children from developing hearing impairment. School based study could be one of the useful and cost-effective modality aimed at community oriented program.

  9. Significant linkage at chromosome 19q for otitis media with effusion and/or recurrent otitis media (COME/ROM).

    PubMed

    Chen, Wei-Min; Allen, E Kaitlynn; Mychaleckyj, Josyf C; Chen, Fang; Hou, Xuanlin; Rich, Stephen S; Daly, Kathleen A; Sale, Michèle M

    2011-09-26

    In previous analyses, we identified a region of chromosome 19 as harboring a susceptibility locus for chronic otitis media with effusion and/or recurrent otitis media (COME/ROM). Our aim was to further localize the linkage signal and ultimately identify the causative variant or variants. We followed up our previous linkage scan with dense SNP genotyping across in a 5 Mb region. A total of 607 individuals from 139 families, including 159 affected sib pairs and 62 second-degree affected relative pairs, were genotyped at 1,091 SNPs. We carried out a nonparametric linkage analysis, modeling marker-to-marker linkage disequilibrium. The maximum log of the odds (LOD) score increased to 3.75 (P = 1.6 × 10(-5)) at position 63.4 Mb, with a LOD-1 support interval between 61.6 Mb and 63.8 Mb, providing significant evidence of linkage between this region and COME/ROM. The support interval contains over 90 known genes, including several genes involved in the inflammasome protein complex, a key regulator of the innate immune response to harmful exogenous or endogenous stimuli. Parametric linkage analysis suggests that for a sib of an affected individual, the recurrence risk of COME/ROM due to this linkage region is twice the recurrence risk in the population. We examined potential associations between the SNPs genotyped in this region and COME/ROM, however none provided evidence for association. This study has refined the 19q region of linkage with COME/ROM, and association results suggest that the linkage signal may be due to rare variants.

  10. What does tympanostomy tube placement in children teach us about the association between atopic conditions and otitis media?

    PubMed

    Juhn, Young J; Wi, Chung-Il

    2014-07-01

    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 USA. While many risk factors for otitis media have been identified, atopic conditions have been underrecognized 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.

  11. 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

  12. Reducing the Frequency of Acute Otitis Media by Individualized Care

    PubMed Central

    Pichichero, Michael E.; Casey, Janet R.; Almudevar, Anthony

    2013-01-01

    Objective We sought to determine if use of more stringent diagnostic criteria for acute otitis media (AOM) than currently advocated by the American Academy of Pediatrics (AAP), tympanocentesis and pathogen-specific antibiotic treatment (individualized care) would result in reducing the incidence of recurrent AOM and consequent tympanostomy tube surgery. Methods A 5 year longitudinal, prospective study in Rochester NY was conducted from July 2006 – July 2011 involving 254 individualized care children. When this individualized care group developed symptoms of AOM, strict diagnostic criteria were applied and a tympanocentesis was performed. Pathogen resistance to empiric high dose amoxicillin/clavulanate (80mg/kg of amoxicillin component) caused a change in antibiotic to an optimized choice. Legacy controls (n=208) were diagnosed with the same diagnostic criteria by the same physicians as the individualized care group and received the same empiric amoxicillin/clavulanate (80mg/kg of Amoxicillin component) but no tympanocentesis or change in antibiotic. Community control children (n=1020) were diagnosed according to current AAP guidelines and treated with high dose amoxicillin (80 mg/kg) without tympanocentesis as guideline recommended. Results 5.9% of children of the individualized care group compared to 14.4% of Legacy controls and 27.3% of community controls became otitis prone (OP), defined as 3 episodes of AOM within a 6-month time span or 4 AOM episodes within a 12-month time span (p<0.0001). 2.4% of the individualized care group compared to 6.3% of Legacy controls, and 14.8% of community controls received tympanostomy tubes (p<0.0001). Conclusions Individualized care of AOM significantly reduces the frequency of AOM and tympanostomy tube surgery. Use of strict diagnostic criteria for AOM and empiric antibiotic treatment using evidence-based knowledge of circulating otopathogens and their antimicrobial susceptibility profile also produces improved outcomes

  13. Acute otitis externa.

    PubMed

    Hui, Charles Ps

    2013-02-01

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

  14. Acute otitis externa

    PubMed Central

    Hui, Charles PS

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present. PMID:24421666

  15. 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.

  16. Therapeutic Mastoidectomy in the Management of Noncholesteatomatous Chronic Otitis Media: Literature Review and Cost Analysis.

    PubMed

    Trinidade, Aaron; Page, Joshua C; Dornhoffer, John L

    2016-12-01

    Despite evidence that therapeutic mastoidectomy does not improve outcomes in noncholesteatomatous chronic otitis media, it remains widely performed. An up-to-date systematic review is undertaken and conclusions drawn regarding the best evidence-based practice of its management. PubMed, Google Scholar, Medline Embase, Cochrane, and Web of Science. A combination of the following words was used: chronic otitis media, chronic suppurative otitis media, COM, CSOM, mastoidectomy, tympanoplasty, atelectasis, retraction, tympanic perforation, and therapeutic. From 1742 studies, 7 were selected for full analysis with respect to the benefit of mastoidectomy in the management of active and inactive mucosal chronic otitis media. Most were retrospective studies, with 1 prospective randomized controlled trial available. Overall, there was no evidence to support routine mastoidectomy in conjunction with tympanoplasty in chronic otitis media. For ears with sclerotic mastoids, the evidence suggested that there may be some benefit as a staged procedure. Two studies were analyzed for the benefit of mastoidectomy in addition to tympanoplasty for the management of the atelectatic ear (inactive squamous chronic otitis media). The conclusion was also that mastoidectomy added no benefit. Examination of the available literature supports the notion that therapeutic mastoidectomy does not lend any additional benefit to the management of noncholesteatomatous chronic otitis media. This has implications for patient care, both clinically and financially. Further research, ideally in the form of a prospective, multi-institutional, geographically wide, ethnically diverse, randomized controlled trial, is needed to further support this notion. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

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

    PubMed

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

    2017-10-01

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

  18. 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.

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

    PubMed

    Damoiseaux, Roger A M J

    2012-01-01

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

  20. 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

  1. Association Between Endocrine Diseases and Serous Otitis Media in Children

    PubMed Central

    Koçyiğit, Murat; Çakabay, Taliye; Örtekin, Safiye G.; Akçay, Teoman; Özkaya, Güven; Üstün Bezgin, Selin; Yıldız, Melek; Adalı, Mustafa Kemal

    2017-01-01

    Objective: Otitis media with effusion (OME) is a condition in which fluid is retained in the middle ear cavity. The association between endocrine disorders and OME has not yet been determined. This study aimed to investigate the presence of OME in children diagnosed with an endocrine disease and the relationship between these two conditions. Methods: The study was conducted on 918 pediatric patients (440 boys, 478 girls; mean age: 8.40, range 3-15 years) and 158 healthy controls (76 boys, 79 girls; mean age: 8.31, range 3-15 years). All children underwent an ear examination and a tympanometry performed by an otorhinolaryngologist. Tympanometry results were used to diagnose OME. Results: OME was detected in 205 (22.3%) of 918 patients and in 19 (12.0%) of 158 subjects in the control group. The difference in frequency of OME between the two groups was statistically significant (p=0.003). Conclusion: The results of the study reveal that there may be a tendency towards the occurrence of OME in pediatric endocrinology patients. PMID:27612192

  2. 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

  3. Molecular Microbiological Profile of Chronic Suppurative Otitis Media

    PubMed Central

    Neeff, Michel; Biswas, Kristi; Hoggard, Michael; Taylor, Michael W.

    2016-01-01

    Chronic suppurative otitis media (CSOM) presents with purulent otorrhea (ear discharge), is characterized by chronic inflammation of the middle ear and mastoid cavity, and contributes to a significant disease burden worldwide. Current antibiotic therapy is guided by swab culture results. In the absence of detailed molecular microbiology studies of CSOM patients, our current understanding of the microbiota of CSOM (and indeed of the healthy ear) remains incomplete. In this prospective study, 24 patients with CSOM were recruited, along with 22 healthy controls. Culture-based techniques and 16S rRNA gene amplicon sequencing were used to profile the bacterial community for each patient. Comparisons between patients with and without cholesteatoma in the middle ear and mastoid cavity were also made. A major finding was that the middle ear of many healthy controls was not sterile, which is contradictory to the results of previous studies. However, sequencing data showed that Staphylococcus aureus, along with a range of other Gram-positive and Gram-negative organisms, were present in all subgroups of CSOM and healthy controls. Large interpatient variability in the microbiota was observed within each subgroup of CSOM and controls, and there was no bacterial community “signature” which was characteristic of either health or disease. Comparisons of the culture results with the molecular data show that culture-based techniques underestimate the diversity of bacteria found within the ear. This study reports the first detailed examination of bacterial profiles of the ear in healthy controls and patients with CSOM. PMID:27487953

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

    NASA Astrophysics Data System (ADS)

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

    2013-05-01

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

  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. Association between vitamin D and development of otitis media

    PubMed Central

    Li, Hong-Bo; Tai, Xu-Hui; Sang, Yue-Hong; Jia, Jian-Ping; Xu, Zhen-Ming; Cui, Xiao-Feng; Dai, Song

    2016-01-01

    Abstract Background: Nutrients related to serum vitamin D level were previously shown to be significantly associated with the risk of many chronic diseases. This study aimed to assess potential relationships between serum vitamin D level and otitis media (OM) risk. Methods: PubMed, EMBASE, and Cochrane Library databases were searched till Aug 18, 2015 for studies of quantitative OM risk estimates in relation to serum vitamin D level. The odds ratio and weighted mean difference, with 95% confidence intervals (CIs), were used to measure the relationship between serum vitamin D level and OM risk. Results: Of the 89 articles identified by database search, 5 studies reported data of 16,689 individuals were included in our meta-analysis. We noted participants with OM was associated with lower level of plasma vitamin D when compared with patients without OM (weighted mean difference −5.67; 95% CI −8.08 to −3.26, P < 0.001). Furthermore, as compared with control group, serum vitamin D level was not associated with the risk of OM (odds ratio 0.80, 95% CI 0.47–1.38, P = 0.425). Subgroup analyses suggested that participants with acute OM might associate with lower serum vitamin D level. Conclusions: Plasma vitamin D level might play an important role on the progression of acute OM, whereas no significant impact in patients with chronic OM. PMID:27749530

  7. The role of nasal allergy in chronic secretory otitis media.

    PubMed

    Pelikan, Zdenek

    2007-11-01

    Chronic secretory otitis media (SOM) has multifactorial causes, and nasal allergy is suspected as one of these causative factors. To investigate the possible role of nasal allergy in SOM in adults and to determine the diagnostic value of nasal challenges with allergens (nasal provocation tests) combined with tympanometry for the diagnosis of this disorder. In 69 young adults with chronic or recurrent SOM, 173 nasal challenges with allergens were performed by anterior rhinomanometry combined with tympanometry (pure-tone air conduction tympanometry). In 42 control subjects with only allergic rhinitis and no history of middle ear disease, 42 nasal challenges with allergens were repeated and combined with tympanometry. The study design was a placebo-controlled comparison. Of the 69 patients, 54 developed 129 positive nasal responses of various types (P < .01), 117 of which were accompanied by significant changes in middle ear pressure (P < .01). No significant tympanometric changes (P > .10) were recorded during the 42 positive nasal responses in control subjects. These results may confirm the occurrence of chronic SOM in some adult patients and the possible involvement of nasal allergy in chronic SOM. The nasal challenges with allergen performed by rhinomanometry, combined with tympanometry, seem to be a valuable supplementary tool for the diagnosis of this disorder.

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

    PubMed

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

    2014-12-01

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

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

    PubMed Central

    Fletcher, Mark A.; Fritzell, Bernard

    2012-01-01

    Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

  10. 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.

  11. Chronic suppurative otitis media in urban private school children of Nepal.

    PubMed

    Adhikari, Prakash; Joshi, Sambudutta; Baral, Dipal; Kharel, Binit

    2009-01-01

    Chronic suppurative otitis media is one of the common ear diseases of the ear, particularly in childhood. It is the commonest cause of persistent mild to moderate hearing impairment in children and young adults. To find out the prevalence of chronic suppurative otitis media among school children studying in urban private schools of Nepal. This study was carried out among 500 school children aged between 5 -15 years. Students were selected from urban private schools of four districts of Nepal. In all students, history was taken and otoscopic examination done from May 2006 to October 2006. Data were described using frequency and percentage. Prospective cross sectional study. Results showed that the prevalence of chronic suppurative otitis media in children studying in urban private schools of Nepal is 5.0%. Unilateral disease was seen in 72.0%, 76.0% had a tubotympanic disease and 24.0% had atticoantral disease. The prevalence of chronic suppurative otitis media in urban private school children in Nepal is higher than other studies done in private school children. Health education, improvement of socioeconomic status and health facilities will be helpful in reducing the prevalence of chronic suppurative otitis media.

  12. Serum Antibody Response to Three Non-typeable Haemophilus influenzae Outer Membrane Proteins During Acute Otitis Media and Nasopharyngeal Colonization in Otitis Prone and Non-Otitis Prone Children

    PubMed Central

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

    2011-01-01

    Non-typeable Haemophilus influenzae (NTHi) is the most common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (rAOM; otitis prone) and AOM treatment failure (AOMTF) in children. In this 3.5 years of prospective study, we measured the serum antibody response to outer membrane proteins D, P6 and OMP26 of NTHi in children with AOM (n= 26), rAOM (n= 32), AOMTF (n=27). The geometric mean titers (GMTs) of IgG at their acute AOM visit against protein D in otitis prone children were significantly lower compared to AOMTF (p value < 0.01) and non-otitis prone (p value <0.03) children; otitis prone children had significantly lower IgG levels to P6 compared to AOMTF children (p value < 0.02); otitis prone children had significantly lower IgG levels to OMP26 compared to AOMTF children (p value <0.04). Comparing acute to convalescent titers after AOM, otitis prone and AOMTF children had no significant change in total IgG against all the three proteins, while non-otitis prone children had significant increases to protein D. Anti-Protein D, P6 and OMP26 antibody levels measured longitudinally during NP colonization between age 6 and 24 months in 10 otitis prone children and 150 non-otitis prone children showed < 2-fold increases over time in otitis prone children compared to > 4 fold increases in the non-otitis prone children (p value < 0.001). We conclude that otitis prone children mount less of an IgG serum antibody response toward Protein D, P6 and OMP26 after AOM which may account for recurrent infections. The data on acute sera of otitis prone versus non-otitis prone children and the acute-to-convalescence response in non-otitis prone children point to a possible link of anti-PD to protection. Moreover, the data suggest that otitis prone children should be evaluated for their responses to Protein D, P6 and OMP26 vaccine antigens of NTHi. PMID:21129398

  13. The effect of caffeic acid phenethyl ester and thymoquinone on otitis media with effusion in rats.

    PubMed

    Gülmez, Mehmet İhsan; Okuyucu, Şemsettin; Dokuyucu, Recep; Gökçe, Hasan

    2017-05-01

    In this study, we aimed to investigate the effect of CAPE and thymoquinone in experimental rat otitis media with effusion (OME) model. Intraoral approach of eustachian tube orifice cauterization were administered to 36 of 40 rats participating the study. After application of exclusion criterias, 22 rats with appropriate conditions were determined. Totally 26 rats (44 otitis model ears and 8 normal ears) were randomly divided into 5 groups. While group I was consisted of healthy rats, the other groups were consisted of rats with otitis model. Group I (saline + control group; n = 8 normal ears) and group II (saline + otitis model; n = 10 otitis model ears) received intraperitoneally saline solution. CAPE was given intraperitoneally to group III (CAPE + otitis model; n = 12 otitis model ears) at a concentration of 10 mg/kg for treatment of otitis media. Group IV (thymoquinone + otitis model; n = 12 otitis model ears) was treated orally with 10 mg/kg of thymoquinone. Group V (methylprednisolone + otitis model; n = 10 otitis model ears) was treated intraperitoneally with 1 mg/kg of methylprednisolone. Tympanic bulla samples were excised after 10th day of treatment and examined under light microscopy. Submucosal neutrophil leukocyte count of group I was significantly lower than other groups (II, IV, V) (respectively p < 0,0001, p < 0,001, p < 0,0001, Tukey test), while it was not significantly different from group III (p = 0,056, Tukey test). Submucosal neutrophil leukocyte count of group III was significantly lower than group II and group V (p = 0.029 ve p = 0.03, Tukey test). There was no significant difference between group IV and group V (p = 0,28, Tukey test). Based on these findings, it could be suggested that CAPE, anti inflammatory properties proven in the literature, plays an important role in OME treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    PubMed

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Stenton, Jan

    This paper provides an overview of the effects of otitis media on the learning and behavior of children and youth. It begins by describing the conductive hearing loss that is caused by otitis media and the classroom behavior that can result, including poor concentration and attention, disobedience, irritability, and poor social skills. Discussed…

  16. Language Learning in a Prospective Study of Otitis Media with Effusion in the First Two Years of Life.

    ERIC Educational Resources Information Center

    Friel-Patti, Sandy; Finitzo, Terese

    1990-01-01

    The relationship between children's early experience with otitis media with effusion, hearing over time, and emerging receptive and expressive language skills was assessed. Better language was found to be associated with better average hearing levels, suggesting that the relationship between otitis media with effusion and language is mediated by…

  17. Attention to Language in Day Care Attending Children: A Mediating Factor in the Developmental Effects of Otitis Media.

    ERIC Educational Resources Information Center

    Feagans, Lynne V.; And Others

    Three ways in which otitis media may affect development of hearing are explored. First, developmental effects may be due to illness in general; second, otitis media may cause fluctuating hearing loss which may lead to deficits in language in many areas; and, third, fluctuating hearing loss may have only a temporary effect on the acquisition of…

  18. Language Learning in a Prospective Study of Otitis Media with Effusion in the First Two Years of Life.

    ERIC Educational Resources Information Center

    Friel-Patti, Sandy; Finitzo, Terese

    1990-01-01

    The relationship between children's early experience with otitis media with effusion, hearing over time, and emerging receptive and expressive language skills was assessed. Better language was found to be associated with better average hearing levels, suggesting that the relationship between otitis media with effusion and language is mediated by…

  19. Attention to Language in Day Care Attending Children: A Mediating Factor in the Developmental Effects of Otitis Media.

    ERIC Educational Resources Information Center

    Feagans, Lynne V.; And Others

    Three ways in which otitis media may affect development of hearing are explored. First, developmental effects may be due to illness in general; second, otitis media may cause fluctuating hearing loss which may lead to deficits in language in many areas; and, third, fluctuating hearing loss may have only a temporary effect on the acquisition of…

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

    PubMed Central

    Wahl, Richard A; Aldous, Michael B; Worden, Katherine A; Grant, Kathryn L

    2008-01-01

    Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT) for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male) were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation) plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo) was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments) were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42). OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10). Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465 PMID:18831749

  1. Modified ear canal ablation and lateral bulla osteotomy for management of otitis media in an alpaca.

    PubMed

    Sumner, Julia P; Mueller, Tami; Clapp, Kemba S; Darien, Benjamin J; Forrest, Lisa J; Colopy, Sara A

    2012-02-01

    To report surgical treatment of severe otitis media in an alpaca by a modification of a subtotal ear canal ablation and lateral bulla osteotomy technique used in dogs. Case report. An 11-week-old female alpaca cria. The cria had a 2-week history of right otitis media, nonresponsive to medical treatment, as well as right facial nerve paralysis, and a melting corneal ulcer of the right eye. Otitis media was confirmed by computed tomography. Right subtotal ear canal ablation and lateral bulla osteotomy were performed using a modification of a technique reported in dogs. There were no surgical complications and the alpaca was discharged from the hospital 5 days later. At 10 months, moderate motor function had been restored to the pinna with the ear standing partially erect. The otitis had resolved, and the alpaca was reportedly well integrated into the herd. Subtotal ear canal ablation and lateral bulla osteotomy, a technique modified from that performed in dogs, were successful in providing complete clinical resolution of otitis media in an alpaca. © Copyright 2011 by The American College of Veterinary Surgeons.

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

    PubMed Central

    Renukananda, G S; U.P., Santosh

    2014-01-01

    Objectives: To study the microbial flora and determine the efficacy of topical ciprofloxacin ear drops in comparison with combination of topical and oral ciprofloxacin as first line management in patients diagnosed with chronic suppurative otitis media. Materials and Methods: Prospective randomized interventional clinical trial on 100 patients who presented with an acute episode of CSOM to our outpatient department. Results: In our study, topical ciprofloxacin therapy was found to be an effective treatment for an acute on chronic otitis media as was the combination therapy though the overall recurrence rate was found to be more in the former group. Conclusion: In the absence of systemic infection or serious underlying disease, topical antibiotics alone constitute first line treatment for most patients with chronic suppurative otitis media, finding no evidence that systemic antibiotics alone or in combination with topical preparations improve treatment outcomes compared with topical antibiotics alone. PMID:25121008

  3. Role of adenoids and adenoiditis in children with allergy and otitis media.

    PubMed

    Marseglia, Gian Luigi; Poddighe, Dimitri; Caimmi, Davide; Marseglia, Alessia; Caimmi, Silvia; Ciprandi, Giorgio; Klersy, Catherine; Pagella, Fabio; Castellazzi, Anna Maria

    2009-11-01

    Adenoids and/or tonsil inflammation with concomitant obstructive hypertrophy is one of the oldest and most common pediatric problems. Adenoids are a component of Waldeyer's ring and because of their anatomic position can be relevant in the pathogenesis of otitis media when they are inflamed and/or enlarged. Adenoid pads can create mechanical eustachian tube obstruction. Therefore, in some cases, adenoidectomy may have a role in the clinical management of otitis media with effusion. However, eustachian tube dysfunction related to the adenoids may also have an allergy-related functional component. Allergic inflammation has been described for middle ear effusion, and some studies have reported that mast cells increase and allergic mediators release in adenoids as well. Nasal endoscopy has a key role in confirming a diagnosis of adenoid hypertrophy and/or adenoiditis and in detecting an association between adenoid inflammation/infection and otitis media with effusion, especially during infancy and early childhood.

  4. Aetiology and pathology of otitis media with effusion in adult life.

    PubMed

    Mills, R; Hathorn, I

    2016-05-01

    To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults. A review of the English language literature from 1970 to the present was conducted. The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease. There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

  5. Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media.

    PubMed

    Picciotti, P M; Della Marca, G; D'Alatri, L; Lucidi, D; Rigante, M; Scarano, E

    2017-05-01

    The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing. Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed. In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation. This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.

  6. Acute otitis media associated bilateral sudden hearing loss: case report and literature review.

    PubMed

    Smith, A; Gutteridge, I; Elliott, D; Cronin, M

    2017-07-01

    Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.

  7. [CD80 and CD86 coreceptors expression on lymphocytes B in hypertrophied adenoids in children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Zelazowska-Rutkowska, Beata; Wysocka, Jolanta; Skotnicka, Bozena; Kasprzycka, Edwina; Ilona, Bauer

    2010-01-01

    The aim of this study was evaluation of the percentage and mean fluorescence intensity of lymphocytes B with expression CD80 and CD86 in hypertrophied adenoids in children with otitis media with effusion. Expression coreceptors CD80 and CD86 on lymphocytes B in adenoid tissue were estimated by flow cytometry method. 15 children with otitis media with effusion and 15 children with hypertrophied adenoid were tested. This study showed significantly higher percentage of lymphocytes CD19+ CD80+ in children with otitis media with effusion (OME 1.42% +/- 0.91) than in comparative group with hypertrophied adenoids (AH 0.63% +/- 0.21). The receptor CD86 didn't show differences in expression on lymphocytes B between both examinated groups. Low expression of CD80 and CD86 indicates that local immunity response in hypertrophied adenoids in children with otitis media with effusion is weakened. It can contribute to the otitis media with effusion.

  8. Recurrent acute otitis media in infants: analysis of risk factors.

    PubMed

    Salah, Mohamed; Abdel-Aziz, Mosaad; Al-Farok, Ahmed; Jebrini, Azzam

    2013-10-01

    Recurrence acute otitis media (RAOM) may cause a considerable morbidity and a great parental concern. The aim of this study was to analyze the risk factors that are likely to be responsible for RAOM in infants, and their impact on treatment failure. A retrospective study on 340 infants with RAOM was conducted. Data were collected from hospital charts. A 10 days course of amoxicillin/clavulanate was used for treatment of recurrence, while surgical management in the form of adenoidectomy and/or myringotomy was reserved for patients with persistent disease. We analyzed various risk factors that may affect the prognosis of RAOM, including: age, prematurity, upper respiratory tract infections (URTI), duration of breastfeeding, use of pacifiers, parental smoking, seasonality, the presence of siblings (family size), gender, adenoid hypertrophy, allergy, and craniofacial abnormalities. Use of pacifiers, short duration of breastfeeding, older infantile age, winter season, URTI and presence of adenoid hypertrophy were identified as risk factors for RAOM. Treatment failure may be due to adenoid hypertrophy, short duration of breastfeeding and it is more common in older age infants. We did not find a significant association between RAOM and gender, prematurity, exposure to passive smoking, the presence of siblings, allergy, craniofacial abnormalities. Factors that may cause recurrence of the disease in infant population are use of pacifiers, short duration of breastfeeding, older infantile age, winter season, upper respiratory tract infections and adenoid hypertrophy. Also, treatment failure may be caused by adenoid hypertrophy and short duration of breastfeeding. Good understanding of these factors may help to decrease the recurrence rate and to improve the treatment of the disease. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Otitis media and spinal manipulative therapy: a literature review

    PubMed Central

    Pohlman, Katherine A.; Holton-Brown, Monisa S.

    2012-01-01

    Objective Otitis media (OM) is one of the common conditions for doctor visits in the pediatric population. Spinal manipulation therapy (SMT) may be a potential conservative treatment of OM. The purpose of this study is to review the literature for OM in children, outlining the diagnosis of OM, SMT description, and adverse event notation. Methods Databases (PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health, Index to Chiropractic Literature, The Allied and Complementary Medicine, and Alt Health Watch) were queried and hand searches were performed to identify relevant articles. All potential studies were independently screened for inclusion by both authors. The inclusion criteria were as follows: written in the English language, addressed OM, involved human participants 6 years or younger, and addressed SMT. Studies were evaluated for overall quality using standardized checklists performed independently by both authors. Results Forty-nine articles were reviewed: 17 commentaries, 15 case reports, 5 case series, 8 reviews, and 4 clinical trials. Magnitude of effect was lower in higher-quality articles. No serious adverse events were found; minor transient adverse effects were noted in 1 case series article and 2 of the clinical trials. Conclusions From the studies found in this report, there was limited quality evidence for the use of SMT for children with OM. There are currently no evidence to support or refute using SMT for OM and no evidence to suggest that SMT produces serious adverse effects for children with OM. It is possible that some children with OM may benefit from SMT or SMT combined with other therapies. More rigorous studies are needed to provide evidence and a clearer picture for both practitioner and patients. PMID:23449823

  10. [Audiological characteristics of young children with otitis media with effusion].

