Search

Purpose: To determine the effect of combining Eustachian tube balloon dilatation with triamcinolone acetonide on inflammatory response and immune function in secretory otitis media patients. Methods: Seventy-six (76) patients diagnosed with acute secretory otitis media in the Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China were randomly assigned to study group (SG) and control group (CG). Patients in CG received 40 mg triamcinolone acetonide injections in the tympanic membrane weekly for 4 weeks, while SG patients were administered Eustachian tube balloon dilatation in addition to triamcinolone acetonide injection. Pre- and posttreatment assessments in the two evaluated groups included the proportion of T lymphocytes, serum inflammatory molecules and Eustachian Tube Score (ETS). Results: The study group exhibited a significantly higher efficacy (92.1 %) than the control group (68.4 %; p < 0.05). In addition, the study group exhibited higher CD8+, CD4+, CD4+/CD8+ ratio and T cells proportion after treatment (p < 0.05). Furthermore, the concentration of serum inflammatory cytokines (PCT, IL-2, IL-4, TNF-α) in SG was significantly lower than that in CG (p < 0.05). Also, the ETS score in CG was lower (3.53 ± 2.40) compared to SG (5.25 ± 2.02) after treatment (p < 0.05). Conclusion: The combination of triamcinolone acetonide and Eustachian tube balloon dilation demonstrates enhanced efficacy in alleviating symptoms, diminishing inflammatory responses and reestablishing immune balance in the treatment of acute secretory otitis media, underscoring its significant promise. Longer follow-up and larger sample size prospective studies are, however, warranted. [ABSTRACT FROM AUTHOR]

Branchiootic syndrome (BOS) is a rare, autosomal dominant syndrome characterized by malformations of the ear associated with hearing loss, second branchial arch anomalies, and the absence of renal anomalies. Herein, we report the case of an 8-year-old male patient with BOS. The proband also experiences mixed conductive and sensorineural hearing loss in the right ear, and severe-toprofound sensorineural hearing loss in the left ear. Preauricular pits, branchial fistulae, and cochlear hypoplasia were present bilaterally. Type III cup-shaped ear, and external auditory canal stenosis were detected in the right ear. Lateral semicircular canal-vestibule dysplasia was detected in the left ear. Moreover, the patient had unilateral secretory otitis media (SOM) in the right ear and bilateral vestibular hypofunction (VH), which has not been reported in previous studies. The patient's hearing on the right side was restored to nearly normal after myringotomy. Whole exome sequencing identified a novel frameshift mutation in EYA1 (NM_000503.6): c.1697_1698delinT [p.(Lys566IlefsTer73)] in the proband, which was defined a "pathogenic" mutation according to American College of Medical Genetics and Genomics guidelines. This is the first report of a child presenting with BOS, SOM and VH, which expands the known clinical manifestations of this syndrome. We also observed a novel EYA1 gene mutation in this patient with BOS, which enriches the mutation map and provides a reference for genetic diagnosis of this syndrome. [ABSTRACT FROM AUTHOR]

Secretory otitis media (SOM) is a clinical condition characterized by the accumulation of fluids and oxidative stress in the middle ear, leading to hearing impairment and infection complications. One potential solution for mitigating oxidative stress associated with SOM is the use of antioxidants such as astaxanthin. However, its effectiveness is limited due to its poor bioavailability and rapid oxidation. Herein, we developed a novel diselenium-crosslinked apotransferrin enriched with astaxanthin (AST@dSe-AFT) nanoparticles to augment the transport of astaxanthin across biological membranes, resulting in increased bioavailability and reduced oxidative stress in SOM. Our research demonstrated that AST@dSe-AFT efficiently accumulated in the middle ear, allowing for controlled delivery of astaxanthin in response to reactive oxygen species and reducing oxidative stress. Additionally, AST@dSe-AFT stimulated macrophages to polarize towards M2 phenotype and neutrophils to polarize towards N2 phenotype, thereby facilitating an anti-inflammatory response and tissue restoration. Importantly, AST@dSe-AFT exhibited no toxicity or adverse effects, suggesting its potential for safety and future clinical translation. Our findings suggested that AST@dSe-AFT represents a promising approach for the treatment of secretory otitis media and other oxidative stress-related disorders. The ROS-responsive nanoparticles AST@dSe-AFT exhibited outstanding ROS/RNS scavenging ability as well as inflammation inhibitory effect by degrading diselenium bond to release AST. [Display omitted] • A self-assembly of AFT and diselenium was employed for encapsulating and delivering AST. • AST@dSe-AFT demonstrates responsive release of AST, specifically triggered by ROS in the inflammatory microenvironment. • AST@dSe-AFT exhibits potent anti-inflammatory and antioxidant activity in a SOM model. [ABSTRACT FROM AUTHOR]

