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Introduction: Balloon Eustachian tuboplasty (BET) is used to treat obstructive Eustachian tube dysfunction (OETD) and recurrent otitis media with effusion (OME). However, there are no indisputable evidence of its efficacy. Here, we present a multicenter, double‐blinded, randomized, placebo‐controlled trial (MDRCT) design to evaluate the efficacy of BET, and the results of a pilot trial with 3‐ and 12‐months' follow‐up. Material and Methods: This was a prospective MDRCT. For a pilot study, OETD (n = 10) and OME (n = 5) patients were recruited and followed. Detailed inclusion and exclusion criteria were used. Participants were randomized at beginning of the operation to active or sham surgery. All procedures were performed under local anesthesia. Controls were performed in double‐blinded manner (both patient and physician), at 3 and 12 months after the procedure. Results: Altogether, 20 ears were treated and followed for 12 months, including 14 active BETs and 6 sham surgeries. Both the active and sham surgery were performed under local anesthesia without problems or deviations from the protocol. There were no differences in the preoperative symptoms (ETDQ‐7) or objective measures (tympanometry, Valsalva and Toynbee maneuvers, tubomanometry, Eustachian tube score) between active and sham surgery arms. During follow‐up, we noticed largely similar reduction in subjective symptoms and improvement in Eustachian tube score both in active and sham surgery arms. Conclusions: The pilot study demonstrates that our MDRCT protocol is feasible, and that blinded RCTs are dearly needed to objectively measure the efficacy of BET. Level of Evidence: 2 Laryngoscope, 134:1874–1881, 2024 [ABSTRACT FROM AUTHOR]

Aim: This study examined the predisposing factors, clinical picture, bacterial aetiology and clinical outcomes of infants and children with bacterial meningitis (BM). Methods: The medical records of patients under 16 years of age, treated by Turku University Hospital, Finland, from 2011 to 2018, were screened for meningitis using the International Classification of Diseases, Tenth Revision codes. Patients were included if bacteria were detected in cerebrospinal fluid (CSF) or other predefined laboratory variables indicated BM, despite CSF testing negative for bacteria. The Glasgow Outcome Scale (GOS) was used to determine outcomes. Results: We identified 37 children with BM: 22 infants aged 0–89 days and 15 children aged 90 days to 15 years. The overall incidence was approximately 5.7/100 000/year. Nosocomial meningitis was documented in 51%. Bacterial growth was detected in the CSF or blood cultures of the majority of patients (57%). Escherichia coli (14%), group B streptococcus (11%) and Streptococcus pneumoniae (8%) were the most common pathogens. There were 14% of patients with unfavourable outcomes, namely GOS scores of 1–4, but no deaths. Conclusion: The incidence of paediatric BM was low during the study period, but the proportion of nosocomial meningitis was substantial. The frequency of unfavourable long‐term outcomes was relatively low. [ABSTRACT FROM AUTHOR]

