68 results on '"Otitis Media, Suppurative"'
Search Results
2. Implantation of bone-anchored hearing device using a three-dimensional template in a child
- Author
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S T Browning, P M Puttasiddaiah, and H Goodrum
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Hearing aid ,Male ,Adolescent ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Hearing Loss, Conductive ,Dentistry ,Computed tomography ,Otitis Media, Suppurative ,Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Hearing Aids ,Imaging, Three-Dimensional ,otorhinolaryngologic diseases ,Medicine ,Humans ,In patient ,030223 otorhinolaryngology ,medicine.diagnostic_test ,business.industry ,Skull ,General Medicine ,medicine.disease ,Conductive hearing loss ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Implant ,business ,Abutment (dentistry) ,Bone Conduction - Abstract
BackgroundImplantation of bone-anchored hearing devices is performed to improve hearing in patients with chronic suppurative otitis media who cannot wear a conventional hearing aid. The surgical procedure can be safely performed in children aged over five years.Case reportA 15-year-old patient with bilateral chronic suppurative otitis media and conductive hearing loss underwent the procedure to implant a bone-anchored hearing device but was found to have skull thickness of less than 2.5 mm and the procedure was abandoned. A computed tomography scan of the skull was undertaken and a three-dimensional template was reconstructed to identify appropriate thickness of the skull to implant the abutment during a second procedure.ConclusionBone-anchored hearing devices can be implanted by prior imaging and using a template to identify the area of appropriate skull thickness to implant the abutment safely.
- Published
- 2020
3. Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty compared with bilateral staged tympanoplasty
- Author
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AD Olusesi and O Oyeniran
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Cartilage graft ,Conchal cartilage ,Otitis Media, Suppurative ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Tympanoplasty ,Myringoplasty ,medicine ,Humans ,Prospective Studies ,030223 otorhinolaryngology ,Tympanic Membrane Perforation ,business.industry ,Cartilage ,General Medicine ,Odds ratio ,Middle Aged ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Chronic Disease ,Cost analysis ,Costs and Cost Analysis ,Female ,Complication ,business - Abstract
Background:Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials.Methods:A prospective randomised observational study was performed of 38 chronic suppurative otitis media patients (76 ears) who were assigned to undergo bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential tympanoplasty performed 3 months apart (20 patients, 40 ears). Disease duration, intra-operative findings, combined duration of surgery, post-operative graft appearance at 6 weeks, post-operative complications, re-do rate and relative cost of surgery were recorded.Results:Tympanic membrane perforations were predominantly subtotal (p = 0.36, odds ratio = 0.75). Most grafts were harvested from the conchal cartilage and fewer from the tragus (p = 0.59, odds ratio = 1.016). Types of complication, post-operative hearing gain and revision rates were similar in both patient groups.Conclusion:Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.
- Published
- 2017
4. Role of circumferential subannular tympanoplasty in anterior and subtotal perforations
- Author
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Shruti Ranjan, Gautam Bir Singh, Sunil Kumar, and Rubeena Arora
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Temporalis fascia ,Temporal Muscle ,Tertiary care ,Otitis Media, Suppurative ,Teaching hospital ,03 medical and health sciences ,0302 clinical medicine ,Myringoplasty ,medicine ,Hearing improvement ,Humans ,Prospective Studies ,Fascia ,030223 otorhinolaryngology ,Adult patients ,Inlay ,Tympanic Membrane Perforation ,business.industry ,General Medicine ,Tympanoplasty ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Chronic Disease ,Audiometry, Pure-Tone ,Female ,Outcome data ,business - Abstract
Objective:This study aimed to evaluate the surgical success of a modified inlay tympanoplasty technique, known as circumferential subannular tympanoplasty, for anterior and subtotal perforations.Methods:This prospective study was performed in a tertiary care teaching hospital between October 2013 and April 2016. A total of 58 adult patients of both sexes with anterior or subtotal perforations underwent circumferential subannular tympanoplasty under local anaesthesia. In this technique, after tympanomeatal flap elevation, the temporalis fascia graft is placed directly onto the annulus instead of being tucked underneath the tympanic membrane remnant. Outcome data were graft uptake and hearing improvement.Results:This technique had a surgical success rate of 97 per cent and led to significant hearing improvement.Conclusion:Circumferential subannular tympanoplasty has a definitive role in managing anterior and subtotal perforations.
- Published
- 2017
5. Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study
- Author
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Lou Zc
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Otitis Media with Effusion ,medicine.medical_treatment ,General Medicine ,Tympanoplasty ,Otitis Media, Suppurative ,Surgery ,03 medical and health sciences ,Myringoplasty ,0302 clinical medicine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Medicine ,Humans ,Female ,030223 otorhinolaryngology ,business ,Prospective cohort study - Published
- 2016
6. Topical aural antibiotic use in the UK - time for a change of policy?
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Musheer Hussain, Robin Youngs, Edward A. Fisher, and Jonathan Fishman
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medicine.medical_specialty ,business.industry ,Administration, Topical ,Health Policy ,General Medicine ,Otitis Media, Suppurative ,United Kingdom ,Anti-Bacterial Agents ,03 medical and health sciences ,0302 clinical medicine ,Chronic disease ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Chronic Disease ,Practice Guidelines as Topic ,medicine ,Optometry ,Humans ,Antibiotic use ,030223 otorhinolaryngology ,Intensive care medicine ,business ,Health policy - Published
- 2016
7. Why are ototopical aminoglycosides still first-line therapy for chronic suppurative otitis media? A systematic review and discussion of aminoglycosides versus quinolones
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A S Harris, H A Elhassan, and E P Flook
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medicine.medical_specialty ,medicine.drug_class ,Administration, Topical ,Chronic Suppurative Otitis Media ,Otitis Media, Suppurative ,03 medical and health sciences ,0302 clinical medicine ,Otology ,Levofloxacin ,030225 pediatrics ,Internal medicine ,Drug Resistance, Bacterial ,medicine ,Tobramycin ,Humans ,030223 otorhinolaryngology ,Randomized Controlled Trials as Topic ,Postoperative Care ,business.industry ,General Medicine ,Quinolone ,Middle Ear Ventilation ,Anti-Bacterial Agents ,Ciprofloxacin ,Otitis ,Aminoglycosides ,Treatment Outcome ,Otorhinolaryngology ,Anesthesia ,Chronic Disease ,Practice Guidelines as Topic ,Gentamicin ,medicine.symptom ,business ,medicine.drug - Abstract
Objective:This systematic review aimed to establish that quinolones are as effective as aminoglycosides when used to treat chronic suppurative otitis media.Method:The review included good quality, randomised, controlled trials on human subjects, published in English, that compared topical aminoglycosides with topical quinolones for the treatment of chronic suppurative otitis media.Results:Nine trials met the criteria. Two studies showed a higher clinical cure rate in the quinolone group (93 per centvs71 per cent,p= 0.04, and 76 per centvs52 per cent,p= 0.009). Four studies showed no statistically significant difference in clinical outcome. A significant difference in microbiological clearance in favour of quinolones was shown in two studies (88 per centvs30 per cent,p< 0.001, and 88 per centvs30 per cent,p< 0.001).Conclusion:Topical quinolones do not carry the same risk of ototoxicity as aminoglycosides. Furthermore, they are equal or more effective in treating chronic suppurative otitis media and when used as prophylaxis post-myringotomy. Topical quinolones should be considered a first-line treatment for these patients.
- Published
- 2015
8. Knowledge, attitudes, beliefs and practices related to chronic suppurative otitis media and hearing impairment in Pokhara, Nepal
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N F Poole, Mica K. Skilton, T C P Martin, and M C F Smith
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Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Hearing loss ,050204 development studies ,Chronic Suppurative Otitis Media ,Ear infection ,Psychological intervention ,Ear disease ,Audiology ,Otitis Media, Suppurative ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Nepal ,Risk Factors ,0502 economics and business ,Medicine ,Humans ,Risk factor ,030223 otorhinolaryngology ,Hearing Loss ,business.industry ,05 social sciences ,General Medicine ,Patient Acceptance of Health Care ,medicine.disease ,Otitis ,Otorhinolaryngology ,Socioeconomic Factors ,Family medicine ,Chronic Disease ,Quality of Life ,Female ,Medicine, Traditional ,medicine.symptom ,business ,Prejudice - Abstract
Background:Nepal has a high prevalence of chronic suppurative otitis media and hearing impairment. An improved understanding of patients' knowledge, attitudes, beliefs and practices is therefore important for effective healthcare planning and intervention.Method:Questionnaires designed to explore their current knowledge, attitudes, beliefs and practices were completed by 153 participants: 71 were affected by a known ear disease and 82 were unaffected.Results:In the unaffected group, 31.7 per cent considered breast milk to be a risk factor for ear infection. Home remedies (e.g. leaf paste, oils, and urine and/or bodily fluids) had been used by 42.3 per cent of the affected group. Most participants (71.9 per cent) believed that society discriminates against those with hearing impairment.Conclusion:Knowledge deficits and false beliefs were found in both groups, along with a significant use of home remedies and a perception of discrimination against people with hearing impairment. These findings are relevant for healthcare providers and may aid the development of policy, interventions and public education initiatives.