Background This study examined the epidemiological correlations between secretory otitis media (SOM) and diseases of neighboring organs. We measured changes in disease incidences during the 2020 COVID-19 pandemic using Internet big data spanning from 2011 to 2021. Methods This study used the Baidu Index (BI) to determine the search volume for the terms “secretory otitis media (SOM)”, “tonsillitis”, “pharyngolaryngitis”, “adenoid hypertrophy (AH)”, “nasopharyngeal carcinoma (NPC)”, “nasal septum deviation (NSD)”, “rhinosinusitis”, “allergic rhinitis (AR)”, and “gastroesophageal reflux disease (GERD)” in Mandarin from January 2011 to December 2021. The correlations between these terms were analyzed using Spearman’s correlation coefficients. The results were compared search data from 2019 and 2021 to assess the effects of isolation on SOM in 2020. Results The seasonal variations trends of SOM and other diseases coincided well (P 0.05). The total search volumes for SOM, rhinosinusitis, NPC, and AH decreased in 2020 compared to 2019. Discussion SOM exhibited a discernible epidemiological connection with rhinosinusitis, nasal septal deviation (NSD), tonsillitis, pharyngolaryngitis, and nasopharyngeal carcinoma (NPC). A decrease in public gatherings was observed to effectively reduce the incidences of SOM. This underscores the pivotal role of social measures in influencing the prevalence of SOM and emphasizes the intricate interplay between SOM and various associated health factors, with implications for public health strategies.

The relationship between Secretory Otitis Media (SOM) and Laryngopharygeal Reflux (LPR) hasn't been well investigated in adult. To study the involvement of LPR- in adult SOM. We analyzed 60 adult SOM patients who were admitted to Department of Otolaryngology and Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, China from January 2022 to October 2022. First, we instructed the patients to fill Reflux Symptom Index (RSI) form and Reflux Finding Score (RFS). Second, Dx-ph monitor was used to monitor patients' oropharyngeal PH for 24 h. Finally, we obtained Ryan index based on the characteristics of reflux events in different body postures. In addition, all patients were evaluated by the Eustachian Tube Dysfunction Questionnaire–7 (ETDQ-7). The positive rate of RSI and/or RFS scale was 73.33% (44/60) in 60 SOM patients. The positive rate of Ryan index was 76.67% (46/60), and the index was the highest in upright position in 60 SOM patients. The positive rate of ETDQ-7 was 100% (46/46) in 46 SOM patients with LPR. LPR may be involved in SOM in adults by impairing the function of the eustachian tube. [ABSTRACT FROM AUTHOR]

Objectives: Increased numbers of patients with secretory otitis media appeared in outpatient clinics after the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron pandemic; however, the relationship between SARS-CoV-2 Omicron variant infection and secretory otitis media is uncertain. Methods: We performed tympanocentesis and used reverse transcription-polymerase chain reaction (RT-PCR) testing to examine middle ear effusion (MEE) and nasopharyngeal secretions from 30 patients with secretory otitis media associated with SARS-CoV-2 infection. RT-PCR was performed using the open reading frame 1ab and nucleocapsid protein gene kit from Shanghai Berger Medical Technology Co., Ltd., as the sole assay method, in accordance with the manufacturer's instructions. Results: MEEs from 5 of the 30 patients tested positive for SARS-CoV-2, including one patient with positive results for both the nasopharyngeal secretion and MEE. We report and discuss the medical records of six patients, including these five MEE-positive patients and a MEE-negative patient. Conclusion: SARS-CoV-2 RNA can be detected in MEE caused by coronavirus disease 2019-related secretory otitis media even when a patient's nasopharyngeal secretion tests PCR-negative for SARS-CoV-2. The virus can remain in the MEE for a long time after SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Abstract Background This prospective case-control study was conducted from June 2018 to October 2019 in a tertiary referral hospital to investigate the correlation between otitis media with effusion (OME) and serum vitamin D level in children. The study population included 50 children with adenotonsillar hypertrophy and OME (group A) who underwent adenotonsillectomy with tympanostomy tubes insertion compared to 50 children free from any medical or surgical disease (control group). Serum 25-hydroxy vitamin D was measured using electrochemiluminescence technique for both groups. Results The mean age in group A was 53.4 ± 9.2 months whereas in group B (control group) it was 65.0 ± 13.2 months (P

