2,474 results on '"Otitis Media, Suppurative"'
Search Results
2. Chronic Suppurative Otitis Media Microbiology
- Author
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Bulent Ulusoy, Selcuk University Faculty of Medicine
- Published
- 2024
3. Mastoid Obliteration Using S53P4 Bioactive Glass Versus Mastoidectomy Alone for Chronic Suppurative Otitis Media
- Published
- 2023
4. Antibiotic Concentration After Delivery to Middle Ear for Chronic Suppurative Otitis Media
- Author
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James E. Saunders, Professor of Otology / Neurotology
- Published
- 2023
5. Platelet Rich Fibrin Augmented Tympanoplasty Versus Cartilage Tympanoplasty
- Author
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Hisham Ebada, Assistant Professor
- Published
- 2023
6. Assessment of an App Based on Artificial Intelligence for Purulent AOM Diagnosis in a Pediatric Department (OMA-IA)
- Published
- 2023
7. Safety Profile of Applied 100% Manuka Honey in Tympanoplasty
- Published
- 2022
8. Effects of 100% Medical Grade Manuka Honey on Tympanic Membrane Reconstruction Healing.
- Published
- 2022
9. Brain abscess as an otorhinolaryngological complication
- Author
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Miguel Hernández and Mildred P. Zambrano Leal
- Subjects
Brain Abscess ,Otitis Media, Suppurative ,Mastoiditis ,Case Reports ,Child ,Pediatrics ,RJ1-570 - Abstract
Introduction: A brain abscess is a fatal infection if it is not diagnosed and treated promptly. It is more common in children and has high mortality rates compared to adults. Respiratory infections, such as otitis and sinusitis, generally precede brain abscesses. In most cases, a double treatment, antibiotics, and surgery should be necessary. Complications can be fatal even with proper treatment. Clinical case: This is a 3-year-old girl patient with a history of respiratory infection. His parents took him to the emergency room due to a severe headache and a seizure episode. The clinical examination revealed left ear otalgia associated with pain and sensitivity to palpation of the mastoid region. Laboratory tests revealed leukocytosis of 18,770/MMC with neutrophilia, thrombocytosis of 628,000/MMC, elevated C-reactive protein of 8.35 mg/dl (average value 0.10-0.30 mg/dl) and elevated ferritin of 250.20 ng/dl (average value 7-140 ng/dl). Due to the history and clinical findings, a computed tomography of the skull was performed, revealing an image of evident hypodensity of the left hemisphere. An MRI was also performed, which revealed the lesion previously associated with thrombosis of the left breast. He received antibiotics and low molecular weight heparin with neurosurgery therapy, with good results. Evolution: Despite the extent of the injury, he had two episodes of seizures. He promptly received adequate antibiotic therapy and surgical treatment with good results. Three months later, for follow-up, he looks normal and has no long-term complications. Conclusions: Complications of brain abscess, even with adequate treatment, can be severe, such as epilepsy or death.
- Published
- 2023
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10. Composite Cartilage Perichondrium Graft for Air Bone Gap Closure in Chronic Suppurative Otitis Media (CSOM) Without Posterior Meatal Flap
- Author
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Dr Zeeshan Ayub, Associate Professor ENT
- Published
- 2021
11. N-Acetylcysteine as an Adjunct for Refractory Chronic Suppurative Otitis Media
- Author
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Dr Brian Westerberg, Clinical Professor, Department of Surgery, UBC Otology & Neurotology
- Published
- 2019
12. Modified Radical Mastoidectomy: Open Mastoid Cavity versus Cavity Obliteration Using Periosteal Temporofascial Flap - A Comparative Study
- Author
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Vignesh Kumar R, Rohit Bhardwaj, Shams Uddin, Smrity Rupa Dutta Borah, Abhinandan Bhattacharjee, Kripamoy Nath, and Manas Pratim Das
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Mastoidectomy ,Tympanoplasty ,Otitis Media, Suppurative ,Hearing Loss ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity. Material and Methods In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at 3rd week, 6th week, 3rd month and 6th month. Results Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up. Conclusion Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care.
- Published
- 2022
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13. Targeting the NLRP3 inflammasome in cochlear macrophages protects against hearing loss in chronic suppurative otitis media.
- Author
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Schiel V, Bhattacharya R, Gupta A, Eftekharian K, Xia A, and Santa Maria PL
- Subjects
- Animals, Female, Humans, Male, Mice, Chronic Disease, Disease Models, Animal, Hearing Loss etiology, Hearing Loss prevention & control, Interleukin-1beta metabolism, Mice, Inbred C57BL, Mice, Knockout, Cochlea metabolism, Cochlea pathology, Inflammasomes metabolism, Macrophages metabolism, NLR Family, Pyrin Domain-Containing 3 Protein metabolism, NLR Family, Pyrin Domain-Containing 3 Protein antagonists & inhibitors, Otitis Media, Suppurative
- Abstract
The activation of the NLRP3 inflammasome has been linked to several inflammatory and autoinflammatory diseases. Despite cases of potential hearing improvement in immune-mediated diseases, direct evidence of the efficacy of targeting this mechanism in the inner ear is still lacking. Previously, we discovered that macrophages are associated with Sensorineural Hearing loss (SNHL) in Chronic Suppurative Otitis Media (CSOM), the leading cause of this permanent hearing loss in the developing world and incurring costs of $4 to $11 billion dollars in the United States. However, the underlying mechanism remained unknown. Here, we investigate how macrophages drive permanent hearing loss in CSOM. We first confirmed the occurrence of NLRP3 inflammasome activation in cochlear macrophages in CSOM. We then revealed that Outer Hair Cells (OHCs) were protected in CSOM by macrophage depletion and subsequently confirmed the same protection in the NLRP3 knockout condition. Furthermore, we showed that therapeutic inhibition of NLRP3 inflammasome activation and downstream inhibition of IL-1β protects OHCs in CSOM. Collectively, our data demonstrates that the main driver for hearing loss in CSOM is NLRP3 inflammasome activation in cochlear macrophages and this is therapeutically targetable, leading the way for the development of interventions to prevent the leading cause of permanent hearing loss and a costly disease in the developed world., (© 2024. The Author(s).)
- Published
- 2024
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14. Pazufloxacin Mesilate Ear Drops in Patients With Chronic Suppurative Otitis Media
- Published
- 2018
15. Preemptive Pregabalin in Myringoplasty
- Author
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Kathmandu University School of Medical Sciences and Dr Ashish Dhakal, Lecturer, Department of Otolaryngology Head and Neck Surgery
- Published
- 2018
16. The Microbiome Variability and Antibiotic Resistance of Chronic Suppurative Otitis
- Published
- 2018
17. Foudroyant middle-ear pneumococcal inflammation with meningoencephalitis in a six-year-old girl
- Author
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Čvorović Ljiljana, Relić Nenad, Rsovac Snežana, and Arsović Nenad
- Subjects
otitis media, suppurative ,meningoencephalitis ,hydrocephalus ,surgery, operative ,antibiotics ,Medicine (General) ,R5-920 - Abstract
Introduction. Intracranial complications of otitis media still occur, despite great progress in the treatment of all forms of inflammation. These are serious conditions which are still life-threatening and require a fast and accurate diagnosis and an adequate treatment. We present an illustrative case of an acute, foudroyant, pneumococcal, suppurative otitis media with infection spreading into endocranium and development of meningoencephalitis and otic hydrocephalus. Case report. A 6-year-old girl was admitted to the University Children's Clinic because of fever, headache, vomiting and disorder of consciousness. Computed tomography scan of the endocranium and temporal bone has revealed brain edema and hypodense content in the left mastoid and timpanic cavity. The diagnosis of acute otitis media with meningoencephalitis was made and we started with intensive antibiotic treatment. Lumbar puncture and haemoculture were confirmed a pneumococcal infection. Otosurgical treatment was conducted too due to an inadequate reaction to conservative treatment. Firstly, left mastoidectomy with the implantation of ventilation tube has been performed, followed by radical tympanomastoidectomy because there was no improvement. Three weeks after the second operation, a magnetic resonance imaging of the endocranium was performed and an otic hydrocephalus was diagnosed. A neurosurgical operation was performed on the same day with the setting of the ventriculo-peritoneal shunt. Conclusion. Intracranial complications of acute otitis media in children are extremely rare and they require multidisciplinary treatment. Surgical treatment of the ear shouldn't be postponed and the choice of the type of otosurgical intervention should be individually adapted. Audiological and neurological complications of the disease are frequent and they further prolong and impair the treatment.