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- 2015
9. Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study
- Author
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Ramandeep Singh Virk, R Shankar, Karan Gupta, Sandeep Bansal, Amanjit Bal, and Anish Gupta
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Chronic otitis ,Histopathological examination ,Otitis Media, Suppurative ,Cohort Studies ,Young Adult ,Vascularity ,Tympanoplasty ,Myringoplasty ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Ear discharge ,business.industry ,Otitis Media with Effusion ,Significant difference ,General Medicine ,Middle Aged ,Surgery ,Otitis Media ,Treatment Outcome ,Otorhinolaryngology ,Chronic Disease ,Female ,medicine.symptom ,business - Abstract
Objective:This study aimed to compare the success rate of type I tympanoplasty in active (wet) and inactive (dry) mucosal chronic otitis media.Methods:A prospective study was performed of 35 patients each with dry ear and wet ear undergoing type I tympanoplasty in the Otolaryngology Department, Postgraduate Institute of Medical Education and Research, India. All patients underwent type I tympanoplasty between January 2010 and June 2011 by the post-auricular approach. Samples of the remnant tympanic membrane were sent for histopathological examination.Results:After a minimum follow up of one year, the success rate was 88.6 per cent for dry ears and 80 per cent for wet ears. Neither the type (p= 0.526) nor the presence (p= 0.324) of discharge influenced the success rate. Histopathological examination of the tympanic membrane margins was performed for 46 patients: of these, 19 showed evidence of vascularity and 27 did not. There was no significant difference in success rate between groups (p= 0.115).Conclusion:The success rate was not influenced by the presence of ear discharge at the time of surgery, and tympanic membrane vascularity did not influence graft uptake.
- Published
- 2015
10. Occurrence of otitis media in children and assessment of treatment options
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L. O. Egwari, O O Olubi, and N N Nwokoye
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Male ,medicine.medical_specialty ,medicine.drug_class ,Antibiotic sensitivity ,Chronic Suppurative Otitis Media ,Antibiotics ,Nigeria ,First year of life ,Microbial Sensitivity Tests ,Amoxicillin-Potassium Clavulanate Combination ,Otitis Media, Suppurative ,Internal medicine ,medicine ,Humans ,Child ,business.industry ,Incidence (epidemiology) ,Treatment options ,Amoxicillin ,Infant ,General Medicine ,Surgery ,Otitis Media ,Otitis ,Otorhinolaryngology ,Child, Preschool ,Acute Disease ,Chronic Disease ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
Background: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.Methods: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.Results: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.Conclusion:The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.
- Published
- 2015
11. A rare case of primary otoscleroma of the middle ear
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A H Patel and A R Kakeri
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Adult ,medicine.medical_specialty ,Hearing loss ,Chronic Suppurative Otitis Media ,Hearing Loss, Conductive ,Ear, Middle ,Histopathological examination ,Otitis Media, Suppurative ,Rare case ,medicine ,Humans ,Ear Diseases ,Rhinoscleroma ,business.industry ,Tubotympanic disease ,General Medicine ,medicine.disease ,Dermatology ,Conductive hearing loss ,Anti-Bacterial Agents ,medicine.anatomical_structure ,Otorhinolaryngology ,Middle ear ,Streptomycin ,Female ,medicine.symptom ,business - Abstract
Objective:We report an extremely rare case of primary otoscleroma.Method:We present a case report and a review of the world literature concerning otoscleroma.Results:An adult woman presented with chronic suppurative otitis media with tubotympanic disease and conductive hearing loss. On mastoid exploration, dark granulations were seen, which were identified as otoscleroma on histopathological examination. The patient responded well to streptomycin.Conclusion:To the best of our knowledge, this is the first report of primary otoscleroma in the world literature. This case indicates that Frisch's bacillus can also spread to the middle ear.
- Published
- 2012
12. Utilising silk fibroin membranes as scaffolds for the growth of tympanic membrane keratinocytes, and application to myringoplasty surgery
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Rangam Rajkhowa, Brett Levin, Sharon L. Redmond, Robert J. Marano, Robert H. Eikelboom, and Marcus D. Atlas
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Adult ,Keratinocytes ,Scaffold ,Tympanic Membrane ,Biocompatibility ,Cell Culture Techniques ,Fibroin ,Fluorescent Antibody Technique ,Biocompatible Materials ,Otitis Media, Suppurative ,Proto-Oncogene Protein c-ets-1 ,Myringoplasty ,Materials Testing ,medicine ,Humans ,Child ,Tympanic Membrane Perforation ,Cell Proliferation ,Tissue Engineering ,Tissue Scaffolds ,business.industry ,fungi ,Membrane Proteins ,General Medicine ,Adhesion ,Anatomy ,medicine.anatomical_structure ,Membrane ,Otorhinolaryngology ,Chronic Disease ,Keratinocyte ,business ,Fibroins ,Biomedical engineering - Abstract
Background:Chronic tympanic membrane perforations can cause significant morbidity. The term myringoplasty describes the operation used to close such perforations. A variety of graft materials are available for use in myringoplasty, but all have limitations and few studies report post-operative hearing outcomes. Recently, the biomedical applications of silk fibroin protein have been studied. This material's biocompatibility, biodegradability and ability to act as a scaffold to support cell growth prompted an investigation of its interaction with human tympanic membrane keratinocytes.Methods and materials:Silk fibroin membranes were prepared and human tympanic membrane keratinocytes cultured. Keratinocytes were seeded onto the membranes and immunostained for a number of relevant protein markers relating to cell proliferation, adhesion and specific epithelial differentiation.Results:The silk fibroin scaffolds successfully supported the growth and adhesion of keratinocytes, whilst also maintaining their cell lineage.Conclusion:The properties of silk fibroin make it an attractive option for further research, as a potential alternative graft in myringoplasty.
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- 2012
13. Cochlear implant failures: lessons learned from a UK centre
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J H K Kong, Sanjiv Kumar, Liam Masterson, Patrick R. Axon, J Briggs, Roger F Gray, and Neil Donnelly
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Adult ,Reoperation ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Skin flap ,Audiology ,Otitis Media, Suppurative ,Surgical Flaps ,Postoperative Complications ,Subsequent revision ,Cochlear implant ,medicine ,Craniocerebral Trauma ,Humans ,Prospective Studies ,Prospective cohort study ,Child ,Device failure ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Incidence ,Retrospective cohort study ,General Medicine ,Middle Aged ,Cochlear Implantation ,United Kingdom ,Surgery ,Prosthesis Failure ,Equipment Failure Analysis ,Cochlear Implants ,Otorhinolaryngology ,Child, Preschool ,business - Abstract
Objectives:To review our experience of cochlear implant failure and subsequent revision surgery, and to illustrate the experience we have gained by presenting a series of lessons learned.Methods:A combined retrospective and prospective study of revision surgery in a UK regional cochlear implant centre.Results:Of the 746 cochlear implantations undertaken, 33 (4.7 per cent of adults and 4.1 per cent of children) had a registered failure requiring re-implantation. The mean time to device failure was 60 months in adults and 35 months in children. Causes of cochlear implant failure were medical (n = 11), electrode displacement (n = 2), ‘hard device failure’ (n = 15) and ‘soft device failure’ (n = 5). Chronic suppurative otitis media and post-auricular mastoid abscess were the commonest causes of medical failure. There was one case of electrode array displacement as a direct result of skin flap revision surgery. In 80 per cent of cases, audiological performances were stable or improved following re-implantation.Conclusion:As the number of cochlear implants increase and patients outlive the lifespan of their devices, we will face a growing number of revision procedures. Audiologists and otologists should be competent in diagnosing and managing device failure and medical complications requiring cochlear re-implantation.