Objective: to determine the cases brought to the Otolaryngology Department with adenoidal hyperplasia. Study Design: Cross-sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital, Multan Pakistan from Jan to May 2022. Methodology: The study was conducted on children of age more than 2.5 years having adenoid hypertrophy that was confirmed by an X-Ray lateral view of the nasopharynx for adenoids. Their tympanogram was obtained. Results: The study showed that 2(2%) cases had a Type-B curve in a single ear, and 14(14.3%) had a Type-B curve in both ears.PTA was normal in 32(32.7%) cases. Up to 25 decibels (dB) of hearing loss was seen in 6(6.1%) cases. In 8(8.2%) cases, hearing loss, was more than 25Db. Conclusion: The tympanometry test is an objective test which is very easy to carry out and can very easily detect patients having glued ears which can be managed, and possible complications of the disease can be avoided.

Background: Secretory otitis media is chronic inflammation of middle ear cleft characterized by accumulation of nonpurulent fluid behind intact tympanic membrane. This study was done to identify various modes of presentation of secretory otitis media in different age groups and gender and to evaluate its outcome by various modalities of treatment. Material And Methods: This study comprised of 50 cases of bilateral or unilateral secretory otitis media of all the age groups. It is prospective observational study. Secretory otitis media is diagnosed by history, otoscopic examination and audiometric evaluation. Complete history and examination was done according to the proforma. All the patients were given conservative and medical treatment and followed up regularly. Cases refractory to medical treatment required surgical treatment based on clinical presentation and associated symptoms. It was carried out during the period of August 2021 to April 2022, in ENT department of Sir T. general hospital Bhavnagar. Result: In this study, maximum number (28%) of cases belonged to age group of 10-20 years, more commonly seen in males with Male: Female ratio of 1.78:1.Most of the cases (44%) were from lower socioeconomic class. Ear blockage or fullness of the ear (76%) was the most common clinical presentation. On otoscopy, fluid level with air bubbles was seen most commonly (84%). All the cases (100%) were put on medical treatment and regularly followed up. 50% responded well but the remaining 50% refractory cases required other surgical modalities of treatment based on clinical presentation and associated symptoms. Surgical treatment included adenoidectomy and adenotonsillectomy (20%), myringotomy with grommet insertion (4%). Myringotomy was done in 20% of cases. Septoplasty was done in 6% of the patients of secretory otitis media. Conclusion: Secretory otitis media was common in 10-20 years age group. More common in males with lower socioeconomic class. Most common clinical presentation was ear blockage or fullness of ear. On otoscopy, fluid level with air bubbles was the most common sign. Treatment consisted of medical and surgical modalities. All the cases obtained subjective relief and improvement in the symptoms. [ABSTRACT FROM AUTHOR]