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- 2021
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18. Prevalence and Associations of Paediatric Chronic Suppurative Otitis Media and Hearing Impairment in Rural Malawi
- Author
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Kamuzu University of Health Sciences and Malawi-Liverpool-Wellcome Trust Clinical Research Programme
- Published
- 2016
19. Clinimetric evaluation and clinical outcomes of the Dutch version of the Chronic Ear Survey
- Author
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S. Geerse, R. J. de Haan, M. J. F. de Wolf, F. A. Ebbens, and E. van Spronsen
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Surveys and questionnaires ,Translations ,Outcome assessment ,Quality of life ,Otitis media, Suppurative ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background To validate and evaluate the reliability of the Dutch version of the Chronic Ear Survey (CES) in patients suffering from Chronic Suppurative Otitis Media (CSOM) and to evaluate clinical outcomes of surgery using this questionnaire. Methods We developed the Dutch version of the CES (D-CES) using forward-backward translation of the original CES into the Dutch language. Next, patients with CSOM and controls completed the D-CES pre- and postoperatively. Internal consistency, test-retest reliability, known-group validity and convergent validity were evaluated. In addition to the D-CES, the Short Form 36 (SF-36) was administered to all participants to correlate D-CES data to quality of life. Results A total of 29 patients with CSOM scheduled for ear surgery were included. Our control group consisted of 26 patients scheduled for eye surgery, all without signs and symptoms of CSOM. Cronbachs’ α of the complete questionnaire was 0.69. The Intraclass Correlation Coefficients (ICCs), reflecting test-retest reliability, ranged between 0.69 and 0.82. Scores differed significantly between CSOM patients and controls with substantial lower (more impaired) D-CES scores in the CSOM group. Duration of complaints preoperatively and the presence of a dry ear and/or improvement of hearing postoperatively all had a significant impact on D-CES improvement scores. Small to moderate correlations were found between D-CES subscales and matching subscales of the SF-36. Conclusion The D-CES is an appropriate disease specific questionnaire to assess a patient’s perceived functional health in CSOM.
- Published
- 2019
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20. Benefit of Tympanoplasty with or without Cortical Mastoidectomy in Active Mucosal Otitis Media – A Comparative Study
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Anushree Raviprakash Bajaj, Shahnaz Sheikh, Samir Joshi, and Bhalchandra Paike
- Subjects
Tympanoplasty ,Otitis Media, Suppurative ,Mastoid ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction: Chronic otitis media (COM) is amongst the most common diseases treated by ENT surgeons in India. It has been advocated in lot of research articles that there is no significant difference in tympanoplasty done in active and inactive COM. The objective was to see if cortical mastoidectomy in cases of active mucosal COM, improves the success rate of tympanoplasty measured as per the following parameters: improvement in the hearing threshold by 15 dB, increased graft uptake and reduction in retraction of tympanic membrane in post operative period. Materials and Methods: This study comprises of 120 patients coming to the ENT OPD from October 2016 to October 2017 with active mucosal COM with central perforation requiring tympanoplasty. These patients were randomly assigned to two groups: Group 1 of 60 subjects in which tympanoplasty without mastoidectomy was done, Group 2 of 60 subjects in which tympanoplasty with mastoidectomy was done. Patients were evaluated after a post operative period of 3 months. Results: The Results were the hearing improvement was 73.33% in group 1 while 83.33% in group 2, graft uptake was 63.33% in group 1 and 80% in group 2, graft retraction was 33.33% and 23.33% in group 1 and group 2 respectively. Conclusion: There was statistically significant difference in results in group with and without mastoidectomy in active mucosal chronic otitis media with respect to graft uptake and improved hearing.
- Published
- 2019
21. Correlation of pre-operative computed tomography, intra-operative findings and surgical outcomes in revision tympanomastoidectomy.
- Author
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Košec, A, Matišić, V, Gregurić, T, Falak, H, Ajduk, J, and Ries, M
- Subjects
- *
CHOLESTEATOMA , *CHRONIC diseases , *COMPUTED tomography , *EXPERIMENTAL design , *LONGITUDINAL method , *MASTOIDECTOMY , *OTITIS media , *PAIRED comparisons (Mathematics) , *PATIENTS , *REOPERATION , *SURGERY , *SURGICAL therapeutics , *TYMPANOPLASTY , *DISEASE relapse , *TREATMENT effectiveness , *RETROSPECTIVE studies , *PREOPERATIVE period ,TEMPORAL bone radiography - Abstract
Objective: To correlate pre-operative computed tomography findings, intra-operative details and surgical outcomes with cholesteatoma recurrence in revision tympanomastoidectomy. Methods: This retrospective, non-randomised, single-institution cohort study included 42 patients who underwent pre-operative computed tomography imaging and revision surgery for recurrent chronic otitis media. Twelve disease localisations noted during revision surgery were correlated with pre-operative temporal bone computed tomography scans. A matched pair analysis was performed on patients with similar intra-operative findings, but without pre-operative computed tomography scans. Results: Pre-operative computed tomography identified 25 out of 31 cholesteatoma recurrences. Computed tomography findings correlated with: recurrent cholesteatoma when attic opacification and ossicular chain involvement were present; and revision surgery type. Sinodural angle disease, posterior canal wall erosion and dehiscent dura were identified as predictors of canal wall down tympanomastoidectomy. Patients with pre-operative computed tomography scans had a higher rate of cholesteatoma recurrence, younger age at diagnosis of recurrent disease, more revision surgical procedures and less time between previous and revision surgical procedures (all p < 0.05). Conclusion: Pre-operative imaging and intra-operative findings have important clinical implications in revision surgery for chronic otitis media. Performing pre-operative computed tomography increases diagnosis accuracy and reduces the time required to diagnose recurrent disease. [ABSTRACT FROM AUTHOR]
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- 2020
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22. MICROORGANISMS PROFILE AND ANTI-MICROBIAL SENSITIVITY IN CHRONIC SUPPURATIVE OTITIS MEDIA
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Muhammad Ibrahim, Syed Maisam Ali, Mohammad Imran Shah, and Muhammad Abkar Khan
- Subjects
Microorganisms ,Sensitivity ,Otitis Media, Suppurative ,Otitis Media ,Chronic suppurative otitis media ,Antibiotics ,Medicine - Abstract
OBJECTIVE: To determine the frequency of common microorganisms involved in chronic suppurative otitis media (CSOM) and their antibiotic sensitivity. METHODS: This cross sectional study of 776 patients suffering with CSOM was conducted at Otolaryngology Department, Ayub Teaching Hospital, Abbottabad from 5th May 2017 to 5th November 2018. Patients fulfilling the inclusion criteria were enrolled for otoscopic examination. Sterile cotton swabs were used to collect pus samples and were sent to microbiological analysis and antibiotics sensitivity. RESULTS: The age ranges of the patients were from 13-73 years, with a mean age of 28.98±13.40 years. The incidence of CSOM was highest in 21-30 years age group (294~37.9%). In a total 776 CSOM patients, only 501 (64.56%) of the samples showed microbial growth. In aerobic isolates, the most common bacterium was Pseudomonas aeruginosa (30.7%) followed by Staphylococcus aureus (11.1%) including 6.7% MRSA. Anaerobes were isolated in 1.2% of the samples in which bacteriodes were being the most common. Samples (1.8%) showed fungal growth and yielded only Candida spp while 0.5% samples were positive for acid fact bacilli. In antimicrobial sensitivity investigation Pseudomonas aeruginosa showed highest sensitivity to piperacillin/tazobactum (84%), to levofloxacin (25.21%), to ciprofloxacin (20.59%). The highest sensitivity of S. aureus was investigated for piperacillin/tazobactum and ceftazidime with 91.18%, and showed no sensitivity to ciprofloxacin and levofloxacin. CONCLUSION: Pseudomonas aeruginosa and Staphylococcus aureus were the most common bacteria. Both show increasingly high resistance to quinolones and amino glycosides, but both isolates are sensitive to piperacillin/tazobactum, imipenam, cefoperazone/salbactum and ceftazidime.