    PubMed

    Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

    2008-12-01

    To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

  11. Cranial Indicators Identified for Peak Incidence of Otitis Media.

    PubMed

    Pagano, Anthony S; Wang, Eugene; Yuan, Derek; Fischer, Daniel; Bluestone, Charles; Marquez, Samuel; Laitman, Jeffrey

    2017-10-01

    Acute otitis media (AOM) is one of the most common pediatric conditions worldwide. Peak age of occurrence for AOM has been identified within the first postnatal year and it remains frequent until approximately six postnatal years. Morphological differences between adults and infants in the cartilaginous Eustachian tube (CET) and associated structures may be responsible for development of this disease yet few have investigated normal growth trajectories. We tested hypotheses on coincidence of skeletal growth changes and known ages of peak AOM occurrence. Growth was divided into five dental eruption stages ranging from edentulous neonates (Stage 1) to adults with erupted third maxillary molars (Stage 5). A total of 32 three-dimensional landmarks were used and Generalized Procrustes Analysis was performed. Next, we performed principal components analysis and calculated univariate measures. It was found that growth change in Stage 1 was the most rapid and comprised the largest amount of overall growth in upper respiratory tract proportions (where time is represented by the natural logarithmic transformation of centroid size). The analysis of univariate measures showed that Stage 1 humans did indeed possess the relatively shortest and most horizontally oriented CET's with the greatest amount of growth change occurring at the transition to Stage 2 (eruption of deciduous dentition at five postnatal months, commencing peak AOM incidence) and ceasing by Stage 3 (approximately six postnatal years). Skeletal indicators appear related to peak ages of AOM incidence and may contribute to understanding of a nearly ubiquitous human disease. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 300:1721-1740, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  12. Ear discharge in children presenting with acute otitis media: observational study from UK general practice

    PubMed Central

    Smith, Lindsay; Ewings, Paul; Smith, Caroline; Thompson, Matthew; Harnden, Anthony; Mant, David

    2010-01-01

    Background National Institute for Health and Clinical Excellence (NICE) guidance to treat otitis media in older children immediately with antibiotics only if they have ear discharge is based on limited evidence. Aim To determine the clinical significance and outcome of ear discharge in children with acute otitis media, in routine clinical practice. Design of study Observational cohort study of children with acute otitis media comparing those with and without ear discharge at presentation. Setting Primary care in East Somerset. Method Two hundred and fifty-six children aged 6 months to 10 years were recruited from primary care. Clinical features and other characteristics were recorded at presentation. Follow-up was undertaken at 2 weeks and 3 months. Results Children with otitis media who present with ear discharge are much more likely to be treated with antibiotics irrespective of age (adjusted odds ratio 15, 95% confidence interval [CI] = 3 to 66). Most with discharge have proven bacterial infection (58%, 95% CI = 42 to 72%). They have a more severe systemic illness, with higher axillary temperature (80% increase in odds of ear discharge for each additional degree centigrade, P = 0.02), pulse rate (9% increase in odds for each extra beat, P<0.001), and Yale score (mean 10.5 versus 9.0, P = 0.003). They may also have an increased likelihood of adverse outcome (adjusted odds ratio of pain at 1 week 2.9; further episodes of acute otitis media 3.3; hearing difficulty at 3 months 4.7; all P<0.10). Conclusion Ear discharge defines a group of children with otitis media who are sicker and may be at higher risk of adverse outcome. NICE guidance to treat them with antibiotics is supported. PMID:20132703

  13. Antibiotics in Pregnancy Increase Children's Risk of Otitis Media and Ventilation Tubes.

    PubMed

    Pedersen, Tine Marie; Stokholm, Jakob; Thorsen, Jonathan; Mora-Jensen, Anna-Rosa Cecilie; Bisgaard, Hans

    2017-04-01

    To study the association between antibiotic intake in pregnancy and the development of otitis media and placement of ventilation tubes (VTs) in the offspring under the hypothesis that antibiotics in pregnancy may alter the offspring's propensity for disease. Data from the 700 children in the Copenhagen Prospective Studies on Asthma in Childhood 2010 unselected birth cohort study were used. Information on maternal antibiotic use and other exposures during pregnancy was collected prospectively from interviews and validated in national registries. Otitis media episodes were registered in a prospective diary for 3 years. Information regarding children's VTs was obtained from national registries. There were 514 children who had diary information and were included in the analysis regarding otitis media episodes. For VTs analysis, 699 children were included. Thirty-seven percent of the mothers received antibiotics during pregnancy, and this was associated with increased risk of otitis media (adjusted hazard ratio 1.30; 95% CI 1.04-1.63; P = .02). The risk of receiving VTs was especially associated with third trimester antibiotics (adjusted hazard ratio 1.60; 95% CI 1.08-2.36, P = .02). The risk of otitis media increased with increasing number of treatments (per-level adjusted hazard ratio 1.20; 95% CI 1.04-1.40; P = .02), but for VTs this association was not significant after adjustment. Maternal use of antibiotics during pregnancy is associated with an increased risk of otitis media and VT insertions in the offspring. Antibiotics late in pregnancy mainly contributed to these effects, pointing toward potential transmission of an unfavorable microbiome from mother to child. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Local and serum IgE in patients affected by otitis media with effusion.

    PubMed

    Sanz, M L; Tabar, A I; Manrique, M; Oehling, A

    1986-01-01

    Various mechanisms intervene in the etiopathogenesis of otitis media with effusion (OME), but to date it is not clear which mechanism is the most important. We studied twenty children affected with persistent otitis media with effusion (OME) inspite of the indicated treatments, and the possible incidence of atopic features, total serum IgE and in effusion, obtained by myringotomy and aspiration were evaluated. In order to evaluate the presence of atopy, an allergic history and skin tests against the different suspected allergens (inhalants and foods) were realized.

  15. New vaccines against otitis media: projected benefits and cost-effectiveness.

    PubMed

    O'Brien, Megan A; Prosser, Lisa A; Paradise, Jack L; Ray, G Thomas; Kulldorff, Martin; Kurs-Lasky, Marcia; Hinrichsen, Virginia L; Mehta, Jyotsna; Colborn, D Kathleen; Lieu, Tracy A

    2009-06-01

    New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed. We created a computerized model to compare the projected benefits and costs of (1) the currently available 7-valent pneumococcal conjugate vaccine, (2) a candidate pneumococcal-nontypeable H influenzae vaccine that has been tested in Europe, (3) a hypothetical pneumococcal-nontypeable H influenzae-Moraxella vaccine, and (4) no vaccination. The clinical probabilities of acute otitis media and of otitis media with effusion were generated from multivariate analyses of data from 2 large health maintenance organizations and from the Pittsburgh Child Development/Otitis Media Study cohort. Other probabilities, costs, and quality-of-life values were derived from published and unpublished sources. The base-case analysis assumed vaccine dose costs of $65 for the 7-valent pneumococcal conjugate vaccine, $100 for the pneumococcal-nontypeable H influenzae vaccine, and $125 for the pneumococcal-nontypeable H influenzae-Moraxella vaccine. With no vaccination, we projected that 13.7 million episodes of acute otitis media would occur annually in US children aged 0 to 4 years, at an annual cost of $3.8 billion. The 7-valent pneumococcal conjugate vaccine was projected to prevent 878,000 acute otitis media episodes, or 6.4% of those that would occur with no vaccination; the corresponding value for the pneumococcal-nontypeable H influenzae vaccine was 3.7 million (27%) and for the pneumococcal-nontypeable H influenzae-Moraxella vaccine was 4.2 million (31%). Using the base-case vaccine costs, pneumococcal-nontypeable H influenzae vaccine use would result in net savings compared with nontypeable 7-valent pneumococcal conjugate use. Conversely, pneumococcal-nontypeable H influenzae-Moraxella vaccine use would not

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

    PubMed Central

    2017-01-01

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

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

    PubMed

    Kim, Sang Hoon; Jeon, Eun Ju; Hong, Seok Min; Bae, Chang Hoon; Lee, Ho Yun; Park, Moo Kyun; Byun, Jae Yong; Kim, Myung Gu; Yeo, Seung Geun

    2017-04-01

    Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy. © 2017 The Korean Academy of Medical Sciences.

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

    PubMed

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

    2017-08-01

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

  19. 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)

  20. Effects of Otitis Media with Effusion on Hearing in the First 3 Years of Life.

    ERIC Educational Resources Information Center

    Gravel, Judith S.; Wallace, Ina F.

    2000-01-01

    Hearing sensitivity was examined prospectively in 114 young children as a function of otitis media with effusion (OEM)status in years 1, 2, and 3. Results indicated that children classified as bilaterally OME positive in years 1, 2, and 3 had significantly poorer hearing than children classified as bilaterally OME free at these periods. (Contains…

  1. [Efficacy and safety of potassium clavulanate/amoxicillin (CLAVAMOX) dry syrup in children with otitis media].

    PubMed

    Sugita, Rinya; Yamanaka, Noboru; Kudo, Fumiyo; Ito, Rie; Kawai, Motoji; Ohwaki, Ichiro; Asano, Satoshi; Nagata, Tsutae

    2007-08-01

    To evaluate the efficacy and safety of CLAVAMOX dry syrup (potassium clavulanate/amoxicillin) in children with otitis media, we conducted a postmarketing surveillance from February to September 2006. The analysis was made on the basis of 470 survey sheets collected from 127 medical institutions, of which we investigated 455 cases for safety, and 433 cases for efficacy. The efficacy was 95.2% in the 433 subjects eligible for the efficacy analysis. The clinical improvement rates for major symptoms (otalgia, otorrhea, flare reaction of drum membrane and fever) were 95% or more. The efficacies for the three major offending bacteria of otitis media (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) were between 94.6% and 100%. The efficacies for penicillin-resistant Streptococcus pneumoniae (PRSP) and penicillin intermediate resistant Streptococcus pneumoniae (PISP) were 95% or more. Adverse drug reactions (ADRs) were reported in 106 (23.3%) of the 455 subjects eligible for safety analysis. The major ADRs were diarrhea, of which incident was 22.6% (103 of 455). These ADRs were observed at a higher rate in younger age patients. Most of the diarrhea cases were non-serious, reversible on discontinuation or continuation of the drug. No clinically important serious diarrhea cases such as pseudomembranous colitis or dehydration were observed. Our surveillance results demonstrated that CLAVAMOX dry syrup had excellent efficacy and clinically manageable safety in children with otitis media. These findings indicated that this medicine was clinically-useful in children with otitis media.

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

    PubMed Central

    Chu, Chia-Huei; Wang, Mao-Che; Lin, Liang-Yu; Tu, Tzong-Yang; Huang, Chii-Yuan; Liao, Wen-Huei; Shiao, An-Suey

    2014-01-01

    Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1%) but it was not noticeably associated with outcome (P = 0.41). The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, P = 0.04). Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases. PMID:24523659

  3. Otitis media: health and social consequences for aboriginal youth in Canada's north.

    PubMed

    Bowd, Alan D

    2005-02-01

    Otitis media is endemic among Inuit, First Nations and Métis children in northern Canada, with prevalence rates in some communities as high as 40 times that found in the urban south. Hearing impairment, much of it attributable to chronic otitis media, is the most common health problem in parts of the arctic, and conductive hearing loss among children may affect as many as two-thirds. There is a need for systematic data based on consistent disease definitions and measures, and taking account of cross-cultural methodological issues and sampling. Otitis media is most likely to develop in infancy. Susceptibility has been linked to immune defects and to a variety of environmental factors. Among the most significant are diet, the decline in initiation and maintenance of breastfeeding, and exposure to cigarette smoke. Hearing loss has been related to difficulties in language acquisition, and to subsequent issues with literacy and school achievement, including learning disabilities and attention deficits. The economic and social costs of otitis media are substantial. Approaches to treatment and prevention have enjoyed limited success. Public health and medical practice need to be informed by the traditional knowledge and practices of indigenous peoples.

  4. Isolation of Kerstersia gyiorum from a Patient with Cholesteatomatous Chronic Otitis Media

    PubMed Central

    Almuzara, Marisa N.; Barberis, Claudia M.; Traglia, German M.; Ordoñez, Andrea Martinez; Famiglietti, Angela M. R.; Ramirez, Maria S.

    2012-01-01

    We describe the first case of a Kerstersia gyiorum strain isolated from a patient with cholesteatomatous chronic otitis media. We emphasize the isolation of members of the family Alcaligenaceae in serious infections and unusual sites and the importance of polyphasic identification addressing the definitive identification. PMID:22972825

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

    ERIC Educational Resources Information Center

    Paul, Rhea; And Others

    This study examines otitis media as a possible factor associated with increased risk for communicative handicap in a group of children with a possible vulnerability for language delay: "late-talkers." Speech and language outcomes at ages 3 and 4 were examined in 28 late talkers and 24 children with normal language development. Late…

  6. The Effect of Otitis Media on Articulation in Children with Cerebral Palsy.

    ERIC Educational Resources Information Center

    Van der Vyver, Marguerite; And Others

    1988-01-01

    A study involving 20 Afrikaans-speaking children with cerebral palsy found that recurrent otitis media in early childhood had a negative effect on articulation abilities of the 7 to 11-year-old children but that other factors such as intelligence also played a role. (JDD)

  7. Risk for Speech Disorder Associated with Early Recurrent Otitis Media with Effusion: Two Retrospective Studies.

    ERIC Educational Resources Information Center

    Shriberg, Lawrence D.; Flipsen, Peter, Jr.; Thielke, Helen; Kwiatkowski, Joan; Kertoy, Marilyn K.; Katcher, Murray L.; Nellis, Robert A.; Block, Michael G.

    2000-01-01

    A study of 35 3-year-olds followed since infancy in a university-affiliated pediatrics clinic and 50 Native American children followed since infancy in a tribal health clinic found early recurrent otitis media with effusion was only associated with increased risk for speech disorder in the Native American children. (Contains extensive references.)…

  8. Effect of Otitis Media with Effusion on Comodulation Masking Release in Children.

    ERIC Educational Resources Information Center

    Hall, Joseph W.; Grose, John H.

    1994-01-01

    This study investigated comodulation masking release (CMR) in 42 children (ages 5 to 10) with a history of otitis media with effusion (OME) and 19 control children with no history of ear disease. Results indicated that monotic CMRs were reduced in children with hearing loss due to OME and these CMRs remained abnormally small for several months.…

  9. The Effects of Otitis Media on Articulation. Final Report for 1982-1983.

    ERIC Educational Resources Information Center

    Roberts, Joanne Erwick

    The study examined the relationship in 44 preschoolers (considered to have varying degrees of predicted risk for poor school performance) between otitis media (middle ear disease) during the first 3 years of life and speech production (articulation) during preschool and school age years. Speech production accuracy was assessed by the number of…

  10. Early Phonological and Lexical Development and Otitis Media: A Diary Study.

    ERIC Educational Resources Information Center

    Donahue, Mavis L.

    1993-01-01

    A child with chronic otitis media with effusion solved the problem of reduced and fluctuating auditory input with phonological selection and avoidance strategies that capitalized on prosodic cues. Findings illustrate the need to consider interactions among performance, input, and linguistic constraints to explain individual variation in language…

  11. Predictors of Phonologic Inadequacy in Young Children Prone to Otitis Media.

    ERIC Educational Resources Information Center

    Paden, Elaine Pagel; And Others

    1987-01-01

    Assessments of 18-to 35-month-olds (N=40) documented as having persistent otitis media with effusion indicated that a combination of low production scores for velars, liquids, and obstruents as well as early onset and late remission were important in characterizing children who would need speech remediation or intervention. (Author/CB)

  12. 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…

  13. Otitis Media and Later Academic Performance: The Linkage and Implications for Intervention.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; Schuele, C. Melanie

    1990-01-01

    This article reviews the literature on the relationship of otitis media with effusion (OME) during early childhood to intelligence, academic achievement, and classroom behavior during the preschool and primary school years. Guidelines for assessment, program planning, and intervention for the child with an active episode or past OME history are…

  14. Communicative Development in Twins with Discordant Histories of Recurrent Otitis Media.

    ERIC Educational Resources Information Center

    Hemmer, Virginia Hoey; Ratner, Nan Bernstein

    1994-01-01

    The communicative abilities of six sets of same-sex, preschool dizygotic twins were examined. In each dyad, one sibling had a strong history of recurrent otitis media (ROM) but the other twin did not. History of ROM was associated with lowered receptive vocabulary, with no consistent effects detected in expressive speech and language tasks.…

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

    ERIC Educational Resources Information Center

    Roberts, Joanne Erwick; Henderson, Frederick W.

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

  16. Effects of Recurrent Otitis Media on Language, Speech, and Educational Achievement in Menominee Indian Children.

    ERIC Educational Resources Information Center

    Thielke, Helen M.; Shriberg, Lawrence D.

    1990-01-01

    Among 28 monolingual English-speaking Menominee Indian children, a history of otitis media was associated with significantly lower scores on measures of language comprehension and speech perception and production at ages 3-5, and on school standardized tests 2 years later. Contains 38 references. (SV)

  17. 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)

  18. 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…

  19. Otitis Media with Effusion and the Development of Language: A Review of the Evidence.

    ERIC Educational Resources Information Center

    Friel-Patti, Sandy

    1990-01-01

    The article reviews possible effects of the mild, fluctuating hearing loss associated with otitis media with effusion (OME) in children. Two hypotheses, the first assuming an indirect relationship between OME and language mediated by hearing and the second that relationships among OME, hearing, and language may change over time, are presented. (DB)

  20. Otitis Media in Early Childhood and Cognitive, Academic, and Behavior Outcomes at 12 Years of Age.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; And Others

    1995-01-01

    Examined the association between otitis media with effusion (OME) during the first 3 years of life and cognitive, academic performance, and behavior outcomes at 12 years of age. Results indicated that OME during early childhood was not related to intellectual performance, academic achievement, behavior, and attention. Suggests that generalizations…

  1. Effect of Otitis Media upon Reading Scores of Indian Children in Ontario.

    ERIC Educational Resources Information Center

    Scaldwell, William A.

    1989-01-01

    Finds that lower reading scores were related to evidence of past or present middle ear infection among 524 American Indian children in northern and southern Ontario. Discusses the high incidence of otitis media among young Indian children, and educational implications. Contains 29 references. (SV)

  2. Perception of Voicing Cues by Children with Early Otitis Media with and without Language Impairment.

    ERIC Educational Resources Information Center

    Groenen, Paul; And Others

    1996-01-01

    This study examined identification and discrimination of initial bilabial stop consonants differing in voicing by 10 9-year-old children with a history of severe otitis media with effusion (OME). Long-term effects of OME were found for both identification and discrimination performance. In cases of language impairment with early OME, no additional…

  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. Theories of otitis media pathogenesis, with a focus on Indigenous children.

    PubMed

    Wiertsema, Selma P; Leach, Amanda J

    2009-11-02

    Otitis media is a common childhood illness associated with hearing loss, social disadvantage and medical costs. Prevalence and severity are high among Indigenous children. Respiratory bacterial and viral pathogens ascend the eustachian tube from the nasopharynx to the middle ear, causing inflammation, fluid accumulation, and bulging of the tympanic membrane, with or without pain. Among Australian Indigenous children, ear disease commences earlier in life, and involves multiple strains of bacterial pathogens at high density that persist longer. Persistent nasal discharge, overcrowded living conditions (particularly exposure to many children) and poor facilities for washing children perpetuate a vicious cycle of transmission and infection. Risk factors include environmental tobacco smoke, season, lack of breastfeeding, younger age and immature immune system, and possibly genetic factors. The innate immune system is a critical first response to infection, particularly as passive maternal antibodies decline and during the maturation of the infant adaptive immune response. The relative contributions of innate factors to protection from otitis media are currently not well understood. A diversity of antibodies that target strain-specific and conserved antigens are generated in response to natural exposure to otitis media pathogens (or to vaccines). Deficiencies in these antibodies may explain susceptibility to recurrent infections. Incremental contributions from all these elements are likely to be important in otitis media susceptibility versus protection. Effective medical and social strategies to prevent early age of onset are urgently needed.

  5. Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media.

    PubMed

    Vikram, B K; Khaja, N; Udayashankar, S G; Venkatesha, B K; Manjunath, D

    2008-05-01

    This study aimed to compare the clinical and epidemiological profiles of cases of complicated and uncomplicated chronic suppurative otitis media, based on their prognostic factors. This was a prospective, cross-sectional study conducted in a tertiary care medical college hospital over a period of two and a half years. The study group comprised 187 ears, out of which 62 had complications while 125 did not. The two groups were compared with respect to nine prognostic variables: age distribution, sex, patient's domicile, literacy status, duration of ear discharge at presentation, ear pathology, predisposing disease focus in the nose or throat, ear swab microbiology, and hearing loss. Patients in the complicated chronic suppurative otitis media group had a higher male predominance and were younger. Rural and illiterate patients had a higher risk of developing complications. Cholesteatoma and granulation tissue were potential risk factors in the complicated chronic suppurative otitis media group. Ears with complications were more prone to develop sensorineural hearing loss. Age, sex, duration of ear discharge, predisposing disease focus in nose or throat, and ear swab microbiology were all less useful prognostic indicators of complications. Early detection and timely treatment of chronic suppurative otitis media in rural and illiterate patients may prevent life-threatening complications and reduce their incidence. Ears that harbour relatively large quantities of both cholesteatoma and granulation tissue together require more urgent surgical intervention and more extensive disease clearance in order to prevent complications.

  6. Otitis Media with Effusion and the Development of Language: A Review of the Evidence.

    ERIC Educational Resources Information Center

    Friel-Patti, Sandy

    1990-01-01

    The article reviews possible effects of the mild, fluctuating hearing loss associated with otitis media with effusion (OME) in children. Two hypotheses, the first assuming an indirect relationship between OME and language mediated by hearing and the second that relationships among OME, hearing, and language may change over time, are presented. (DB)

  7. 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…

  8. Communicative Development in Twins with Discordant Histories of Recurrent Otitis Media.

    ERIC Educational Resources Information Center

    Hemmer, Virginia Hoey; Ratner, Nan Bernstein

    1994-01-01

    The communicative abilities of six sets of same-sex, preschool dizygotic twins were examined. In each dyad, one sibling had a strong history of recurrent otitis media (ROM) but the other twin did not. History of ROM was associated with lowered receptive vocabulary, with no consistent effects detected in expressive speech and language tasks.…

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

    ERIC Educational Resources Information Center

    Roberts, Joanne Erwick; Henderson, Frederick W.

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

  10. The Impact of Otitis Media with Effusion on Infant Phonetic Perception

    ERIC Educational Resources Information Center

    Polka, Linda; Rvachew, Susan

    2005-01-01

    The effect of prior otitis media with effusion (OME) or current middle ear effusion (MEE) on phonetic perception was examined by testing infants' discrimination of "boo" and "goo" syllables in 2 test sessions. Middle ear function was assessed following each perception test using tympanometry. Perceptual performance was compared…

  11. Effect of Otitis Media with Effusion on Comodulation Masking Release in Children.

    ERIC Educational Resources Information Center

    Hall, Joseph W.; Grose, John H.

    1994-01-01

    This study investigated comodulation masking release (CMR) in 42 children (ages 5 to 10) with a history of otitis media with effusion (OME) and 19 control children with no history of ear disease. Results indicated that monotic CMRs were reduced in children with hearing loss due to OME and these CMRs remained abnormally small for several months.…

  12. 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…

  13. Perception of Voicing Cues by Children with Early Otitis Media with and without Language Impairment.

    ERIC Educational Resources Information Center

    Groenen, Paul; And Others

    1996-01-01

    This study examined identification and discrimination of initial bilabial stop consonants differing in voicing by 10 9-year-old children with a history of severe otitis media with effusion (OME). Long-term effects of OME were found for both identification and discrimination performance. In cases of language impairment with early OME, no additional…

  14. Effect of Otitis Media upon Reading Scores of Indian Children in Ontario.

    ERIC Educational Resources Information Center

    Scaldwell, William A.

    1989-01-01

    Finds that lower reading scores were related to evidence of past or present middle ear infection among 524 American Indian children in northern and southern Ontario. Discusses the high incidence of otitis media among young Indian children, and educational implications. Contains 29 references. (SV)

  15. 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…

  16. Predictors of Phonologic Inadequacy in Young Children Prone to Otitis Media.

    ERIC Educational Resources Information Center

    Paden, Elaine Pagel; And Others

    1987-01-01

    Assessments of 18-to 35-month-olds (N=40) documented as having persistent otitis media with effusion indicated that a combination of low production scores for velars, liquids, and obstruents as well as early onset and late remission were important in characterizing children who would need speech remediation or intervention. (Author/CB)

  17. Allergic rhinitis and allergy are risk factors for otitis media with effusion: A meta-analysis.

    PubMed

    Cheng, X; Sheng, H; Ma, R; Gao, Z; Han, Z; Chi, F; Cong, N; Wang, J; Liu, X; Luo, X; Yu, J; Ra, Y

    We systematically reviewed the associations between allergic rhinitis or allergy and otitis media with effusion, by reference to published data. A meta-analysis of case-controlled studies. Five databases (Pubmed, Highwire, Medline, Wanfang, and China National Knowledge Infrastructure) were searched for relevant studies in the English language published prior to November 12, 2015. Studies with clearly defined experimental and control groups, in which the experimental groups had otitis media with effusion together with allergic rhinitis or allergy, were selected. We performed a meta-analysis on data from the identified cross-sectional and case-controlled studies using fixed- or random-effects models (depending on heterogeneity). We used Reviewer Manager 5.3 software to this end. Seven studies met the inclusion criteria. The prevalence of allergic rhinitis in patients with otitis media with effusion and the control groups differed significantly in three studies (P<0.00001), as did the prevalence of allergy (in six studies; P=0.003). Allergic rhinitis and allergy appear to be risk factors for otitis media with effusion. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  18. Effects of Recurrent Otitis Media on Language, Speech, and Educational Achievement in Menominee Indian Children.