Background: T-helper (Th)1/Th2 inflammatory responses are responsible for secretory otitis media (SOM) development. However, the mechanisms underlying these immune responses remain unknown. This study aims to identify the primary cytokines that play essential roles in chronic SOM. Methods: Two groups were established for the present study: chronic SOM group (n = 21) and control group (n = 10). The middle ear effusion and serum samples of the expression cytokines (interleukin IL-2, IL-4, IL-5, IL-13, IL-17, IL-25, IL-33, interferon [IFN]-γ, thymic stromal lymphopoietin [TSLP], immunoglobulin IgE, and pepsins) were analyzed by enzyme-linked immunosorbent assay. Results: The levels of IL-4, IL-5, IL-13, IL-17, IL-25, IFN-γ, TLSP, pepsins, IL-2, and IL-33 (all, p < 0.001) were higher in middle ear effusion, when compared to those in serum, in chronic SOM group (non-paired sample). However, there was no significant difference in serum expression for those cytokines compared chronic SOM group and control group. The paired sample expression for IL-33 and TLSP (both, p = 0.046) were higher compared the effusion and serum in chronic SOM group. Conclusions: IL-33 produces inflammatory cytokines, such as IL-1b, IL-6, TNF-α, IL-10, IL-4, and TGF-β, which through nucleus into cytoplasm causing inflammatory responses. The present study revealed that IL-33 also produce IL-17, IL-4, IL-5, and IL-13 inflammatory factors, triggering an inflammatory response. Study reported that the combined stimulation of TSLP and IL-33 elicits an approximately 10-fold increase in cytokine production, when compared to the stimulation of IL-33 alone. This suggests that IL-33 and TLSP may be the primary cytokines involved in Th1/Th2 inflammatory responses in chronic SOM. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of Mometasone furoate (Elocon Cream) Nasal Spray (MFNS) treatment on hearing secretory Otitis Media (SOM) in younger children., Methods: Seventy-six children with SOM (ages 5 to 10 years-old) were selected as study subjects and divided into two groups of 38 cases each using a randomized numerical table. The control group was given conventional treatment, and the observation group was treated with MFNS based on the control group. Both groups were treated for 12 weeks. The improvements in clinical symptoms and hearing were compared between the two groups at weeks 4, 8 and 12 of treatment, respectively., Results: The total effective rate of treatment in the observation group was higher than that in the control group. The middle ear resonance frequency of the children in the observation group was higher than that of the control group at weeks 4, 8 and 12 of treatment, and the air-conduction hearing threshold was lower than that of the control group. The total effective rate of the observation group after 12-weeks of treatment was 92.11 %, which was significantly higher than that of the control group (73.68 %). In addition, the T-ETDQ score of the observation group was lower than that of the control group after treatment., Conclusion: MFNS has clinical efficacy in the treatment of SOM in young children, which can improve clinical symptoms, promote the recovery of hearing and eustachian tube function, reduce the local inflammatory response, and improve immune function., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Objective: to determine the cases brought to the Otolaryngology Department with adenoidal hyperplasia. Study Design: Cross-sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital, Multan Pakistan from Jan to May 2022. Methodology: The study was conducted on children of age more than 2.5 years having adenoid hypertrophy that was confirmed by an X-Ray lateral view of the nasopharynx for adenoids. Their tympanogram was obtained. Results: The study showed that 2(2%) cases had a Type-B curve in a single ear, and 14(14.3%) had a Type-B curve in both ears. PTA was normal in 32(32.7%) cases. Up to 25 decibels (dB) of hearing loss was seen in 6(6.1%) cases. In 8(8.2%) cases, hearing loss, was more than 25Db. Conclusion: The tympanometry test is an objective test which is very easy to carry out and can very easily detect patients having glued ears which can be managed, and possible complications of the disease can be avoided. [ABSTRACT FROM AUTHOR]

Background: T-helper (Th)1/Th2 inflammatory responses are responsible for secretory otitis media (SOM) development. However, the mechanisms underlying these immune responses remain unknown. This study aims to identify the primary cytokines that play essential roles in chronic SOM. Methods: Two groups were established for the present study: chronic SOM group (n = 21) and control group (n = 10). The middle ear effusion and serum samples of the expression cytokines (interleukin IL-2, IL-4, IL-5, IL-13, IL-17, IL-25, IL-33, interferon [IFN]-γ, thymic stromal lymphopoietin [TSLP], immunoglobulin IgE, and pepsins) were analyzed by enzyme-linked immunosorbent assay. Results: The levels of IL-4, IL-5, IL-13, IL-17, IL-25, IFN-γ, TLSP, pepsins, IL-2, and IL-33 (all, p < 0.001) were higher in middle ear effusion, when compared to those in serum, in chronic SOM group (non-paired sample). However, there was no significant difference in serum expression for those cytokines compared chronic SOM group and control group. The paired sample expression for IL-33 and TLSP (both, p = 0.046) were higher compared the effusion and serum in chronic SOM group. Conclusions: IL-33 produces inflammatory cytokines, such as IL-1b, IL-6, TNF-α, IL-10, IL-4, and TGF-β, which through nucleus into cytoplasm causing inflammatory responses. The present study revealed that IL-33 also produce IL-17, IL-4, IL-5, and IL-13 inflammatory factors, triggering an inflammatory response. Study reported that the combined stimulation of TSLP and IL-33 elicits an approximately 10-fold increase in cytokine production, when compared to the stimulation of IL-33 alone. This suggests that IL-33 and TLSP may be the primary cytokines involved in Th1/Th2 inflammatory responses in chronic SOM. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of holistic nursing intervention for patients undergoing Laser-assisted tympanostomy under otoendoscopy for secretory otitis media. Methods Totally 126 (155 ears) patients with secretory otitis media were randomly divided into the observation group and the control group, with 63 cases in each group. All patients were given routine care during the treatment, and those in the observation group received holistic nursing interventions. The anxiety, depression and pain degree were evaluated before and after intervention, and the intervention efficacy and patients’ satisfaction with nursing were compared between two groups. Results The scores of Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Visual Analogue Scale (VAS) on pain in the observation group were lower than those in the control group (P＜0. 05). There was no significant difference in total effective rate and degree of patient satisfaction between two groups ((P＞0. 05) . Conclusion The holistic nursing interventions are potentially effective to relieve patients’ anxiety and depression, and reduce pain during laser-assisted tympanostomy under otoendoscopy for secretory otitis media. (目的 探讨分泌性中耳炎耳内镜下鼓膜激光打孔治疗中整体护理干预的应用效果。方法 选取2018年8月—2019年10月间收治的分泌性中耳炎患者126例患者(155耳)作为研究对象, 随机分为观察组和对照组, 各63例。对照组采用常规护理模式, 观察组在对照组基础上实施整体护理干预。观察2组患者干预后的焦虑、抑郁以及疼痛情况, 评价2组干预效果和护理满意度。结果 观察组干预后抑郁自评量表(SDS)、焦虑自评量表(SAS)、疼痛视觉模拟评分(VAS)均低于对照组, 差异有统计学意义(P＜0. 05)。观察组总有效率和护理满意度均高于对照组, 但差异无统计学意义(P＞0. 05)。结论 对采用耳内镜下鼓膜激光打孔治疗的分泌性中耳炎患者实施整体护理干预, 有助于改善患者焦虑抑郁情绪, 缓解疼痛。)