- Published
- 2019
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23. Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study
- Author
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Niaz Fakhruddin, Chethan Kumar Gangaiah, Gopakumar KP, Geogin George Thottan, and Mon Noufal
- Subjects
Otitis Media, Suppurative ,Tympanoplasty ,Incus ,Necrosis ,Cartilage ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction Ossicular chain reconstruction is the surgical procedure used to correct the hearing problems in patients with chronic otitis media (COM). In this era, where a large variety of innovative artificial prosthetic materials are being used to replace and reconstruct the ossicular chain, autografts still play a significant role. Materials and Methods The present study included 40 patients. Study population was selected based on inclusion and exclusion criteria. The ossicular reconstructive procedure was done under anesthesia and according to the status of the ossicular chain. Temporalis fascia was used to close the perforation. Mainly two procedures were performed: one is intact canal wall and the other is canal wall down. Results Most of the study population was middle aged and males were more compared to females. Thirty five patients had air bone gap above 30dB. In 38 patients, the incus had undergone necrosis. Most of the patients underwent short columella reconstruction. A closure of air bone gap with in 20 dB was achieved in 72.2% in patients with malleus stapes assembly. In short columella 22.2% of patients had closure of air bone gap within 20 dB. Incus remnant grafts gave better hearing gain. Discussion The published literature on the result of use of sculptured ossicle and cartilage in tympanoplasty have been reviewed Conclusion In the present study, cases with COM showed good hearing results patients implanted with autogenous cartilage and bone.
- Published
- 2017
24. Povidone-Iodine Fails to Eradicate Chronic Suppurative Otitis Media and Demonstrates Ototoxic Risk in Mice
- Author
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Adam C. Kaufman, Brian S. Bacacao, Betul Berkay, Devesh Sharma, Anupam Mishra, George A. O'Toole, James E. Saunders, Anping Xia, Laurent A. Bekale, and Peter L. Santa Maria
- Subjects
Mice ,Otorhinolaryngology ,Anti-Infective Agents, Local ,Animals ,Neurology (clinical) ,Neoplasm Recurrence, Local ,Ototoxicity ,Povidone-Iodine ,Otitis Media, Suppurative ,Article ,Sensory Systems - Abstract
HYPOTHESIS: Commercially available povidone-iodine solution can eliminate biofilms and persister cells rapidly in in vivo achievable concentrations without inducing ototoxicity. BACKGROUND: Chronic suppurative otitis media (CSOM) is a substantial global problem. Current treatment options often induce a temporary remission without leading to a permanent cessation of symptoms secondary to the treatments’ inability to eliminate persister cells. Povidone-iodine has been shown to be able to clear biofilm and planktonic cells in in vitro assays, but there are reports of ototoxic effects limiting its clinical utility. METHODS: Bacterial and biofilm growth with quantification by spectrophotomer, murine auditory brainstem response (ABR), and distortion product otoacoustic emissions, immunohistochemistry, in vivo povidone-iodine treatment of murine CSOM, persister cell assay. RESULTS: Commercially available 10% povidone-iodine solution is able to completely eradicate multiple clinical strains of Pseudomonas aeruginosa and Staphylococcus aureus in vitro with 10 minutes of exposure. Mice that have received a transtympanic injection of 1% povidone-iodine solution did not have significantly different auditory brainstem response or distortion product otoacoustic emission results compared with the control. Mice that received a povidone-iodine scrub or 10% povidone-iodine solution had significantly worsened hearing (25- and 13-dB increase in threshold, respectively; p < 0.05). In vivo CSOM infection recurred in all mice after the completion of treatment with 10% povidone-iodine solution, and there was no improvement in the bacterial load after treatment, indicating in vivo failure of therapy. CONCLUSION: Povidone-iodine solution is effective at eliminating biofilm and persister cells in vitro at in vivo achievable concentrations but fails in vivo most likely because of kinetics of distribution in vivo. Even if drug distribution could be improved, the therapeutic window is likely to be too small given that the diluted solution does not have ototoxic potential, whereas while the scrub variant, which contains detergents, and the undiluted solution are ototoxic after a single treatment.
- Published
- 2022
25. Mastoidobliterációhoz használt csontpor és bioaktív üveggranulátum a cholesteatoma sebészetében
- Author
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Imre, Gerlinger, Éva, Szabó, István, Szanyi, Tamás, Rostás, István, Pap, Péter, Révész, and Eszter, Kopjár
- Subjects
Bone Transplantation ,Cholesteatoma, Middle Ear ,Dust ,General Medicine ,Otitis Media, Suppurative ,Bone and Bones ,Mastoid ,Treatment Outcome ,Bone Substitutes ,Quality of Life ,Humans ,Glass ,Prospective Studies ,Otologic Surgical Procedures - Abstract
Mastoid obliteration technique combines the advantages of canal wall-up (CWU) and canal wall-down (CWD) approaches in the surgery of chronic suppurative otitis media with cholesteatoma. We aim to demonstrate our experience with mastoid obliteration technique using bone dust and BonAlive® (S53P4) bioactive glass granule in a comparative prospective clinical study.Between 1st of March 2012 and 31st of November 2021, mastoid obliteration surgery was performed in 14 patients using bone dust (7 cases) and BonAlive® granule (7 cases). Prior to these interventions, the patients had undergone more than three ear surgeries (CWU and CWD) generally in both groups. Changes of complaints, audiological results, and changes in quality of life were analysed in both groups, postoperatively.Having performed the mastoid obliteration technique, cochlear damage did not occur in either patient group. Long-term ear discharge and vertigo were occasionally observed after performing obliteration with bone dust. However, these complaints disappeared after a while. Complications were not reported in the case of obliteration with BonAlive®. Outstanding improvement was experienced in both groups.In our practice, mastoid obliteration surgery, using either bone dust or BonAlive® granule, has proved to be a safe and effective method in the management of chronic suppurative otitis media with cholesteatoma, resulting in continuous putrid ear discharge after CWU or CWD tympanoplasty. Obliteration with BonAlive® granule provides several advantages for patients, such as antibacterial effect, osteoconductive effect ensuring frame for bone growth and osteoproductive effect stimulating the ossification. Orv Hetil. 2022; 163(21): 838-845.Bevezetés és célkitűzés: Az otitis media suppurativa chronica cholesteatomatosa sebészetében a mastoidobliterációval végzett megoldás egyesíti a nyitott és a zárt technikával végzett műtétek előnyeit. Összehasonlító prospektív klinikai tanulmányunkban a csontporral és a BonAlive® (S53P4) bioaktív üveggranulátummal végzett mastoidobliterációs műtéteinkkel szerzett tapasztalatainkat összegeztük. Beteganyag és módszerek: 2012. március 1. és 2021. november 31. között 14 felnőtt betegünknél végeztünk mastoidobliterációs műtétet csontporral (7 beteg), illetve BonAlive® granulátummal (7 beteg). A mastoidobliterációt megelőzően a betegek mindkét csoportban átlagosan több mint 3 fülműtéten (nyitott vagy zárt technikájú tympanoplastica) estek át. A műtéteket követően mindkét csoportban elemeztük a panaszok változását, az audiológiai eredmények alakulását és a betegek életminőségében bekövetkezett változásokat. Eredmények: A mastoidobliterációs műtéti megoldás egyik betegcsoportban sem okozott cochlearis károsodást. A csontporral történt obliterációt követően gyakrabban tapasztaltunk elhúzódó fülváladékozást és esetenként szédülést, mely panaszok idővel megszűntek. A BonAlive® granulátummal obliterált esetekben komplikációt nem észleltünk. Mindkét betegcsoportban igen jelentős életminőség-javulást figyeltünk meg. Következtetés: A mastoidobliterációs műtétek – akár csontporral, akár BonAlive® granulátummal végezve – gyakorlatunkban biztonságos és hatásos megoldásnak bizonyultak korábban otitis media suppurativa chronica cholesteatomatosa miatt akár nyitott, akár zárt technikával végzett, állandó bűzös fülváladékozással járó esetekben. A BonAlive® granulátummal végzett obliterációk számos előnnyel járnak a betegek számára: az üveggranulátum antibakteriális hatású, oszteokonduktív hatású (keretet biztosít a csont növekedéséhez), és oszteoproduktív hatást is kivált (stimulálja a csontosodást). Orv Hetil. 2022; 163(21): 838–845.