- Published
- 2011
14. The conservative treatment of chronic suppurative otitis media
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J. Chalmers Ballantyne and R. Scott Stevenson
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Conservative treatment ,medicine.medical_specialty ,Otitis Media ,Otorhinolaryngology ,business.industry ,Chronic Suppurative Otitis Media ,Chronic Disease ,medicine ,Humans ,General Medicine ,business ,Dermatology ,Otitis Media, Suppurative - Published
- 2010
15. Case of left temporal lobe abscess, extradural abscess and lateral sinus thrombosis, following exacerbation of chronic suppurative otitis media, drainage, recovery
- Author
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Boss L
- Subjects
medicine.medical_specialty ,Epidural abscess ,Exacerbation ,Chronic Suppurative Otitis Media ,Brain Abscess ,Otitis Media, Suppurative ,Temporal lobe ,Sinus Thrombosis, Intracranial ,medicine ,Humans ,Abscess ,Brain abscess ,Lateral Sinus Thrombosis ,business.industry ,Brain ,General Medicine ,medicine.disease ,Extradural abscess ,Temporal Lobe ,Surgery ,Otorhinolaryngology ,Epidural Abscess ,Drainage ,business - Published
- 2010
16. Molecular and epidemiological analysis of methicillin-resistant Staphylococcus aureus otorrhoea: hospital- or community-acquired?
- Author
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David H. Edwards, Sajjad Hussain, R G Nassif, N Kara, and R Soliman
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Male ,Methicillin-Resistant Staphylococcus aureus ,medicine.medical_specialty ,Adolescent ,Ear infection ,Microbial Sensitivity Tests ,medicine.disease_cause ,Otitis Media, Suppurative ,Medical microbiology ,Risk Factors ,Internal medicine ,Epidemiology ,Medicine ,Humans ,Risk factor ,Intensive care medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cross Infection ,business.industry ,Incidence ,Retrospective cohort study ,General Medicine ,Middle Aged ,Staphylococcal Infections ,Otitis Externa ,Methicillin-resistant Staphylococcus aureus ,United Kingdom ,Anti-Bacterial Agents ,Community-Acquired Infections ,Molecular Typing ,Otorhinolaryngology ,Scotland ,Staphylococcus aureus ,Gentamicin ,Female ,business ,medicine.drug - Abstract
Objectives:(1) To identify newly diagnosed cases of methicillin-resistant Staphylococcus aureus ear infection in our local population; (2) to determine the risk factors involved in these patients' clinical courses, and (3) to type the bacterial strains isolated and thus identify whether they were hospital- or community-acquired.Design and setting:Retrospective review of case notes, together with laboratory-based molecular studies in the departments of otolaryngology and medical microbiology in a university teaching hospital in Scotland, UK.Subjects:Over a two-year period, 35 patients were identified with ear swabs positive for methicillin-resistant Staphylococcus aureus infection. These cases came from both hospital and community settings.Main outcome measures:(1) Identification of primary methicillin-resistant Staphylococcus aureus otorrhoea in patients with no previously documented colonisation; and (2) molecular typing of the strains isolated, using spa technology, to identify whether they were hospital- or community-acquired.Results:Of the 35 positive patients, 27 were previously known carriers of methicillin-resistant Staphylococcus aureus. The eight patients with newly diagnosed methicillin-resistant Staphylococcus aureus otorrhoea presented initially in the community. All of these patients had had contact with hospital staff (as in-patients or out-patients) in the weeks preceding development of their ear infection. Using the spa technique for molecular typing, we identified hospital-acquired (‘epidemic’) methicillin-resistant Staphylococcus aureus type 15 in all eight patients' isolates. All were sensitive to topical gentamicin.Conclusions:In our cohort, hospital-acquired methicillin-resistant Staphylococcus aureus type 15 was the commonest cause of methicillin-resistant Staphylococcus aureus otorrhoea, despite the fact that these patients all first presented in the community. We believe that contact with hospital staff or health care workers is a risk factor for acquiring methicillin-resistant Staphylococcus aureus otorrhoea in the community.
- Published
- 2010
17. Acute supperative otitis media and mastoiditis (R) manifest diffuse labyrinthitis, meningitis; recovery
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J P, STEWART
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Otitis Media ,Acute Disease ,Humans ,Meningitis ,Mastoiditis ,Labyrinthitis ,Otitis Media, Suppurative - Published
- 2010
18. 'Umbrella' graft tympanoplasty
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M Malhotra
- Subjects
Adult ,Male ,medicine.medical_specialty ,Surgical strategy ,Adolescent ,medicine.medical_treatment ,Incus ,Chronic Suppurative Otitis Media ,Stapes Surgery ,Otitis Media, Suppurative ,Young Adult ,Tympanoplasty ,Hearing ,medicine ,Humans ,Malleus ,Stage (cooking) ,Stapes ,business.industry ,General Medicine ,Middle Aged ,Surgery ,medicine.anatomical_structure ,Cartilage ,Otorhinolaryngology ,Chronic Disease ,Middle ear ,Female ,Implant ,business - Abstract
Objectives:Tympanoplasty continues to pose a challenge in developing countries, where treatment cost and lack of compliance with second stage surgery are often important factors in determining the surgical strategy. This study aimed to determine the effectiveness of the newly developed, ‘umbrella’ autograft.Materials and methods:In 22 patients suffering chronic suppurative otitis media, in whom the incus and stapes suprastructure were found to be absent during surgery, reconstruction was achieved using cartilage-malleus umbrella graft assembly. Six-month post-operative results were evaluated on the basis of average hearing gain, measured at 0.5, 1, 2 and 3 kHz.Results:At six months post-operatively, 77.3 per cent of patients showed hearing improvement. Audiography at this time indicated significant improvement (p Conclusion:Umbrella graft tympanoplasty appears to be a promising technique in terms of cost-effectiveness and the autologous nature of implant materials.
- Published
- 2010
19. Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media
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Bhat K. Vikram, N Khaja, Belur Keshavamurthy Venkatesha, Shankarappa Gangadharaiah Udayashankar, and Dandinarasaiah Manjunath
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Hearing loss ,Hearing Loss, Sensorineural ,Chronic Suppurative Otitis Media ,Rural Health ,Otitis Media, Suppurative ,Age Distribution ,Throat ,Epidemiology ,otorhinolaryngologic diseases ,medicine ,Humans ,Sex Distribution ,Child ,Nose ,Cholesteatoma, Middle Ear ,business.industry ,Urban Health ,Cholesteatoma ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Sensorineural hearing loss ,Female ,medicine.symptom ,Complication ,business ,Epidemiologic Methods - Abstract
Introduction: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.Materials and methods: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.Results: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.Conclusion: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.
- Published
- 2007
20. Challenges in management of chronic suppurative otitis media in a developing country
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O V Akinpelu, A O Oladele, Edward O. Komolafe, Y B Amusa, A A Adeolu, and S A Ameye
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Adult ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Chronic Suppurative Otitis Media ,Developing country ,Nigeria ,Audiology ,Mastoiditis ,Otitis Media, Suppurative ,Late presentation ,Age Distribution ,Throat ,medicine ,Humans ,Prospective Studies ,Sex Distribution ,Prospective cohort study ,Child ,Developing Countries ,Nose ,Aged ,business.industry ,Cerebrospinal Fluid Otorrhea ,Mortality rate ,Infant, Newborn ,Infant ,General Medicine ,Middle Aged ,Abscess ,medicine.anatomical_structure ,Otorhinolaryngology ,Child, Preschool ,Chronic Disease ,University teaching ,business - Abstract
Background:In developing countries, the rate of complications from chronic suppurative otitis media is still high, due to factors associated with poverty. This study aimed to determine the prevalence of chronic suppurative otitis media and associated complications.Patients and methods:We prospectively studied all patients presenting with chronic suppurative otitis media to the ear, nose and throat unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, over a two-year period.Results:One hundred and sixty new cases of chronic suppurative otitis media were seen. These constituted 11.1 per cent of all new cases and 21.5 per cent of all otological cases seen. About half (51.7 per cent) of these patients were younger than 15 years. Most patients were from rural areas and had been previously managed by unlicensed, untrained practitioners. Complications were mostly seen in children. Intracranial complications were seen in 10 (6.3 per cent) cases; this was associated with a high mortality rate.Conclusion:This study found that, in Nigeria, a developing country, ‘safe’ chronic suppurative otitis media was not without serious problems. Provision of adequate health facilities may reduce such problems.