Objective To investigate the inhibitory effect of batroxobin on inflammation of secretory otitis media （SOM）rats. Methods Thirty rats were randomly divided into the control group，model group，and batroxobin group. In the model group and batroxobin group，we used endotoxin to establish the acute SOM models，while rats in the control group were injected with the same volume of normal saline. On the next day after modeling，the rats in the batroxobin group were given intraperitoneal injection of 1. 0 BU/kg batroxobin，and the rats in the control group and model group were given the same amount of normal saline，once a day，for 14 days. The expression levels of TNF-α，IFN- γ，and IL-4 in middle ear effusion（MEE）were detected by ELISA，and then IFN-γ/IL-4 was calculated；HE staining was used to observe the pathological changes of middle ear mucosa；qRT-PCR was used to detect the expression levels of TNF-α，IFN-γ and IL-4 mRNA in the middle ear mucosal tissues of rats. Results There were no changes in the tympanic mem‑ brane morphology or middle ear mucosa pathology in the control group；the tympanic membrane morphology and middle ear mucosa pathological changes in the batroxobin group were lighter than those in the model group. Compared with control group，the expression of TNF-α，IFN-γ，and IL-4 in the MEE of the model group were up-regulated，and IFN-γ/IL-4 was down-regulated（all P<0. 05）. Compared with the model group，the expression of TNF-α in the MEE of the batroxobin group decreased，the expression of IFN-γ and the level of IFN-γ/IL-4 increased（all P<0. 05）；however，there was no statistically significant difference in IL-4 expression between the two groups（P>0. 05）. Compared with the control group，the expression of TNF-α，IFN-γ and IL-4 mRNA in the middle ear mucosa of the model group was higher（all P<0. 05）. Compared with the model group，the expression of TNF-α mRNA in the middle ear mucosa of the batroxobin group was lower， and the expression of IFN-γ mRNA was higher（all P<0. 05）. Conclusion Batroxobin may inhibit the inflammation of SOM rats by inhibiting the secretion of TNF-α and regulating the balance of IFN-γ/IL-4 expression. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of adenoidectomy combined with tympanic intubation under nasal endoscopy on serum inflammatory factors and T cell subsets in children with secretory otitis media (SOM). Methods: From August 2016 to December 2018, 113 children with SOM in our hospital were selected. According to the random number table, the children were divided into the control group (n=56) and study group (n=57). The children in the control group were treated with tympanum catheterization, while the study group was treated with adenoidectomy under nasal endoscope on the basis of the control group. The efficacy, serum inflammatory factors and T cell subsets, time of middle ear effusion, average auditory valve in speech frequency area and complications of the two groups were compared. Results: The total clinical effective rate of the study group was 94.74%(54/57), which was higher than 75.00% (42/56) of the control group(P<0.05). The levels of serum interleukin-2(IL-2), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) of the two groups decreased at 3 months after operation, and the levels of the study group were lower than those of the control group (P<0.05). 3 months after operation, CD8+ decreased of the two groups, and it in the study group was lower than that in the control group (P<0.05). CD4+, CD4+/CD8+ increased, and those in the study group were higher than those in the control group(P<0.05). The time of middle ear effusion in the study group was shorter than that in the control group, and the average auditory valve in the speech frequency area was higher than that in the control group(P<0.05). There was no significant difference between the two groups in postoperative complications (P>0.05). Conclusion: Adenoidectomy combined with tympanic intubation under nasal endoscopy is effective in the treatment of SOM children. It can effectively improve the serum inflammatory factors, T cell subsets, the time of middle ear effusion and the average auditory valve in the speech frequency area. It has good safety and high clinical application value. [ABSTRACT FROM AUTHOR]