    ERIC Educational Resources Information Center

    Thielke, Helen M.; Shriberg, Lawrence D.

    1990-01-01

    Among 28 monolingual English-speaking Menominee Indian children, a history of otitis media was associated with significantly lower scores on measures of language comprehension and speech perception and production at ages 3-5, and on school standardized tests 2 years later. Contains 38 references. (SV)

  19. 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)

  20. Early Phonological and Lexical Development and Otitis Media: A Diary Study.

    ERIC Educational Resources Information Center

    Donahue, Mavis L.

    1993-01-01

    A child with chronic otitis media with effusion solved the problem of reduced and fluctuating auditory input with phonological selection and avoidance strategies that capitalized on prosodic cues. Findings illustrate the need to consider interactions among performance, input, and linguistic constraints to explain individual variation in language…

  1. Otitis Media and Later Academic Performance: The Linkage and Implications for Intervention.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; Schuele, C. Melanie

    1990-01-01

    This article reviews the literature on the relationship of otitis media with effusion (OME) during early childhood to intelligence, academic achievement, and classroom behavior during the preschool and primary school years. Guidelines for assessment, program planning, and intervention for the child with an active episode or past OME history are…

  2. Effects of Otitis Media with Effusion on Hearing in the First 3 Years of Life.

    ERIC Educational Resources Information Center

    Gravel, Judith S.; Wallace, Ina F.

    2000-01-01

    Hearing sensitivity was examined prospectively in 114 young children as a function of otitis media with effusion (OEM)status in years 1, 2, and 3. Results indicated that children classified as bilaterally OME positive in years 1, 2, and 3 had significantly poorer hearing than children classified as bilaterally OME free at these periods. (Contains…

  3. The Effect of Otitis Media on Articulation in Children with Cerebral Palsy.

    ERIC Educational Resources Information Center

    Van der Vyver, Marguerite; And Others

    1988-01-01

    A study involving 20 Afrikaans-speaking children with cerebral palsy found that recurrent otitis media in early childhood had a negative effect on articulation abilities of the 7 to 11-year-old children but that other factors such as intelligence also played a role. (JDD)

  4. Otitis Media in Early Childhood and Cognitive, Academic, and Behavior Outcomes at 12 Years of Age.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; And Others

    1995-01-01

    Examined the association between otitis media with effusion (OME) during the first 3 years of life and cognitive, academic performance, and behavior outcomes at 12 years of age. Results indicated that OME during early childhood was not related to intellectual performance, academic achievement, behavior, and attention. Suggests that generalizations…

  5. 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)

  6. Risk for Speech Disorder Associated with Early Recurrent Otitis Media with Effusion: Two Retrospective Studies.

    ERIC Educational Resources Information Center

    Shriberg, Lawrence D.; Flipsen, Peter, Jr.; Thielke, Helen; Kwiatkowski, Joan; Kertoy, Marilyn K.; Katcher, Murray L.; Nellis, Robert A.; Block, Michael G.

    2000-01-01

    A study of 35 3-year-olds followed since infancy in a university-affiliated pediatrics clinic and 50 Native American children followed since infancy in a tribal health clinic found early recurrent otitis media with effusion was only associated with increased risk for speech disorder in the Native American children. (Contains extensive references.)…

  7. The Impact of Otitis Media with Effusion on Infant Phonetic Perception

    ERIC Educational Resources Information Center

    Polka, Linda; Rvachew, Susan

    2005-01-01

    The effect of prior otitis media with effusion (OME) or current middle ear effusion (MEE) on phonetic perception was examined by testing infants' discrimination of "boo" and "goo" syllables in 2 test sessions. Middle ear function was assessed following each perception test using tympanometry. Perceptual performance was compared…

  8. 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…

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

    PubMed

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

    2016-06-01

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

  10. Adenoid Vegetations - Reservoir of Bacteria for Chronic Otitis Media with Effusion and Chronic Rhinosinusitis.

    PubMed

    Davcheva-Chakar, Marina; Kaftandzhieva, Ana; Zafirovska, Beti

    2015-01-01

    Otitis media and rhinosinusitis are commonly encountered illnesses in pediatric population. Literature reports have documented the association between the occurrence of these two conditions and even their almost identical microbiological findings. Until recently, the key factor in the association of these two conditions was considered to be the hypertrophic adenoid tissue, but within the past few years there have been evidences in the literature about the presence of bacterial biofilms on the adenoids suggesting biofilms to be also responsible for both conditions, chronic otitis media with effusion and chronic rhinosinusitis. The aim of this study was to make a microbiological analysis of the adenoid tissue specimens taken from patients with chronic otitis media with effusion and chronic or recurrent rhinosinusitis and to determine their potential for biofilms formation. After the surgical intervention, adenoidectomy, microbiological evaluation and analysis of the adenoid tissue specimens taken from 20 patients were made. Having in mind the disease history, chronic otitis media with effusion was diagnosed in all 20 patients and chronic rhinosinusitis in 9 patients. The results obtained from the microbiological analyses showed many potentially pathogenic bacteria in the adenoids that were almost identical with the most common organisms incorporated in the etiopathogenesis of both conditions, in chronic otitis media with effusion and in chronic rhinosinusitis. In 7 (35%) patients Haemophylus influenzae was isolated, in 6 (30%) Streptococcus pneumoniae, in 4 (20%) Moraxella catаrrhalis, in 2 (10%) patients Staphylococcus aureus and in 1 (5%) patient Streptococcus pyogenes - group A was isolated. One bacterium was isolated from all adenoid vegetations, except in one case when two bacteria (Haemophylus influenzae and Staphylococcus aureus) were concurrently isolated. Our results have shown that the key role in adenoid vegetations in chronic otitis media with effusion

  11. Use of a hearing loss grading system and an owner-based hearing questionnaire to assess hearing loss in pet dogs with chronic otitis externa or otitis media.

    PubMed

    Mason, Carly L; Paterson, Susan; Cripps, Peter J

    2013-10-01

    Hearing loss is important when assessing the suitability of dogs with otitis externa/media for medical or surgical therapy. To assess an owner-completed questionnaire as an indicator of hearing loss and a canine hearing loss scoring system in chronic canine otitis. One hundred hospital population dogs referred for chronic otitis investigation. Owners completed a questionnaire to assess their dog's response to common household noises. The presence of otitis externa or media was determined and brainstem auditory-evoked response measurements were performed on each dog. The minimal hearing threshold (MHT) in decibels normal hearing level (dB NHL) was recorded and categorized according to the human World Health Organization grading system into five grades from 0 to 4 with cut-off values of ≤25 dB NHL, 26-40 dB NHL, 41-60 dB NHL, 60-80 dB NHL and ≥81 dB NHL. The questionnaire correctly determined normal hearing in grade 0 cases, but did not reliably detect unilateral or grade 1 bilateral hearing loss. For dogs with bilateral hearing loss ≥ grade 2, questionnaire sensitivity was 83% [24 of 29, 95% confidence interval, (CI) 64-94%] and specificity was 94% (67 of 71, 95% CI 86-98%). Higher grades of hearing loss were significantly associated with the presence of otitis media (P < 0.01). The questionnaire may be a useful in-practice screening tool in chronic canine otitis for moderate to severe bilateral hearing deficits (MHT ≥41 dB NHL). The hearing loss grading system may help clinicians make therapeutic decisions. Chronic otitis media may be associated with higher grades of hearing loss. © 2013 ESVD and ACVD.

  12. 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.

  13. [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.

  14. Association of cytokine gene polymorphisms and risk factors with otitis media proneness in children.

    PubMed

    Miljanović, Olivera; Cikota-Aleksić, Bojana; Likić, Dragan; Vojvodić, Danilo; Jovićević, Ognjen; Magić, Zvonko

    2016-06-01

    In order to assess the association between gene polymorphisms and otitis media (OM) proneness, tumor necrosis factor alpha (TNFA) -308, interleukin (IL) 10-1082 and -3575, IL6 -597, IL2 -330, and CD14 -159 genotyping was performed in 58 OM-prone children and 85 controls who were exposed to similar number and frequency of environmental and host risk factors. The frequencies of genotypes (wild type vs. genotypes containing at least one polymorphic allele) were not significantly different between groups, except for IL10 -1082. Polymorphic genotypes IL10 -1082 GA and GG were more frequent in OM-prone children than in control group (RR 1.145, 95 % CI 1.011-1.298; p = 0.047). However, logistic regression did not confirm IL10 -1082 polymorphic genotypes as an independent risk factor for OM proneness. The present study indicates that high-producing IL10 -1082 GA/GG genotypes may increase the risk for OM proneness in its carriers when exposed to other environmental/host risk factors (day care attendance, passive smoking, male sex, respiratory infections, and atopic manifestations). This study revealed no significant independent genetic association, but the lack of breastfeeding in infancy was found to be the only independent risk factor for development of OM-prone phenotype, implying that breastfeeding had a protective role in development of susceptibility to OM. • The pathogenesis of OM is of multifactorial nature, dependent on infection, environmental factors, and immune response of the child. • Cytokines and CD14 play an important role in the presentation and clinical course of otitis media, but a clear link with otitis media proneness was not established. What is new: • This is the first clinical and genetic study on Montenegrin children with the otitis media-prone phenotype. • The study revealed that high-producing IL10 -1082 genotypes may influence otitis media proneness in children exposed to other environmental/host risk factors.

  15. Association of microRNA 146 with middle ear hyperplasia in pediatric otitis media.

    PubMed

    Samuels, Tina L; Yan, Justin; Khampang, Pawjai; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Kerschner, Joseph E

    2016-09-01

    Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours. Middle ear biopsies were collected from children with otitis media with effusion (n = 20), recurrent otitis media (n = 9), and control subjects undergoing cochlear implantation (n = 10). miR-146a, miR-146b expression was assayed by quantitative PCR (qPCR). Expression of miR-146 targets involved in TLR signaling, IRAK1 and TRAF6, was assayed by qPCR in middle ear biopsies. Middle ear biopsies were cryosectioned and epithelial thickness measured by a certified pathologist. Proinflammatory cytokines induced expression of miR-146 in middle ear epithelial cells in vitro. Middle ear miR-146a and miR-146b expression was elevated in otitis media patients relative to control subjects and correlated with middle ear epithelial thickness. A trend towards inverse correlation was observed between miR-146 and TRAF6 expression in the clinical population. This report is the first to assess miRNA expression in a clinical population with OM. Findings herein suggest miR-146 may play a role in OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Otitis media with effusion in an allergic animal model: A functional and morphological study.

    PubMed

    Kim, Dong-Kee; Park, Hyu Eun; Back, Sang-A; Park, Hyang Rim; Kim, Soo Whan; Park, Yooyeon; Yeo, Sang Won; Park, Shi-Nae

    2016-05-01

    Allergy is considered as one of important etiologic factor of otitis media with effusion (OME). In present study, we evaluated the causal effect of allergy on OME in an animal model, and investigated the secondary effect of bacterial infection. Allergy and control animals were subdivided into groups with and without intratympanic injection of lipopolysaccharide (IT-LPS). Allergic otitis media was induced via intraperitoneal ovo-albumin injection with intranasal challenge. We assessed the occurrence of OME in allergic animals and the effect of IT-LPS on allergic otitis media. We also investigated the Th1 and Th2 responses in the middle-ear mucosa. Hearing of the animals was measured by ABR and DPOAE. OME was observed in 75% of the allergic animals. After IT-LPS, 100% of the control and allergy groups showed otitis media. Light microscopy revealed that the middle-ear mucosa of animals of both groups also was significantly increased after IT-LPS, and the Th1 response (IL-2 and IFN-γ) and Th2 response (IL-5 and IL-13) cytokines were expressed at higher levels in the allergy group with IT-LPS than in control group with IT-LPS. Hearing tests between the allergy and control group with IT-LPS did not reveal any differences. Our findings may be direct evidence of an allergic causal effect on OME. Th2 response cytokines were strongly expressed in allergic OME, and the inflammatory reaction to LPS was more intense in the allergic group, which indicates that otitis media related to allergy can be severely aggravated by an inflammatory reaction to bacterial infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2017-06-01

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

  18. 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

  19. Physicians’ knowledge of the epidemiology, diagnosis, and management of otitis media

    PubMed Central

    Lee, Ambrose; Flowerdew, Gordon; Delaney, Mary

    2009-01-01

    ABSTRACT OBJECTIVE To develop a survey instrument with good internal consistency and test-retest reliability to explore the level of knowledge among Nova Scotia family physicians concerning the risk factors, signs and symptoms, and treatment of otitis media and the use of pneumatic otoscopy. DESIGN Prospective cohort design. SETTING Fee-for-service family practices in Nova Scotia. PARTICIPANTS A convenience sample of 25 family physicians. MAIN OUTCOME MEASURES Test-retest reliability and internal consistency of the survey. RESULTS The constructs including “signs and symptoms of otitis media with effusion” and “comprehensive knowledge scores” showed excellent internal consistency with Kuder-Richardson 20 scores greater than 0.7 whereas the construct “signs and symptoms of acute otitis media” has a Kuder-Richardson 20 score of 0.54 after deletion of several items. The Cohen κ and Spearman ρ tests showed the survey has very good test-retest reliability. CONCLUSION The questionnaire that we developed proved to have very good internal consistency and test-retest reliability. We hope to use this questionnaire to explore the practice patterns of family physicians in managing otitis media disease. PMID:19155374

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

    PubMed

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

    2012-01-01

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

  1. Presumptive meningoencephalitis secondary to extension of otitis media/interna caused by Streptococcus equi subspecies zooepidemicus in a cat.

    PubMed

    Martin-Vaquero, Paula; da Costa, Ronaldo C; Daniels, Joshua B

    2011-08-01

    A 5-year-old castrated male domestic longhair cat was presented with neurological signs consistent with a central vestibular lesion and left Horner's syndrome. Computed tomography images revealed hyperattenuating, moderately contrast-enhancing material within the left tympanic bulla, most consistent with left otitis media/interna. Marked neutrophilic pleocytosis was identified on cerebrospinal fluid analysis. Streptococcus equi subspecies zooepidemicus (SEZ) was isolated from the cerebrospinal fluid. Intracranial extension of otitis media/interna is relatively infrequent in small animals. There are no reports of otitis media/interna caused by SEZ in dogs or cats. This is the first report of otitis media/interna and presumptive secondary meningoencephalitis caused by SEZ in a cat. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  2. Anti-inflammatory and anti-oxidative effects of alpha-lipoic acid in experimentally induced acute otitis media.

    PubMed

    Tatar, A; Korkmaz, M; Yayla, M; Gozeler, M S; Mutlu, V; Halici, Z; Uslu, H; Korkmaz, H; Selli, J

    2016-07-01

    To investigate the anti-inflammatory, anti-oxidative and tissue protective effects, as well as the potential therapeutic role, of alpha-lipoic acid in experimentally induced acute otitis media. Twenty-five guinea pigs were assigned to one of five groups: a control (non-otitis) group, and otitis-induced groups treated with saline, penicillin G, alpha-lipoic acid, or alpha-lipoic acid plus penicillin G. Tissue samples were histologically analysed, and oxidative parameters in tissue samples were measured and compared between groups. The epithelial integrity was better preserved, and histological signs of inflammation and secretory metaplasia were decreased, in all groups compared to the saline treated otitis group. In the alpha-lipoic acid plus penicillin G treated otitis group, epithelial integrity was well preserved and histological findings of inflammation were significantly decreased compared to the saline, penicillin G and alpha-lipoic acid treated otitis groups. The most favourable oxidative parameters were observed in the control group, followed by the alpha-lipoic acid plus penicillin G treated otitis group. Alpha-lipoic acid, with its antioxidant, anti-inflammatory and tissue protective properties, may decrease the clinical sequelae and morbidity associated with acute otitis media.

  3. The variation in quality and content of patient-focused health information on the Internet for otitis media.

    PubMed

    Joury, A; Joraid, A; Alqahtani, F; Alghamdi, A; Batwa, A; Pines, J M

    2017-09-14

    When symptoms of otitis media appear, parents and patients often access the Internet for health information. We study the content and quality of health information in parent-patient-focused websites for otitis media. We searched the 3 search engines (Google, Yahoo, and Bing) using "otitis media" and "middle ear infection" then reviewed the top 30 hits for each search. We included sites that were focused on providing patient-patient information about otitis media. A variety of instruments were used to assess website content and quality. In 35 included websites, there was considerable variation in content, with the average site having 11 out of 15 informational items potentially useful to parents and patients on otitis media (range 4-15). Across included websites, the mean DISCERN score was 47 out of 80 (low to medium quality), 16 (46%) were HONcode certified, and 8 (23%) fulfilled all the JAMA benchmark criteria. The average website was written at a 9th/10th-grade reading level. The content and quality of health information for otitis media in parent-and-patient-focused websites is highly variable. Although easy-to-read, high-quality websites with complete content are available, the average website sites is difficult to read without a high school education and is difficult to use. Consideration should be given to adopting a standard approach for presenting disease-specific information to parents and patients. © 2017 John Wiley & Sons Ltd.

  4. Clinical Practice Guideline: Otitis Media with Effusion (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

    This update of a 2004 guideline codeveloped by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, the American Academy of Pediatrics, and the American Academy of Family Physicians, provides evidence-based recommendations to manage otitis media with effusion (OME), defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection. Changes from the prior guideline include consumer advocates added to the update group, evidence from 4 new clinical practice guidelines, 20 new systematic reviews, and 49 randomized control trials, enhanced emphasis on patient education and shared decision making, a new algorithm to clarify action statement relationships, and new and expanded recommendations for the diagnosis and management of OME. The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing OME and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to improve diagnostic accuracy, identify children who are most susceptible to developmental sequelae from OME, and educate clinicians and patients regarding the favorable natural history of most OME and the clinical benefits for medical therapy (eg, steroids, antihistamines, decongestants). Additional goals relate to OME surveillance, hearing and language evaluation, and management of OME detected by newborn screening. The target patient for the guideline is a child aged 2 months through 12 years with OME, with or without developmental disabilities or underlying conditions that predispose to OME and its sequelae. The guideline is intended for all clinicians who are likely to diagnose and manage children with OME, and it applies to any setting in which OME would be identified, monitored, or managed. This guideline, however, does not apply to patients <2 months or >12 years old. The update group made strong recommendations that clinicians (1

  5. Otitis media with effusion in relation to socio economic status: a community based study.

    PubMed

    Siddartha; Bhat, Vadisha; Bhandary, Satheesh Kumar; Shenoy, Vijaya; Rashmi

    2012-03-01

    Otitis media with effusion (OME) is the presence of non purulent effusion within the middle ear cleft. The symptoms of this disease are not alarming as in suppurative otitis media. The disease is common in young children. The main symptom of this disease is decreased hearing, which may sometime go unnoticed more so if the parents are not attentive. We conducted a community based study among 1,020 school children of the age group 5-10 years from schools of sub-urban areas of Dakshina Kannada district, Karnataka, to explore the relationship of OME in relation to socioeconomic status. Diagnosis of OME was done by clinical examination and tympanometry. Prevalence of OME was 4.5%. Out of 46 cases, 4% belong to upper class, 26% to upper middle class, 26% to lower middle class, 43% to upper lower class.

  6. Relationship between Otitis Media and Epithelial Function in the Lymphoepithelium of Pediatric Adenoids.

    PubMed

    Ogasawara, Noriko; Yamamoto, Keisuke; Takano, Kenichi; Himi, Tetsuo

    2016-01-01

    Nose- or nasopharynx-associated lymphoid tissue (NALT) has a unique role that is distinct from that of other lymphoid tissues. During upper airway mucosal immune response, NALT induces a variety of responses, including cytokine and chemokine production and innate immune response, to establish acquired immunity. NALT consists of epithelial cells, epithelium-associated lymphoid tissues such as IgA-committed B cells, innate lymphocytes, T helper cells and dendritic cells. Intranasal immunization has recently been shown to effectively induce a proactive immune response in the local mucosa in addition to a systemic immune response. A variety of factors can cause otitis media, including Eustachian tube dysfunction, inflammation, allergy and viral and bacterial infections. However, the detailed pathogenesis of otitis media is not yet completely understood. In this report, we provide evidence suggesting that adenoid tissue as a component of NALT in children may play an important role in inducing innate immunity following viral infection. © 2016 S. Karger AG, Basel.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2006-03-01

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

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

    PubMed

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

    2007-02-01

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

  10. [Microbiological characteristics of otitis media purulenta chronica: effects on the disease course].

    PubMed

    Gurov, A V; Guseva, A L

    2007-01-01

    Bacteria in different portions of the middle ear were studied in 68 patients with otitis media purulenta chronica (OMPC) as well as sensitivity of the bacteria to different antibacterial medicines. Microflora was followed up for a months after surgical treatment. Prevalent were Staphylococcus aureus and gram-negative flora most sensitive to defended penicillines, cephalosporins of the third generation and fluoroquinolones. Destructive changes in the temporal bone, acoustic and vestibular functions by type of the causative agent were examined.

  11. 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;…

  12. 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.

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

    PubMed

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

    2014-11-01

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

  14. 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;…

  15. Oral Antibiotic Use for Otitis Media with Effusion: Ongoing Opportunities for Quality Improvement.

    PubMed

    Roditi, Rachel E; Liu, C Carrie; Bellmunt, Angela M; Rosenfeld, Richard M; Shin, Jennifer J

    2016-05-01

    (1) To evaluate the probability of antibiotic administration associated with ICD-9 diagnosis of otitis media with effusion (OME) in the absence of acute otitis media, (2) to determine whether usage varies according to visit setting, and (3) to ascertain if practice gaps are such that future practice changes might be measured. Cross-sectional analysis of an administrative database. Ambulatory visits in the United States. National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005-2010; univariate, multivariate, and stratified analyses of antibiotic usage were performed. The study population was restricted to children without acute or unspecified otitis media. The primary outcome was the probability of oral antibiotic administration when OME was diagnosed. The impact of the location of service and subspecialty care was also analyzed. Data from 1,390,404,196 pediatric visits demonstrated that oral antibiotics were administered for 32% of visits with an OME diagnosis, even in the absence of acute otitis media (odds ratio, 4.31; 95% confidence interval: 2.88-6.44; P < .001). The highest antibiotic administration was seen in the emergency department (risk difference, 37.1%; number needed to harm, 3). No significant increased risk of antibiotic usage was seen during otolaryngology visits. Diagnoses of infections at nonotologic sites were associated with a 1.98 to 26.60 increase in odds of oral antibiotic administration. Oral antibiotics continue to be administered in children with OME in the absence of acute infection, with risk varying by location of service. There is a potential opportunity for quality improvement through reducing antibiotic administration for pediatric OME. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

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

    PubMed

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse; Faber, Christian Emil; Johansen, Eva Charlotte Jung; Godballe, Christian

    2015-10-01

    The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to investigate possible predictors for clinical success. Longitudinal observational study. Secondary care units. Four hundred ninety-one families were enrolled in the study. The Otitis Media-6 questionnaire was applied in the assessment of child quality of life. Caregivers completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube treatment. A diagnosis of rAOM was found to predict baseline quality of life. Children with rAOM with or without OME were found to suffer significantly more than children with only OME before treatment. Factors associated with disease severity were found to predict clinical success. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  17. 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

  18. Immunoglobulin G, total and subclass, in children with or without recurrent otitis media.

    PubMed

    Berman, S; Lee, B; Nuss, R; Roark, R; Giclas, P C

    1992-08-01

    Total IgG and subclasses IgG1, IgG2, IgG3, and IgG4 were measured in 89 subjects with recurrent otitis media. There was no significant difference between the groups with respect to the arithmetic or geometric mean levels for total IgG or subclasses IgG1, IgG2, IgG3, or IgG4.

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

    PubMed

    Kryukov, A I; Garov, E V; Ivoilov, A Yu; Shadrin, G B; Sidorina, N G; Lavrova, A S

    2015-01-01

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

  20. Indications and radiological findings of acute otitis media and its complications.

    PubMed

    Pont, Elena; Mazón, Miguel

    Most cases of acute otitis media resolve with antibiotics and imaging is not required. When treatment fails or a complication is suspected, imaging plays a crucial role. Since the introduction of antibiotic treatment, the complication rate has decreased dramatically. Nevertheless, given the critical clinical relevance of complications, the importance of early diagnosis is vital. Our objective was to review the clinical and radiological features of acute otitis media and its complications. They were classified based on their location, as intratemporal or intracranial. Imaging makes it possible to diagnose the complications of acute otitis media and to institute appropriate treatment. Computed tomography is the initial technique of choice and, in most cases, the ultimate. Magnetic resonance is useful for evaluating the inner ear and when accurate evaluation of disease extent or better characterization of intracranial complications is required. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  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.

  2. The forced-response test does not discriminate ears with different otitis media expressions.

    PubMed

    Casselbrant, Margaretha L; Mandel, Ellen M; Seroky, James T; Swarts, J Douglas; Doyle, William J

    2014-11-01

    Test the hypothesis that the eustachian tube (ET) function measured using standard manometric test methods is different between groups of ears with tympanostomy tubes inserted for recurrent acute otitis media (RAOM) and for chronic otitis media with effusion (COME). A cross-sectional study of ET function in populations of young children with different otitis media expressions. The results for forced-response testing of ET function were compared using a general linear model between 37 ears of 26 children and 34 ears of 26 children, aged 3 and 4 years, with ventilation tubes inserted for COME and RAOM, respectively. There were no significant between-group differences in either the active measure of ET opening function, dilatory efficiency, or in the passive measures reflecting the magnitude of the forces that tend to hold the ET lumen closed, the opening and closing pressures, and passive trans-ET conductance. The results do not support the hypothesis that ET closing forces are less in ears with RAOM when compared to ears with COME, and from the results of earlier studies, ears without disease. Both groups were characterized by a low ET opening efficiency (referenced to ears of adults with no disease history). Because both disease expressions present the same pattern of ET dysfunction, other factors are required to explain why a subset of ears with that type of dysfunction develop RAOM, as opposed to the default expression of COME. 2b © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  3. A systematic review of patient-reported outcome measures for chronic suppurative otitis media.