- Published
- 2022
26. Comparative study of cholesteatoma in paediatric and adult patients
- Author
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M Kalia, A Dass, S K Singhal, and N Gupta
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Adult ,Otitis Media ,Cholesteatoma, Middle Ear ,Otorhinolaryngology ,Mastoidectomy ,Chronic Disease ,Humans ,General Medicine ,Child ,Cholesteatoma ,Otitis Media, Suppurative ,Mastoid ,Retrospective Studies - Abstract
BackgroundThe aggressiveness of paediatric cholesteatoma has long been a matter of debate. While much of the evidence is substantiated by data from the Western world, it is further limited by the retrospective nature of most studies. Therefore, this paper presents a comparative analysis of various characteristics of cholesteatoma between paediatric and adult populations seen at our centre.MethodsA total of 50 patients (25 adults and 25 paediatric) with clinical diagnosis of chronic suppurative otitis media with cholesteatoma underwent canal wall down mastoidectomy over a period of two years. The intra-operative findings were noted and patients were followed up for six months.ResultsThere was more extensive spread and ossicular erosion in paediatric cases. However, complications such as facial canal dehiscence and lateral semicircular canal dehiscence were more common in adults.ConclusionPaediatric cholesteatoma is more aggressive and invasive than adult cholesteatoma, and the clinical behaviour is consistent with findings from other parts of the world.
- Published
- 2022
27. Amoxicillin-clavulanate in Treating Acute Otitis Media Evaluated by Daily Tympanometry
- Author
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Terhi Tapiainen, M.D., Ph.D.
- Published
- 2012
28. Effect of eardrum perforation and chronic otitis media on the results of infrared tympanic thermometer in adults: A systematic review and meta-analysis.
- Author
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Kim YH, Park HJ, and Yoo JH
- Subjects
- Adult, Humans, Thermometers, Tympanic Membrane, Chronic Disease, Tympanic Membrane Perforation diagnosis, Otitis Media, Suppurative, Otitis Media diagnosis, Cholesteatoma
- Abstract
Background: This study was conducted to determine whether tympanic membrane perforation or chronic otitis media affects the results of an infrared tympanic membrane thermometer in adults., Methods: A literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar., Results: Four nonrandomized studies were included in the analysis. The temperatures of the bilateral eardrums (one eardrum with normal condition [control group] and the other eardrum with perforation or chronic otitis media [experimental group]) were measured for the same subject in the studies. The mean and standard deviation of the bilateral tympanic membrane temperatures were used to calculate the mean difference (MD) with a corresponding 95% confidence interval (CI). The fixed-effect model was utilized based on the results of the heterogeneity measurement using the Chi2 test and I2 statistic. The results of a meta-analysis in the normal eardrum (control group) and perforated eardrum, chronic suppurative otitis media with tympanic membrane perforation, or chronic otitis media with cholesteatoma (experimental group) were 343 subjects (MD = 0.05; 95% CI = -0.00 to 0.11; P = .06). A meta-analysis of the normal eardrum (control group) and perforated eardrum or chronic suppurative otitis media with tympanic membrane perforation except for cholesteatoma (experimental group) found 296 subjects (MD = 0.05; 95% CI = -0.01 to 0.11; P = .10)., Conclusion: When the temperatures of the bilateral eardrums were measured using an infrared tympanic membrane thermometer, no difference was observed between the eardrum with perforation or chronic otitis media and the normal eardrum., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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29. TELI COM - Telithromycin in Children With Otitis Media
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ICD Study Director
- Published
- 2009
30. Surgical treatment of chronic ear disease in remote or resource-constrained environments.
- Author
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Smith, M C F, Huins, C, and Bhutta, M
- Subjects
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EAR diseases , *EAR surgery , *MASTOIDECTOMY , *OTITIS media , *TYMPANOPLASTY , *SURGICAL equipment , *MIDDLE-income countries , *LOW-income countries - Abstract
Background: Surgery for chronic suppurative otitis media performed in low- and middle-income countries creates specific challenges. This paper describes the equipment and a variety of techniques that we find best suited to these conditions. These have been used over many years in remote areas of Nepal. Results and conclusion: Extensive chronic suppurative otitis media is frequently encountered, with limited pre-operative investigation or treatment possible. Techniques learnt in better-resourced settings with good follow up need to be modified. The paper describes surgical methods suitable for resource-poor conditions, with rationales. These include methods of tympanoplasty for subtotal wet perforations, hearing reconstruction in wet ears and open cavities, large aural polyps, and canal wall down mastoidectomy with cavity obliteration. Various types of autologous ossiculoplasty are described in detail for use in the absence of prostheses. The following topics are discussed: decision-making for surgery on wet or best hearing ears, children, bilateral surgery, working with local anaesthesia, and obtaining adequate consent in this environment. [ABSTRACT FROM AUTHOR]
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- 2019
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31. Studying the result of underlay myringoplasty using platelet-rich plasma.
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Yadav, S P S, Malik, J S, Malik, P, Sehgal, P K, Gulia, J S, and Ranga, R K
- Subjects
- *
AUTOGRAFTS , *COST effectiveness , *HEARING levels , *PATIENT aftercare , *MEDICAL care costs , *TYMPANOPLASTY , *STATISTICAL significance , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *TYMPANIC membrane perforation , *PLATELET-rich plasma - Abstract
Objective: Perforations of the tympanic membrane are treated with various surgical techniques and materials. This study aimed to determine the efficacy of platelet-rich plasma during underlay myringoplasty. Methods: The study included 40 patients. Autologous platelet-rich plasma was applied in-between temporalis fascia graft and tympanic membrane remnant during underlay myringoplasty in group 1 (n = 20). The outcome was evaluated after three months and compared with group 2 (n = 20), a control group that underwent routine underlay tympanoplasty. Results: After three months' follow up, graft uptake was 95 per cent in group 1 and 85 per cent in group 2 (p < 0.03). Mean hearing threshold gain was 18.62 dB in group 1 and 13.15 dB in group 2. This difference was statistically significant (p < 0.01). Conclusion: Platelet-rich plasma, with its ease of preparation technique, availability, low cost, autologous nature and good graft uptake rate, justifies its use in tympanoplasty type I procedures. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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32. Hearing loss in the trenches – a hidden morbidity of World War I.
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Conroy, K and Malik, V
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- *
NOISE-induced deafness , *DISEASES , *MALINGERING , *NOISE , *OTOLARYNGOLOGISTS , *MILITARY personnel , *WAR , *WEAPONS , *WOUNDS & injuries - Abstract
Background: One hundred years ago, millions of British and Allied troops were fighting in the trenches of the Great War. With a tenth of soldiers losing their lives, hearing loss seemed a low priority; however, vast numbers of troops sustained significant hearing loss. Method: A review was conducted of literature published between 1914 and 1925. Results: Soldiers were exposed to up to 185 dB of sustained noise from new, high-energy weapons, which caused 'labyrinthine concussion'. Traumatic injuries, non-organic hearing loss and malingering were also common. One source estimated that 2.4 per cent of the army was disabled by hearing loss. However, many British doctors viewed this 'soldier's deafness' as a temporary affliction, resulting in soldiers being labelled as malingerers or 'hysterical'. Conclusion: Today, one can recognise that a scant evidence base and misconceptions influenced the mismanagement of hearing loss by otolaryngologists in World War I. However, noise-induced hearing loss is still very much a feature of armed conflict. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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33. A Clinical Study on the Influence of Sinusitis in Chronic Suppurative Otitis Media
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Sellappampatty Veerappapillai Dhanasekaran, Jiji Sanjeevan Nair, Komathi Raja, Govind Krishnan Gopalakrishnapillai, Abhilash Kuniyath Chandran, and Shankar Radhakrishnan
- Subjects
Otitis Media, Suppurative ,Otitis Media with Effusion ,Paranasal Sinuses ,Maxillary Sinusitis ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction Diseases of the nose and paranasal sinuses are known to influence the middle ear conditions. In the evaluation of the patients with chronic otitis media, radiological, endoscopic, and other auxiliary diagnostic tools may have their roles in the objective assessment of the patients, and to rule out lesions of the nasal cavity and the nasopharynx as potential aetiological factors. Materials and method This cross sectional observational study was conducted for a period of two years to establish the role of sinusitis as focus of sepsis in patients with tubotympanic type of CSOM. All patients in the age group of 20-40 years with more than 2 months of ear discharge and with a hearing loss of 25- 40 db and diagnosed as tubotympanic type of CSOM were included in our study. Patients who had features of mastoiditis on X-ray and also with persistent ear discharge even after treatment with oral and topical antibiotics were subjected (n=70) to diagnostic nasal endoscopy and computed tomography of paranasal sinuses. Result Among the 100 patients of CSOM, 70% had features suggestive of sinusitis. Deviated nasal septum (40%) was the most common pathology among the study population. Majority (54%) of them had mucopurulent type of ear discharge. The CT findings of the paranasal sinuses revealed that 48.5% of the study population had grade I type of involvement of the PNS. 54.2% of the patients had a large central perforation and the middle ear mucosa was found to be edematous for 65.7% of the patients. Discussion Coexistence of deviated nasal septum and chronic rhinosinusitis with discharging CSOM is at par with several other studies conducted in other parts of the world. Conclusion Deviated nasal septum, enlarged middle turbinate, medialised uncinate associated with sinusitis are the predisposing factors in the development of CSOM. So assessment for sinusitis in the treatment of CSOM should become a routine practice.