Secretory otitis media (SOM) is characterized by persistence of fluid in the middle ear, often following an episode of acute otitis media. Our hypothesis is that failure to eliminate bacterial or viral pathogens may result in persistent low-grade inflammation. In this study, we analyzed inflammatory mediators in middle ear fluids from 67 children with SOM. This was combined with determinations of viable bacteria by culture along with detection of bacterial and viral genetic material by real-time polymerase chain reaction (PCR). The inflammatory mediators found at the highest concentrations (>30 ng/mL) were stem cell growth factor-β (median 110 ng/mL), CXCL1, IL-16, IL-8, migration inhibitory factor, CXCL10, and CXCL9. Among bacterial pathogens, Moraxella catarrhalis and Haemophilus influenzae dominated, regardless of detection methods, while rhinovirus dominated among viral pathogens. Middle ear fluid levels of interleukin (IL)-1α, IL-17, IL-1β, fibroblast growth factor basic, and tumor necrosis factor correlated strongly with presence of bacteria detected either by culture or PCR, while IL-1RA, IL-3, IL-6, IL-8, CCL3, CCL4, and granulocyte-colony stimulating factor correlated significantly with real-time PCR values. CXCL10, CXCL9, CCL2, and TRAIL correlated significantly with viral nucleic acid levels. To conclude, persistence of viral and bacterial pathogens may fuel persistent inflammation in SOM. Bacteria caused a broad inflammatory response, while viruses chiefly elicited the interferon-induced chemokines CXCL9 and CXCL10. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of tympanic membrane catheterization on the quality of life of children with secretory otitis media (SOM) after operation, so as to provide theoretical reference for clinical treatment of SOM. Methods: The Chinese version of Chronic Ear Survey (CCES), Questionnaire on the quality of life of children with otitis media (OM-6) and child behavior checklist (CBCL) were used to evaluate the quality of life of 300 SOM children before and after tympanic membrane catheterization in our hospital from January 2016 to August 2019. Results: After treatment, the scores of CCES items were significantly higher than those before treatment (P<0.05). OM-6 questionnaire scores were significantly lower in hearing loss, emotional disorder, physical pain, activity limitation and parents' worries (P<0.05). After treatment, the scores of depression, social withdrawal, hyperactivity, aggression, schizoid and compulsion in CBCL of male children were significantly lower than those before treatment (P<0.05); the scores of depression, social withdrawal, hyperactivity, aggression and schizoid compulsion in CBCL of female children were significantly lower than those before treatment (P<0. 05). Conclusion: The clinical symptoms and quality of life of children with SOM were significantly improved after tympanic membrane catheterization. tympanic membrane catheterization is an effective treatment for children with secretory otitis media. [ABSTRACT FROM AUTHOR]

Objectives: Otitis media with effusion is widespread in pre-school and schoolgoing children. The objective of this study was to compare the prevalence of otitis media with effusion (OME) in normal versus mentally handicapped children in perspective of seasonal variation. Study Design: Randomized controlled trial. Setting: Pakistan Air Force Hospital Masroor, Karachi. Period: January 2015 till August 2016. Material & Methods: 208 children between 3-8 years of age were divided into ‘Mentally Normal’ and ‘Mentally Handicapped’ groups based on a cut off intelligence quotient score of 70. Results: Otitis media with effusion uniformly affected all school children. Tympanometric pressures from middle ears of both study groups responded indifferently from each other (p value 0.467 and 0.365 for right middle ear, and 0.708 and 0.920 for left middle ears, in summer and winter, respectively). However, most caregivers of mentally handicapped children exhibited greater concerns about complications associated with otitis media with effusion in winters (p value 0.002). Conclusion: Otitis media with effusion is an insidious condition which remains under diagnosed and adversely affects auditory function and speech. Children may develop this condition regardless of their intellectual status. However craniofacial dysmorphism puts a child at a greater risk of otitis media with effusion. Awareness at primary education and healthcare level, a high index of suspicion in these children, careful examination and prompt referral for expert otologic intervention is pivotal in avoiding complications. [ABSTRACT FROM AUTHOR]