    PubMed

    Phillips, John S; Yung, Matthew W

    2016-06-01

    The purpose of this review was to systematically appraise the world literature to identify existing patient-reported outcome measures (PROMs) for the assessment of outcomes in patients with chronic suppurative otitis media, to verify the diversity of the individual questionnaire items, to report the methods employed to evaluate the questionnaires, and to identify areas for development in the future. Embase (January 1980-November 2014), MEDLINE (January 1946-November 2014), Cumulative Index to Nursing and Allied Health Literature (January 1981-November 2014), and PsycINFO (January 1806-November 2014). A systematic literature search was independently undertaken by the two authors according to predefined inclusion and exclusion criteria. Nine original articles were identified, which overall outlined the evaluation of four different questionnaires. This systematic appraisal of the world literature has identified four PROM questionnaires for use in patients with chronic suppurative otitis media. All four questionnaires evaluate reliability and validity using different psychometric methods. The Chronic Ear Survey questionnaire has been most broadly evaluated and disseminated. All four questionnaires assess static health status. There are many advantages to developing a dynamic one-hit questionnaire to assess the health status of patients having undergone an intervention for chronic suppurative otitis media. NA Laryngoscope, 126:1458-1463, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Using an epidemiological model to investigate unwarranted variation: the case of ventilation tubes for otitis media with effusion in England.

    PubMed

    Schang, Laura; De Poli, Chiara; Airoldi, Mara; Morton, Alec; Bohm, Natalie; Lakhanpaul, Monica; Schilder, Anne; Bevan, Gwyn

    2014-10-01

    To investigate unwarranted variation in ventilation tube insertions for otitis media with effusion in children in England. This procedure is known to be 'overused' from clinical audits, as only one in three ventilation tube insertions conforms to the appropriateness criteria of the National Institute for Health and Care Excellence (NICE); but audits cannot identify the scale of 'underuse' - i.e. patients who would benefit but are not treated. To explore both 'underuse' and 'overuse' of ventilation tubes for otitis media with effusion, we developed an epidemiological model based on: definitions of children with otitis media with effusion expected to benefit from ventilation tubes according to NICE guidance; epidemiological and clinical information from a systematic review; and expert judgement. A range of estimates was derived using Monte Carlo simulation and compared with the number of ventilation tubes provided in the English National Health Service in 2010. About 32,200 children in England would be expected to benefit from ventilation tubes for otitis media with effusion per year (between 20,411 and 45,231 with 90% certainty). The observed number of ventilation tubes for otitis media with effusion-associated diagnoses was 16,824. The expected population capacity to benefit from ventilation tubes for otitis media with effusion based on NICE guidance appeared to exceed, by far, the number of ventilation tubes provided in the English National Health Service. So, while there is known 'overuse', there also may be substantial 'underuse' of ventilation tubes for otitis media with effusion if NICE criteria were applied. Future investigations of unwarranted variation should, therefore, not only focus on the patients who are treated but also consider the potential for benefit at the population level. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

    PubMed

    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.

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

    PubMed

    Bellussi, L; Mandalà, M; Passàli, F M; Passàli, G C; Lauriello, M; Passali, D

    2005-12-01

    Purpose of this study was to correlate results from a survey on otitis media and the State-Trait Anxiety Inventory test. This survey investigated prevalence of otitis media (OM) in our territory, influence on development of language and personality and social costs. State-Trait Anxiety Inventory is a suitable test to differentiate state anxiety caused by a specific event [in this case, otitis media with effusion (OME)] from a trait anxiety (anxious personality) in parents and caregivers. The otitis media study was conducted, retrospectively, in two primary public schools in Colle Val D'Elsa (Siena) on 252 children (6-11 years old). The State-Trait Anxiety Inventory test had been administered to the parents or caregivers of 20 paediatric outpatients (4-12 years, mean 6.8) at the ENT Department of Siena University. The results of the OM survey showed a correlation between OM and difficulties in speech and reading, delayed answering and limited vocabulary. All these problems improved as children grew up. On the other hand, psycho-social development appeared to be more problematic even in the 4th and 5th class, mostly due to persistent attention disturbances. In the State-Trait Anxiety Inventory test, 50% of parents or caregivers had a high state-anxiety score and so were mostly concerned with health status of the children. The State-Trait Anxiety Inventory results indicated that 50% of parents or caregivers had a high trait-anxiety score and thus had an anxious personality. These findings could be helpful in understanding the real severity of symptoms. The two proposed tests could provide complementary data to evaluate children with OME: the OM survey can be used as a screening test to detect children with non-symptomatic OME, to establish whether delayed language development may be associated with OME, to predict prognosis and children's quality of life as well as social costs of OME; the State-Trait Anxiety Inventory test can be used to reveal a state or a trait

  7. Diagnosis and antibiotic treatment of acute otitis media: report from International Primary Care Network.

    PubMed Central

    Froom, J; Culpepper, L; Grob, P; Bartelds, A; Bowers, P; Bridges-Webb, C; Grava-Gubins, I; Green, L; Lion, J; Somaini, B

    1990-01-01

    STUDY OBJECTIVE--The relation between a history of disorders suggestive of acute otitis media, symptoms, and findings of an examination of the tympanic membrane and doctors' certainty of diagnosis. Also, to examine differences in prescribing habits for acute otitis media among doctors from different countries. DESIGN--Questionnaires were completed by participating doctors for a maximum of 15 consecutive patients presenting with presumed acute otitis media. SETTING--General practices in Australia, Belgium, Great Britain, Israel, The Netherlands, New Zealand, Canada, Switzerland, and the United States. PATIENTS--3660 Children divided into the three age groups 0-12 months, 13-30 months, and greater than or equal to 31 months. MAIN OUTCOME MEASURES--General practitioners' responses to questions on their diagnostic certainty and resolution of patients' symptoms after two months. RESULTS--The diagnostic certainty in patients aged 0-12 months was 58.0%. This increased to 66.0% in those aged 13-30 months and 73.3% in those aged greater than or equal to 31 months. In all age groups diagnostic certainty was positively associated with the finding of a tympanic membrane that was discharging pus or bulging. Redness of the membrane and pain were also associated with certainty in patients aged 13-30 months, and a history of decreased hearing or recent upper respiratory infection was positively associated in patients aged greater than or equal to 31 months. The proportion of patients prescribed antibiotics varied greatly among the countries, from 31.2% in The Netherlands to 98.2% in both Australia and New Zealand, as did the duration of treatment. Patients who did not take antibiotics had a higher rate of recovery than those who did; the rate of recovery did not differ between different types of antibiotic. CONCLUSIONS--Doctors' certainty of diagnosis of acute otitis media was linked to patient's age. Improved criteria or techniques for diagnosing acute otitis media, especially in

  8. Recurrent acute otitis media. A prospective study of children during the first three years of life.

    PubMed

    Harsten, G; Prellner, K; Heldrup, J; Kalm, O; Kornfält, R

    1989-01-01

    To evaluate possible risk factors for developing recurrent acute otitis media (rAOM), 113 children were followed prospectively from birth to the age of 3 years. One of the aims was to determine whether such risk factors could be identified before the onset of the recurrences, so that optimal care and prophylactic measures could be made available at an early stage in such cases, on the basis of continuous follow-up by an ENT specialist. During the follow-up, 13 children developed rAOM, defined as six or more episodes of acute otitis media (AOM) during a 12-month period, 57 children had occasional episodes of AOM, and 43 children had no AOM at all. Of the children with onset of AOM before 6 months of age, 80% developed frequent episodes of AOM. The frequency of other respiratory tract infections and of family histories of otitis-proneness was higher among rAOM children than among the other children. The development of rAOM was unrelated to such factors as sex, familial history of allergy, duration of breast-feeding, or domestic environment. Nor could attendance at day-care centres be concluded as constituting a risk factor for the development of rAOM. An onset of AOM before 6 months of age was highly predictive of subsequent recurrent bouts of AOM, which emphasizes the importance of correct diagnosis in infants.

  9. Cellular immune response in young children accounts for recurrent acute otitis media.

    PubMed

    Sharma, Sharad K; Pichichero, Michael E

    2013-10-01

    Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae (Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years, our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis prone(sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B and T cell responses and an immaturity in antigen-presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children.

  10. Cellular Immune Response in Young Children Accounts for Recurrent Acute Otitis Media

    PubMed Central

    Sharma, Sharad K.; Pichichero, Michael E.

    2013-01-01

    Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae(Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis-prone (sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B-& T- cell responses and an immaturity in antigen presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children. PMID:24022464

  11. A genome-wide association study of chronic otitis media with effusion and recurrent otitis media identifies a novel susceptibility locus on chromosome 2.

    PubMed

    Allen, E Kaitlynn; Chen, Wei-Min; Weeks, Daniel E; Chen, Fang; Hou, Xuanlin; Mattos, José L; Mychaleckyj, Josyf C; Segade, Fernando; Casselbrant, Margaretha L; Mandel, Ellen M; Ferrell, Robert E; Rich, Stephen S; Daly, Kathleen A; Sale, Michèle M

    2013-12-01

    Chronic otitis media with effusion (COME) and recurrent otitis media (ROM) have been shown to be heritable, but candidate gene and linkage studies to date have been equivocal. Our aim was to identify genetic susceptibility factors using a genome-wide association study (GWAS). We genotyped 602 subjects from 143 families with 373 COME/ROM subjects using the Illumina Human CNV370-Duo DNA Bead Chip (324,748 SNPs). We carried out the GWAS scan and imputed SNPs at the regions with the most significant associations. Replication genotyping in an independent family-based sample was conducted for 53 SNPs: the 41 most significant SNPs with P < 10(-4) and 12 imputed SNPs with P < 10(-4) on chromosome 15 (near the strongest signal). We replicated the association of rs10497394 (GWAS discovery P = 1.30 × 10(-5)) on chromosome 2 in the independent otitis media population (P = 4.7 × 10(-5); meta-analysis P = 1.52 × 10(-8)). Three additional SNPs had replication P values < 0.10. Two were on chromosome 15q26.1 including rs1110060, the strongest association with COME/ROM in the primary GWAS (P = 3.4 ×10(-7)) in KIF7 intron 7 (P = 0.072), and rs10775247, a non-synonymous SNP in TICRR exon 2 (P = 0.075). The third SNP rs386057 was on chromosome 5 in TPPP intron 1 (P = 0.045). We have performed the first GWAS of COME/ROM and have identified a SNP rs10497394 on chromosome 2 is significantly associated with COME/ROM susceptibility. This SNP is within a 537 kb intergenic region, bordered by CDCA7 and SP3. The genomic and functional significance of this newly identified locus in COME/ROM pathogenesis requires additional investigation.

  12. A hybrid feature-based segmentation and classification system for the computer aided self-diagnosis of otitis media.

    PubMed

    Shie, Chuen-Kai; Chang, Hao-Ting; Fan, Fu-Cheng; Chen, Chung-Jung; Fang, Te-Yung; Wang, Pa-Chun

    2014-01-01

    We propose a novel hybrid otitis media (OM) computer aided detection (CAD) system, designed to aid in the self-diagnosis of various forms of OM. OM is a prevalent disease in both children and adults. Our system is able to differentiate normal ear from acute otitis media (AOM), otitis media with effusion (OME) and the multi-categories of chronic otitis media including perforation, retraction, cholesteatoma, etc. We propose a modified double active contour segmentation method designed for use with otoscope images, and enabled to handle user acquired data. To describe the visual symptoms (e.g., red, bulging, effusion, perforation, retraction, etc.) of otitis media accurately, we extract color, geometric and texture features by grid color moment, Gabor filter, local binary pattern and histogram of oriented gradients. A powerful classification structure based on Adaboost is used to select the most useful features and build a strong classifier. Our system achieves classification accuracy as high as 88.06% and is suitable for real use. In addition, some interesting observations about OM otoscope images are also discussed.

  13. [Expression of receptor CD23+ on B lymphocytes in hypertrophied adenoids of children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Wysocka, Jolanta; Hassmann-Poznańska, Elzbieta; Kasprzycka, Edwina

    2005-01-01

    Tonsil pharyngeal is stimulated chronic by pathogens can be causes this hypertrophied; whose often is companions to otitis media with effusion. Subpopulation dominates in tonsil pharyngeal are lymphocytes B, and their markers activation are expression of antigen CD23+. The aim of this study was finding dependence between otitis media with effusion and coexistent hypertrophy adenoids, and percentage of lymphocytes CD19+ with expression of antigen CD23+ in hypertrophy adenoids. In the study showed higher significant percentage of lymphocytes CD19+ CD23+ at children in otitis media with effusion (20.08+/-2.93) with reference to comparative group, which was only hypertrophy adenoid (18.16+/-2.25). Percentage lymphocytes B (CD23+) were the highest (20.01+/-5.81) in children subgroup above 5 years old with otitis media with effusion, and lowest (17.36+/-2.78) in children comparative subgroup above 5 years old. As regards on different functions of antigen CD23+ the assessment of percentage lymphocytes B with expression of CD23+ can be additional marker in course immunological and inflammatory processes to occur in hypertrophy adenoids at children are sick otitis media with effusion.

  14. 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.

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

    PubMed Central

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

    2014-01-01

    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

  16. Comparative prevalence of otitis media in children living in urban slums, non-slum urban and rural areas of Delhi.

    PubMed

    Chadha, Shelly K; Gulati, Kriti; Garg, Suneela; Agarwal, Arun K

    2014-12-01

    The study aimed to determine the prevalence and profile of otitis media in different parts of a city, i.e. non-slum urban areas, urban slums and rural areas. A door to door survey was conducted in identified areas of Delhi. A total of 3000 children (0-15 years) were randomly selected and examined for presence of otitis media. These children were equally distributed in the three areas under consideration. Data was analyzed to establish the prevalence of different types of otitis media. Chi-square test was then applied to compare disease prevalence among the three areas. 7.1% of the study population was identified with otitis media, which includes CSOM (4.26%), OME (2.5%) and ASOM (0.4%). In the non-slum urban parts of the city, 4.6% children had otitis media. This was significantly lower compared to 7% children in rural parts of Delhi and 9.9% in urban slums of the city. The prevalence of CSOM was considerably higher in slum areas (7.2%) as compared with rural (3%) and non-slum urban areas (2.6%). Ear infections are significantly more common in urban slums as compared to non-slum city areas and rural parts of Delhi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Evaluation of 15 functional candidate genes for association with chronic otitis media with effusion and/or recurrent otitis media (COME/ROM).

    PubMed

    Sale, Michèle M; Chen, Wei-Min; Weeks, Daniel E; Mychaleckyj, Josyf C; Hou, Xuanlin; Marion, Miranda; Segade, Fernando; Casselbrant, Margaretha L; Mandel, Ellen M; Ferrell, Robert E; Rich, Stephen S; Daly, Kathleen A

    2011-01-01

    DNA sequence variants in genes involved in the innate immune response and secondary response to infection may confer susceptibility to chronic otitis media with effusion and/or recurrent otitis media (COME/ROM). We evaluated single nucleotide polymorphisms (SNPs) in 15 functional candidate genes. A total of 99 SNPs were successfully genotyped on the Sequenom platform in 142 families (618 subjects) from the Minnesota COME/ROM Family Study. Data were analyzed for association with COME/ROM using the Generalized Disequilibrium Test (GDT). Sex and age at exam were adjusted as covariates, relatedness was accounted for, and genotype differences from all phenotypically discordant relative pairs were utilized to measure the evidence of association between COME/ROM and each SNP. SNP rs2735733 in the region of the mucin 5, subtypes A/C gene (MUC5AC) exhibited nominal evidence for association with COME/ROM (P = 0.002). Two additional SNPs from this region had P values<0.05. Other variants exhibiting associations with COME/ROM at P<0.05 included the SCN1B SNP rs8100085 (P = 0.013), SFTPD SNP rs1051246 (P = 0.039) and TLR4 SNP rs2770146 (P = 0.038). However, none of these associations replicated in an independent sample of COME/ROM families. The candidate gene variants examined do not appear to make a major contribution to COME/ROM susceptibility, despite a priori evidence from functional or animal model studies for a role in COME/ROM pathology.

  18. Evaluation of 15 Functional Candidate Genes for Association with Chronic Otitis Media with Effusion and/or Recurrent Otitis Media (COME/ROM)

    PubMed Central

    Sale, Michèle M.; Chen, Wei-Min; Weeks, Daniel E.; Mychaleckyj, Josyf C.; Hou, Xuanlin; Marion, Miranda; Segade, Fernando; Casselbrant, Margaretha L.; Mandel, Ellen M.; Ferrell, Robert E.; Rich, Stephen S.; Daly, Kathleen A.

    2011-01-01

    DNA sequence variants in genes involved in the innate immune response and secondary response to infection may confer susceptibility to chronic otitis media with effusion and/or recurrent otitis media (COME/ROM). We evaluated single nucleotide polymorphisms (SNPs) in 15 functional candidate genes. A total of 99 SNPs were successfully genotyped on the Sequenom platform in 142 families (618 subjects) from the Minnesota COME/ROM Family Study. Data were analyzed for association with COME/ROM using the Generalized Disequilibrium Test (GDT). Sex and age at exam were adjusted as covariates, relatedness was accounted for, and genotype differences from all phenotypically discordant relative pairs were utilized to measure the evidence of association between COME/ROM and each SNP. SNP rs2735733 in the region of the mucin 5, subtypes A/C gene (MUC5AC) exhibited nominal evidence for association with COME/ROM (P = 0.002). Two additional SNPs from this region had P values<0.05. Other variants exhibiting associations with COME/ROM at P<0.05 included the SCN1B SNP rs8100085 (P = 0.013), SFTPD SNP rs1051246 (P = 0.039) and TLR4 SNP rs2770146 (P = 0.038). However, none of these associations replicated in an independent sample of COME/ROM families. The candidate gene variants examined do not appear to make a major contribution to COME/ROM susceptibility, despite a priori evidence from functional or animal model studies for a role in COME/ROM pathology. PMID:21857919

  19. Microbiological profile with antibiotic sensitivity pattern of cholesteatomatous chronic suppurative otitis media among children.

    PubMed

    Madana, J; Yolmo, Deeke; Kalaiarasi, R; Gopalakrishnan, S; Sujatha, S

    2011-09-01

    Chronic suppurative otitis media (CSOM) is the most common cause of childhood hearing impairment in the developing countries and atticoantral type is associated with increased incidence of intracranial and extracranial complications. This study was undertaken to define the microbiology of atticoantral type of chronic otitis media and the antibiotic sensitivity pattern, thereby reducing the potential risks of complications. A retrospective study was done in the Department of Otolaryngology, JIPMER, Puducherry from the year August 2003 to October 2009 using the medical record department database to retrieve the patient details. During this study period, 223 children with atticoantral type CSOM consisting of 126 males and 97 females with an age range of 1-14 years were assessed. Patients with persistent otorrhea for more than 3 months with atticoantral type of chronic otitis media were selected. The exudates were collected under sterile conditions and inoculated onto culture media; bacterial growth and antibiotic sensitivity pattern were studied. Nine species of micro organisms were isolated from the middle ear aspirate, Pseudomonas aeruginosa being the most predominant isolate constituting about 32% (72 discharging ears) of the total isolates followed by Proteus mirabilis (20% of isolates) and Staphylococcus aureus (19% of isolates). Gram negative organisms accounted 58% of total isolates and gram positive organisms constituted 22% isolates. Candida albicans and methicillin resistant S. aureus were identified in 4% and 2% of isolates, respectively. 100% of Pseudomonas isolates showed susceptibility to ceftazidime and a high sensitivity (92% of isolates) to ciprofloxacin and 88% isolates were sensitive to amikacin. 100% of P. mirabilis isolated from inoculates showed sensitivity to ceftazidime and ciprofloxacin. It also showed 87-97% sensitivity to ceftriaxone, amikacin and ampicillin. All (100%) of the Staphylococcus isolates were sensitive to vancomycin and 84

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

    PubMed

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

    2015-12-01

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

  1. Nasopharyngeal antibodies to pneumococcal pneumolysin in children with acute otitis media.

    PubMed Central

    Virolainen, A; Jero, J; Käyhty, H; Karma, P; Eskola, J; Leinonen, M

    1995-01-01

    Pneumolysin, an intracellular protein toxin of all clinically relevant pneumococcal serotypes, is released in vivo during the autolysis of pneumococci and is believed to pave the way for intact pneumococci to invade and cause disease. Therefore, antibodies to pneumolysin should prevent its destructive function. We measured antibodies to pneumococcal pneumolysin in acute- and convalescent-phase nasopharyngeal aspirate samples of 120 children (median age, 2.5 years) with acute otitis media by enzyme immunoassay. Nasopharyngeal immunoglobulin M (IgM) and IgG class antibodies to pneumolysin were rarely detectable, whereas IgA class antibody was detected often, occurred independently of serum IgA antibody in serum, and correlated with the presence of the secretory component in pneumococcal antibody, indicating local production of IgA antibodies. Nasopharyngeal IgA antibody to pneumolysin was detected in 93% of the children already in the acute phase of otitis. Twenty percent of the children developed at least a threefold rise in the pneumolysin-specific IgA antibody concentration by the convalescent phase of otitis, with the youngest at 6 months of age, regardless of the pneumococcal findings in the nasopharynx or middle ear fluid. We suggest that nasopharyngeal IgA antibody to pneumolysin can be produced early in life by pneumococcal colonization. PMID:8574834

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

    PubMed

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

    2012-01-01

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

  3. Dynamic Properties of Round Window Membrane in Guinea Pig Otitis Media Model Measured with Electromagnetic Stimulation

    PubMed Central

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

    2013-01-01

    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 to 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. PMID:23333258

  4. 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". Copyright © 2013 Elsevier B.V. All rights reserved.

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

    PubMed

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

    2016-01-01

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

  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. The effect of the leukotriene antagonist pranlukast on pediatric acute otitis media.

    PubMed

    Nakamura, Yoshihisa; Hamajima, Yuki; Suzuki, Motohiko; Esaki, Shinichi; Yokota, Makoto; Oshika, Masanori; Takagi, Ippei; Yasui, Keiko; Miyamoto, Naoya; Sugiyama, Kazuko; Nakayama, Meiho; Murakami, Shingo

    2016-08-01

    Conventional treatment for acute otitis media mainly targets bacteria with antibiotics, neglecting to control for mediators of inflammation. Mediators of inflammation, such as leukotrienes, have been identified in patients with acute otitis media (AOM) or subsequent secretory otitis media (SOM). They can cause functional eustachian tube dysfunction or increase mucous in the middle ear, causing persistent SOM following AOM. The objective of the present study was to evaluate whether or not administration of pranlukast, a widely used leukotriene C4, D4, and E4 antagonist, together with antibiotics could inhibit the progression to SOM. Children with AOM, who were from two to 12 years old, were randomly divided into two groups as follows: a control group in which 50 patients received antibiotic-based conventional treatment according to guidelines for treating AOM proposed by the Japan Otological Society (version 2006); and a pranlukast group, in which 52 patients were administered pranlukast for up to 28 days as well as given conventional treatment. Cases were regarded as persistent SOM when a tympanogram was type B or C2 four weeks after treatment was initiated. Two patients in the pranlukast group and 3 patients in the control group were excluded because they relapsed AOM within 28 days after initial treatment. Therefore, the analysis included 50 and 47 subjects in the pranlukast and control groups, respectively. The percentage of patients diagnosed with persistent SOM (22.0%) was significantly smaller in the pranlukast group compared with the control group (44.7%) (p = 0.018, chi-squared test). The results indicate that combined treatment of AOM with antibiotics and a leukotriene antagonist to control inflammation is useful for preventing progression to persistent SOM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Same-Day Evaluation and Surgery for Otitis Media and Tympanostomy Tube Placement: A Feasibility Study.

    PubMed

    Billings, Kathleen R; Hajduk, John; Rose, Allison; De Oliveira, Gildasio S; Suresh, Suresh S; Thompson, Dana M

    2016-10-01

    To determine the feasibility of providing streamlined same-day evaluation and surgical management of children with recurrent otitis media or chronic serous otitis media who meet criteria for tympanostomy tube (TT) placement. Retrospective matched case series. Tertiary care children's hospital. A comparison group (age, sex, insurance product) was utilized to determine if the same-day process decreased facility time and surgical time for the care episode. A parent satisfaction survey was administered. Thirty children, with a median age of 16 months (range, 12-22 months), participated in the same-day surgery process for TT. Twenty-one patients (70.0%) were male, and these patients were matched to a comparison group (similar age, sex, and insurance product) having non-same-day (routine) TT placement. The same-day patients spent significantly less time in clinic for the preoperative physician visit (average, 15 minutes) when compared with the non-same-day patients (average, 51.5 minutes; P < .001). The operative experience for the same-day patients was similar to the non-same-day patients (average, 145 vs 137 minutes, respectively; P = .35), but the overall experience was significantly shorter for the same-day patients (average, 151 vs 196 minutes for comparisons; P < .001). All parents surveyed in the same-day group were satisfied with the efficiency of the experience. The same-day surgery process for management of children who meet the criteria for TT placement is a model of improved efficiency of care for children who suffer from otitis media. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  11. Effect of ciprofloxacin/dexamethasone versus ciprofloxacin/hydrocortisone on lipopolysaccharide-induced experimental otitis media.

    PubMed

    Dattaray, Piali; Pudrith, Charles; Nyc, Mary Ann; Martin, Dusan; Kim, You Hyun; Jahng, Patrick; Chung, You Sun; Wall, G Michael; Jung, Timothy

    2011-08-01

    The purpose of this study is to compare the effect of topical ciprofloxacin/dexamethasone versus topical ciprofloxacin/hydrocortisone on the outcome of lipopolysaccharide (LPS)–induced otitis media with effusion in chinchillas. A randomized experimental animal study. Jerry L. Pettis Veteran's Medical Center. Otitis media with effusion was induced in 5 groups of chinchillas, 6 per group, by injecting 0.3 mL (1 mg/mL) of Salmonella enteric LPS into the superior bullae of each chinchilla with a venting needle in place. Each group was treated with 0.2 mL of test substance at –2, 24, 48, and 72 hours relative to the 0-hour LPS induction. Group 1 was treated with vehicle control. Groups 2 to 5 received 0.3% ciprofloxacin with either 0.1% dexamethasone (group 2), 1% dexamethasone (group 3), 0.1% hydrocortisone (group 4), or 1% hydrocortisone (group 5). The outcome of each treatment was measured by the amount of middle ear effusion present and mucosal thickness at 120 hours posttreatment. Ciprofloxacin/dexamethasone 1% significantly (P = .0150) reduced middle ear effusion compared with control. Ciprofloxacin/dexamethasone 1% significantly reduced the mucosal thickness when compared with vehicle control (P = .0005), ciprofloxacin/dexamethasone 0.1% (P = .0240), and ciprofloxacin/hydrocortisone 0.1% (P = 1.00). Results also showed a dose-response effect between the ciprofloxacin/dexamethasone concentrations. This study demonstrated that treatment with a combination of topical ciprofloxacin and corticosteroid decreased the middle ear effusion when compared with the control group and that ciprofloxacin/dexamethasone suspension reduced the severity of LPS-induced experimental otitis media more than ciprofloxacin/hydrocortisone did.