- Published
- 2007
21. Pseudomonas cervical osteomyelitis with retropharyngeal abscess: an unusual complication of otitis media
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A Garhnam, V V Raut, A Kumar, Naresh Kumar, and C A Paul
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Male ,medicine.medical_specialty ,Chronic Suppurative Otitis Media ,Otitis Media, Suppurative ,Mastoid antrum ,medicine ,Humans ,Pseudomonas Infections ,Abscess ,Retropharyngeal space ,Neck Pain ,business.industry ,Osteomyelitis ,Retropharyngeal abscess ,General Medicine ,Middle Aged ,medicine.disease ,Retropharyngeal Abscess ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Otitis ,Otorhinolaryngology ,Chronic Disease ,Middle ear ,Cervical Vertebrae ,medicine.symptom ,business - Abstract
We present the unusual case of a 54-year-old diabetic man with chronic suppurative otitis media, presenting with cervical osteomyelitis and retropharyngeal abscess. This was treated with decompression, debridement and fusion from C2 to C4 with external halo-frame stabilization. Pseudomonas aeruginosa was cultured from the ear and the osteomyelitis specimen. Exploration of the left ear showed evidence of mucosal disease, with granulations in the middle ear and oedematous mucosa in the mastoid antrum, but no evidence of dural-plate dehiscence. Haematogenous spread probably led to cervical osteomyelitis and retropharyngeal abscess formation. Cervical osteomyelitis may develop as a rare complication and present as a cause of severe neck pain in patients with otitis media.
- Published
- 2005
22. Outcome of bacterial culture from mastoid granulations: is it relevant in chronic ear disease?
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Alice John, Rita Ruby Albert, Anand Job, K. N. Brahmadathan, George Kuruvilla, and Richard Joseph
- Subjects
Adult ,Male ,medicine.medical_specialty ,Microbiological culture ,Time Factors ,Aerobic bacteria ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Ear disease ,Mastoidectomy ,Asymptomatic ,Gastroenterology ,Otitis Media, Suppurative ,Mastoid ,Bacteria, Anaerobic ,Internal medicine ,medicine ,Mastoid antrum ,Humans ,Prospective Studies ,Cholesteatoma, Middle Ear ,business.industry ,Cholesteatoma ,General Medicine ,medicine.disease ,Surgery ,Bacteria, Aerobic ,medicine.anatomical_structure ,Otorhinolaryngology ,Chronic Disease ,Granulation Tissue ,Female ,medicine.symptom ,business - Abstract
Objective: To detect the presence of bacteria in mastoid granulations and compare its prevalence in both types of chronic suppurative otitis media (CSOM). To find out if stage of disease activity, age, duration of disease, and aditus patency relate to obtaining positive cultures.Study design and setting: A prospective, parallel group study done at a tertiary care referral centre. Mastoid granulations from 79 patients with CSOM undergoing mastoidectomy were processed for anaerobic and aerobic bacteria.Results: Aerobes were isolated from 57.55 per cent of the tubotympanic and 74.4 per cent of atticoantral disease (p = 0.18). Anaerobic cultures were positive in one case from each group. Monomicrobial growth was detected in 37.5 per cent of tubotympanic and 48.5 per cent of atticoantral disease. Polymicrobial growth occurred in 20 per cent and 25.6 per cent in the tubotympanic and atticoantral groups, respectively. The predominant aerobic isolate was coagulase negative Staphylococcus, followed by Pseudomonas aeruginosa, Staphylococcus aureus, non-fermenting Gram-negative bacteria, Enterobacter and Enterococcus, Proteus species, Citrobacter, non-pathogenic Neisseria, aerobic spore formers were grown only in atticoantral disease. A single isolate of Aspergillus was grown. Correlating the state of disease activity of the ears with positive mastoid granulation cultures, six out of the eight inactive ears were culture positive along with seven out of the nine active and 10 out of the 23 quiescent ears. Positive mastoid granulation cultures were obtained in 60 per cent of those with blocked aditus and 42.9 per cent with patent aditus.Conclusion and significance: In this study, we found that mastoid granulations are not sterile but harbour polymicrobial pathogens. Positive cultures were obtained irrespective of stage of disease activity, age, duration of disease and aditus patency. The pattern of organisms cultured from safe and unsafe CSOM and also from ears in active, quiescent and inactive stages, were similar. These findings suggest that these organisms may be responsible for mastoid granulations. We also noted that positive cultures had no statistical correlation with aditus patency and duration of disease. We suggest further studies to evaluate the significance of asymptomatic mastoid granulations harbouring organisms and whether opening the mastoid antrum and achieving aditus patency, irrespective of the stage of disease activity, will help improve the long-term surgical outcome and also prevent recurrence of ear discharge.
- Published
- 2005
23. A comparative evaluation of ear diseases in children of higher versus lower socioeconomic status
- Author
-
Anju Garg, Amit Agarwal, Shelly Chadha, and Achal Gulati
- Subjects
medicine.medical_specialty ,Pediatrics ,media_common.quotation_subject ,India ,Ear disease ,Family income ,Otitis Media, Suppurative ,Group B ,Hygiene ,Epidemiology ,medicine ,Prevalence ,Humans ,Child ,Ear Diseases ,Socioeconomic status ,media_common ,Family Characteristics ,medicine.diagnostic_test ,business.industry ,Otitis Media with Effusion ,Baths ,General Medicine ,Tympanometry ,medicine.disease ,Otitis Externa ,Otorhinolaryngology ,El Niño ,Mycoses ,Social Class ,Child, Preschool ,Housing ,Income ,Educational Status ,business ,Demography - Abstract
This study was conducted with an aim to assess the prevalence and profile of ear diseases in children from the higher and lower socioeconomic strata of society. Two groups of schools within Delhi were selected. Group A comprised of government schools located in slum areas with an average parental income of INR (Indian National Rupees) 1050 per month and group B of elite private schools with an average family income of TNR 35 000 per month. Three thousand children between the ages of 5–12 years were screened with the help of a written proforma and ear examination. Tympanometry and audiometry were done, where required. 19.6 per cent of children of group A were found to be suffering from ear diseases compared to 2.13 per cent of group B children. The two groups were also compared for number of family members, status of hygiene and parental education.
- Published
- 2005
24. Topical vancomycin for chronic suppurative otitis media with methicillin-resistant Staphylococcus aureus otorrhoea
- Author
-
Chang-Hun Song, Chul Ho Jang, and Pa-Chun Wang
- Subjects
Adult ,Male ,Staphylococcus aureus ,Micrococcaceae ,Adolescent ,medicine.drug_class ,Administration, Topical ,Antibiotics ,Chronic Suppurative Otitis Media ,Microbial Sensitivity Tests ,medicine.disease_cause ,Otitis Media, Suppurative ,Drug Administration Schedule ,Vancomycin ,otorhinolaryngologic diseases ,Medicine ,Humans ,Prospective Studies ,Antibacterial agent ,biology ,business.industry ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,Middle Aged ,Staphylococcal Infections ,biology.organism_classification ,Methicillin-resistant Staphylococcus aureus ,Anti-Bacterial Agents ,Treatment Outcome ,Otorhinolaryngology ,Anesthesia ,Gentamicin ,Female ,Methicillin Resistance ,Gentamicins ,business ,medicine.drug - Abstract
There has been a steady increase in the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) otorrhoea; this is a growing concern. The purpose of this study was to evaluate the efficacy of topical vancomycin treatment in patients with MRSA otorrhoea. Fifty-five patients with MRSA otorrhoea were prospectively enrolled into the study. Thirty-five patients were treated with vancomycin eardrops as outpatients. The concentration of the locally prepared vancomycin solution was 25 mg/ml. The dose of vancomycin was two drops three times daily for 10 days. As a control group, 20 patients were treated with gentamicin 0.3% solution. Data were analysed by the Mann-Whitney U test to compare the efficacy of vancomycin eardrops and gentamicin eardrops. In the vancomycin group, the otorrhoea was significantly reduced in 33 ears (94%); in the gentamicin group, in four ears (20 per cent); this reduction was statistically significant (P < 0.03). The use of topical vancomycin treatment was effective for patients with MRSA otorrhoea refractory to conventional antibiotic treatment.
- Published
- 2004
25. Abducens nerve palsy as the sole presenting symptom of petrous apicitis
- Author
-
T. Price and G. Fayad
- Subjects
medicine.medical_specialty ,Eyelid Neoplasms ,Otitis Media, Suppurative ,Delayed recognition ,medicine ,Paralysis ,Cranial nerve disease ,Humans ,Facial pain ,Child ,Abducens nerve ,Osteitis ,Palsy ,business.industry ,General Medicine ,Magnetic Resonance Imaging ,Surgery ,Otitis ,Otorhinolaryngology ,Female ,medicine.symptom ,business ,Complication ,Hemangioma ,Abducens Nerve Diseases ,Petrous Bone - Abstract
Petrous apicitis as a potentially fatal complication of suppurative otitis media presents in a variety of forms. Gradenigo’s triad of abducens paralysis, deep facial pain due to trigeminal involvement and acute suppurative otitis media rarely occurs. The conflicting symptoms reported in the literature usually result in the delayed recognition of the condition with potentially disastrous consequences. The VIth nerve palsy is considered to be the least reliable sign as it is least often present. We present a case in which it was the sole presenting symptom.