Most common respiratory viruses are present in children with acute otitis media (AOM) and seem to actually be contributory to causing or increasing the risk of AOM. The viruses were found in 75% of 92 children between the ages of three months and seven years and included human rhinovirus (HRV), respiratory syncytial virus and coronavirus. HRV was the most common, found in 24% - 35% of the children with AOM. These tests reinforce, confirm and extend conclusions of earlier studies., Objective. To determine the frequencies of human rhinovirus (HRV), respiratory syncytial virus (RSV), and coronavirus (HCV) infection in children with acute otitis media (AOM). Methods. Middle ear fluids (MEF) collected by tympanocentesis and nasopharyngeal aspirates (NPA) at the time of the AOM diagnosis were examined by reverse transcriptase polymerase chain reaction for HRV, RSV, and HCV RNA. Patients. Ninety-two children aged 3 months to 7 years during a 1-year period. Results. Virus RNA was detected in a total of 69 children (75%) and in 44 MEF samples (48%) and 57 NPA samples (62%) at the time of AOM diagnosis. HRV RNA was detected in both MEF and NPA in 18 (20%), in MEF alone in 4 (4%), and in NPA alone in 10 (11%). RSV was detected in both MEF and NPA in 12 (13%), in MEF alone in 5 (5%), and in NPA alone in 9 (10%). HCV RNA was detected in both MEF and NPA in 5 (5%), in MEF alone in 2 (2%), and in NPA alone in 9 (10%). Dual viral infections were detected in 5% of children. HRV and RSV were detected simultaneously in 2 MEF samples and in 2 NPA samples; RSV and HCV were detected in I NPA sample. Bacterial pathogens were detected in 56 (62%) MEF from 91 children. Viral RNA was detected in 20 (57%) MEF of 35 bacteria-negative and in 25 (45%) of 56 bacteria-positive MEF samples. No important differences in the risk of treatment failure, relapse, or occurrence of late secretory otitis media were noted between children with virus-positive and virus-negative MEF aspirates. Conclusion. These findings highlight the importance of common respiratory viruses, particularly HRV and RSV, in predisposing to and causing AOM in young children. Pediatrics 1998;102:291-295; RT-PCR, acute otitis media, rhinovirus, respiratory syncytial virus, coronavirus., ABBREVIATIONS: AOM, acute otitis media; RSV, respiratory syncytial virus; HRV, human rhinovirus; RT-PCR, reverse transcriptase polymerase chain reaction; HCV human coronavirus; NPA, nasopharyngeal aspirates; MEF, middle ear fluids; PBS, phosphate-buffered [...]

Children who attend day care centers appear to be at an increased risk for invasive pneumococcal disease. A total of 149 children younger than 16 years with invasive pneumococcal disease were compared with 284 children who did not develop the disease. Parents completed questionnaires about their children's risk factors for the disease. There were no significant differences between the two groups in birth-weight or -length or duration of breastfeeding. Analysis of the questionnaires indicated that attendance at day care centers was significantly associated with an increased risk of the disease. Among children younger than two years a 36-fold increase in risk was found. Attendance at residential, or family, day care centers, which tend to be smaller, was associated with a 4.4-fold increase in risk for the disease. Having siblings who were younger than school age was found to be a risk factor for children who were at least two years old., Objective. - To study risk factors for invasive pneumococcal disease among children. Design. - A population-based, case-control study of 149 cases and 284 control matched for age, sex, and place of residence. Setting. - Finland, November 1986 through November 1989. Patients and Controls. - Patients were identified from a prospective nationwide surveillance for invasive bacterial diseases among children (0 to 15 years of age) through a network of bacteriologic laboratories. Two matched controls were selected for 135 of the cases and one matched control for 14 of the cases from the respective cases' child health center or school. Questionnaires evaluating potential risk factors were mailed to families of cases and controls. Results. - An increased risk for invasive pneumococcal disease among children younger than 2 years was associated with day care center attendance (odds ratio [OR]=36; 95% confidence interval [Cl], 5.7 to 233), family day care (OR=4.4; 95% Cl, 1.7 to 12), and history of frequent otitis media (OR=8.8; 95% Cl, 2.5 to 31). For those at least2 years of age, existence of siblings younger than school-age indicated increased risk for invasive pneumococcal disease (OR=2.2; 95% Cl, 1.1 to 4.4). Conclusions. - Day care center attendance is a major risk factor for invasive pneumococcal disease for children younger than 2 years, with significantly higher risk than the risk associated with family day care.

The article presents the feasibility study that investigates the effectiveness of balloon Eustachian tuboplasty in improving the function of eustachian tube of patients suffering from pain caused by endoscopic sinus surgery.

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We report on a previously healthy 11-year-old male presenting with meningoencephalitis and otitis media. Computed tomography demonstrated opacification of the right middle ear and mastoid ear cells, but no destructive changes. Anti-Mycoplasma pneumoniaeIgG and IgM were positive in serum and at high concentrations in cerebrospinal fluid (CSF), and its nucleic acid was detected in the middle ear fluid and in a throat swab, but not in CSF. EEG showed generalized slowing and right temporal sharp waves. Brain MRI imaging remained normal. After a 3-week treatment with doxycycline and a tympanostomy tube, the patient recovered, and no long-term neurological sequelae have appeared. Diagnostics and pathogenetic mechanisms in meningoencephalitis caused byM. pneumoniaeare discussed. [ABSTRACT FROM PUBLISHER]