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

    PubMed

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

    2014-08-01

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

  13. Otitis media in Inuit children in the Eastern Canadian Arctic--an overview--1968 to date.

    PubMed

    Baxter, J D

    1999-10-05

    Clinical observations made on the Inuit in the Eastern Canadian Arctic during the past three decades support that the current high prevalence of chronic otitis media among their children is a relatively new phenomenon. It is a social/economic disease related to their urbanization that occurred following World War II when the vast majority of the Inuit abandoned their isolated nomadic way of life and moved into permanent settlements. The disease, in a great many, runs a natural course with spontaneous healing. There is evidence that as the new millennium approaches the prevalence of the disease among the children is decreasing.

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

    PubMed

    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.

  15. [Actual problem of meningitis and other intracranial complications in cases of otitis media and sinusitis in children].

    PubMed

    Zieliński, Rafał; Zakrzewska, Anna

    2012-01-01

    The most frequent primary infections causing purulent meningitis in older children are both acute and chronic otitis media and sinusitis or upper and lower airways infections. In these cases sometimes purulent meningitis is accompanied with other intracranial complications. Pharmacological treatment of intracranial complications without surgical intervention concerning primary source of infection increases risk of complications including death of a patient and also recurrences of bacterial meningitis. In the paper authors present two uncommon cases of children with purulent meningitis and other intracranial complications of otitis media and sinusitis diagnosed by pediatricians.

  16. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2010-03-01

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

  18. Bacterial pathogens related to chronic suppurative otitis media in individuals with cleft palate: bacteriological culture and polymerase chain reaction.

    PubMed

    Weckwerth, Paulo Henrique; de Mattias Franco, Adriana Terezinha; de Magalhães Lopes, Carlos Alberto; Santos, Fernando Dos; Weckwerth, Ana Carolina Villas Bôas; Vivan, Rodrigo Ricci; Duarte, Marco Antonio Húngaro

    2014-03-01

    To characterize the microbial etiology of chronic suppurative otitis media comparing the methods of classical bacteriological culture and polymerase chain reaction. Bacteriological analysis by classical culture and by molecular polymerase chain reaction of 35 effusion otitis samples from patients with cleft lip and palate attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, Brazil. Collection of clinical samples of otitis by effusion through the external auditory tube. Otolaryngologic diagnosis of chronic suppurative otitis media. Positive cultures were obtained from 83% of patients. Among the 31 bacterial lineages the following were isolated. In order of decreasing frequency: Pseudomonas aeruginosa (54.9%), Staphylococcus aureus (25.9%), and Enterococcus faecalis (19.2%). No anaerobes were isolated by culture. The polymerase chain reaction was positive for one or more bacteria investigated in 97.1% of samples. Anaerobe lineages were detected by the polymerase chain reaction method, such as Fusobacterium nucleatum , Bacteroides fragilis , and Peptostreptococcus anaerobius . Patients with cleft lip and palate with chronic suppurative otitis media presented high frequency of bacterial infection in the middle ear. The classical bacteriological culture did not detect strict anaerobes, whose presence was identified by the polymerase chain reaction method.

  19. Otitis externa in children

    PubMed Central

    Price, John

    1976-01-01

    The commonest cause of ear-ache in children is otitis externa and five new cases of otitis externa will be seen for every case of otitis media. Acute otitis externa and otitis media are quite different and distinct clinical entities in children: the former is a tender, dirty, pruritic ear, often recurring in children with simple febrile illnesses; the latter is more isolated than is realised, non-recurrent and usually accompanying upper respiratory catarrhal illness. The fleeting nature of otitis externa as seen in childhood is typical of clinical material in general practice that presents quite differently from that in hospital practice. The long aetiological lists quoted in all series of cases of otitis externa in adults do not apply to otitis externa as seen in children. PMID:966211

  20. 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

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

    SciTech Connect

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

    1987-07-01

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

  2. [Consensus document on the aetiology, diagnosis and treatment of acute otitis media].

    PubMed

    Del Castillo Martín, F; Baquero Artigao, F; de la Calle Cabrera, T; López Robles, M V; Ruiz Canela, J; Alfayate Miguelez, S; Moraga Llop, F; Cilleruelo Ortega, M J; Calvo Rey, C

    2012-11-01

    This is the consensus document on acute otitis media (AOM) of the Sociedad Española de Infectología Pediatrica (SEIP), Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), Sociedad Española de Urgencias Pediátricas (SEUP) and Asociación Española de Pediatría de Atención Primaria (AEPAP). It discusses the aetiology of the disease and its potential changes after the introduction of the pneumococcal 7-valent, 10-valent and 13-valent vaccines. A proposal is made based on diagnostic classification of otitis media as either confirmed or likely. AOM is considered confirmed if 3 criteria are fulfilled: acute onset, signs of occupation of the middle ear (or otorrhea) and inflammatory signs or symptoms, such as otalgia or severe tympanic hyperaemia. Oral amoxicillin is the antibiotic treatment of choice (80mg/kg/day divided every 8hours). Amoxicillin-clavulanate (80mg/kg/day) is indicated in the following cases: when the child is under 6 months, in infants with severe clinical manifestations (fever>39°C or severe pain), there is family history of AOM sequels, and after amoxiciline treatment failure.

  3. 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.

  4. Montelukast is as effective as penicillin in treatment of acute otitis media: An experimental rat study

    PubMed Central

    Uçar, Seçil; Huseynov, Tural; Çoban, Melahat; Sarıoğlu, Sülen; Şerbetçioğlu, Bülent; Yalcin, Arzu Didem

    2013-01-01

    Background Leukotrienes are the major factors in the formation of edema and mucus, as well as development of tuba Eustachii dysfunction in acute otitis media. We developed an experimental acute suppurative otitis media model and compared the responses of rats to penicillin and combinations of leukotriene antagonist with respect to histopathological observations conducted in early and late phases. Material/Methods A total of 83 ears from 56 Wistar rats were used in this study. Pneumococcus suspension was injected trans-tympanically into all rats. Subjects were classified into 4 different groups with 14 rats in each. In Group A, intramuscular penicillin G was injected for a period of 5 days. In Group B, intraperitoneal montelukast was injected for 21 days in addition to penicillin. In Group C, intraperitoneal montelukast isotonic NaCl in Group D was injected into rats for 21 days. Results No significant difference was found between the groups, except for mucosal vascularization with respect to mucosal and TM parameters in early phases. Furthermore, considerable deviations were observed for the recuperation of TM and mucosal inflammation for groups in which subjects were injected with montelukast as compared to other groups of the study in the late phases. Conclusions When the parameters of inflammation in the rat middle ear were compared with each other, most of these parameters did not show any statistically significant beneficial effects in montelukast and penicillin groups. PMID:24048018

  5. The association of particular types of Proteus with chronic suppurative otitis media.

    PubMed

    Senior, B W; Sweeney, G

    1984-04-01

    During a period of 12 months, 57 strains of Proteus were isolated from the ears of 38 unrelated patients with chronic suppurative otitis media. Each strain was identified, typed for bacteriocin production and sensitivity, and tested for Dienes compatibility. The majority of the strains (79%) were P. mirabilis; all but one of the remainder were P.vulgaris. Although 19 different bacteriocin production/sensitivity types were found, two rare types, P. mirabilis P7/S5,12 and P. vulgaris P0/S9, were associated with 47% of these infections. This was confirmed by Dienes typing. Patients with bilateral ear disease carried a different strain in each ear. There was no evidence that persistence of infection had arisen because of the development of antibiotic resistance. Although there was some evidence that persistence may have been the result of reinfection, the isolation of these rare types of Proteus from so many patients with chronic suppurative otitis media may indicate that they play an important role in the pathogenesis of the disease. Most of the Proteus isolates were of "non-faecal" types and it is believed that infection had arisen by a route other than the faecal-aural one.

  6. bold-Squamous Metaplasia and BCL-6 in Pediatric Adenoid Accompanied by Otitis Media with Effusion

    PubMed Central

    Park, Dong Choon; Choo, Jae Hak; Cha, Chang Il

    2007-01-01

    Purpose Deterioration of local immunity in the adenoids may make them vulnerable to infection by microorganisms, resulting in otitis media with effusion. To determine the factors associated with this condition, we evaluated adenoid size, mucosal barrier, squamous changes of ciliated epithelium, IgA secretion, and BCL-6 expression in adenoids. Materials and Methods Seventeen children diagnosed with otitis media with effusion (OME group) and 20 children without any history of OME (control group) were enrolled. Their adenoids were sized by lateral view X-ray and stained with hematoxylin and eosin to detect squamous metaplasia. The adenoids were also stained with cytokeratin to evaluate mucosal barriers, and with anti-IgA antibody and anti- BCL-6 antibody to determine expression of IgA and BCL-6. Results The OME group showed greater incidence of squamous metaplasia, fewer ciliated cells, and lower expression of BCL-6 (p < 0.05 each). Deterioration of the mucosal barrier was detected in the OME group (p > 0.05). IgA secretion and adenoid size were the same for the OME and the control groups. Conclusion These results suggest that increased squamous metaplasia and lower BCL-6 expression in adenoids may be associated with increased susceptibility to OME. PMID:17594153

  7. Antibiotic resistance in pathogens causing acute otitis media in Finnish children.

    PubMed

    Sillanpää, Saara; Sipilä, Markku; Hyöty, Heikki; Rautiainen, Markus; Laranne, Jussi

    2016-06-01

    Microbiology and susceptibility of middle ear pathogens in children change over time and antibiotic resistance is increasing globally. For the clinicians it is important to be up to date about the resistance situation when considering antibiotic treatment in acute otitis media (AOM). In this study we analysed the resistance profile of AOM pathogens in out-patient children in Finland. A total of 41 culture positive middle ear fluid (MEF) samples were analysed for bacteria and the presence of antibiotic resistant strains. The samples were obtained from children aged six - 39 months who participated in the otitis media trial during one year period. The most common pathogen was Haemophilus influenzae 17 (40%), followed by Streptococcus pneumoniae in 15 (35%) and Moraxella catarrhalis in 8 (19%). Other pathogens were detected in 3 (7%) of cases. Antibiotic resistance or diminished sensitivity was seen in 63% of the detected bacteria and 28% of pathogens produced beta-lactamase. Antibiotic resistant bacterial strains causing AOM have increased in Finland. Nevertheless, most of the pathogens (72%) were sensitive to amoxicillin, which is still recommended as the first line antibiotic in the treatment of AOM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Effect of systemic clarithromycin and prednisolone on histamine-induced otitis media in guinea pigs.

    PubMed

    Kozan, Günay; Aktan, Bülent; Sakat, Muhammed Sedat; Kurt, Sezgin; Öner, Fatih; Kara, Adem

    2015-01-01

    The results of the study showed that clarithromycin has anti-inflammatory and antioxidant effects and, when it is combined with prednisolone, those effects gain strength. The present study aims to investigate the effects that the antioxidant and anti-inflammatory activities of clarithromycin and/or prednisolone have on experimental otitis media in effusion-induced guinea-pigs. In this study, 35-male guinea pigs were randomly divided into five-groups. For the experimental otitis media, intra-tympanic histamine (0.1 ml) was injected into the guinea pigs in all of the groups except the control group. Then, 24-h after the intra-tympanic injections, clarithromycin (15 mg/kg/day) and/or prednisolone (1 mg/kg/day) were applied intraperitoneally to the guinea-pigs for 7-days. The biochemical analysis showed an increase in antioxidant capacity and a decrease in oxidant status and malondialdehyde (MDA) levels in the clarithromycin group and the prednisolone group and especially in the clarithromycin+prednisolone group, as compared to the experimental group (p < 0.05). In the cytokine analysis, lower levels of interleukin (IL)-6 and IL-17A and higher IL-10 were found in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups than in the experimental group (p < 0.05). Furthermore, the histologic analyses showed histopathologic changes in the middle ear mucosa of the experimental group, but comparatively fewer-histopathologic changes were observed in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups.

  9. Computed tomography in chronic suppurative otitis media: value in surgical planning.

    PubMed

    Payal, Garg; Pranjal, Kulshreshtha; Gul, Motwani; Mittal, M K; Rai, A K

    2012-09-01

    The present study was conducted prospectively to evaluate how accurately high resolution computed tomography scanning could define the extent and severity of the underlying disease in patients with chronic suppurative ear disease, thus, helping convert a surgical exploration into a planned procedure. Sixty adult consecutive cases of chronic suppurative otitis media underwent a detailed high resolution computed tomography by a single radiologist. The recorded radiological findings in various heads were then compared to the surgical findings during mastoid exploration of these patients by a single otologist and the two statistically compared. The presence and distribution of soft tissue in the middle ear cleft and mastoid could confidently be predicted using this modality. The malleus, body and short process of incus were well visualized, but not the long process of incus and the stapes suprastructure. Lateral semicircular canal fistulae could be demonstrated with an acceptable degree of accuracy. It was possible to detect facial nerve dehiscence and defects in tegmen tympani in significant number of cases although, statistical values were low for these structures. High resolution scanning is a modality which can accurately image the pathological anatomy in unsafe chronic suppurative otitis media. Otologists should use it more often, especially in complicated cases as an adjunct to better preoperative assessment, and thus, the surgical outcome. Its accuracy is likely to improve with larger studies and better experience, wherein its routine use may become justifiable.

  10. 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.

  11. Post-irradiation otitis media, rhinosinusitis, and their interrelationship in nasopharyngeal carcinoma patients treated by IMRT.

    PubMed

    Hsin, Chung-Han; Tseng, Hsien-Chun; Lin, Huang-Pin; Chen, Tsai-Hsin

    2016-02-01

    This study aimed to investigate the occurrences of post-irradiation chronic suppurative otitis media (CSOM), otitis media with effusion (OME), chronic rhinosinusitis (CRS), and their interrelationship in nasopharyngeal carcinoma (NPC) patients treated by intensity-modulated radiotherapy (IMRT). A retrospective review of medical records and magnetic resonance imaging for NPC patients across a 5-year follow-up was conducted. Rhinosinusitis was diagnosed and staged by Lund-Mackay system. A total of 102 patients were enrolled in the study. On the 5th year following IMRT, 8 patients (7.8 %), 30 patients (29.4 %), and 17 patients (16.7 %) suffered from IMRT-induced CSOM, post-irradiation OME, and CRS, respectively. Analysis by logistic regression showed a lack of association between the occurrence of post-irradiation OME and CRS (P = 0.06). These observations indicated that the modern radiotherapy technique exhibits capability in decreasing the incidences of CSOM and CRS comparing to the data of traditional radiotherapy. But post-irradiation OME was still encountered in more than one-quarter of long-term survivors of NPC. Of note, rhinosinusitis in NPC survivors does not predispose to the development of post-irradiation OME, suggesting nasal irrigation might be unnecessary for the management of OME following radiotherapy.

  12. Household wood and charcoal smoke increases risk of otitis media in childhood in Maputo.

    PubMed

    da Costa, João Leopoldo; Navarro, Albert; Neves, José Branco; Martin, Miguel

    2004-06-01

    This study examined the association of otitis media in children <6 years old and the exposure to wood and charcoal smoke, as well as to other risk factors, in Maputo. Case-control study. In all 750 children matched by sex and age were enrolled in a hospital-community study. Cases were gathered from among children visiting the Central Hospital of Maputo with otitis media and controls were recruited in the same village as the cases. Conditional logistic regression was performed to evaluate, simultaneously, the effect of each risk factor. Cases were more likely to have been exposed to tobacco smoke (OR = 1.51), to wood (OR = 1.85) and charcoal (OR = 1.50) household smoke, to short term breastfeeding (OR = 1.47), and to live in overcrowded conditions (OR = 1.49). Multivariate analysis stratified by age groups (younger and older than 2 years) showed that cases were more likely to be exposed to wood and charcoal smoke than controls, regardless of age. Among children aged >2 years, Eustachian tube dysfunction was evident (OR = 3.06) particularly in those living in less overcrowded conditions. Findings of this study are consistent with earlier studies that have reported an association between parental smoking, short duration of breastfeeding, and Eustachian tube dysfunction. The association with wood and charcoal smoke indicates that there is a need to educate people regarding the avoidance of exposing their children to this environmental hazard.

  13. [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.

  14. Middle Ear Fluid Cytokine and Inflammatory Cell Kinetics in the Chinchilla Otitis Media Model

    PubMed Central

    Sato, Katsuro; Liebeler, Carol L.; Quartey, Moses K.; Le, Chap T.; Giebink, G. Scott

    1999-01-01

    Streptococcus pneumoniae is the most frequent microbe causing middle ear infection. The pathophysiology of pneumococcal otitis media has been characterized by measurement of local inflammatory mediators such as inflammatory cells, lysozyme, oxidative metabolic products, and inflammatory cytokines. The role of cytokines in bacterial infection has been elucidated with animal models, and interleukin (IL)-1β, IL-6, and IL-8 and tumor necrosis factor alpha (TNF-α) are recognized as being important local mediators in acute inflammation. We characterized middle ear inflammatory responses in the chinchilla otitis media model after injecting a very small number of viable pneumococci into the middle ear, similar to the natural course of infection. Middle ear fluid (MEF) concentrations of IL-1β, IL-6, IL-8, and TNF-α were measured by using anti-human cytokine enzyme-linked immunosorbent assay reagents. IL-1β showed the earliest peak, at 6 h after inoculation, whereas IL-6, IL-8, and TNF-α concentrations were increasing 72 h after pneumococcal inoculation. IL-6, IL-8, and TNF-α but not IL-1β concentrations correlated significantly with total inflammatory cell numbers in MEF, and all four cytokines correlated significantly with MEF neutrophil concentration. Several intercytokine correlations were significant. Cytokines, therefore, participate in the early middle ear inflammatory response to S. pneumoniae. PMID:10085040

  15. Penicillin treatment accelerates middle ear inflammation in experimental pneumococcal otitis media.

    PubMed Central

    Kawana, M; Kawana, C; Giebink, G S

    1992-01-01

    Most Streptococcus pneumoniae strains are killed by very low concentrations of penicillin and other beta-lactam antibiotics, yet middle ear inflammation and effusion persist for days to weeks after treatment in most cases of pneumococcal otitis media. To study the effect of beta-lactam antibiotic treatment on pneumococci and the middle ear inflammatory response during pneumococcal otitis media, we measured concentrations of pneumococci, inflammatory cells, and lysozyme in middle ear fluid (MEF) by using the chinchilla model. Procaine penicillin G given intramuscularly 12 and 36 h after inoculation of pneumococci into the middle ear caused a significant acceleration in the MEF inflammatory cell concentration compared with that in untreated controls, with a significant peak in the inflammatory cell concentration 24 h after pneumococcal inoculation. The lysozyme concentration in MEF also increased more rapidly in treated than in control animals. Viable pneumococci were not detected in MEF after the second dose of penicillin, but the total pneumococcal cell concentration remained unchanged for at least 45 days. Therefore, penicillin treatment accelerated middle ear inflammation while killing pneumococci, but treatment did not accelerate clearance of the nonviable pneumococcal cells from MEF. Further studies will need to define the contribution of these responses to acute and chronic tissue injury. PMID:1563782

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

    PubMed

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

    2015-11-15

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

  17. Oxidative metabolic products released from polymorphonuclear leukocytes in middle ear fluid during experimental pneumococcal otitis media.

    PubMed Central

    Kawana, M; Kawana, C; Yokoo, T; Quie, P G; Giebink, G S

    1991-01-01

    To determine whether oxidative metabolic products of phagocytic cells are present in the middle ear during experimental pneumococcal otitis media, we measured the concentration of myeloperoxidase (MPO) in middle ear fluid (MEF) and the capacity of neutrophils isolated from MEF and peripheral blood to produce MPO and superoxide anion (O2-) after in vitro stimulation. Free MPO in MEF was significantly increased 24 and 48 h after either viable or nonviable pneumococci were inoculated into the middle ear. In vitro-stimulated production of MPO and O2- from middle ear neutrophils was significantly less than that from peripheral blood neutrophils 24 h after nonviable pneumococci were inoculated but similar to it after 48 h. Twenty-four hours after viable pneumococci were inoculated, middle ear neutrophils stimulated in vitro produced less MPO but the same amount of O2- as did blood neutrophils. Oxidative metabolic products, therefore, are released from phagocytic cells into the MEF during pneumococcal otitis media, and future studies will need to define the contribution of these products to acute and chronic middle ear tissue injury. PMID:1657782

  18. Auditory consequences of early mild hearing loss associated with otitis media.

    PubMed

    Gravel, J S; Wallace, I F; Ruben, R J

    1996-03-01

    Two groups of children received periodic documentation of their middle ear status by pneumatic otoscopy in the first year of life and had hearing sensitivity estimated by multiple auditory brainstem response (ABR) assessments during the same period. One group was considered otitis media (OM)-positive, with repeated bilateral episodes of OM and mild conductive hearing loss. The second group was considered OM-free with normal middle ear function bilaterally and normal hearing sensitivity in the first year of life. Children's higher-order auditory abilities were examined at 4, 6 and 9 years of age. Various measures such as speech recognition-in-competition, visual-auditory learning, sound blending, auditory memory, and masking level difference estimates were utilized to probe the children's auditory abilities. Results show that children with a first-year history of otitis media demonstrate deficits in the long term in some aspects of higher-order auditory processing. Performance appears to be associated with the mild hearing loss experienced during an important period of early development.

  19. Evidence and evidence gaps in the treatment of Eustachian tube dysfunction and otitis media.

    PubMed

    Teschner, Magnus

    2016-01-01

    Evidence-based medicine is an approach to medical treatment intended to optimize patient-oriented decision-making on the basis of empirically proven effectiveness. For this purpose, a classification system has been established to categorize studies - and hence therapy options - in respect of associated evidence according to defined criteria. The Eustachian tube connects the nasopharynx with the middle ear cavity. Its key function is to ensure middle ear ventilation. Compromised ventilation results in inflammatory middle ear disorders. Numerous evidence-based therapy options are available for the treatment of impaired middle ear ventilation and otitis media, the main therapeutic approach being antibiotic treatment. More recent procedures such as balloon dilation of the Eustachian tube have also shown initial success but must undergo further evaluation with regard to evidence. There is, as yet, no evidence for some of the other long-established procedures. Owing to the multitude of variables, the classification of evidence levels for various treatment approaches calls for highly diversified assessment. Numerous evidence-based studies are therefore necessary in order to evaluate the evidence pertaining to existing and future therapy solutions for impaired middle ear ventilation and otitis media. If this need is addressed, a wealth of implications can be expected for therapeutic approaches in the years to come.

  20. Otitis Media Caused by V. cholerae O100: A Case Report and Review of the Literature.

    PubMed

    Kechker, Peter; Senderovich, Yigal; Ken-Dror, Shifra; Laviad-Shitrit, Sivan; Arakawa, Eiji; Halpern, Malka

    2017-01-01

    Infections due to Vibrio cholerae are rarely documented in Israel. Here we report a case of recurrent otitis media in a young male, caused by V. cholerae non-O1/O139. This extra-intestinal infection was caused by V. cholerae O100 and has been associated with freshwater exposure and travel. Symptoms of chronic periodic earaches along with purulent exudate began about one week after the patient suffered a water skiing accident on a river in Australia. The condition lasted for three years, until his ear exudate was examined in a clinical laboratory, diagnosed and treated. Five bacterial isolates were identified as V. cholerae O100. The isolates were screened for genetic characteristics and were found positive for the presence of hapA, hlyA, and ompU virulence genes. All isolates were negative for the presence of ctxA. Based on antibiogram susceptibility testing, ciprofloxacin ear drops were used until the patient's symptoms disappeared. This case demonstrates that exposure to freshwater can cause otitis media by V. cholerae non-O1/O139 in young and otherwise healthy humans.

  1. Relationship between CT findings and sensorineural hearing loss in chronic otitis media.

    PubMed

    Yoshida, Haruo; Miyamoto, Ikue; Takahashi, Haruo

    2014-06-01

    To investigate the relationships between the temporal bone CT findings and sensorineural hearing loss in ears with non-cholesteatomatous chronic otitis media (COM). Preoperative bone conduction (BC) hearing thresholds of 266 patients (304 ears) with COM were compared with those of 342 normal individuals (440 ears) by audiometry. The incidence of abnormal BC threshold at lower frequencies (250-1000 Hz) and at higher frequencies (2000-4000 Hz) were examined and the differences between control and COM groups were compared by using χ2 test. In the COM group, the cross-sectional area of the mastoid air cells based on the axial CT image (n=255) were correlated with the results of BC threshold. The percentage in the COM group exceeds 15% in their 50s at lower frequencies while in their 40s at higher frequencies. The BC thresholds were significantly better in the group with normal mastoid area than in those with smaller mastoid area at each decadal age group. The BC impairment from COM becomes worse as the course of the disease progresses and deteriorated from 40s rapidly, especially at higher frequencies and in the group with smaller mastoid area. These results recommend that early treatment, including surgery, should be considered as early as possible before BC impairment occurs, especially for COM cases with smaller mastoid area, which may indicate the existence of more severe otitis media since earlier childhood. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis media.

    PubMed

    Iino, Yukiko; Yoshida, Naohiro; Kato, Toshinori; Kakizaki, Keiko; Miyazawa, Tetsuo; Kakuta, Hiroyuki

    2015-03-01

    Additional treatment with clarithromycin (CAM) reduced persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children. CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion. We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children. H. influenzae-infected children with AOM were treated acutely with antimicrobial agents, after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine (S-CMC) alone or S-CMC combined with clarithromycin (CAM) for 1 week. The two regimens were compared in terms of clinical effects. After the initial acute treatment, many patients still showed abnormal otoscopic findings. At the completion of additional treatment, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group (p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug (p = 0.097).