- Published
- 2002
26. Vinegar treatment in the management of granular myringitis
- Author
-
Sung Won Chae, Chan Ki Yoo, Sung Dong Cho, Hak Hyun Jung, and Hyun Ho Lim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ofloxacin ,Tympanic Membrane ,Adolescent ,medicine.drug_class ,medicine.medical_treatment ,Antibiotics ,medicine.disease_cause ,Otitis Media, Suppurative ,Anti-Infective Agents ,otorhinolaryngologic diseases ,medicine ,Humans ,Ear drop ,Acetic Acid ,Treated group ,business.industry ,Follow up studies ,General Medicine ,Hydrogen-Ion Concentration ,Middle Aged ,Surgery ,Otitis Media ,Treatment Outcome ,Otorhinolaryngology ,Granular myringitis ,External Canal ,Chronic Disease ,Granulation Tissue ,Female ,Irritation ,business ,medicine.drug ,Follow-Up Studies - Abstract
To compare the therapeutic efficacy in the management of granular myringitis, 15 patients with chronic granular myringitis were treated with antibiotic ear drops that were used twice to four times a day, and another 15 patients were treated with daily irrigation of the external canal with dilute vinegar solution. All patients treated with dilute vinegar solution had resolution of their original otorrhoea within three weeks, whereas two-thirds of patients recovered within three weeks when treated with antibiotic ear drops. The disadvantages of dilute vinegar therapy were canal irritation with pain and dizziness. When the therapeutic efficacy was compared statistically, a dry ear was attained in the dilute vinegar-treated group at six weeks and six months in the antibiotic ear drop treated group (p
- Published
- 2002
27. Role of mastoid obliteration in patients with persistent cavity problems following modified radical mastoidectomy
- Author
-
G. Gopalan, D. Ravi, S. Gopalakrishnan, and Shelly K. Chadha
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Mastoides ,medicine.medical_treatment ,Otomycosis ,Mastoidectomy ,Otitis Media, Suppurative ,Mastoid ,law.invention ,Randomized controlled trial ,Anti-Infective Agents ,law ,Recurrence ,medicine ,Humans ,In patient ,Pseudomonas Infections ,Hearing Loss ,Chi-Square Distribution ,biology ,business.industry ,Granulation tissue ,General Medicine ,medicine.disease ,biology.organism_classification ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Otorhinolaryngology ,Otologic Surgical Procedures ,Audiometry, Pure-Tone ,Female ,Mastoid obliteration ,business - Abstract
A randomized clinical trial was conducted to determine the efficacy of mastoid obliteration in controlling persistent ear discharge, wax accumulation, fungal infection and granulation tissue formation in patients with cavity problems following modified radical mastoidectomy (MRM). Thirty patients underwent revision mastoidectomy with mastoid obliteration using a temporoparietal fascial flap. They were then followed up over a one-year period and the stated parameters observed. They were compared with 30 patients with similar complaints who were treated conservatively and kept under observation for 12 months. On follow-up, the number of patients in both the groups suffering from various cavity problems was compared. The chi-squared test was applied to the results and it was determined that there was a significantly lower incidence of discharging ear and formation of granulations in the operative group. However, audiological status, development of otomycosis and wax accumulation did not reveal any significant variation between the two groups.
- Published
- 2002
28. Clinical features of newly presenting cases of chronic otitis media
- Author
-
Robin Kane, Martin J. Donnelly, and Patrick Sheahan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Hearing loss ,Perforation (oil well) ,Chronic otitis ,Otitis Media, Suppurative ,Age groups ,otorhinolaryngologic diseases ,medicine ,Humans ,Abnormal Finding ,In patient ,Central tympanic membrane ,Prospective Studies ,Child ,Hearing Loss ,Aged ,Cholesteatoma, Middle Ear ,business.industry ,Cholesteatoma ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Otorhinolaryngology ,Child, Preschool ,Audiometry, Pure-Tone ,Female ,medicine.symptom ,business - Abstract
The clinical features of 58 consecutive patients presenting with a new case of chronic otitis media were prospectively collected over a 15-month period. Twenty-three ears had a keratin filled marginal or attic defect (14 with cholesteatoma), 20 had a self-clearing marginal or attic defect, and 21 had a central tympanic membrane perforation (including one cholesteatoma). Twenty patients (35 per cent) had an abnormal finding in the opposite ear. The patients' ages were dispersed over a wide range of age groups with a mean age of 34 years. Hearing loss was the most common presenting symptom (78 per cent), followed by otorrhoea (64 per cent). A significant proportion of patients denied any history of otorrhoea. Our findings should alert the clinician to suspecting a new case of COM in patients with hearing loss of any age, with, or without, a history of otorrhoea, regardless of their background ear history or the duration of their symptoms.
- Published
- 2002
29. Otitic hydrocephalus of tubercular origin: a rare cause
- Author
-
Ashwin Dwivedi, Ritu Agarwal, Rohan Walvekar, Bachi T. Hathiram, and D. S. Grewal
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Otitis Media, Suppurative ,Otitic hydrocephalus ,Central nervous system disease ,medicine ,Humans ,Tuberculosis ,Child ,Lateral Sinus Thrombosis ,business.industry ,Middle ear disease ,General Medicine ,medicine.disease ,Surgery ,Hydrocephalus ,Otitis ,Otorhinolaryngology ,Etiology ,Neurological dysfunction ,Female ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
Otitic hydrocephalus is characterized by increased intra – cranial pressure without focal signs of neurological dysfunction. It usually occurs secondary to lateral sinus thrombosis more commonly on the right side, but it can also occur without lateral sinus thrombosis. With the advent of new antibiotics there has been a spectacular decrease in the complications of otitis media. Otogenic intra – cranial hypertension, always an uncommon condition, is seen only very rarely nowadays. Tubercular otitis media still occurs in India, and due to delays in its diagnosis it usually presents with complications. We present three patients with otitic hydrocephalus of tubercular origin.
- Published
- 2001
30. Burow's solution in the treatment of active mucosal chronic suppurative otitis media: determining an effective dilution
- Author
-
I. B. Gardiner, M. A. Thorp, and C. A. J. Prescott
- Subjects
Male ,medicine.medical_specialty ,Chronic Suppurative Otitis Media ,Statistical difference ,Acetates ,Otitis Media, Suppurative ,chemistry.chemical_compound ,Minimum inhibitory concentration ,Aluminium acetate ,medicine ,In vitro study ,Humans ,Prospective Studies ,Chromatography ,business.industry ,General Medicine ,Bacterial Infections ,Treatment period ,Dilution ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,chemistry ,Child, Preschool ,Audiometry, Pure-Tone ,Burow's solution ,Female ,business - Abstract
Burow’s solution (13 per cent aluminium acetate) has been found to inhibit in vitro the growth of most commonly occurring bacteria found in the discharging ear. An in vitro study has shown that the minimum inhibitory concentration of Burow’s solution for these organisms lies between a 1:80 and a 1:160 dilution. This paper reports on a clinical trial that incorporated 67 discharging ears to establish the most effective strength of aluminium acetate solution. There was no statistical difference in the effectiveness of full strength Burow’s solution compared to 3.25 per cent aluminium acetate solution (a quarter strength Burow’s solution). Response rates of 80.8 per cent and 75 per cent respectively following a two-week treatment period were achieved using these two solutions. A 1.3 per cent aluminium acetate solution (1/10 strength Burow’s solution) was found to be markedly inferior. Bacteriological and audiological profiles were recorded for each patient.
- Published
- 2000
31. Tympanosclerosis: review of literature and incidence among patients with middle-ear infection
- Author
-
Saad M Asiri, Alaa Hasham, Adel A Banjar, Siraj M. Zakzouk, and Fatma H. Al Anazy
- Subjects
Adult ,Male ,medicine.medical_specialty ,Myringosclerosis ,Adolescent ,Hearing loss ,Chronic Suppurative Otitis Media ,Hearing Loss, Conductive ,Ear, Middle ,Otitis Media, Suppurative ,otorhinolaryngologic diseases ,medicine ,Humans ,Child ,Cholesteatoma ,Tympanosclerosis ,Retrospective Studies ,Sclerosis ,business.industry ,Incidence (epidemiology) ,Incidence ,General Medicine ,Middle Aged ,medicine.disease ,Dermatology ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Child, Preschool ,Chronic Disease ,Middle ear ,Etiology ,Female ,medicine.symptom ,business - Abstract
The aim of the study was to review the literature of tympanoscierosis especially its pathogenesis, to study the general incidence of tympanoscierosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis.Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected.The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20–40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap >40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent.The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.