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- 2016
34. Acetic Acid Instillation after Canal Wall Down Mastoidectomy
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Hamsa Shetty and Gangadhara K S
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Otitis Media, Suppurative ,Acetic Acid ,Mastoid. ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction: Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice. Materials and Methods In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy. 40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for 8 weeks and were followed up every week. 10 patients of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks. Results: In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients. Conclusion: Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue.
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- 2015
35. Long‐Term Health Utilization and Outcomes in Chronic Suppurative Otitis Media
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Peter L. Santa Maria, Anthony Thai, Adam C Kaufman, and Ksenia A Aaron
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Male ,Pediatrics ,medicine.medical_specialty ,business.industry ,Hearing Loss, Sensorineural ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Middle Aged ,Tympanoplasty ,medicine.disease ,Otitis Media, Suppurative ,Otorhinolaryngology ,Chronic Disease ,medicine ,Humans ,Female ,Persistent Infection ,Surgery ,Sensorineural hearing loss ,Tympanomastoidectomy ,In patient ,business ,Retrospective Studies - Abstract
To report health utilization patterns and outcomes of medical and surgical management in patients with chronic suppurative otitis media (CSOM).Retrospective cohort.Academic otology clinic.This study included 175 patients with CSOM with a first clinic visit at our institution between March 2011 and November 2016. All patients displayed a diagnosis of CSOM byPatients had an average of 9.5 ± 0.5 otology visits, 4.7 ± 0.4 prescriptions, and 1.7 ± 0.1 surgeries, with estimated per patient cost ranging from $3927 to $20,776. Under medical management, 69% of patients displayed recurrence of disease, with a median time to recurrence of 4 months. For tympanoplasty and tympanomastoidectomy, median time to recurrence was similar at 5 and 7 years, respectively (CSOM represents a major public health issue with high health care utilization and associated costs. Surgery is superior to medical therapy for achieving short- to medium-term inactive disease. Patients with CSOM display a high SNHL burden.
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- 2021
36. Gustatory Function of Patients With and Without Cholesteatoma Undergoing Middle Ear Surgery.
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Neumann AS, Soyka MB, Rushing EJ, and Röösli C
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- Humans, Taste Perception, Prospective Studies, Ear, Middle surgery, Taste Disorders diagnosis, Taste Disorders etiology, Dysgeusia etiology, Chorda Tympani Nerve physiology, Chorda Tympani Nerve surgery, Cholesteatoma, Middle Ear complications, Cholesteatoma, Middle Ear surgery, Otitis Media surgery, Otitis Media, Suppurative
- Abstract
Objective: To compare measured and perceived taste function before and after surgery of patients with chronic otitis media with cholesteatoma (OMCC) to patients without cholesteatoma (patients with chronic suppurative otitis media [CSOM] and patients with lateral skull base lesions [LSB])., Methods: This prospective cohort study included 29 patients undergoing surgery for unilateral OMCC. The chorda tympani nerve (CTN) was resected in 8 of these patients. Fourteen patients undergoing surgery for unilateral CSOM and 5 patients undergoing surgery for unilateral LSB (with CTN resection) served as the comparison group. Taste function was measured using taste strips on both sides of the tongue before surgery, 2 weeks postoperatively and 3 months postoperatively. The affected side of the tongue was compared to the unaffected side. A questionnaire on taste perception was completed at each visit., Results: Preoperatively, cholesteatoma patients showed higher taste strip scores than non-cholesteatoma patients, indicating a larger difference between the healthy and affected sides of the tongue. Despite this difference in measured taste function few cholesteatoma patients reported taste alteration before surgery (3/29 [10.3%]). Postoperatively, patients with CTN resection (OMCC patients with CTN resection and LSB patients) showed a decreased measured taste function. Subjectively, only approximately 20% of these patients reported taste alteration 3 months postoperatively., Conclusions: Before surgery, cholesteatoma patients displayed an impaired measured taste function compared to patients without cholesteatoma (CSOM, LSB). Subjectively this was often unnoticed. After surgery, despite removal of the CTN and consequent reduction of measured taste function, few patients reported taste alteration and subjective taste perception was seen to be improving. In regards to middle ear surgery, perceived taste function does not seem to reflect measured gustatory function.
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- 2023
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37. Chronic suppurative otitis media and immunocompromised status in paediatric patients
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R D, Restuti, A A, Sriyana, H, Priyono, R R, Saleh-Saleh, T J, Airlangga, S, Zizlavsky, R, Suwento, and F H, Yasin
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Immunocompromised Host ,Cross-Sectional Studies ,Adolescent ,Child, Preschool ,Chronic Disease ,Infant, Newborn ,Humans ,Infant ,HIV Infections ,Persistent Infection ,Child ,Otitis Media, Suppurative - Abstract
The role of immunodeficiency in the development of chronic suppurative otitis media (CSOM), especially in paediatric populations, have yet to be fully elucidated. The purposesof this study is to investigate the association between immunocompromised status and CSOM among paediatric population in a tertiary hospital in Indonesia.A cross-sectional study was performed by retrieving medical records of paediatric patients, with and without CSOM (age 0-18 years), visiting otorhinolaryngology (ENT-HNS) outpatient clinic in a tertiary hospital in Indonesia (2018-2020). We collected data on comorbidities causing immunosuppression such as HIV status, tuberculosis, and cancer.Among the 1018 included patients (50 immunocompromised children), HIV infection was the most common cause of immunodeficiency in the CSOM group (24 patients, 60%), and cancer in the non-CSOM group (10 patients, 100%). We found a significant association between immunocompromised hosts and CSOM (odds ratio 19.5 [95% confidence interval: 9.5-39.9], p0.001).Immunocompromised children with HIV, tuberculosis, or cancer may be more vulnerable to CSOM. Further research is required to explore the association between other immunocompromised conditions and CSOM in paediatric populations.
- Published
- 2022
38. Chronic suppurative otitis media causes macrophage-associated sensorineural hearing loss
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Anping, Xia, Anthony, Thai, Zhixin, Cao, Xiaohua, Chen, Jing, Chen, Brian, Bacacao, Laurent A, Bekale, Viktoria, Schiel, Paul L, Bollyky, and Peter L Santa, Maria
- Subjects
Mice ,Cellular and Molecular Neuroscience ,Neurology ,Hearing Loss, Sensorineural ,Macrophages ,General Neuroscience ,Chronic Disease ,Immunology ,Animals ,Humans ,Child ,Otitis Media, Suppurative - Abstract
Background Chronic suppurative otitis media (CSOM) is the most common cause of permanent hearing loss in children in the developing world. A large component of the permanent hearing loss is sensory in nature and our understanding of the mechanism of this has so far been limited to post-mortem human specimens or acute infection models that are not representative of human CSOM. In this report, we assess cochlear injury in a validated Pseudomonas aeruginosa (PA) CSOM mouse model. Methods We generated persisters (PCs) and inoculated them into the mouse middle ear cavity. We tracked infection with IVIS and detected PA using RT-PCR. We assessed cochlear damage and innate immunity by Immunohistochemistry. Finally, we evaluated cytokines with multiplex assay and quantitative real-time PCR. Results We observed outer hair cell (OHC) loss predominantly in the basal turn of the cochlear at 14 days after bacterial inoculation. Macrophages, not neutrophils are the major immune cells in the cochlea in CSOM displaying increased numbers and a distribution correlated with the observed cochlear injury. The progression of the morphological changes suggests a transition from monocytes into tissue macrophages following infection. We also show that PA do not enter the cochlea and live bacteria are required for cochlear injury. We characterized cytokine activity in the CSOM cochlea. Conclusions Taken together, this data shows a critical role for macrophages in CSOM-mediated sensorineural hearing loss (SNHL).