  3. Evidence and evidence gaps in the treatment of Eustachian tube dysfunction and otitis media

    PubMed Central

    Teschner, Magnus

    2016-01-01

    Evidence-based medicine is an approach to medical treatment intended to optimize patient-oriented decision-making on the basis of empirically proven effectiveness. For this purpose, a classification system has been established to categorize studies – and hence therapy options – in respect of associated evidence according to defined criteria. The Eustachian tube connects the nasopharynx with the middle ear cavity. Its key function is to ensure middle ear ventilation. Compromised ventilation results in inflammatory middle ear disorders. Numerous evidence-based therapy options are available for the treatment of impaired middle ear ventilation and otitis media, the main therapeutic approach being antibiotic treatment. More recent procedures such as balloon dilation of the Eustachian tube have also shown initial success but must undergo further evaluation with regard to evidence. There is, as yet, no evidence for some of the other long-established procedures. Owing to the multitude of variables, the classification of evidence levels for various treatment approaches calls for highly diversified assessment. Numerous evidence-based studies are therefore necessary in order to evaluate the evidence pertaining to existing and future therapy solutions for impaired middle ear ventilation and otitis media. If this need is addressed, a wealth of implications can be expected for therapeutic approaches in the years to come. PMID:28025605

  4. AM-111 prevents hearing loss from semicircular canal injury in otitis media.

    PubMed

    Grindal, Tyler C; Sampson, Edith M; Antonelli, Patrick J

    2010-01-01

    Iatrogenic semicircular canal (SC) transection during mastoidectomy for chronic otitis media often leads to profound hearing loss. AM-111, an apoptosis inhibitor, has been shown to mitigate hearing loss resulting from a variety of inner ear injuries. The goal of this study was to determine if round window application of AM-111 following SC transection in the presence of Pseudomonas aeruginosa otitis media (PA-OM) may reduce the associated hearing loss. Prospective, randomized, controlled study in an animal model. PA-OM was induced bilaterally in 34 guinea pigs. After 3 days, both bullae were opened and the lateral SC of one ear was transected. AM-111 or vehicle was applied topically to the round window of the ear that had undergone SC transection. Hearing was assessed with auditory brainstem responses. The mean change in hearing thresholds was significantly less in transected ears treated with AM-111 than those receiving vehicle alone when testing with clicks (22.1 dB vs. 35.0 dB; P = .019) and at 4kHz (11.3 dB vs. 40.0 dB; P = .021). A similar trend was shown with 16 kHz tone pips (27.7 dB vs. 41.1 dB; P = .119). AM-111 prevents hearing loss from SC transection in the guinea pig model of PA-OM.

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

    PubMed Central

    Labout, Joost A. M.; Duijts, Liesbeth; Lebon, Ankie; de Groot, Ronald; Hofman, Albert; Jaddoe, Vincent V. W.; Verbrugh, Henri A.; Hermans, Peter W. M.

    2010-01-01

    Acute otitis media is the most frequent diagnosis in children visiting physicians’ offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24–2.71 and aOR 2.72, 95% CI 2.18–3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13–1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life. PMID:20821039

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

    PubMed

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  8. [Expression of adhesion molecule CD44 on subpopulations of lymphocytes in hypertrophied adenoids in children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Zelazowska-Rutkowska, Beata; Wysocka, Jolanta; Skotnicka, Bozena

    2007-01-01

    The CD44 on lymphocytes binding to its ligand hyaluronan can mediate primary adhesion (rolling interactions) of lymphocytes on high endothelial venules (HEV). This adhesion molecule plays an important role to maturation and proliferation of lymphocytes in the secondary lymphoid organs. CD44 has a crucial role in migrate of lymphocytes to inflammatory sites. The AIM of this study was evaluation of the percentage and MFI (mean fluorescence intensity) of lymphocytes CD4+, CD8+, CD19+ with expression of surface adhesive molecule CD44 in hypertrophied adenoids in children with otitis media with effusion. 42 children with otitis media with effusion and 30 children with hypertrophied adenoids were tested. Children were also divided into two subgroups: young (below 5 years) and older children (above 5 years old). Expression of adhesion molecule CD28 on lymphocytes of adenoids tissue was estimated by flow cytometry method. This study showed significantly higher percentage of lymphocytes CD19+CD44+ in children with otitis media with effusion (OME 87,83%) than in comparative group with hypertrophied adenoids (AH 85,61%). We did not find difference between OME and AH in mean fluorescence intensity of subpopulations lymphocytes T and B with expression CD44. Adhesion molecule CD44 is important for developing of effectors lymphocytes in hypertrophy adenoid. Increase percentage of lymphocytes CD19 with expression CD28, especially in older children confirms their participation in developing and forming of immunological response in otitis media with effusion.

  9. Complete Genome Sequence of Haemophilus influenzae Strain 375 from the Middle Ear of a Pediatric Patient with Otitis Media

    PubMed Central

    Sinha, Sunita; Balashov, Sergey; Viadas, Cristina; Grassa, Christopher J.; Ehrlich, Garth D.; Nislow, Corey; Redfield, Rosemary J.; Garmendia, Junkal

    2014-01-01

    Originally isolated from a pediatric patient with otitis media, Haemophilus influenzae strain 375 (Hi375) has been extensively studied as a model system for intracellular invasion of airway epithelial cells and other pathogenesis traits. Here, we report its complete genome sequence and methylome. PMID:25477405

  10. Complete Genome Sequence of Haemophilus influenzae Strain 375 from the Middle Ear of a Pediatric Patient with Otitis Media.

    PubMed

    Mell, Joshua Chang; Sinha, Sunita; Balashov, Sergey; Viadas, Cristina; Grassa, Christopher J; Ehrlich, Garth D; Nislow, Corey; Redfield, Rosemary J; Garmendia, Junkal

    2014-12-04

    Originally isolated from a pediatric patient with otitis media, Haemophilus influenzae strain 375 (Hi375) has been extensively studied as a model system for intracellular invasion of airway epithelial cells and other pathogenesis traits. Here, we report its complete genome sequence and methylome. Copyright © 2014 Mell et al.

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

    ERIC Educational Resources Information Center

    Silva, Phil A.; And Others

    1986-01-01

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

  12. The Effect of Otitis Media with Effusion on the Masking-Level Difference and the Auditory Brainstem Response.

    ERIC Educational Resources Information Center

    Hall, Joseph W.; Grose, John H.

    1993-01-01

    This study of 14 children (ages 5-9) with a history of otitis media with effusion found that subjects had significantly reduced masking-level differences (MLD) compared to controls. Results suggest that the reduction in MLD may be related to abnormal brainstem processing. (Author/JDD)

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

    ERIC Educational Resources Information Center

    Funk, Jeanne B.; Ruppert, Elizabeth S.

    1986-01-01

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

  15. 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.…

  16. At-Risk Children and Otitis Media with Effusion: Management Issues for the Early Childhood Special Educator.

    ERIC Educational Resources Information Center

    Medley, Lynn P.; And Others

    1995-01-01

    This article describes the implications of otitis media with effusion (OME) for children with disabilities who are already at risk for speech, language, and learning difficulties. The results of a survey of 189 early childhood special educators on management of young children with OME and the role of the early childhood special educator are…

  17. 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…

  18. 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…

  19. 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…

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

    ERIC Educational Resources Information Center

    Silva, Phil A.; And Others

    1986-01-01

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

  1. The Effect of Otitis Media with Effusion on the Masking-Level Difference and the Auditory Brainstem Response.

    ERIC Educational Resources Information Center

    Hall, Joseph W.; Grose, John H.

    1993-01-01

    This study of 14 children (ages 5-9) with a history of otitis media with effusion found that subjects had significantly reduced masking-level differences (MLD) compared to controls. Results suggest that the reduction in MLD may be related to abnormal brainstem processing. (Author/JDD)

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

    ERIC Educational Resources Information Center

    Funk, Jeanne B.; Ruppert, Elizabeth S.

    1986-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  4. 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.…

  5. At-Risk Children and Otitis Media with Effusion: Management Issues for the Early Childhood Special Educator.

    ERIC Educational Resources Information Center

    Medley, Lynn P.; And Others

    1995-01-01

    This article describes the implications of otitis media with effusion (OME) for children with disabilities who are already at risk for speech, language, and learning difficulties. The results of a survey of 189 early childhood special educators on management of young children with OME and the role of the early childhood special educator are…

  6. 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…

  7. 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…

  8. Knowledge, attitudes and practices with respect to risk factors for otitis media in a rural South Indian community.

    PubMed

    Srikanth, S; Isaac, Rita; Rebekah, Grace; Rupa, V

    2009-10-01

    (a) To study knowledge, attitudes and practices with respect to risk factors of otitis media in a rural South Indian Community where the prevalence of otitis media is high. (b) To discover the association between parental education, socioeconomic status (SES) and family type (nuclear or joint) with knowledge, attitudes and practices regarding risk factors for otitis media. Using a cluster sampling design, the caregivers of 150 children attending daycare were interviewed to note knowledge, attitudes and practices with respect to risk factors for otitis media. Data on level of education of the caregiver, house type (an indicator of SES) and type of family structure were noted. A questionnaire was administered to collect all the relevant data. Statistical analysis of the data obtained was performed to note frequencies. Correlations between sociodemographic parameters and knowledge, attitudes and practices were studied using Chi-square test of proportions. Over 50% of the population showed knowledge deficits with regard to the various risk factors for otitis media. Caregivers from nuclear families were slightly less knowledgeable regarding lack of immunization and household smoke as risk factors for the disease. There was no correlation between any of the sociodemographic factors and attitudes. However, educated mothers were more likely than illiterate mothers to clean their children's ears of wax on a regular basis with the belief that it would prevent ear disease (p=0.05). Treatment practices in the community were more or less uniform in that earache was either disregarded (26.4%) or treated with home remedies (67.2%) by most caregivers, while a doctor's opinion was often sought for ear discharge (50%). Parents of higher SES were more likely to use home remedies than those of lower SES (p=0.008). Sociodemographic factors as well as poor knowledge and attitudes and unhealthy practices with respect to risk factors of otitis media contribute to the high prevalence of

  9. Otitis media: re-evaluation of diagnosis and treatment in the era of antimicrobial resistance, pneumococcal conjugate vaccine, and evolving morbidity.

    PubMed

    Pelton, Stephen I

    2005-06-01

    The changing susceptibility of bacterial otopathogens is only one aspect of the evolving concepts regarding pathogenesis, immunoprophylaxis, pharmacodynamics, and sequelae of acute otitis media that mandates new insights for achieving a successful outcome. 2004 guidelines by the American Academy of Pediatrics for the treatment of acute otitis media provide one perspective that proposes a rethinking of the routine use of antimicrobial therapy with the hope of preventing further increases in bacterial resistance among otopathogens. The goals of this article are to incorporate the advances in diagnosis, treatment, prevention, and management of sequelae into strategies that optimize the outcome of acute otitis media and limit further emergence of resistant otopathogens.

  10. Middle ear microbiome differences in indigenous Filipinos with chronic otitis media due to a duplication in the A2ML1 gene.

    PubMed

    Santos-Cortez, Regie Lyn P; Hutchinson, Diane S; Ajami, Nadim J; Reyes-Quintos, Ma Rina T; Tantoco, Ma Leah C; Labra, Patrick John; Lagrana, Sheryl Mae; Pedro, Melquiadesa; Llanes, Erasmo Gonzalo D V; Gloria-Cruz, Teresa Luisa; Chan, Abner L; Cutiongco-de la Paz, Eva Maria; Belmont, John W; Chonmaitree, Tasnee; Abes, Generoso T; Petrosino, Joseph F; Leal, Suzanne M; Chiong, Charlotte M

    2016-11-01

    Previously rare A2ML1 variants were identified to confer otitis media susceptibility in an indigenous Filipino community and in otitis-prone US children. The goal of this study is to describe differences in the middle ear microbiome between carriers and non-carriers of an A2ML1 duplication variant that increases risk for chronic otitis media among indigenous Filipinos with poor health care access. Ear swabs were obtained from 16 indigenous Filipino individuals with chronic otitis media, of whom 11 carry the A2ML1 duplication variant. Ear swabs were submitted for 16S rRNA gene sequencing. Genotype-based differences in microbial richness, structure, and composition were identified, but were not statistically significant. Taxonomic analysis revealed that the relative abundance of the phyla Fusobacteria and Bacteroidetes, and genus Fusobacterium were nominally increased in carriers compared to non-carriers, but were non-significant after correction for multiple testing. We also detected rare bacteria including Oligella that was reported only once in the middle ear. These findings suggest that A2ML1-related otitis media susceptibility may be mediated by changes in the middle ear microbiome. Knowledge of middle ear microbial profiles according to genetic background can be potentially useful for therapeutic and prophylactic interventions for otitis media and can guide public health interventions towards decreasing otitis media prevalence within the indigenous Filipino community.

  11. Comparison of computed tomography and routine radiography of the tympanic bullae in the diagnosis of otitis media in the calf.

    PubMed

    Finnen, A; Blond, L; Francoz, D; Parent, J

    2011-01-01

    Otitis media is difficult to diagnose antemortem. Case reports have described computed tomography (CT) in the diagnosis, but not all cases were confirmed. CT is a sensitive and specific imaging modality of the tympanic bullae and can be used as the gold standard for the diagnosis of otitis media. Sixteen Holstein calves 5-7 weeks of age were included. Prospective study. All calves were sedated with i.v. xylazine (0.05-0.15 mg/kg) for routine radiography (3 views) and CT of the tympanic bullae followed by necropsy. Based upon necropsy findings, 10 of 16 calves were affected with otitis media, 4 unilaterally and 6 bilaterally. Imaging changes associated with otitis media included increased soft tissue opacity within the bulla, thickening of the bulla wall, enlarged bulla, and osteolysis of the bulla wall and trabeculations. The most frequent radiographic changes were lysis of trabeculations and increased soft tissue opacity, which were present in 56.3% of affected bullae. On CT, increased soft tissue opacity within the bulla was present in 93.8% of affected bullae. Sensitivity of radiography and CT was 68.8 and 93.8% and specificity was 50 and 100%, respectively. The κ value between radiography and CT with necropsy diagnosis was 0.19 for radiography, indicating poor agreement, and 0.94 for CT, indicating excellent agreement. CT is more specific, more sensitive, and easier to interpret than radiography and can be used as the gold standard in the diagnosis of otitis media in the calf. Copyright © 2010 by the American College of Veterinary Internal Medicine.

  12. 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

  13. [Expression of adhesion molecule CD28 on subpopulations of lymphocytes in hypertrophied adenoids in children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Zelazowska-Rutkowska, Beata; Wysocka, Jolanta; Skotnicka, Bozena

    2006-01-01

    The expansion of an optimal immune response requires fully activated T lymphocytes. For complete activation several signals are needed. The first signal is an antigen dependent via the TCR receptor, and the second signal is a costimulatory that can be delivered by the CD28 molecule after binding to their ligands. Fully activated T lymphocytes are competent to deliver activation to B cells. We suppose that this way can be important for development of immune response in hypertrophied adenoid (AH) in children with otitis media with effusion (OME). The aim of this study was evaluation of the percentage and MFI (mean fluorescence intensity) of lymphocytes CD4+, CD8+, CD19+ with expression of superficial adhesive molecule CD28 in hypertrophied adenoids in children with otitis media with effusion. 37 children with otitis media with effusion and 35 children with hypertrophied adenoids were tested. Children were also divided into two subgroups: young (below 5 years) and older children (above 5 years old). Expression of adhesion molecule CD28 on lymphocytes of adenoids tissue was estimated by flow cytometry method. This study showed significantly higher percentage of lymphocytes CD4+CD28+ in children with otitis media with effusion (OME 93,87%) than in comparative group with hypertrophied adenoids (AH 91,01%). Mean fluorescence intensity CD28 was higher on subpopulation lymphocytes CD4+ to children with OME (3,94) than AH (3,32). We did not find difference between OME and AH in percentages and MFI of subpopulations CD8+CD28+ and CD19+CD28+ lymphocytes. Adhesion molecule CD28 is very important for adenoidal lymphocytes activation and protection against apoptosa. Higher percentage of lymphocytes CD4 with expression CD28 confirms their participation in developing and forming of immunological response in otitis media with effusion.

  14. Relationship of the Middle Ear Effusion Microbiome to Secretory Mucin Production in Pediatric Patients With Chronic Otitis Media.

    PubMed

    Krueger, Anna; Val, Stéphanie; Pérez-Losada, Marcos; Panchapakesan, Karuna; Devaney, Joe; Duah, Vanessa; DeMason, Christine; Poley, Marian; Rose, Mary; Preciado, Diego

    2017-07-01

    Acute otitis media, an infection of the middle ear, can become chronic after multiple episodes. Microbial influence on chronic otitis media remains unclear. It has been reported that mucin glycoproteins are required for middle ear immune defense against pathogens. We aim to characterize the middle ear effusion (MEE) microbiome using high-throughput sequencing and assess potential associations in microbiome diversity with the presence of the secretory mucins MUC5B and MUC5AC. We hypothesize that MEEs containing MUC5B will exhibit a microbiome largely devoid of typical acute otitis media bacteria. Fifty-five MEEs from children undergoing myringotomy at Children's National Health System were recovered. Mucin was semiquantitatively determined through Western blot analysis. DNA was subjected to 16S rRNA amplicon sequencing using the Illumina MiSeq platform. Raw data were processed in mothur (SILVA reference database). Alpha- and beta-diversity metrics were determined. Abundance differences between sample groups were estimated. MUC5B was present in 94.5% and MUC5AC in 65.5% of MEEs. Sequencing revealed 39 genera with a relative abundance ≥0.1%. Haemophilus (22.54%), Moraxella (11.11%) and Turicella (7.84%) were the most abundant. Turicella and Pseudomonas proportions were greater in patients older than 24 months of age. In patients with hearing loss, Haemophilus was more abundant, while Turicella and Actinobacteria were less abundant. Haemophilus was also more abundant in samples containing both secretory mucins. The microbiome of MEEs from children with chronic otitis media differs according to specific clinical features, such as mucin content, age and presence of hearing loss. These associations provide novel pathophysiologic insights across the spectrum of otitis media progression.

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

    PubMed

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

    2010-01-01

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

  16. Bacterial polysaccharide immune globulin for prophylaxis of acute otitis media in high-risk children.

    PubMed

    Shurin, P A; Rehmus, J M; Johnson, C E; Marchant, C D; Carlin, S A; Super, D M; Van Hare, G F; Jones, P K; Ambrosino, D M; Siber, G R

    1993-11-01

    We evaluated the prevention of recurrences of acute otitis media (AOM) by bacterial polysaccharide immune globulin (BPIG), a hyperimmune human immune globulin prepared by immunizing donors with bacterial polysaccharide vaccines. We used a randomized, stratified, double-blind, placebo-controlled design. Children < or = 24 months of age with 1 to 3 prior episodes of AOM received BPIG, 0.5 ml/kg, or saline placebo intramuscularly at entry and 30 days later. During the 120-day follow-up period, AOM was diagnosed by using clinical criteria and was confirmed with tympanocentesis and culture of the middle ear exudates. Eighty-eight episodes of AOM were observed in 76 patients who completed the study. The incidence of AOM during the entire 120-day study period was similar in BPIG and placebo recipients. Pneumococcal AOM was significantly less frequent in BPIG recipients (0.21 episode per patient) than in placebo recipients (0.45 episode per patient; p = 0.05). Time spent free of AOM was significantly prolonged in recipients of BPIG, in comparison with placebo recipients (51 vs 35 days; p = 0.034). This study demonstrated that circulating antibody, even without stimulation of specific local immunity, may prevent infection of the middle ear. The use of immune globulin preparations for longer periods or at a higher dosage might decrease the incidence of recurrent AOM in otitis-prone children, and deserves further evaluation.

  17. [Bacteria and resistance to antibiotics in acute otitis media in paediatrics, depending on the geographical origin].

    PubMed

    Bidet, Philippe; Doit, Catherine; Bingen, Edouard

    2003-11-22

    EPIDEMIOLOGY OF THE BACTERIA RESPONSIBLE: Acute otitis media (AOM) is the most common bacterial infection in childhood below the age of 5 years. Bacteria may be isolated from middle ear fluid in about two-thirds of patients. The prevalence of bacteria varies from one country to the next. The most common pathogens recovered are Streptococcus pneumoniae, Haemophilus influenzae (20-50%) and less frequently Moraxella catarrhalis (10%). However, several recent reports suggest an increasing rate of isolation of M. catarrhalis approaching 20%. Concomitant isolation of two or more organisms occurs in up to 10% of cases. The role of Group A Streptococci and Staphylococcus aureus in AOM has decreased since the use of antibiotics. EPIDEMIOLOGY OF ANTIMICROBIAL RESISTANCE: The recent spread of penicillin resistant S. pneumoniae and amoxycillin resistant H. influenzae varies considerably from one country to an other and appears related to the use of antibiotics and socio-economic conditions. A follow up of bacterial epidemiology and antibiotic resistance is necessary in each region of the world to define accurate strategies of acute otitis antibiotherapy.

  18. Treatment of Acute Otitis Media in Children under 2 Years of Age

    PubMed Central

    Hoberman, Alejandro; Paradise, Jack L.; Rockette, Howard E.; Shaikh, Nader; Wald, Ellen R.; Kearney, Diana H.; Colborn, D. Kathleen; Kurs-Lasky, Marcia; Bhatnagar, Sonika; Haralam, Mary Ann; Zoffel, Lisa M.; Jenkins, Carly; Pope, Marcia A.; Balentine, Tracy L.; Barbadora, Karen A.

    2011-01-01

    Background Recommendations vary regarding immediate antimicrobial treatment versus watchful waiting for children younger than 2 years of age with acute otitis media. Methods We randomly assigned 291 children 6 to 23 months of age, with acute otitis media diagnosed with the use of stringent criteria, to receive amoxicillin–clavulanate or placebo for 10 days. We measured symptomatic response and rates of clinical failure. Results Among the children who received amoxicillin–clavulanate, 35% had initial resolution of symptoms by day 2, 61% by day 4, and 80% by day 7; among children who received placebo, 28% had initial resolution of symptoms by day 2, 54% by day 4, and 74% by day 7 (P = 0.14 for the overall comparison). For sustained resolution of symptoms, the corresponding values were 20%, 41%, and 67% with amoxicillin–clavulanate, as compared with 14%, 36%, and 53% with placebo (P = 0.04 for the overall comparison). Mean symptom scores over the first 7 days were lower for the children treated with amoxicillin–clavulanate than for those who received placebo (P = 0.02). The rate of clinical failure — defined as the persistence of signs of acute infection on otoscopic examination — was also lower among the children treated with amoxicillin–clavulanate than among those who received placebo: 4% versus 23% at or before the visit on day 4 or 5 (P<0.001) and 16% versus 51% at or before the visit on day 10 to 12 (P<0.001). Mastoiditis developed in one child who received placebo. Diarrhea and diaper-area dermatitis were more common among children who received amoxicillin–clavulanate. There were no significant changes in either group in the rates of nasopharyngeal colonization with nonsusceptible Streptococcus pneumoniae. Conclusions Among children 6 to 23 months of age with acute otitis media, treatment with amoxicillin–clavulanate for 10 days tended to reduce the time to resolution of symptoms and reduced the overall symptom burden and the rate of

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

    PubMed

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

    2014-01-01

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

  20. Ectopic Mineralization and Conductive Hearing Loss in Enpp1asj Mutant Mice, a New Model for Otitis Media and Tympanosclerosis

    PubMed Central

    Tian, Cong; Harris, Belinda S.; Johnson, Kenneth R.

    2016-01-01

    Otitis media (OM), inflammation of the middle ear, is a common cause of hearing loss in children and in patients with many different syndromic diseases. Studies of the human population and mouse models have revealed that OM is a multifactorial disease with many environmental and genetic contributing factors. Here, we report on otitis media-related hearing loss in asj (ages with stiffened joints) mutant mice, which bear a point mutation in the Enpp1 gene. Auditory-evoked brainstem response (ABR) measurements revealed that around 90% of the mutant mice (Enpp1asj/asj) tested had moderate to severe hearing impairment in at least one ear. The ABR thresholds were variable and generally elevated with age. We found otitis media with effusion (OME) in all of the hearing-impaired Enpp1asj/asj mice by anatomic and histological examinations. The volume and inflammatory cell content of the effusion varied among the asj mutant mice, but all mutants exhibited a thickened middle ear epithelium with fibrous polyps and more mucin-secreting goblet cells than controls. Other abnormalities observed in the Enpp1 mutant mice include over-ossification at the round window ridge, thickened and over-calcified stapedial artery, fusion of malleus and incus, and white patches on the inside of tympanic membrane, some of which are typical symptoms of tympanosclerosis. An excessive yellow discharge was detected in the outer ear canal of older asj mutant mice, with 100% penetrance by 5 months of age, and contributes to the progressive nature of the hearing loss. This is the first report of hearing loss and ear pathology associated with an Enpp1 mutation in mice. The Enpp1asj mutant mouse provides a new animal model for studying tympanosclerotic otitis and otitis media with effusion, and also provides a specific model for the hearing loss recently reported to be associated with human ENPP1 mutations causing generalized arterial calcification of infancy and hypophosphatemic rickets. PMID:27959908

  1. Ectopic Mineralization and Conductive Hearing Loss in Enpp1asj Mutant Mice, a New Model for Otitis Media and Tympanosclerosis.

    PubMed

    Tian, Cong; Harris, Belinda S; Johnson, Kenneth R

    2016-01-01

    Otitis media (OM), inflammation of the middle ear, is a common cause of hearing loss in children and in patients with many different syndromic diseases. Studies of the human population and mouse models have revealed that OM is a multifactorial disease with many environmental and genetic contributing factors. Here, we report on otitis media-related hearing loss in asj (ages with stiffened joints) mutant mice, which bear a point mutation in the Enpp1 gene. Auditory-evoked brainstem response (ABR) measurements revealed that around 90% of the mutant mice (Enpp1asj/asj) tested had moderate to severe hearing impairment in at least one ear. The ABR thresholds were variable and generally elevated with age. We found otitis media with effusion (OME) in all of the hearing-impaired Enpp1asj/asj mice by anatomic and histological examinations. The volume and inflammatory cell content of the effusion varied among the asj mutant mice, but all mutants exhibited a thickened middle ear epithelium with fibrous polyps and more mucin-secreting goblet cells than controls. Other abnormalities observed in the Enpp1 mutant mice include over-ossification at the round window ridge, thickened and over-calcified stapedial artery, fusion of malleus and incus, and white patches on the inside of tympanic membrane, some of which are typical symptoms of tympanosclerosis. An excessive yellow discharge was detected in the outer ear canal of older asj mutant mice, with 100% penetrance by 5 months of age, and contributes to the progressive nature of the hearing loss. This is the first report of hearing loss and ear pathology associated with an Enpp1 mutation in mice. The Enpp1asj mutant mouse provides a new animal model for studying tympanosclerotic otitis and otitis media with effusion, and also provides a specific model for the hearing loss recently reported to be associated with human ENPP1 mutations causing generalized arterial calcification of infancy and hypophosphatemic rickets.