- Published
- 2000
32. Early complications of surgery for chronic otitis media
- Author
-
P. J. D. Dawes
- Subjects
medicine.medical_specialty ,Chronic otitis ,Hearing Loss, Conductive ,Threshold elevation ,Otitis Media, Suppurative ,Drug Hypersensitivity ,Postoperative Complications ,Vertigo ,medicine ,Humans ,Surgical Wound Infection ,Surgery operative ,Hydrocarbons, Iodinated ,Medical Audit ,biology ,Temporomandibular Joint ,business.industry ,General Medicine ,biology.organism_classification ,Facial nerve ,Wound infection ,Arthralgia ,Surgery ,Drug Combinations ,medicine.anatomical_structure ,Otorhinolaryngology ,Anesthesia ,Chronic Disease ,Middle ear ,Chorda Tympani Nerve ,business ,Complication ,Bismuth ,Bone Conduction - Abstract
This audit report details early post-operative complications following surgery for chronic otitis media. One hundred and forty-five cases were assessed. There were no facial nerve palsies, a bone conduction threshold elevation occurred in 4.6 per cent of cases. A wound infection occurred in six per cent of cases as did BIPP allergy. Twenty-six per cent of patients reported symptoms consistent with chorda tympani trauma. Short-lived symptoms of jaw discomfort were reported by 46 per cent of patients and imbalance or vertigo by 10 per cent of patients. The findings are compared with other published reports of complications following ear surgery.
- Published
- 2000
33. Paediatric tympanoplasty
- Author
-
J. L. Lancaster, Z. G. G. Makura, G. Porter, and M. McCormick
- Subjects
Adolescent ,Patient Selection ,General Medicine ,Otitis Media, Suppurative ,Otolaryngology ,Treatment Outcome ,Tympanoplasty ,Otorhinolaryngology ,Health Care Surveys ,Myringoplasty ,Surveys and Questionnaires ,Chronic Disease ,Humans ,Child - Abstract
Much debate exists over the management of mucosal chronic suppurative otitis media in children, with the majority of it centred around the correct timing to perform either a myringoplasty (an operative repair of the tympanic membrane) or type I tympanoplasty (reconstruction of the tympanic membrane when there is an intact and mobile ossicular chain). Further discussion will use the term tympanoplasty to mean both of the above definitions. We present the findings of a recent survey of UK ENT consultants questioning their opinions on various management aspects of mucosal CSOM in the paediatric population. We also present an extensive review of the literature to provide us with published evidence in order to analyse the results of the questionnaire.
- Published
- 1999
34. Topical aminoglycosides in the management of active mucosal chronic suppurative otitis media
- Author
-
Z. G. G. Makura, M. McCormick, J. Lancaster, and G. Porter
- Subjects
Adult ,medicine.medical_specialty ,Tympanic Membrane Perforation ,business.industry ,Administration, Topical ,Perforation (oil well) ,Chronic Suppurative Otitis Media ,Middle ear disease ,General Medicine ,Otitis Media, Suppurative ,Surgery ,Anti-Bacterial Agents ,Aminoglycosides ,Otorhinolaryngology ,Current practice ,Health Care Surveys ,Chronic Disease ,medicine ,Humans ,In patient ,Practice Patterns, Physicians' ,Intensive care medicine ,business - Abstract
Debate has currently re-emerged following a renewed warning issued from the Committee on the Safety of Medicines (CSM) regarding the relative risk of ototoxicity from the use of aminoglycoside-containing drops in patients with tympanic membrane perforations. We present the findings of a survey of ENT consultants, questioning their views and current practice, and we add to the debate by means of a review and discussion of the literature.
- Published
- 1999
35. Tympanoplasty in children--a prospective study
- Author
-
Bakul Mukherjee, Yogesh Bajaj, and A. S. Bais
- Subjects
medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Temporalis fascia ,Otitis Media, Suppurative ,Tympanoplasty ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Child ,business.industry ,Patient Selection ,Middle ear disease ,Tympan ,Cholesteatoma ,General Medicine ,medicine.disease ,Predictive factor ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,El Niño ,Child, Preschool ,business - Abstract
Considerable controversy surrounds the subject of tympanoplasty in children. This prospective study looked at the results of type-I tympanoplasty in children. Forty-five children in the age group of five to 14 years were selected for the study. All these cases had a central perforation without any evidence of cholesteatoma. The ear to be operated had to be dry for at least six weeks before surgery. Type I tympanoplasty was performed on these patients with autograft temporalis fascia by either the underlay or overlay technique.The overall success rates in 45 operations evaluated one year post-operatively was 91.1 per cent. The age of the patient had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of near total perforation and bilateral perforations.It was concluded that type-I tympanoplasty has a good chance of success in children regardless of age.
- Published
- 1999
36. Systemic absorption of gentamicin ear drops
- Author
-
J. P. de Carpentier, J. W. A. Curley, D. W. P. Lappin, and Kevin Green
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Administration, Topical ,Chronic Suppurative Otitis Media ,Antibiotics ,Absorption (skin) ,Otitis Media, Suppurative ,Absorption ,Medicine ,Humans ,Antibacterial agent ,Chemotherapy ,business.industry ,Aminoglycoside ,General Medicine ,Middle Aged ,Surgery ,Anti-Bacterial Agents ,Otitis ,Otorhinolaryngology ,Anesthesia ,Kidney Failure, Chronic ,Gentamicin ,medicine.symptom ,Gentamicins ,business ,medicine.drug - Abstract
Aminoglycoside-containing topical preparations are commonly used in the treatment of chronic suppurative otitis media and otitis externa. We report a case where systemic absorption of topical Gentisone HC™ occurred producing a serum gentamicin level of 6.2 μg/ml.
- Published
- 1998
37. Bacterial colonization of pacifiers of infants with acute otitis media
- Author
-
Alan E. Gober and Itzhak Brook
- Subjects
Disease reservoir ,Staphylococcus aureus ,Aerobic bacteria ,Colony Count, Microbial ,medicine.disease_cause ,Otitis Media, Suppurative ,Microbiology ,Staphylococcus epidermidis ,Candida albicans ,medicine ,Humans ,Disease Reservoirs ,biology ,Streptococcus ,business.industry ,Infant ,General Medicine ,biology.organism_classification ,Bacteria, Aerobic ,Otorhinolaryngology ,Pacifier ,Acute Disease ,Infant Care ,business ,Staphylococcus ,Neisseria - Abstract
The presence of aerobic and facultative anaerobic bacteria on the surface of pacifiers used by children with acute otitis media was investigated. The surface of 40 recently used pacifiers was swabbed after they were allowed to dry for five to six minutes. The swabs were processed quantitatively for the presence of aerobic bacteria. The antibacterial activity of the pacifier material was testedin vitro. Microorganisms were isolated from 21 (52.5 per cent) pacifiers. The number of colonies per pacifier varied between one and 35 (average six). The isolates included eight α-haemolytic streptococci, sixStaphylococcus epidermis, fiveCandida albicans, five α-haemolytic streptococci, threeNeisseriaspp. and twoStaphylococcus aureus. The pacifier material was shown to be inhibitory againstS. aureus. This study illustrated that pacifiers do not contain high numbers of organisms and therefore are not likely to serve as a source of persistence of transfer of organisms.
- Published
- 1997
38. Use of pre-reduced swabs in bacteriology of chronic suppurative otitis media
- Author
-
J. Ashraful Haq and R. Indudharan
- Subjects
medicine.medical_specialty ,Bacteriological Techniques ,Isolation (health care) ,business.industry ,Middle ear disease ,Chronic Suppurative Otitis Media ,General Medicine ,Dermatology ,Otitis Media, Suppurative ,Surgery ,Specimen Handling ,Bacteria, Anaerobic ,medicine.anatomical_structure ,Otorhinolaryngology ,medicine ,Middle ear ,Bacteriology ,Humans ,business ,Child - Abstract
A simple, safe and effective procedure for improving the bacterial isolation in chronic suppurative otitis media (CSOM) is described. It is most useful for the isolation of aerobes as well as anaerobes from the middle ear.