- Published
- 2022
39. Erosion of the long process of the incus with incomplete ossicular discontinuity in simple chronic otitis media: Should we reconstruct or leave it be?
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Sarmento, Jr, K. M. A., de Oliveira, C. A. C. P., Sampaio, A. L. L., and Sales, A. F.
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- *
GENETICS , *ACUTE otitis media , *PATIENTS , *DIAGNOSIS , *THERAPEUTICS , *DISEASE risk factors - Abstract
Objective: To determine whether patients with simple chronic otitis media and incomplete ossicular discontinuity should undergo ossicular reconstruction. Design: Prospective, randomised surgical trial comparing no intervention with incus interposition over a 5‐year period. Setting: Tertiary referral hospital. Participants: Seventy‐six participants with simple chronic otitis media and erosion of the long process of the incus but apparent good transmission throughout the ossicular chain as tested intra‐operatively. Forty‐four patients had partial erosion of the incus but still bony contact with the stapes head (Group A—Type I), and 32 had mainly connective tissue binding the incus and stapes (Group B—Type II). Each of these groups was randomised to either leaving the ossicular chain as it was (A1 and B1) or performing an incus interposition (A2 and B2). Main outcome measures: Average postoperative air‐bone gap and the degree of ABG closure. A postoperative air‐bone gap under 20 dB was considered a successful result. Results: In group A, there was no significant difference between no intervention and incus interposition. In group B, patients in the no reconstruction subgroup had a significantly worse hearing result than the incus interposition subgroup (postoperative air‐bone gap of 27.5 dB and 31% closure within 20 dB vs 15 dB and 75% closure). Conclusions: For Type I patients, the postoperative hearing results were similar for the reconstruction and no reconstruction groups. For Type II patients, the results clearly favour reconstruction. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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40. Modified Radical Mastoidectomy: Open Mastoid Cavity versus Cavity Obliteration Using Periosteal Temporofascial Flap - A Comparative Study
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R, Vignesh Kumar, Bhardwaj, Rohit, Uddin, Shams, Dutta Borah, Smrity Rupa, Bhattacharjee, Abhinandan, Nath, Kripamoy, Das, Manas Pratim, R, Vignesh Kumar, Bhardwaj, Rohit, Uddin, Shams, Dutta Borah, Smrity Rupa, Bhattacharjee, Abhinandan, Nath, Kripamoy, and Das, Manas Pratim
- Abstract
Introduction The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity. Material and Methods In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at 3rd week, 6th week, 3rd month and 6th month. Results Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up. Conclusion Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care.
- Published
- 2022
41. [A case of hearing preservation during surgical treatment of distributed fistula labyrinth in a patient with chronic purulent means otitis and cholesteatoma]
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A.I. Kryukov, E.V. Garov, L.A. Moseikina, G.V. Kurilenkov, M.A. Chugunova, M.A. Pryakhina, and V.A. Saydulaev
- Subjects
Otorhinolaryngology ,Cholesteatoma, Middle Ear ,Fistula ,Hearing ,Vestibular Diseases ,Labyrinth Diseases ,Humans ,Otitis Media, Suppurative ,Semicircular Canals ,Retrospective Studies - Abstract
The article provides a brief overview of the epidemiology, diagnosis, clinical manifestations and surgical methods of treatment of labyrinthine fistulas (LF) in patients with chronic suppurative otitis media (CSOM) with cholesteatoma. The efficacy of various LF treatment techniques, their complications, and the principles of prevention of cochleovestibular disorders during surgical treatment are described. The prognostic criteria for the deterioration of bone conduction thresholds during LF surgery, which include a large LF size, the opening of the membranous labyrinth, and the extent of damage to the structures of the inner ear, are presented. A clinical case of surgical treatment of widespread LF in CSOM with cholesteatoma is presented, which proves the possibility of preserving the auditory and vestibular functions while observing the stages of sanitation, manipulations on the LF and obliteration of semicircular canals defects with auto tissues. Combined surgery of such a plan must certainly be accompanied by local instillation of solutions of hormonal preparations in case of a deficiency of perilymphatic fluid in the labyrinth and postoperative antibacterial and hormonal therapy.В статье представлен краткий обзор эпидемиологии, диагностики, клинических проявлений и хирургических методов лечения фистул лабиринта (ФЛ) у больных с хроническим гнойным средним отитом (ХГСО) и холестеатомой. Описана эффективность различных методик обработки ФЛ, рассмотрены их осложнения, принципы профилактики кохлеовестибулярных расстройств. Приведены прогностические критерии ухудшения порогов костной проводимости при хирургическом вмешательстве, к которым относятся большой размер ФЛ, открытие перепончатого лабиринта и протяженность поражения структур внутреннего уха. Представлен клинический случай хирургического лечения распространенной ФЛ при ХГСО с холестеатомой, который доказывает возможность сохранения слуховой и вестибулярной функций при соблюдении этапности санации, манипуляций на ФЛ и облитерации аутотканями дефектов полукружного канала. Комбинированное хирургическое вмешательство такого плана непременно должно сопровождаться местной инстилляцией растворов гормональных препаратов при дефиците перилимфатической жидкости в лабиринте и послеоперационной антибактериальной и гормональной терапией.
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- 2022
42. Tuberculosis of the middle ear: A systematic review
- Author
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Kavya K. Pai, Ariel O. Omiunu, Dhiraj K. Peddu, Vivienne H. Au, Soly Baredes, Robert W. Jyung, Jean Anderson Eloy, and Christina H. Fang
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Male ,Otitis Media ,Otorhinolaryngology ,Tympanic Membrane Perforation ,Ear, Middle ,Humans ,Tuberculosis ,Female ,Otitis Media, Suppurative - Abstract
Tuberculous otitis media (TOM) is a rare extrapulmonary manifestation of tuberculosis (TB) and remains challenging to diagnose due to non-specific symptoms. This systematic review identifies clinical characteristics, diagnostic evaluation, and outcomes in cases of TOM.A comprehensive literature search utilizing the PubMed, CINAHL, Scopus, and Cochrane Library databases was conducted for relevant articles published between 2000 and 2021. Cases involving adult patients with TOM were included. Non-English studies, animal studies, and reviews were excluded.41 case reports and 7 case series were included, comprising data from 67 patients. The mean age was 40 years (range, 19-87 years) and the majority were female (n = 46, 68.7 %). The mean symptom duration was 12.8 months (range, 0.25-120 months). Common symptoms included otorrhea (n = 60, 89.6 %), HL (n = 58, 86.6 %), otalgia (n = 19, 28.4 %), and FP (n = 18, 26.9 %). Otoscopy revealed tympanic membrane (TM) perforation in 45 patients (67.2 %). Most patients were diagnosed with tissue biopsy (n = 53, 79.1 %). Surgical interventions were performed in 48 patients (71.6 %) and 63 patients (94.0 %) were prescribed anti-TB chemotherapy. Long-term sequelae (e.g., HL, FP, and TM perforation) were noted in 39 patients (58.2 %) at a mean follow-up of 18.8 months (range, 1-120 months).TOM should be included in the differential diagnosis of chronic suppurative otitis media. Histopathological examination is a reliable diagnostic method. Early detection and management are recommended for optimizing outcomes.3b.