  2. Nasopharyngeal pleomorphic adenoma presenting as otitis media with effusion: case report and literature review.

    PubMed

    Maruyama, Ayako; Tsunoda, Atsunobu; Takahashi, Masatoki; Kishimoto, Seiji; Suzuki, Masami

    2014-01-01

    Most tumors arising in the nasopharynx are malignant and frequently develop otitis media with effusion (OME). On the contrary, benign nasopharyngeal tumors are very rare, and pleomorphic adenoma, which is a benign mixed tumor of the nasopharynx, is also rarely encountered. We herein report a case of nasopharyngeal pleomorphic adenoma which initially presented as OME. This tumor completely blocked the orifice of the Eustachian tube but was removed by a combination of transnasal and transoral endoscopic resection. A defect in the mucous membrane was covered with polyglycolic acid sheet and fibrin glue. Mucous membrane completely covered the exposed tubal cartilage without adhesion near the tubal orifice. OME and hearing loss completely subsided 3 months after the surgery. She was disease-free 2 years after the surgery. Use of polyglycolic acid sheet could be a feasible mesh for closure of surgical defect without scarring, and it also led to healing of OME. © 2013.

  3. Increased TLR7 expression in the adenoids among children with otitis media with effusion.

    PubMed

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

    2010-01-01

    Toll-like receptor 7 (TLR7) is present in the adenoids in young children and might play a role in the immunological response behind the development of otitis media with effusion (OME). To investigate the expression of the TLRs TLR4 and TLR7 in adenoids from children with OME and to compare the results with data obtained from healthy controls. This was a controlled, prospective study. Eleven young children with long-standing OME and 10 controls with healthy middle ears were recruited consecutively when scheduled for adenoidectomy. mRNA was quantified using real-time polymerase chain reaction (PCR) and the localization of the corresponding proteins was assessed by immunohistochemistry. mRNA for TLR4 and TLR7 could be obtained from all samples tested along with their corresponding proteins. The mRNA levels for TLR7 were increased among the children with a history of OME. No such increase was found for TLR4.

  4. Isolation and characterization of dendritic cells from adenoids of children with otitis media with effusion.

    PubMed Central

    van Nieuwkerk, E B; van der Baan, S; Richters, C D; Kamperdijk, E W

    1992-01-01

    Dendritic cells were enriched from adenoids of children with otitis media with effusion (OME) by density gradient centrifugation and culture techniques. An enrichment of 40-140-fold was obtained for dendritic cells. These cells were identified using morphology, enzyme cytochemistry, immunocytochemistry and functional criteria. Dendritic cells could be easily distinguished from macrophages. It appeared that the MoAb EBM11 (CD68) discriminated between dendritic cells and macrophages; in dendritic cells this activity was localized in a spot, whereas in macrophages it was found throughout the whole cytoplasm. The fractions enriched with dendritic cells showed a strong stimulatory effect on allogeneic T cells. These responses were MHC class II dependent since they could be blocked by anti-HLA-DR/DQ MoAbs. The data clearly show that dendritic cells from adenoids of children with OME still have functional capacities. Images Fig. 1 Fig. 2 Fig. 3 PMID:1572100

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

    PubMed

    Principi, Nicola; Marchisio, Paola; Esposito, Susanna

    2016-01-01

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

  6. 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.

  7. The relationship between chronic otitis media-induced hearing loss and the acquisition of social skills.

    PubMed

    Bidadi, Sanam; Nejadkazem, Mohammad; Naderpour, Masoud

    2008-11-01

    To investigate the effects of hearing loss caused by chronic otitis media (COM) on acquiring social skills. A case-control study of 90 patients, including patients with COM, age range 15-30 years, was conducted in the otorhinolaryngology ward of Tabriz University Hospital. Social skills were assessed with a social skills questionnaire. Social skill scores were found to be lower in hearing-impaired COM patients compared with the control group (P < 0.001). Social skill disabilities in patients with bilateral COM were more severe than in patients with unilateral COM and the controls (P < 0.001). Correlation between social skills score and degree of hearing loss was significantly negative (P = 0.014, rho = -0.314). These data indicate an inverse relationship between hearing loss and social skills. Social skills and educational level of COM patients are affected because of hearing impairment. This study suggests that COM has effects on social development and education.

  8. Does the type of rhinitis influence development of otitis media with effusion in children?

    PubMed

    Quaranta, Nicola; Iannuzzi, Lucia; Gelardi, Matteo

    2014-11-01

    Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear cavity behind an intact eardrum and is considered a multifactorial condition with Eustachian tube dysfunction as the underlying pathophysiologic condition. One of the most debated causes of OME is allergy, in particular allergic rhinitis. The aim of this paper is to review the role of rhinitis in the development of OME and in particular the role of both allergic (AR) and non-allergic rhinitis (NAR). Most of the recent literature confirms the role of AR in the development of OME, while there are few reports on the role of NAR. In non-allergic children affected by obstructive adenoid hypertrophy, the presence of mast cells in the nasal smear was associated with a high risk of developing a chronic OME.

  9. Interleukin 10 is an essential modulator of mucoid metaplasia in a mouse otitis media model

    PubMed Central

    Tsuchiya, Katsuyuki; Komori, Masahiro; Zheng, Qing Yin; Ferrieri, Patricia; Lin, Jizhen

    2009-01-01

    Inflammatory cytokines are involved in the development of mucus cell metaplasia/hyperplasia (MCM) in otitis media (OM). However, which cytokines play an essential role in MCM OM is not clear at the moment. In this study, we hypothesized that interleukin-10 (IL-10) played an indispensable role in MCM of bacterial OM and used IL-10 knockout mice to test this hypothesis. In wild-type mice, both S. pneumoniae and H. influenzae triggered the development of MCM in the middle ear mucosa. In IL-10 knockout mice, the number of goblet cells and mucin-producing cells in the middle ear was significantly reduced after bacterial middle ear infection compared with that in wild-type mice. We, therefore, concluded that IL-10 plays an essential role in MCM of bacterial OM. IL-10 is a potential target for the treatment of MCM in OM. PMID:18771082

  10. [Current opinions on pathogenesis and treatment of otitis media with effusion in children].

    PubMed

    Niedzielska, Graiyna

    2006-01-01

    Otitis media with effusion (OME) is one of the most often diagnosed diseases in the pre-school children. OME is defined as the presence of effusion behind the intact tympanic memebrane without symptoms of acute infection. Pathogenesis of OME is multifactorial and represents the interactions between environmental, social, anatomical and infectious factors and an allergy. Due to the hearing impairment accompanying this disease, effective prevention and treatment are necessary. This publication presents current knowledge concerning etiopathogenesis of OME taking into consideration the role of Eustachian tube, infectious factor, allergy, immunological factors, NO and gastroesophageal reflux disease. Recommended methods of treatment depending on the clinical condition and the age of children are also presented. The initiation of appropriate therapy is crucial because of the possibility of remote complications.

  11. Early phonological and lexical development and otitis media: a diary study.

    PubMed

    Donahue, M L

    1993-10-01

    This diary study describes early phonological and lexical development in a child with chronic otitis media with effusion. Equipped with the tools of a referential/analytic language-learner, the child solved the problem of reduced and fluctuating auditory input with phonological selection and avoidance strategies that capitalized on prosodic cues. This 'tone-language' approach resulted in a lexical inventory that would be categorized as an extreme expressive style. Having 'boot-strapped' her lexical learning, the child continued to rely on phonological constraints and selection strategies to fuel lexical and syntactic growth, i.e. cross-domain interactions leading to a vocabulary spurt and the onset of two-word utterances. These findings illustrate the need to consider interactions among performance, input and linguistic constraints in order to explain individual variation in language learning.

  12. Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity.

    PubMed

    Ovnat Tamir, Sharon; Shemesh, Shay; Oron, Yahav; Marom, Tal

    2017-05-01

    Acute otitis media (AOM) is a common childhood disease, with an enormous economic and healthcare-related burden. Guidelines and consensus papers for AOM diagnosis and management were published in many countries. Our objective was to study the differences and similarities between these protocols in developing and developed countries. The keywords: 'acute otitis media' AND 'children' AND ['treatment' or 'management'] AND ['guideline' or 'consensus'] were used in various electronic databases between 1 January 1989 through 31 December 2015. Overall, 99 sources from 62 countries were retrieved: 53 from 22 developed countries, and 46 from 40 developing countries. Representative guidelines from America (the USA, Argentina), Europe (Italy, Moldova), Africa (South Africa, Tanzania, Ethiopia), Asia (Japan, Afghanistan, Sri Lanka),and Oceania (South Australia, Fiji) were compared. Paediatric societies publish guidelines in most developed countries; in developing countries, the Ministry of Health usually initiates guideline formulation. Most guidelines use the same diagnostic criteria and offer watchful waiting in mild-moderate scenarios. Amoxicillin is the suggested first-line antibiotic, whereas options for second-line and third-line therapies vary. Duration of therapy varies and is usually age dependent: 5-7 days for children <2 years and 10 days for children >2 years in developed countries, while duration and age groups vary greatly in developing countries. Reduction of AOM risk factors is encouraged in developed countries, but rarely in developing countries. Guidelines for AOM from developing and developed countries are similar in many aspects, with variation in specific recommendations, due to local epidemiology and healthcare accessibility. Formulation of regional guidelines may help reduce AOM burden. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Scholarly investigation into otitis media: who is receiving funding support from the National Institutes of Health?

    PubMed

    Hojjat, Houmehr; Johnson, Andrew P; Svider, Peter F; Hong, Robert S; Zuliani, Giancarlo; Folbe, Adam J; Shkoukani, Mahdi A

    2015-07-01

    Otitis media (OM) is highly prevalent and represents a major public health concern. We evaluate National Institutes of Health (NIH) funding support for OM research and examine the role of otolaryngology primary investigators (PIs). Examination of bibliometrics and funding history of NIH grant recipients. The NIH RePORTER database was examined for PIs funded for otitis media-related projects. The specialty, education level, academic department, scholarly impact (as measured by the h-index), and funding levels of PIs were obtained. There were 320 projects funded for 1,102 fiscal years supporting OM research. Since 2000, there has been >$280 million in support. PhDs received 47.5% of awards, more than any single medical specialty. Pediatricians received 54.8% of grants awarded to physicians followed by otolaryngologists (29.9%). Pediatric infectious disease specialists and pediatric otolaryngologists had the greatest funding per PI upon considering subspecialties, whereas non-fellowship-trained otolaryngologists had the lowest funding levels. Funded otolaryngologists had lower scholarly impact than several specialties. Aggregate funding levels to otolaryngologists decreased between 2000 and 2013. The NIH provided considerable grant support for researchers studying OM as awards to practitioners in numerous specialties exceeded a quarter of a billion dollars since 2000. Although awards to otolaryngologists were significant, the share of grants awarded to otolaryngologists has declined, suggesting that increased recruitment of basic scientists and enhanced cooperation with other specialists may facilitate further scholarship. These findings suggest a need for improving initiatives that prepare otolaryngology trainees interested in translational OM research for the rigorous NIH peer-review grant process. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

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

    PubMed

    Duncan, Ian; Clark, Kara; Wang, Stacy

    2016-10-01

    A common acute condition seen by providers in retails clinics is the evaluation and treatment of acute otitis media (AOM) in children younger than age 20. Annual direct treatment costs for AOM were US $5.3 billion in 1998 dollars. Based on the experience of a large retail pharmacy employer, the authors compared AOM episodes in covered dependents younger than age 20 in retail clinic states to those in states without retail clinic access. Relative costs as well as frequency of visits and antibiotic prescriptions were analyzed for both retail clinic-based, and non-retail clinic-based episodes. Rates of AOM episodes were lower in retail clinic than in non-retail clinic states (62.5 vs. 76.9 per 1000 members per year; P < .0001). The average number of visits per episode was similar between retail clinic and non-retail clinic states (1.417 vs. 1.430, respectively; P = 0.657), suggesting that retail clinics do not result in an increase in overall utilization. On a risk-adjusted basis, retail clinic episodes cost approximately $30-$130 less than community episodes, depending on year. In retail clinic states, the antibiotic prescription fill rate was 95.4% for retail clinic episodes and 82.8% for community episodes, consistent with rates in the literature. This study confirms results of earlier studies that retail clinics are a less costly setting than the community for the treatment of episodes of otitis media There also is little evidence that retail clinics lead to duplication of services (patients receiving follow-up care in other settings).

  15. Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media.

    PubMed

    Sinha, M N; Siddiqui, V A; Nayak, C; Singh, Vikram; Dixit, Rupali; Dewan, Deepti; Mishra, Alok

    2012-01-01

    To compare the effectiveness of Homeopathy and Conventional therapy in Acute Otitis Media (AOM). A randomized placebo-controlled parallel group pilot study of homeopathic vs conventional treatment for AOM was conducted in Jaipur, India. Patients were randomized by a computer generated random number list to receive either individualized homeopathic medicines in fifty millesimal (LM) potencies, or conventional treatment including analgesics, antipyretics and anti-inflammatory drugs. Patients who did not improve were prescribed antibiotics at the 3rd day. Outcomes were assessed by the Acute Otitis Media-Severity of Symptoms (AOM-SOS) Scale and Tympanic Membrane Examination over 21 days. 81 patients were included, 80 completed follow-up: 41 for conventional and 40 for homeopathic treatment. In the Conventional group, all 40 (100%) patients were cured, in the Homeopathy group, 38 (95%) patients were cured while 02 (5%) patients were lost to the last two follow-up. By the 3rd day of treatment, 4 patients were cured in Homeopathy group but in Conventional group only one patient was cured. In the Conventional group antibiotics were prescribed in 39 (97.5%), no antibiotics were required in the Homeopathy group. 85% of patients were prescribed six homeopathic medicines. Individualized homeopathy is an effective conventional treatment in AOM, there were no significant differences between groups in the main outcome. Symptomatic improvement was quicker in the Homeopathy group, and there was a large difference in antibiotic requirements, favouring homeopathy. Further work on a larger scale should be conducted. Copyright © 2011 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  16. [The expression and clinical significance of pepsin and pepsinogen in patients with otitis media with effusion].

    PubMed

    Luo, Huanan; Gao, Yin; Ma, Sijing; Yang, Qimei; Shao, Na; Zhang, Aling; Xu, Min

    2015-07-01

    To analyze the role and significance of pepsin and pepsinogen in the pathogenesis of OME in children. Pediatric patients with otitis media aged 2-8 years who enrolled in our department of the hospital from May of 2012 to December of 2012 were set as experimental group (38 cases, 48 ears) which should be underwent tympanic membrane puncture/tube insertion. Meanwhile, pediatric patients waiting for cochlear implant without otitis media (10 ears), were set as control group. Middle ear lavage fluid and plasma samples from the two groups were collected and detected using enzyme-linked immune method for pepsin and pepsinogen. The concentrations of pepsin and pepsinogen in the middle ear lavage fluid of OME group [(48.8 ± 415.99) ng/ml and 676.32 ± 336.71)ng/ml] were significantly higher than those in the control group [(8.20 ± 4.59)ng/ml and (77.27 ± 50.33) ng/ml] (P < 0.01). Meanwhile, the concentration of pepsinogen in the middle ear lavage of OME patients was significantly higher than that of plasma (P < 0.01). The concentration of pepsin in the middle ear lavage fluid from the dry ear subgroup was lower than those in the serum ear and mucous ear subgroups (P < 0.01), but there was no significant difference about concentrations of pepsinogen among the dry ear, serum ear and mucous ear subgroups (P > 0.05). Pepsin and pepsinogen in the middle ear cavity of OME patients maybe originated from laryngopharyngeal reflux (LPR), indicating that LPR is associated with the pathogenesis of OME in children.

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2015-12-01

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

  19. 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. PMID:27413407

  20. Taste damage (otitis media, tonsillectomy and head and neck cancer), oral sensations and BMI.

    PubMed

    Bartoshuk, Linda M; Catalanotto, Frank; Hoffman, Howard; Logan, Henrietta; Snyder, Derek J

    2012-11-05

    Otitis media and tonsillectomy are associated with enhanced palatability of energy dense foods and with weight gain. Otitis media can damage the chorda tympani nerve (CN VII); tonsillectomy and head and neck radiation treatment can damage the glossopharyngeal nerve (CN IX). Both of these nerves function prominently in taste sensation. The present study utilizes these sources of damage to study central interactions among the nerves that mediate oral sensations. Mild damage restricted to one of these nerves can actually intensify sensations evoked from undamaged nerves (i.e., whole-mouth taste, oral tactile sensations evoked by fats and irritants). These intensifications may result from disruption of central inhibitory taste circuits, as taste damage appears to disinhibit other oral sensory nerves. In addition, mild damage restricted to one taste nerve can intensify odors perceived from foods in the mouth during chewing and swallowing (i.e., retronasal olfaction); this may be a secondary consequence of the intensification of whole-mouth taste. Damage to both nerves leads to widespread oral sensory loss. At present, the link between sensory alterations and weight gain has not been established for adults (e.g., does increased fat preference occur in individuals with oral sensory intensifications, those with losses, or both?). Finally, pain in non-oral locations is also related to taste loss. When participants rated "the most intense pain of any kind they had ever experienced," those with the greatest taste loss gave the highest ratings. These effects suggest that taste loss significantly influences long-term health outcomes.

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

    PubMed Central

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

    2017-01-01

    Introduction: Vitamin D has been suggested to play a considerable role in the function of the immune system in various infectious, inflammatory, and autoimmune conditions. Otitis media with effusion (OME), defined as the presence of non-purulent fluid within the middle ear without signs or symptoms of suppurative otitis media, has a number of inflammatory predisposing factors. This study was designed to explore the association between vitamin D deficiency and OME. Materials and Methods: In this cross-sectional study, 74 children aged 2–7 years with an obstructive indication for adenotonsillectomy were included. Patients were divided into two groups based on the need for ventilation tube insertion for OME. Thirty-two children were enrolled in the OME group and 42 in the control group. The mean vitamin D level was compared between the two groups. Results: Mean vitamin D concentration in all patients was 11.96±5.85 ng/ml (9.79±4.36 ng/ml in the OME group and 13.61±6.33 ng/ml in the control group; P=0.003). There was also a significant difference in levels of vitamin D in patients referred in winter (9.0±2.94 ng/ml) compared with the summer (19.85±4.21 ng/ml; P=0.001). Data analyzed based on the season in which the patients were referred showed no significant difference between the OME and the control group. Conclusion: Although our results showed lower serum levels of vitamin D in OME patients, the difference was not significant when seasons were taken into consideration. Therefore, the season is an important confounding factor in any research related to vitamin D due to the effect of sun-induced vitamin D. PMID:28229060

  2. Treatment of eosinophilic otitis media with pegylated interferon-α 2a and 2b.

    PubMed

    Neff, Brian A; Voss, Stephen G; Carlson, Matthew L; O'Brien, Erin K; Butterfield, Joseph H

    2017-05-01

    Eosinophilic otitis media (EOM) is a variant of chronic otitis media that is characterized by the development of thick mucoid middle ear effusion, adult onset bronchial asthma, sinonasal polyposis, and aspirin sensitivity. EOM is typically refractory to corticosteroid therapy and surgical intervention. Pegylated interferon (PEG-IFN) has effectively treated hypereosinophilic syndrome in clinical trials; however, the efficacy of this medication for EOM treatment remains undefined. Retrospective, case series, tertiary academic center. A retrospective chart review was performed on EOM patients from 2008-2014. A total of 32 patients met the clinical criteria for EOM according to established diagnostic guidelines. Outcomes of all patients with severe, refractory EOM who initiated PEG-IFN therapy are reported. Eight patients were treated with pegylated interferon-α 2a or 2b for refractory EOM. Half of the patients had significant side effects with interferon treatment. Three of these were able to continue at a reduced dosage without side effect reoccurrence, and one patient stopped the medication permanently. Four of eight (50%) patients had a complete clinical response with total resolution of otorrhea and normalization of middle ear mucosa, and were able to discontinue corticosteroid treatment. Two patients attempted to stop PEG-IFN therapy after prolonged symptom remission and had recurrent otorrhea. Both patients had symptom resolution after PEG-IFN reinitiation. These data demonstrate that pegylated interferon-α 2a and 2b therapy may benefit patients with severe, refractory EOM. Further larger studies with long-term follow-up are required to validate these early but promising results. 4. Laryngoscope, 127:1208-1216, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Eosinophil-derived neurotoxin, elastase, and cytokine profile in effusion from eosinophilic otitis media.

    PubMed

    Uchimizu, Hirotaka; Matsuwaki, Yoshinori; Kato, Masahiko; Otori, Nobuyosi; Kojima, Hiromi

    2015-09-01

    Eosinophilic otitis media (EOM) is an intractable disease characterized by a remarkably viscous effusion and accumulation of numerous eosinophils in both the middle ear effusion and the mucosa. The key factors in EOM pathogenesis remain unclear. The purpose of this study is to identify the important factors involved in EOM pathogenesis. Middle ear effusion samples were collected from 12 patients with EOM and 9 patients with secretory otitis media (SOM), as controls. Multiple cytokines in the effusion were measured using a Bio-Plex™ Human Cytokine 27-Plex panel. Eosinophil-derived neurotoxin (EDN) and elastase were measured by ELISA. The concentrations of EDN, elastase, and each cytokine were compared between the EOM and SOM groups. Furthermore, in the EOM group, each cytokine was examined for correlation with EDN and elastase. EDN and elastase concentrations were significantly higher in the EOM group than in the SOM group (p < 0.05). IL-5, IL-1β, MIP-1α, G-CSF, IL-1ra, IL-4, IFN-γ, MIP-1β, IL-10, TNF-α, VEGF, and IL-2 concentration was significantly higher in the EOM group than in the SOM group (p < 0.05). Significant positive correlations were found between EDN and IL-1ra, IL-2, IL-5, IL-9, IL-13, eotaxin, MIP-1α, PDGF-BB, and RANTES in the EOM group (p < 0.05). Our study showed that IL-5, IL-2, MIP-1α, and IL-1ra are the important factors involved in EOM pathogenesis. Furthermore, not only eosinophil, but also neutrophil are involved in middle ear inflammation of EOM. Copyright © 2015 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

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

    PubMed

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

    2014-04-01

    We hypothesized that capsular switch event, in which pneumococcus acquires a new capsule operon by horizontal gene transfer, may result in emergence of strains with increased virulence in acute otitis media. Using serotype 6A strain from a patient with invasive pneumococcal disease and clonally distant serotype 6C strain isolated from asymptomatic carrier we created 6A:6C (6A background with 6C capsule) capsular transformants and applied whole genome macro-restriction analysis to assess conservation of the 6A chassis. Next, we assessed complement (C3) and antibodies deposition on surface of pneumococcal cells and tested capsule recipient, capsule donor and two 6A:6C transformants for virulence in chinchilla experimental otitis media model. Both 6A:6C(1 or 2) transformants bound less C3 compared to 6C capsule-donor strain but more compared to serotype 6A capsule-recipient strain. Pneumococci were present in significantly higher proportion of ears among animals challenged with either of two 6A:6C(1 or 2) transformants compared to chinchillas infected with 6C capsule-donor strain [p < 0.001] whereas a significantly decreased proportion of ears were infected with 6A:6C(1 or 2) transformants as compared to 6A capsule-recipient strain. Our observations though limited to two serotypes demonstrate that capsular switch events can result in Streptococcus pneumoniae strains of enhanced virulence for respiratory tract infection. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

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

    PubMed Central

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

    2015-01-01

    ABSTRACT Otitis media with effusion (OME) is the most common cause of hearing loss in children, and tympanostomy (ear tube insertion) to alleviate the condition remains the commonest surgical intervention in children in the developed world. Chronic and recurrent forms of otitis media (OM) are known to have a very substantial genetic component; however, until recently, little was known of the underlying genes involved. The Jeff mouse mutant carries a mutation in the Fbxo11 gene, a member of the F-box family, and develops deafness due to a chronic proliferative OM. We previously reported that Fbxo11 is involved in the regulation of transforming growth factor beta (TGF-β) signalling by regulating the levels of phospho-Smad2 in the epithelial cells of palatal shelves, eyelids and airways of the lungs. It has been proposed that FBXO11 regulates the cell's response to TGF-β through the ubiquitination of CDT2. Additional substrates for FBXO11 have been identified, including p53. Here, we have studied both the genetic and biochemical interactions between FBXO11 and p53 in order to better understand the function of FBXO11 in epithelial development and its potential role in OM. In mice, we show that p53 (also known as Tp53) homozygous mutants and double heterozygous mutants (Jf/+ p53/+) exhibit similar epithelial developmental defects to Fbxo11 homozygotes. FBXO11 and p53 interact in the embryonic lung, and mutation in Fbxo11 prevents the interaction with p53. Both p53 and double mutants show raised levels of pSMAD2, recapitulating that seen in Fbxo11 homozygotes. Overall, our results support the conclusion that FBXO11 regulates the TGF-β pathway in the embryonic lung via cross-talk with p53. PMID:26471094

  6. Role of pneumococcal proteins in sensorineural hearing loss due to otitis media.

    PubMed

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

    2008-12-01

    Two Streptococcus pneumoniae proteins, pneumococcal surface protein A (PspA) and pneumolysin (Ply), have functional and histopathologic effects on the inner ear. Temporary or permanent sensorineural hearing loss is known to be a sequela of pneumococcal otitis media. Several pneumococcal proteins such as PspA and Ply have been shown to contribute to the pathogenesis of the middle ear; however, effects of these proteins on the inner ear and hearing loss are unknown. Middle ears of chinchillas were inoculated with either wild-type S. pneumoniae or its mutants, deficient in PspA or Ply proteins. After 28 days, auditory brainstem response of animals was tested, and their bullae were processed for histopathologic analysis by light microscopy. Twenty-eight days after instillation of 20 colony-forming units of wild-type pneumococci, auditory brainstem response test showed threshold changes of 10 to 15 dB for 4 to 32 kHz and more than 20 dB for 1 to 2 kHz. No significant hearing loss was observed after instillation of the same or even higher doses of isogenic S. pneumoniae mutants of PspA or Ply proteins, or saline injection, after the same period. Histologic analysis showed no fluid, inflammatory cells, or bacteria in the middle ear, indicating that hearing loss was sensorineural. Inner ear morphology showed pathologic changes in the stria vascularis, suggesting it as the target of otitis media-induced damage, which may lead to sensorineural hearing loss. The virulence PspA and Ply proteins of S. pneumoniae affect the inner ear and auditory function.