- Published
- 1996
39. Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media
- Author
-
Eero Vartiainen and Jukka Vartiainen
- Subjects
Adult ,medicine.medical_specialty ,Staphylococcus aureus ,Micrococcaceae ,Adolescent ,Chronic Suppurative Otitis Media ,Disease ,medicine.disease_cause ,Otitis Media, Suppurative ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Bacteriology ,Humans ,Pseudomonas Infections ,Child ,biology ,Cholesteatoma, Middle Ear ,Pseudomonas aeruginosa ,business.industry ,Incidence (epidemiology) ,Cholesteatoma ,General Medicine ,Staphylococcal Infections ,medicine.disease ,biology.organism_classification ,Surgery ,Otorhinolaryngology ,Cohort ,Chronic Disease ,business ,Proteus Infections ,Follow-Up Studies - Abstract
The effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients. Staphylococcus aureus was isolated in cholesteatoma ears more frequently than Pseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common in Pseudomonas ears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected by P. aeruginosa.
- Published
- 1996
40. Non-cholesteatomatous suppurative otitis media: facial nerve palsy in an immunocompromised patient
- Author
-
C. Hartley, T. J. Lyons, and Shakeel R. Saeed
- Subjects
Graft Rejection ,Male ,medicine.medical_specialty ,Facial Paralysis ,Otitis Media, Suppurative ,Immunocompromised Host ,medicine ,Paralysis ,Cranial nerve disease ,Humans ,Immunosuppression Therapy ,Palsy ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Facial nerve ,Kidney Transplantation ,Facial paralysis ,Surgery ,Transplantation ,Otitis ,medicine.anatomical_structure ,Otorhinolaryngology ,Middle ear ,medicine.symptom ,business - Abstract
A 47-year-old man developed a complete facial nerve palsy secondary to non-cholesteatomatous suppurative otitis media. At operation, this was seen to be due to destruction of the nerve from halfway along the horizontal segment to a point just distal to the second genu. The history of recent renal transplantation and subsequent immunosuppression was judged to be significant in the pathogenesis of the palsy.
- Published
- 1995
41. Subtotal petrosectomy with external canal overclosure in the management of chronic suppurative otitis media
- Author
-
Abhi Parikh and Gerald B. Brookes
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Chronic Suppurative Otitis Media ,Vestibular Nerve ,Otitis Media, Suppurative ,Mastoid ,otorhinolaryngologic diseases ,medicine ,Humans ,Ear canal ,Cochlear Nerve ,Retrospective Studies ,Vestibular system ,business.industry ,Cochlear nerve ,Retrospective cohort study ,General Medicine ,Middle Aged ,Vestibular nerve ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Vestibular Diseases ,External Canal ,Chronic Disease ,Female ,Complication ,business ,Ear Canal ,Follow-Up Studies ,Petrous Bone - Abstract
Subtotal petrosectomy with external canal overclosure has been used in the management of 10 patients with chronic suppurative otitis media in the past four years. These patients fall into two categories. One group consisted of patients with end-stage chronically discharging mastoid cavities, despite aggressive medical therapy. The other group comprised patients who had developed disabling peripheral vestibular symptoms and had a mastoid cavity from past surgery for chronic otitis media. In both groups the affected ear had absent or poor auditory function. In the second group, a translabyrinthine section of the vestibular and/or cochlear nerves was performed in conjunction with subtotal petrosectomyThe procedure has been very successful in relieving the persistent otorrhoea, giving the patient an ear without a cavity that would need regular care. No restriction on swimming and participation in other water sports is an additional advantage.Illustrative cases are used to discuss the technique and indications.
- Published
- 1994
42. The styloid process in ossicular chain reconstruction. II: Long-term analysis
- Author
-
Sunil N. Dutt, Sugato Thakur, S. B. Ogale, and Manisha Pawar
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Technical success ,Chronic Suppurative Otitis Media ,Dentistry ,Otitis Media, Suppurative ,Hearing ,medicine ,Cadaver ,Humans ,Postoperative Period ,Process (anatomy) ,business.industry ,Temporal Bone ,General Medicine ,Tympanoplasty ,Tissue Donors ,Surgery ,Transplantation ,Ossicular replacement prosthesis ,Ossicular Prosthesis ,Otorhinolaryngology ,Chronic Disease ,Cadaveric spasm ,business ,Ossicular chain reconstruction ,Follow-Up Studies - Abstract
The human cadaveric styloid process was used as a homograft material for ossicular chain reconstruction in 41 cases of chronic suppurative otitis media over a five-year period. Although technical success was achieved in about 88.23 per cent of the cases, actual patient benefit was around 70.58 per cent; this is comparable to results obtained with most other homologous graft materials. The problem of breakage while remodelling the bone has also increased the risk of transmitting the AIDS virus and consequently undermines the use of this material.
- Published
- 1994
43. Radical mastoidectomy: its place in otitic intracranial complications
- Author
-
Tejprakash Jugpershad Maharaj and Bharath Singh
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Facial Paralysis ,Brain Abscess ,Mastoidectomy ,Otitis Media, Suppurative ,Mastoid ,Meningitis, Bacterial ,Recurrence ,otorhinolaryngologic diseases ,medicine ,Humans ,Prospective Studies ,Child ,Cholesteatoma ,Ear Diseases ,Brain abscess ,Aged ,Brain Diseases ,business.industry ,Infant ,General Medicine ,Bacterial Infections ,Middle Aged ,medicine.disease ,Facial nerve ,Facial paralysis ,Abscess ,Surgery ,Otitis ,Otorhinolaryngology ,Child, Preschool ,Female ,medicine.symptom ,Complication ,business ,Meningitis - Abstract
Standard recommended treatment for patients with intracranial complications from otitis media, has been radical mastoidectomy, whether cholesteatoma is present or not. This was established in the pre-antibiotic era to improve survival. Over a six-year period, from January 1985 to December 1990, 268 patients were admitted with intracranial and extracranial complications of otitis media. The prospective treatment consisted of antibiotics and surgery. Surgery entailed mastoidectomy and drainage of intracranial collections of pus in all patients.However, prospectively in these patients the ear pathology and not the complication dictated the type of mastoidectomy performed. Cortical mastoidectomy was performed in non-cholesteatomatous ears and radical mastoidectomy in cholesteatomatous ears.Recurrence of intracranial complications occurred in only four patients (two per cent), a temporal lobe cerebritis in the non-cholesteatomatous ear group, and, a temporal lobe abscess, posterior fossa abscess and subdural empyema in the cholesteatomatous ear group. The temporal lobe cerebritis settled on intravenous antibiotics whilst the temporal lobe abscess, posterior fossa abscess and subdural empyema required redrainage. In none of these was the ear surgery revised.There were 15 deaths (eight per cent), all occurring in patients with intracranial complications, 12 associated with brain abscess, two with subdural empyema and one with meningitis. Eight were from the non-cholesteatomatous group and seven from the cholesteatomatous group. The mortality was directly related to the patients consciousness level on admission and not to the type of ear pathology.It can therefore be concluded that radical mastoidectomy is unwarranted in the non-cholesteatomatous ear, even with an otogenic intracranial complication.
- Published
- 1993
44. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases
- Author
-
Jaran Kangsanarak, Kobkiat Ruckphaopunt, Sunanta Teotrakul, Supranee Fooanant, and Niramon Navacharoen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Facial Paralysis ,Mastoiditis ,Otitis Media, Suppurative ,Labyrinthitis ,Prevalence ,Medicine ,Humans ,Child ,Ear Diseases ,Brain abscess ,Brain Diseases ,business.industry ,Mortality rate ,Age Factors ,Cholesteatoma ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Thailand ,Facial paralysis ,Surgery ,Anti-Bacterial Agents ,Bacteria, Aerobic ,Otitis ,Otorhinolaryngology ,Child, Preschool ,Acute Disease ,Chronic Disease ,Female ,medicine.symptom ,business ,Complication ,Meningitis - Abstract
During the eight-year period, 1983–1990, 102 cases of intracranial (IC) and extracranial (EC) complications from 17 144 suppurative otitis media were reviewed. The prevalence of each complication was 0.24 and 0.45 per cent respectively. Facial paralysis, subperiosteal abscess and labynnthitis were the common complications among the EC group, while meningitis and brain abscess were common in the IC group. Twenty five per cent of the EC group and 44 per cent of the IC group had more than two complications. The reliable warning signs and symptoms for IC complications were fever, headache, earache, vestibular symptoms, meningeal signs and impairment of consciousness. Proteus spp., Pseudomonas aeuruginosa and Staphylococcus spp. were the commonest organisms isolated from both groups. Cholesteatoma and granulation/polyp in the middle earl mastoid were the major findings in both patient groups. Mortality rate in the IC group was 18.6 per cent. Morbidity rate in each group was 14.3 per cent (EC) and 27.9 per cent (IC) respectively. Epidemiological presentations, clinical features and the result of treatment are discussed.