- Published
- 2022
43. 宽频声导抗在中耳胆脂瘤与慢性化脓性中耳炎鉴别诊断中的价值
- Subjects
Adult ,Diagnosis, Differential ,论著—研究报告 ,Acoustic Impedance Tests ,Cholesteatoma, Middle Ear ,Humans ,Persistent Infection ,Acoustics ,Otitis Media, Suppurative - Abstract
OBJECTIVE: Through analysis of the sound energy absorbance of wideband acoustic immittance to provide a basis for differential diagnosis of adult acquired secondary cholesteatoma of the middle ear and patients with chronic suppurative otitis media(CSOM). METHODS: 38 cases of cholesteatoma and 40 cases of CSOM admitted to the Department of Otolaryngology, Affiliated Hospital of Xuzhou Medical University from September 2020 to December 2021 were selected as the research group, and 30 cases (60 ears) of normal adults were selected as the control group. A total of 16 frequency points were selected, and the energy absorbance of wideband acoustic immittance was taken as the research parameter. The characteristics of energy absorbance under ambient pressure among the three are compared. Then the ROC in the cholesteatoma group was drawn, and by calculating the AUC, the Cut-off values and the corresponding sensitivity and specificity were found. RESULTS: The energy absorbance in CSOM group at 1100-5700 Hz and the cholesteatoma group at 560-5700 Hz was lower than that in the control group, and the difference in some frequency bands was statistically significant. The energy absorbance in the cholesteatoma group at 226-7100 Hz was lower than that in the CSOM group, and the difference between the two groups in many frequency points was statistically significant. The ROC in the research group was drawn and it was found that the AUC in the 560, 710, 890, and 4500 bands was > 0.5, and in the other bands was > 0.7(P < 0.05). The AUC in the 2800 Hz was the largest (0.78), the Cut-off value was 0.31, the corresponding sensitivity was 78.38%, specificity was 73.33%. CONCLUSION: Wideband acoustic immittance can be used as an auxiliary method for the differential diagnosis of adult-acquired secondary cholesteatoma of the middle ear and chronic suppurative otitis media in adults.
- Published
- 2022
44. Granulation Tissue mimicking a Glomus Tumor in a Patient with Chronic Middle Ear Infection
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Kimberly Mae C. Ong, Patrick John P. Labra, Rosario R. Ricalde, Criston Van C. Manasan, and Jose M. Carnate
- Subjects
tinnitus, pulsatile ,otitis media, suppurative ,glomus tympanicum ,Otorhinolaryngology ,RF1-547 - Abstract
Objective: To present an unusual cause of pulsatile tinnitus, presenting in a young adult suffering from chronic recurrent foul-smelling discharge from the same ear. Methods: Study Design: Case report Setting: Tertiary National University Hospital Patient: One Results: A 24-year old woman presented with pulsatile tinnitus on a background of chronic recurrent foul-smelling discharge. Clinico-radiologic findings seemed consistent with a glomus tympanicum coexisting with chronic suppurative otitis media with cholesteatoma. She underwent tympanomastoidectomy with excision of the mass. Histopathologic evaluation revealed the mass to be granulation tissue. Conclusion: Pulsatile tinnitus is rarely associated with chronic middle ear infection. Granulation tissue arising at the promontory may mimic glomus tumors when accompanied with this symptom. Despite this revelation, it would still be prudent to prepare for a possible glomus tumor intraoperatively, so that profuse bleeding and complications may be avoided. Keywords: tinnitus, pulsatile; otitis media, suppurative; glomus tympanicum
- Published
- 2016
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45. Outcomes of tympanoplasty in a low resource setting: Our experience in 429 ears in Cambodia
- Author
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Touch Sokdavy, Mahmood F. Bhutta, Carolina Watters, Chris Waterworth, Kelley Graydon, and Patrick Bowers
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Low resource ,medicine.medical_treatment ,Chronic Suppurative Otitis Media ,Otitis Media, Suppurative ,03 medical and health sciences ,Myringoplasty ,Tympanoplasty ,0302 clinical medicine ,Disease severity ,Outcome Assessment, Health Care ,Humans ,Medicine ,Child ,030223 otorhinolaryngology ,Anecdotal evidence ,business.industry ,Middle Aged ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Family medicine ,Chronic Disease ,Female ,Cambodia ,business - Abstract
Tympanoplasty outcomes are well established in high income nations, but less reported in low-middle income countries (LMICs). LMICs see a higher prevalence of chronic suppurative otitis media, with anecdotal evidence of greater disease severity at presentation. Here we find that tympanoplasty performed by local surgeons in the LMIC of Cambodia has 85.8% successful closure, which is comparable to other settings. For audiological outcomes, there was a mean reduction in the air-bone gap of 15.8dB, and improvement in the air-conduction average in 85.5% of participants. We find no evidence that tympanoplasty outcomes in LMICs should differ from those in other settings.
- Published
- 2021
46. Foudroyant middle-ear pneumococcal inflammation with meningoencephalitis in a six-year-old girl
- Author
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Snezana Rsovac, Nenad Relić, Ljiljana Cvorovic, and Nenad Arsovic
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Pediatrics ,medicine.medical_specialty ,Medicine (General) ,business.industry ,media_common.quotation_subject ,Meningoencephalitis ,otitis media, suppurative ,meningoencephalitis ,Inflammation ,medicine.disease ,antibiotics ,3. Good health ,medicine.anatomical_structure ,R5-920 ,Middle ear ,medicine ,Pharmacology (medical) ,Girl ,medicine.symptom ,business ,hydrocephalus ,surgery, operative ,media_common - Abstract
Introduction. Intracranial complications of otitis media still occur, despite great progress in the treatment of all forms of inflammation. These are serious conditions which are still life-threatening and require a fast and accurate diagnosis and an adequate treatment. We present an illustrative case of an acute, foudroyant, pneumococcal, suppurative otitis media with infection spreading into endocranium and development of meningoencephalitis and otic hydrocephalus. Case report. A 6-year-old girl was admitted to the University Children's Clinic because of fever, headache, vomiting and disorder of consciousness. Computed tomography scan of the endocranium and temporal bone has revealed brain edema and hypodense content in the left mastoid and timpanic cavity. The diagnosis of acute otitis media with meningoencephalitis was made and we started with intensive antibiotic treatment. Lumbar puncture and haemoculture were confirmed a pneumococcal infection. Otosurgical treatment was conducted too due to an inadequate reaction to conservative treatment. Firstly, left mastoidectomy with the implantation of ventilation tube has been performed, followed by radical tympanomastoidectomy because there was no improvement. Three weeks after the second operation, a magnetic resonance imaging of the endocranium was performed and an otic hydrocephalus was diagnosed. A neurosurgical operation was performed on the same day with the setting of the ventriculo-peritoneal shunt. Conclusion. Intracranial complications of acute otitis media in children are extremely rare and they require multidisciplinary treatment. Surgical treatment of the ear shouldn't be postponed and the choice of the type of otosurgical intervention should be individually adapted. Audiological and neurological complications of the disease are frequent and they further prolong and impair the treatment.
- Published
- 2021
47. Middle east tuberculosis in an immunocompromised patient: Case report and review of the literature
- Author
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Marko Velepic, Tamara Braut, Jelena Vukelić, Zana Dvojkovic, and Ivana Skrobonja
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Tuberculosis ,medicine.medical_treatment ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Otorhinolaryngology ,030106 microbiology ,Suppurative otitis media ,Disease ,Liver transplantation ,Otitis Media, Suppurative ,lcsh:Infectious and parasitic diseases ,Mycobacterium tuberculosis ,03 medical and health sciences ,Middle East ,0302 clinical medicine ,Tympanoplasty ,Immunocompromised patient ,Medicine ,Humans ,Immunocompromised patient Liver transplant Mycobacterium tuberculosis Suppurative otitis media Tympanoplasty ,lcsh:RC109-216 ,030212 general & internal medicine ,Liver transplant ,biology ,business.industry ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Otorinolaringologija ,lcsh:RA1-1270 ,General Medicine ,Achromobacter xylosoxidans ,Middle Aged ,biology.organism_classification ,medicine.disease ,Dermatology ,Otitis Media ,Infectious Diseases ,medicine.anatomical_structure ,Middle ear ,Coinfection ,Female ,Differential diagnosis ,business - Abstract
Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis. In 15–20% cases of active disease extrapulmonary tuberculosis may occur, most commonly in the head and neck region. Tuberculous otitis media accounts for 0,1% of the total number of tuberculosis patients. This paper provides insight into current state of literature of tuberculous otitis media. It also includes the case of a 53-year-old patient with tuberculous otitis media. The patient had a liver transplantation and she showed an atypical manifestation of the disease including acute otitis media and coinfection with Achromobacter xylosoxidans. The paper describes in detail the methods of diagnosis and the infection treatment. Considering the polymorphic clinical presentation of tuberculous otitis media in cases with long lasting otorrhoea differential diagnosis should include an infection with Mycobacerium tuberculosis.