  7. Age inconsistency in the American Academy of Pediatrics guidelines for acute otitis media.

    PubMed

    Meropol, Sharon B; Glick, Henry A; Asch, David A

    2008-04-01

    The American Academy of Pediatrics acute otitis media guidelines could reduce antibiotic use. The objective was to compare strategies for diagnosing and treating otitis: (1) a commonly used, 2-criteria strategy, (2) the guidelines' 3-criteria algorithm, and (3) initially watching without antibiotics. A decision analysis was performed with literature-based parameter. The target population was children presenting to primary care physicians with possible otitis media. Main outcomes were antibiotic use, sick days, mild adverse drug events, and number needed to treat/avoided sick day. For children 2 to <6 months of age, compared with the 2-criteria strategy, guideline use predicted 21% less antibiotic use, 13% more sick days, and 23% fewer adverse drug events; the number needed to treat for the 2-criteria strategy versus the American Academy of Pediatrics strategy was 1.2 children per avoided sick day. For children 6 to <24 months of age, guideline use, compared with the 2-criteria strategy, predicted 26% less antibiotic use, 14% more sick days, and 28% fewer adverse drug events; the number needed to treat for the 2-criteria strategy versus the American Academy of Pediatrics strategy was 1.4 children per avoided sick day. For children >2 years of age, guideline use, compared with the 2-criteria strategy, predicted 67% less antibiotic use, 4% more sick days, and 68% fewer adverse drug events. The number needed to treat for the guideline strategy versus the watch strategy was 6.3 children per avoided sick day; that for the 2-criteria strategy versus the guideline strategy was 12.3. Guideline use for children <2 years implies that our number needed to treat to avoid a sick day is <1.4; for children >2, guideline use implies we are willing to treat at least 6.3 children to avoid a sick day. Thus, the guidelines imply a greater willingness to treat older children, compared with younger children. The American Academy of Pediatrics guidelines are inconsistent in their outcomes

  8. 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

  9. No association between hearing loss due to bilateral otitis media with effusion and Denver-II test results in preschool children.

    PubMed

    Serbetcioglu, Bulent; Ugurtay, Ozgur; Kirkim, Gunay; Mutlu, Basak

    2008-02-01

    Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioral problems. In this study, children with an evidently recurrent otitis media were investigated. The present study examines the association between hearing loss versus developmental screening test parameters of preschool children. Sixteen children with bilateral otitis media were compared with age-matched same number of children with normal hearing (controls). Language and verbal cognitive abilities were not affected significantly as a result of the presence of hearing loss because of OME. Using internationally standardized Denver-II test to evaluate the language development and other developmental screening parameters, no significant difference was found between the patient and control groups. This study failed to find any association between the hearing loss due to otitis media with effusion and speech and language parameters in preschool children.

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

    PubMed

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

    2017-09-01

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

  11. A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess

    PubMed Central

    Muranjan, Mamta; Karande, Sunil; Parikh, Shefali; Sankhe, Shilpa

    2014-01-01

    A 5-year-old girl presented with a 3-month history of left side facial palsy, followed sequentially by purulent ear discharge, complete external ophthalmoplaegia and blurred vision. On clinical examination she was febrile with left-sided conductive hearing loss. She was clinically diagnosed to have chronic suppurative otitis media of the unsafe type with petrous apicitis, middle cranial fossa abscess and cavernous sinus involvement. Preliminary CT scan findings were reported as a large left temporal lobe abscess and left otitis media with cholesteatoma. MRI of the brain obtained later corroborated the abnormalities detected on the CT scan. Ten days after admission, a mass was seen protruding from the external auditory canal. A biopsy of the mass was obtained and sent for histopathological examination. Meanwhile, review of the MRI suggested an aggressive neoplasm such as sarcoma/rhabdomyosarcoma. Histopathology clinched the final diagnosis of an anaplastic type of embryonal rhabdomyosarcoma of the middle ear cleft. PMID:25240007

  12. 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.

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

    PubMed

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

    2010-01-01

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

  14. OTO-201: nonclinical assessment of a sustained-release ciprofloxacin hydrogel for the treatment of otitis media.

    PubMed

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

    2014-03-01

    OTO-201 can provide sustained release to the middle ear and effectively treat otitis media, when compared with FDA-approved ciprofloxacin otic drop formulations. 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. 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. OTO-201 demonstrated sustained release of ciprofloxacin in the middle ear compartment for days to approximately 2 weeks depending on the dose. The substantial C(max) 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. 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.

  15. Evolving microbiology of complicated acute otitis media before and after introduction of the pneumococcal conjugate vaccine in France.

    PubMed

    Dupont, Damien; Mahjoub-Messai, Farah; François, Martine; Doit, Catherine; Mariani-Kurkdjian, Patricia; Bidet, Philippe; Bonacorsi, Stéphane; Carol, Agnès; Bingen, Edouard

    2010-09-01

    We compare the microbiology of otopathogens causing recurrent acute otitis media (AOM) or AOM treatment failure in 600 children during 2000 to 2008 before and after the introduction of 7-valent pneumococcal conjugate vaccine (PCV-7). Streptococcus pneumoniae predominated before PCV-7 introduction and during 2007 to 2008, whereas Haemophilus influenzae predominated during 2005 to 2006. S. pneumoniae 19A became the most frequent serotype after PCV-7 introduction.

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

    PubMed Central

    Coco, Andrew S; Horst, Michael A; Gambler, Angela S

    2009-01-01

    Background Overuse of broad-spectrum antibiotics is associated with antibiotic resistance. Acute otitis media (AOM) is responsible for a large proportion of antibiotics prescribed for US children. Rates of broad-spectrum antibiotic prescribing for AOM are unknown. Methods Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1998 to 2004 (N = 6,878). Setting is office-based physicians, hospital outpatient departments, and emergency departments. Patients are children aged 12 years and younger prescribed antibiotics for acute otitis media. Main outcome measure is percentage of broad-spectrum antibiotics, defined as amoxicillin/clavulanate, macrolides, cephalosporins and quinolones. Results Broad-spectrum prescribing for acute otitis media increased from 34% of visits in 1998 to 45% of visits in 2004 (P < .001 for trend). The trend was primarily attributable to an increase in prescribing of amoxicillin/clavulanate (8% to 15%; P < .001 for trend) and macrolides (9% to 15%; P < .001 for trend). Prescribing remained stable for amoxicillin and cephalosporins while decreasing for narrow-spectrum agents (12% to 3%; P < .001 for trend) over the study period. Independent predictors of broad-spectrum antibiotic prescribing were ear pain, non-white race, public and other insurance (compared to private), hospital outpatient department setting, emergency department setting, and West region (compared to South and Midwest regions), each of which was associated with lower rates of broad-spectrum prescribing. Age and fever were not associated with prescribing choice. Conclusion Prescribing of broad-spectrum antibiotics for acute otitis media has steadily increased from 1998 to 2004. Associations with non-clinical factors suggest potential for improvement in prescribing practice. PMID:19552819

  18. [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.

  19. [Expression CD27 on T and B lymphocytes in hypertrophied adenoids at children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Zelazowska-Rutkowska, Beata; Wysocka, Jolanta; Skotnicka, Bozena; Kasprzycka, Edwina; Hassmann-Poznańska, Elzbieta

    2009-01-01

    Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The mining of antigen CD27 on lymphocytes T and B in creation of memory cells is still unclear. CD27 on lymphocytes T and B has a crucial role in development of immune response against inflammatory state. Aim of this study was evaluation functions of lymhocytes with expression CD27 in hypertrophied adenoid in children with otitis media with effusion. [corrected] We tested 24 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 29 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19, anty-CD3, anty-CD5 and anty-CD27 monoclonal antibodies to examinations. We showed the lowest percentage lymphocytes B CD5+ with expression of CD27 in subgroup older children with otitis media with effusion (O.M.E. 22.43 +/- 2.66%) in compartative to younger children in the same group (15.96 +/- 5.31%; p < 0.005) and to older comparative subgroup (H.A. 15.50 +/- 8.03; p < 0.001). Percentages of B CD5 cells with expression of CD27 was statistical lower in examinated group (7.25 +/- 3.81) than in comparative group (H.A. 16.26 +/- 5.82; p < 0.04). In group with hypertrophied adenoid showed higher percentages of CD5-CD27+CD19+ cells both in younger and older supgroup than in equivalent supgroups with O.M.E. Iteraction of CD27-CD70 regulates many functions of T and B lymphocytes. It seems that disorders humoral immunologucal answer in hypertrophied adenoids are supported to develop of otitis media with effusion.

  20. [Evaluation of percentage of the CD19+CD5+ lymphocytes in hypertrophied adenoids at children with otitis media with effusion].

    PubMed

    Ratomski, Karol; Skotnicka, Bozena; Kasprzycka, Edwina; Zelazowska-Rutkowska, Beata; Wysocka, Jolanta; Anisimowicz, Sławomir

    2007-01-01

    Otitis media with effusion and hypertrophied adenoid are still common diseases in childhood. Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The origin CD19+CD5+ B cells remains controversial. The differentiation response to ligation of CD5 resulting in apoptosis or proliferation lymphocytes. The aim of this study was compare the percentage of CD19+CD5+ lymphocytes in hypertrophied adenoid tissue at children with otitis media with effusion to comparative group without inflammatory state in middle ear. We tested 37 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 32 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19 and anty-CD5 monoclonal antibodies to examinations. In this study we showed significantly higher percentage of the CD19+CD5+ lymphocytes at children with examined group (OME 22.12 +/- 4.31%) than in comparative group (HA 19.16 +/- 4.32%), p < 0,04. Percentage of the subpopulation CD5+ B cells was significantly higher (p < 0,02) at younger subgroup (21.55 +/- 5.34%) than in older subgroup (18.24 +/- 2.35%) of children with both groups (OME + HA). The significant higher percentage of B lymphocytes with expressions of CD5+ receptor in hypertrophied adenoid tissue at children with otitis media with effusion are important to develop of early immunological response to inflammatory state in middle ear.

  1. 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

  2. Use of transrenal DNA for the diagnosis of extrapulmonary tuberculosis in children: a case of tubercular otitis media.

    PubMed

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

    2015-01-01

    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. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

    PubMed

    Trune, Dennis R; Kempton, Beth; Hausman, Frances A; Larrain, Barbara E; MacArthur, Carol J

    2015-08-01

    Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 h. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 h samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2-122 fold higher at 18 h, declining slightly from there at 24 h. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media.

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

    PubMed

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

    2014-12-01

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

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

    PubMed

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

    2016-02-01

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

  6. Correlative mRNA and Protein Expression of Middle and Inner Ear Inflammatory Cytokines during Mouse Acute Otitis Media

    PubMed Central

    Trune, Dennis R.; Kempton, Beth; Hausman, Frances A.; Larrain, Barbara E.; MacArthur, Carol J.

    2015-01-01

    Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 hours. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 hour samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2 to 122 fold higher at 18 hours, declining slightly from there at 24 hours. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media. PMID:25922207

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

    PubMed

    Ulku, Cagatay Han

    2017-03-08

    The objective of this study was to analyze the results of endoscopy-assisted ear surgery for the treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets.Fifty-one patients who underwent oto-endoscopy-assisted canal wall up tympanomastoid surgery and/or limited anterior atticotomy with tympanoplasty for chronic otitis media with cholesteatoma, adhesion, or retraction pocket from 2006 to 2013 have been included in this study. Eradication of the disease from the middle ear and mastoid air cells was achieved by combination of the oto-microscobic and oto-endoscopic approaches. Second look surgery was performed 18 months later from the initial surgery in selected patients. Age, gender, pre-/postoperative otoscopy findings/audiograms, type of the used prostheses, and follow-up time were obtained from the patient's file. Anatomic integrity rates of the tympanic membrane, the mean gains of air bone gap, on pure-tone audiogram at 4 frequencies and existence of the residual disease were reviewed parameters. Functional evaluation was made in patients with intact tympanic membrane.Of the 51 patients, the ratios of the chronic otitis media with cholesteatoma and isolated adhesive otitis or retraction pocket cases were 74.5% (38/51) and 25.5% (13/51), respectively. Ossicular chain reconstruction was made with PORP in 27 patients and TORP in 20 patients, whereas the ossicular chain was intact in 4 patients. Anatomic integrity rates of the tympanic membrane were 90.2% (46/51). The overall (n = 46) pre-/postoperative mean ABG obtained at 4 frequencies were 28.3 ± 12.26 and 9.18 ± 5.68 dB (P < 0.0001) respectively. Residual cholesteatoma rate was 10.5% (34/38) for chronic otitis media with cholesteatoma patients. However, there was no recurrence or new cholesteatoma formation in isolated retraction pockets or adhesive otitis patients.Oto-endoscopic eradication of the cholesteatoma or epithelial tissue from hidden area after the all

  8. 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

  9. Survey of parenting books for advice on the common cold, diarrhea, and otitis media in infants and toddlers.

    PubMed

    Holland, Paul R; Mau, Monica K; Yamamoto, Loren G

    2004-09-01

    Parenting books often provide advice for common medical ailments of infants and toddlers. However, the accuracy of such advice has never been evaluated. The purpose of this study is to survey the informational content of a sample of parenting books. Fifty general parenting books were identified and reviewed for the informational content on the following topics: common colds, diarrhea, and otitis media. When covered by the book, accurate and consistent information was generally provided in the following topic areas: non-medicated nose drops for nasal congestion, upright positioning for children with colds, breastfeeding infants with diarrhea, electrolyte solutions for diarrhea, and feeding practices as they relate to otitis media. The following topic areas displayed significant inconsistency: the use of decongestants, antihistamines, expectorants, cough suppressants, and decongestant nose drops for colds; antidiarrheal medications; soft drinks and juice for diarrhea; home recipes for oral hydration solutions; and the usefulness of pressure equalization tubes for refractory otitis media. Practitioners should be aware that parents may be misinformed by some parenting books and take measures to educate parents.

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

    PubMed

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

    2016-01-01

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

  11. [Expression of chosen chemokine receptors on the Th lymphocytes in children with hypertrophied adenoids with otitis media with effusion].

    PubMed

    Ratomski, Karol; Wysocka, Jolanta; Skotnicka, Bozena; Kasprzycka, Edwina; Zelazowska-Rutkowska, Beata; Zak, Janusz; Hassmann-Poznańska, Elzbieta

    2009-01-01

    Chemokine receptors play a crucial role in the recruitment of leucocytes into inflamed tissue from secondary lymphoid organs. was evaluation of the percentage Th (CD4+) lymphocytes with expression of chemokine receptors: CCR3, CCR4, and CCR5 in hypertrophied adenois tissue in children with otitis media with effusion. 36 children with otitis media with effusion and 25 children with hypertrophied adenoids were tested. Expression of chemokine receptors CCR3, CCR4 and CCR5 on T CD4 lymphocytes of hypertrophied adenoid's tissue was estimated by flow cytometry method. Average percentage of T CD4+ lymphocytes with expression CCR4 in hypertrophied adenoid in children group with otitis media with effusion (OME = 64.11%) was significantly higher than in comparative group with hypertrophied adenoid (HA = 75.05%, p < 0.04). We showed statistically lower percentage of CD3+CD4+ cells with expression CCR3 in examinated group (OME = 47.19%) than HA group (62.66%; p < 0.003). Results suggests that intensify of humoral immunological answer in hypertrophied adenoid depends on Th2 lymphocytes with expression CCR3 and CCR4 chemokine receptors in course of inflammatory state in middle ear.

  12. Different structural changes in membrana Shrapnelli in serous and purulent otitis media. An experimental study in the rat.

    PubMed

    Widemar, L; Hellström, S; Stenfors, L E

    1986-01-01

    In an animal model, production of serous and purulent effusion material was induced by blocking the Eustachian tube and cleaving the soft palate, respectively. Two and 6 weeks after the different surgical procedures, animals were sacrificed and the membrana Shrapnelli was analysed by light- and electronmicroscopy. The two types of middle ear effusion were associated with various structural changes of the membrana Shrapnelli. In serous otitis media the pars flaccida appeared fibrotic, with large dilated vessels. Sometimes its inner layer, facing the attic space, was contiguous with the investing layer of the ossicles. In purulent otitis media the pars flaccida was thickened and the inner epithelial lining was replaced by a pseudostratified squamous epithelium containing ciliated and secretory cells. Ciliated cells lining the pars flaccida appeared pathognomonic for a longstanding middle ear infection. It is inferred that the structure of membrana Shrapnelli changes under the influence of inflammatory conditions in the middle ear cavity, changes which specifically reflect the different types of otitis media.

  13. Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children?

    PubMed

    Fixsen, Alison

    2013-04-01

    Otitis media with effusion (OME) or 'glue ear' is the most common cause of pediatric hearing loss, and a drain on global healthcare resources. It is associated with frequent episodes of acute otitis media (AOM) and upper respiratory tract infections (URTIs) and linked with environmental and social factors, including diet, smoking households, overcrowding and day care use. Current conventional treatment for OME is unsatisfactory, the area constitutes an 'effectiveness gap'. Homeopathy is a relatively common and popular choice of complementary and alternative medicine (CAM) treatment for childhood conditions, including otitis media. Antibiotic resistance is now a major global problem, homeopathy may have a role to play in combating its further development. Systematic review of the literature for clinical studies of homeopathy for AOM and upper respiratory tract disorders. Discussion in the context of current treatment options and public health issues including antibiotic resistance. Several randomized trials and outcome studies of homeopathy for AOM and upper respiratory tract disorders have been published. The results are encouraging, but the volume of research is small and insufficient to draw definitive conclusions. A strategy based on multi-centre or multiple, linked clinical trials of homeopathy for OME, using a pragmatic framework and evaluating long-term effects in different settings, in conjunction with other healthcare and social services should be considered. Reduction of antibiotic use is an important outcome. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  14. [The comparative analysis of the clinical and morphological picture of the various forms of chronic suppurative otitis media].

    PubMed

    Baike, E V

    2016-01-01

    We present the results of the surgical treatment of 300 patients presenting with chronic suppurative otitis media. The changes in the mucous membrane of the tympanic cavity were revealed in 61% of the patients with mesotympanitis while spreading cholesteatoma occurred in 48% of the cases of «dry» perforations. The cholesteatomic process was documented in 64% of the patients with epitympanitis, the remaining patients presented with the pyo-carious process. The efficiency of the surgical intervention on the «dry» ear of the patients with the tubotympanic form of chronic suppurative otitis media (CSOM) amounted to 91.4% compared with 85% in the case of the altered mucous membrane of the tympanic cavity, 85.5% and 92.9% in the patients with the pyo-carious and cholesteatomic forms of the tympano-antral lesions, respectively. Residual cholesteatomas were found in 7.8% of the patients suffering from epitympanitis during the three year follow-up period. It is concluded that the results of clinical and morphological observations taken together with intraoperative findings give reason to consider mesotympanitis to be a prognosticallyunfavourable form of chronic suppurative otitis media.

  15. A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

    PubMed

    Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

    2017-10-01

    To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Otitis media in children vaccinated during consecutive 7-valent or 10-valent pneumococcal conjugate vaccination schedules

    PubMed Central

    2014-01-01

    Background In 2001 when 7-valent pneumococcal conjugate vaccine (PCV7) was introduced, almost all (90%) young Australian Indigenous children living in remote communities had some form of otitis media (OM), including 24% with tympanic membrane perforation (TMP). In late 2009, the Northern Territory childhood vaccination schedule replaced PCV7 with 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10). Methods We conducted regular surveillance of all forms of OM in children in remote Indigenous communities between September 2008 and December 2012. This analysis compares children less than 36 months of age who received a primary course of at least two doses of PCV7 or PHiD-CV10, and not more than one dose of another pneumococcal vaccine. Results Mean ages of 444 PCV7- and 451 PHiD-CV10-vaccinated children were 20 and 18 months, respectively. Bilaterally normal middle ears were detected in 7% and 9% respectively. OM with effusion was diagnosed in 41% and 51% (Risk Difference 10% [95% Confidence Interval 3 to 17] p = 0.002), any suppurative OM (acute OM or any TMP) in 51% versus 39% (RD −12% [95% CI −19 to −5] p = 0.0004], and TMP in 17% versus 14% (RD −3% [95% CI −8 to 2] p = 0.2), respectively. Multivariate analyses described a similar independent negative association between suppurative OM and PHiD-CV10 compared to PCV7 (Odds Ratio = 0.6 [95% CI 0.4 to 0.8] p = 0.001). Additional children in the household were a risk factor for OM (OR = 2.4 [95% CI 2 to 4] p = 0.001 for the third additional child), and older age and male gender were associated with less disease. Other measured risk factors were non-significant. Similar clinical results were found for children who had received non-mixed PCV schedules. Conclusions Otitis media remains a significant health and social issue for Australian Indigenous children despite PCV vaccination. Around 90% of young children have some form of OM. Children vaccinated

  17. Long-term Outcomes of Titanium Ossiculoplasty in Chronic Otitis Media.

    PubMed

    O'Connell, Brendan P; Rizk, Habib G; Hutchinson, Tanisha; Nguyen, Shaun A; Lambert, Paul R

    2016-06-01

    The primary objective is to report long-term hearing outcomes (>2 years) after titanium ossiculoplasty in patients with chronic otitis media. Case series with chart review. Tertiary care hospital. In total, 156 patients with chronic otitis media undergoing titanium ossiculoplasty were included. The primary outcome measure was the long-term postoperative ABG. The stability of hearing over time was determined by comparing short-term and long-term postoperative air-bone gap (ABG). Secondary outcome measures included ΔABG, postoperative speech reception thresholds, air-conduction pure-tone average (AC PTA), word recognition scores, and percentage of patients achieving ABG ≤20 dB. Revision and extrusion rates were examined. At short-term follow-up (<6 months), mean postoperative ABG was 18.4 ± 10.6 dB and AC PTA was 31.7 ± 15.2 dB; 67% of patients achieved ABG ≤20 dB. At long-term follow-up (>2 years), mean ABG was 20.0 dB ± 15.4 and AC PTA was 35.3 ± 16.1 dB; 60% of patients achieved ABG ≤20. At both short- and long-term follow-up, ABG and AC PTA were significantly improved compared with preoperative values. No difference in hearing outcomes was observed when comparing partial titanium ossicular prostheses (PORPs) to total titanium ossicular prostheses (TORPs) at either short- or long-term follow-ups. In patients with both short- and long-term follow-up (n = 50), deterioration in hearing was noted (3.4 dB, P = .04). When analyzed by type of prosthesis, PORPs demonstrated statistically significant deterioration in ABG over time (4.9 dB, P = .02), while TORPs did not (2.5 dB, P = .50). The long-term extrusion rate was 3.2%. With a minimum follow-up of 2 years, titanium ossiculoplasty provides good long-term hearing results. Modest deterioration in hearing is noted over time. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  18. Cost effectiveness of pneumococcal conjugate vaccination against acute otitis media in children: a review.

    PubMed

    Boonacker, Chantal W B; Broos, Pieter H; Sanders, Elisabeth A M; Schilder, Anne G M; Rovers, Maroeska M

    2011-03-01

    While pneumococcal conjugate vaccines have shown to be highly effective against invasive pneumococcal disease, their potential effectiveness against acute otitis media (AOM) might become a major economic driver for implementing these vaccines in national immunization programmes. However, the relationship between the costs and benefits of available vaccines remains a controversial topic. Our objective is to systematically review the literature on the cost effectiveness of pneumococcal conjugate vaccination against AOM in children. We searched PubMed, Cochrane and the Centre for Reviews and Dissemination databases (Database of Abstracts of Reviews of Effects [DARE], NHS Economic Evaluation Database [NHS EED] and Health Technology Assessment database [HTA]) from inception until 18 February 2010. We used the following keywords with their synonyms: 'otitis media', 'children', 'cost-effectiveness', 'costs' and 'vaccine'. Costs per AOM episode averted were calculated based on the information in this literature. A total of 21 studies evaluating the cost effectiveness of pneumococcal conjugate vaccines were included. The quality of the included studies was moderate to good. The cost per AOM episode averted varied from &U20AC;168 to &U20AC;4214, and assumed incidence rates varied from 20,952 to 118,000 per 100,000 children aged 0-10 years. Assumptions regarding direct and indirect costs varied between studies. The assumed vaccine efficacy of the 7-valent pneumococcal CRM197-conjugate vaccine was mainly adopted from two trials, which reported 6-8% efficacy. However, some studies assumed additional effects such as herd immunity or only took into account AOM episodes caused by serotypes included in the vaccine, which resulted in efficacy rates varying from 12% to 57%. Costs per AOM episode averted were inversely related to the assumed incidence rates of AOM and to the estimated costs per AOM episode. The median costs per AOM episode averted tended to be lower in industry

  19. IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

    PubMed

    Wiertsema, Selma P; Corscadden, Karli J; Mowe, Eva N; Zhang, Guicheng; Vijayasekaran, Shyan; Coates, Harvey L; Mitchell, Timothy J; Thomas, Wayne R; Richmond, Peter C; Kirkham, Lea-Ann S

    2012-01-01

    Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply) and 3 NTHi (P4, P6 and PD) proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion) and 63 healthy age-matched controls, using a newly developed multiplex bead assay. Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

  20. Childhood Otitis Media: A Cohort Study With 30-Year Follow-Up of Hearing (The HUNT Study).

    PubMed

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

    2015-01-01

    To study the extent to which otitis media (OM) in childhood is associated with adult hearing thresholds. Furthermore, to study whether the effects of OM on adult hearing thresholds are moderated by age or noise exposure. 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 to 56 years. Three thousand sixty-six children were diagnosed with hearing loss; the remaining sample had normal childhood hearing. Compared with participants with normal childhood hearing, those diagnosed with childhood hearing loss caused by otitis media with effusion (n = 1255), chronic suppurative otitis media (CSOM; n = 108), or hearing loss after recurrent acute otitis media (rAOM; n = 613) had significantly increased 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 rAOM had somewhat improved hearing thresholds as adults. The effects of CSOM and hearing loss after rAOM 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 rAOM. The study could not reveal significant differences in the effect of self-reported noise exposure on adult hearing thresholds between the groups with OM and the group with normal childhood hearing. This cohort study indicates that CSOM and rAOM in childhood are associated with adult hearing loss, underlining the importance of optimal treatment in these conditions. It appears that ears with a subsequent hearing loss after OM in childhood age at a faster rate than those without; however this should be confirmed by studies with several follow-up tests through