- Published
- 1993
45. Temporal bone histopathology of open mastoidectomy cavities
- Author
-
Robin Youngs
- Subjects
Male ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,Ear, Middle ,Mastoidectomy ,Otitis Media, Suppurative ,Epithelium ,Mastoid ,Postoperative Complications ,Temporal bone ,otorhinolaryngologic diseases ,Middle Ear Cholesteatoma ,Medicine ,Humans ,Cholesteatoma ,Ear Diseases ,Aged ,Aged, 80 and over ,business.industry ,Granulation tissue ,Temporal Bone ,General Medicine ,Anatomy ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Otorhinolaryngology ,Middle ear ,Respiratory epithelium ,Histopathology ,Female ,business - Abstract
Open cavity mastoidectomy remains the principle surgical treatment of middle ear cholesteatoma in the United Kingdom. A significant proportion of mastoid cavities are prone to intermittent or continuous discharge.In this study the temporal bone histopathology of four patients who had undergone open cavity mastoidectomy is presented. Cavities were predominantly lined with stratified keratinizing squamous epithelium. Residual air cells were obliterated by fibrous tissue, with no evidence of persistent respiratory epithelium. Where inflammatory changes were found, these consisted of areas of granulation tissue in association with epithelial ulceration. Residual cholesteatoma pearls (epidermoids) were not associated with significant inflammatory changes.
- Published
- 1993
46. Grommets, swimming and otorrhoea--a review
- Author
-
M. B. Pringle
- Subjects
medicine.medical_specialty ,Adolescent ,Audiology ,Otitis Media, Suppurative ,Postoperative Complications ,Middle ear mucosa ,otorhinolaryngologic diseases ,Medicine ,Humans ,Ear protection ,Grommet ,Child ,Swimming ,Middle ear ventilation ,business.industry ,Otitis Media with Effusion ,Middle ear disease ,Water ,Baths ,General Medicine ,Middle Ear Ventilation ,Grommet Insertion ,medicine.anatomical_structure ,Otorhinolaryngology ,Child, Preschool ,Middle ear ,business - Abstract
Ever since Armstrong reintroduced the concept of grommet insertion parents have been asking 'may my child swim?', yet there is still no consensus as to the correct answer. This paper reviews the work that has been done on this subject in the last 25 years. A review of the rates of otorrhoea following grommet insertion, irrespective of swimming, shows a variation from 12 to 64 per cent. Evidence suggests that pressures of 12-23 cm H2O are needed to push water through a grommet and that it is unlikely that water will enter the middle ear during surface swimming. Only bath water seems to cause significant inflammatory changes to middle ear mucosa. Not a single paper comparing swimmers with non-swimmers shows an increased rate of otorrhoea in those patients who swam; to the contrary, rates of otorrhoea were repeatedly higher in those patients who did not swim. The evidence suggests that swimming without ear protection can be safely permitted for children with grommets.
- Published
- 1993
47. The use of antibiotic/steroid ear drops to reduce post-operative otorrhoea and blockage of ventilation tubes. A prospective study
- Author
-
H. R. Cable and M A Salam
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Betamethasone ,Otitis Media, Suppurative ,Route of administration ,Postoperative Complications ,otorhinolaryngologic diseases ,medicine ,Humans ,Statistical analysis ,Prospective randomized study ,Prospective Studies ,Post operative ,Prospective cohort study ,Child ,business.industry ,Otitis Media with Effusion ,Neomycin ,General Medicine ,Middle Ear Ventilation ,Surgery ,Drug Combinations ,Otorhinolaryngology ,Effusion ,Anesthesia ,Child, Preschool ,Female ,Complication ,business - Abstract
This prospective randomized study investigates whether the use of antibiotic/steroid ear drops (Betnesol-N) is effective in reducing early post-operative otorrhoea and blockjage of ventilation tubes (VTs). The study included 162 children who had bilateral VT insertion and used Betnesol-N ear drops in one ear only for three days after surgery, the other ear was left as cotrol. These children were reviewed two weeks later and their ears wer examined for VT patency, presence of blood or of mucopus. Statistical analysis of our results showed that the use of Betneso-N ear drops has significantly reduced the incidence of post-operative otorrhoes within two weeks of VTs insertion (pp>0.05).
- Published
- 1993
48. The cellular mechanism of ossicular erosion in chronic suppurative otitis media
- Author
-
P. Mcphie, F. Lannigan, and Paul O'Higgins
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Cellular activity ,Adolescent ,Chronic Suppurative Otitis Media ,Otitis Media, Suppurative ,Bone resorption ,Cellular mechanism ,Examination technique ,Medicine ,Humans ,Bone Resorption ,Child ,Aged ,Ear Ossicles ,business.industry ,Middle ear disease ,General Medicine ,Anatomy ,Middle Aged ,Ossicular erosion ,Otorhinolaryngology ,Child, Preschool ,Chronic Disease ,Microscopy, Electron, Scanning ,Female ,business ,Retraction pocket - Abstract
This is the first report of the application of a new examination technique for the assessment of cellular activity during bone resorption in chronic suppurative otitis media (CSOM). A total of nineteen incudes removed during the course of tympanomastoid surgery were studied (retraction pocket: 2; tubo-tympanic CSOM: 4; attico-antral CSOM: 13). The microscopic surface topography of each specimen was examined using the scanning electron microscopy (SEM), and the appearances are interpreted in terms of cortical cellular activity. The results suggest that the mechanism of ossicular erosion in CSOM is similar regardless of the exact type of disease. Extensively, pitted areas were seen in all specimens. These pits are morphologically indistinguishable from those characteristic of osteoclastic activity (Howship's lacunae). We conclude that in all causes the surface topography of eroded incudes is consistent with the activity of osteoclasts.
- Published
- 1993
49. Conservative treatment in the management of inflammatory aural polyp
- Author
-
S. S. M. Hussain
- Subjects
Adult ,Male ,Intracranial pathology ,medicine.medical_specialty ,Time Factors ,Adolescent ,Hydrocortisone ,medicine.medical_treatment ,Otitis Media, Suppurative ,Pharmacotherapy ,Polyps ,Ambulatory care ,otorhinolaryngologic diseases ,medicine ,Ambulatory Care ,Humans ,Prospective Studies ,Prospective cohort study ,Ear Neoplasms ,Chemotherapy ,business.industry ,Cholesteatoma ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Conservative treatment ,Otorhinolaryngology ,Drug Therapy, Combination ,Female ,Gentamicins ,business ,Topical steroid - Abstract
This prospective study assesses the role of intensive outpatient based conservative treatment in the management of aural polyp.All cases of aural polyp that presented to the department during 1990 were included. Patients with obvious cholesteatoma or in whom inner ear or intracranial pathology was suspected were excluded as were children and patients who had undergone previous ear surgery.We found that treatment with topical steroid/antibiotic decreases disease activity and renders subsequent surgery less extensive.
- Published
- 1992
50. Secretory IgA- and IgG-coated bacteria in chronically discharging ears
- Author
-
Lars-Eric Stenfors and Simo Räisänen
- Subjects
Adult ,Male ,Colony Count, Microbial ,Fluorescent Antibody Technique ,medicine.disease_cause ,Immunofluorescence ,Otitis Media, Suppurative ,Haemophilus influenzae ,stomatognathic system ,Streptococcus pneumoniae ,Medicine ,Humans ,Child ,Aged ,biology ,medicine.diagnostic_test ,Bacteria ,business.industry ,Pseudomonas aeruginosa ,Infant ,General Medicine ,Exudates and Transudates ,Middle Aged ,biology.organism_classification ,Otitis ,Otorhinolaryngology ,Staphylococcus aureus ,Immunoglobulin G ,Immunology ,Chronic Disease ,Immunoglobulin A, Secretory ,biology.protein ,Female ,medicine.symptom ,Antibody ,business - Abstract
SIgA- and IgG-coated bacteria obtained from 17 discharging middle ears (14 patients, 9 male, 5 female, age range from 1 to 79 years) were evaluated using an immunofluorescence assay. Simultaneously, quantitative and qualitative bacteriological analyses of the middle ear effusions (MEEs) were performed. MEEs containingStaphylococcus aureusharboured bacteria which were intensely coated with both SIgA and IgG antibodies. In contrast, MEEs containingPseudomonas aeruginosadisplayed minimal, if any, SIgA- and IgG-coated bacteria. Two young patients harboured bacteria (Haemophilus influenzae and S. aureus/Streptococcus pneumoniae, respectively) which were heavily coated with IgG, but not with SIgA. Immunoglobulin-coating of bacteria involved in otitis media is of the utmost importance in eradication of the infection.
- Published
- 1991
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