- Published
- 2021
48. The effect of N-acetyl cysteine on biofilm layers in an experimental model of chronic otitis media
- Author
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Tuba Müderris, Tolga Oguzhan, Arzu Tuzuner, Mehmet Hakan Korkmaz, Elif Ersoy Callioglu, Muzaffer Kiris, Gülçin Başdemir, Sami Bercin, Mustafa F. Sargon, and İlkan Tatar
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Acetyl cysteine ,Chronic otitis ,Otology ,Pharmacology ,Otitis Media, Suppurative ,biofilm ,03 medical and health sciences ,0302 clinical medicine ,Dexamethasone Sodium Phosphate ,Fibrosis ,ratto ,medicine ,Animals ,Humans ,rat ,Inner ear ,030223 otorhinolaryngology ,Experimental model ,business.industry ,Biofilm ,Models, Theoretical ,medicine.disease ,chronic otitis ,otite cronica ,N-acetylcysteine ,Acetylcysteine ,Rats ,N-acetilcisteina ,Ciprofloxacin ,Otitis Media ,General Energy ,medicine.anatomical_structure ,Otorhinolaryngology ,Biofilms ,030220 oncology & carcinogenesis ,business ,medicine.drug - Abstract
The aim of this study was to investigate the efficacy of N-acetylcysteine (NAC) on biofilm layers and on the course of disease in chronic otitis media.Twenty-five rats that were induced with chronic otitis media (COM) were separated into three groups. In Group 1 (N = 18), 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate + 0.5 mg/ml NAC solution was locally injected to the right ear of the rats; in Group 2, (N=18) 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate was locally injected to the left ear of the rats. No treatment was applied to either ear of rats in Group 3 (N = 5). Histopathological and scanning electron microscope (SEM) evaluations were performed in all groups.SEM revealed biofilm formation in all COM induced groups. No significant difference was seen between groups 1 and 2 in terms of suppuration levels, fibrosis, inner ear involvement, infection staging and biofilm formation (p0.05).In this study, while histopathological and SEM evaluation revealed no effect of 0.5 mg/ml NAC on the biofilm layer in COM-induced rats, further studies with NAC at different concentrations are still needed on different types of experimental animals.L’effetto della N-acetil cisteina sullo strato di biofilm in un modello sperimentale di otite media cronica.Lo scopo di questo studio è quello di valutare l’efficacia della N-acetilcisteina (NAC) sullo strato di biofilm e sul decorso della malattia nell’otite media cronica.Venticinque ratti con otite media cronica (COM) sono stati divisi in tre gruppi. Nel gruppo 1 (N = 18) sono stati iniettati 0,2% di ciprofloxacina + 0,1% di desametasone sodio fosfato + 0,5 mg / ml di soluzione NAC all’orecchio destro dei ratti; nel gruppo 2 (N = 18) sono stati iniettati localmente 0,2% di ciprofloxacina + 0,1% di desametasone sodio fosfato all’orecchio sinistro dei ratti. Nessun trattamento è stato applicato alle orecchie inoculate dei ratti nel gruppo 3 (N = 5, entrambe le orecchie). Sono state eseguite valutazioni istopatologiche e valutazioni al microscopio elettronico (SEM) mediante scansione.SEM ha documentato la formazione di biofilm in tutti i gruppi indotti con COM. Nessuna differenza statisticamente significativa è stata osservata tra i gruppi 1 e 2 in termini di livelli di suppurazione, fibrosi, coinvolgimento dell’orecchio interno, stadiazione dell’infezione e formazione di biofilm (p0,05).Anche se in questo studio la valutazione istopatologica e SEM non ha rivelato alcun effetto del 0,5 mg/ml NAC sullo strato di biofilm nei ratti indotti dalla COM, per arrivare a una conclusione migliore è necessario eseguire ulteriori studi con di NAC a diverse concentrazioni su differenti tipi di animali da esperimento.
- Published
- 2020
49. [Correlation between acoustic immittance and ETS in eustachian tube function test]
- Author
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Yali, Yang, Shijie, Wang, Shuguang, Han, Shusheng, Gong, Jiao, Liu, Jieqiong, Lu, Shuang, Zhang, and Wei, Wang
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Acoustic Impedance Tests ,Tympanic Membrane Perforation ,论著—临床研究 ,Eustachian Tube ,Ear, Middle ,Humans ,Acoustics ,Otitis Media, Suppurative - Abstract
OBJECTIVE: To investigate the correlation between acoustic immittance and eustachian tube score(ETS) in eustachian tube function test. METHODS: 124 ears eustachian tube function with tympanic tension perforation of 107 patients with chronic suppurative otitis media were measured by acoustic immittance positive pressure balance method and ETS. According to the positive pressure balance test results of acoustic immittance, the ear eustachian tube open pressure between 100 and 200 daPa is assigned 2, the ear with open pressure between 200 and 300 daPa is assigned 3, the ear with open pressure betwween 300 and 400 daPa is assigned 4, the ear open pressure is greater than 400 daPa but eustachian tube open after swallowing is assigned 5, and the ear which eustachian tube open pressure is greater than 400 daPa and cannot open after swallowing is assigned 6. Then compare the results. RESULTS: In the acoustic immittance test, there was no ears whose eustachian tube opening pressure less than 100 daPa, 10 ears(8.1%) open pressure between 100 and 200 daPa, 16 ears(12.9%) open pressure between 200 and 300 daPa, 46 ears(37.1%) open pressure between 300 and 400 daPa, 19 ears(15.3%) whose eustachian tube don't open pressure at 400 daPa but open after swallowing, and the cumulative percentage of the above was 73.4%. There were 33 ears(26.6%) whose eustachian tubes not opening after receiving maximum pressure(400 daPa) and repeated swallowing. The score of acoustic immittance eustachian tube function test was significantly correlated with the scores of ETS, eustachian tube manometry(TMM) and subjective part of ETS(P < 0.05). The result of acoustic immittance was moderately negatively correlated with ETS(r=-0.439) and TMM(r=-0.425), and weakly negatively correlated with subjective part of ETS(r=-0.249). The scores of 2-5 points (the affected ears with open eustachian tube in all acoustic impedance test methods) were defined as the normal group, and the scores of 6 point were defined as the abnormal group. The results of acoustic immittance between the normal group and the abnormal group showed that there were significant differences with the subjective scores of ETS, TMM and ETS. The consistency compared the results of acoustic immittance eustachian tube test with the results of ETS was poor(kappa value was negative), and the difference was statistically significant. CONCLUSION: The open pressure of acoustic immittance positive pressure balance method is a good predictor of the subjective scores of ETS, TMM and ETS. The smaller the open pressure is, the better the subjective scores of ETS, TMM and ETS may be. This two methods results are inconsistent and cannot be replaced. More consideration should be given to the middle ear. The open pressure, equilibrium pressure and the difference between them need to be paid attention to at the same time.
- Published
- 2022
50. A contemporary overview on the enigma of managing recalcitrant or intractable post-operative otorrhoea following middle-ear surgery: perspectives, principles and practices
- Author
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A Kumar Pandey, S Hernot, A ul Haq, C Bansal, M Kaintura, A Bhardwaj, A Varma, F Anjum, and A Kumawat
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Otorhinolaryngology ,otorhinolaryngologic diseases ,Anti-Infective Agents, Local ,Humans ,General Medicine ,Otologic Surgical Procedures ,Otitis Media, Suppurative ,Anti-Bacterial Agents ,Retrospective Studies - Abstract
BackgroundA common problem in otological surgeries is the persistence of ear discharge in a patient who has undergone middle-ear reconstructive surgery, despite an intact graft. There is a dearth of knowledge in the literature on treatment strategies in such post-operative cases of recalcitrant otorrhoea.MethodThis was a retrospective observational descriptive study conducted on 45 patients who fitted the criteria for recalcitrant post-operative otorrhoea. All 45 patients showed no response to conservative treatment for 14 days from onset of discharge. Therefore, these patients were then given antiseptic ear drops.ResultsThirty patients out of 45 showed a good response to antiseptic ear drops and achieved a dry ear at the end of the treatment.ConclusionIn patients with recalcitrant otorrhoea with or without granulations after middle-ear reconstruction surgery, this study found that topical antiseptic ear drops, particularly those using boric acid powder, are more effective than topical antibiotic drops.
- Published
- 2022
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