Objective: To investigate the changes of proinflammatory, fluid balance, vascular permeability and oxidative stress in patients with secretory otitis media. Methods: A total of 42 patients with secretory otitis media treated in our hospital from September 2016 to January 2018 were selected as the observation group and 42 healthy people as the control group. The levels of proinflammatory effect [including transforming growth factor beta 1 (TGF-β1), transforming growth factor-beta 2 (TGF-β2)], fluid balance [including aquaporin-1 (AQP-1) and aquaporin-4 (AQP-4)], vascular permeability [including hyaluronic acid (HA), fibronectin (Fn) and platelet activating factor (PAF)] and oxidative stress-related indexes [including malondialdehyde (MDA) and superoxide dismutase (SOD)] were observed and compared between the two groups. Results: The levels of AQP-1, AQP-4 and Fn in the observation group were significantly lower than those in the control group. The expression levels were (4.52±0.39) g/L, (23.06±7.21) g/L and (120.59±13.07) mg/L, respectively. The levels of TGF- β1, TGF-β2, HA, PAF, MDA and SOD were significantly higher than those of the control group and the expression levels were (11.99±4.23) μg/L, (4.22±1.66) μg/L, (70.54±6.99) μg/L, (123.83±20.58) ng/mL, (6.30±0.44) nmol/mL and (15.85±0.78) NU/mL, respectively. The difference was statistically significant. Conclusions: Inflammatory reaction occurs in patients with otitis media with secretory otitis media. It is easy to break the liquid balance in the middle ear cavity and to increase vascular permeability and oxidative stress. The relevant indicators should be strengthened in clinical practice, so as to provide evidence for early diagnosis and treatment of the disease. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effect of dexamethasone combined with ambroxol hydrochloride on T cell subsets and hearing in patients with secretory otitis media. Eighty-six cases of patients with secretory otitis media admitted to "Gansu Provincal Hospital, Lanzhou, China" from September 2016 to September 2018 were regarded as subjects of the study. The patients were divided in two groups according to the digital table method. Among them, the control group was treated with ambroxol hydrochloride, while the study group was treated with dexamethasone combined with ambroxol hydrochloride. The clinical efficacy, T cytokines before and after treatment, auditory threshold and middle ear resonance frequency were observed and compared between the two groups of the patients. SPSS 18.0 software was used to statistically analyze the data. The therapeutic efficacy of the study group was better than that of the control group and the levels of CD4+, CD4+/CD8+ after treatment of the study group were higher than that of the control group (P<0.05), while the content of CD8+ in the study group was lower than that in the control group (P<0.05). In addition, the auditory threshold of the study group was lower than that of the control group (P<0.05), whereas the middle ear resonance frequency was higher than that of the control group (P<0.05). The application of dexamethasone combined with ambroxol hydrochloride improved the clinical symptoms and restored hearing in the clinical treatment of patients with secretory otitis media and the therapeutic efficacy was ideal. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effect of comprehensive rehabilitation treatment on hearing impairment in children with secretory otitis media. Methods: 88 children with hearing loss caused by secretory otitis media diagnosed in our hospital from January 2016 to August 2017 were studied. All children were randomly divided into the comprehensive group and the control group, with 44 cases in each group. The comprehensive treatment group was given comprehensive rehabilitation, the control group was given ear massage.The curative effect, changes of air conduction and bone conduction threshold before and after treatment were observed and compared between two groups. Results: The effective rate of combined group(79.55 %) was significantly higher than that of the control group(56.82%, P<0.05). Compared with those before treatment, the air conduction threshold at 0.25-0.8 Hz and the bone conduction threshold at 2.0 and 4.0 kHz were significantly decreased after treatment in both groups(P<0.05). The above indicators were significantly lower in the comprehensive group than those in the control group(P<0.05). Conclusions: Comprehensive rehabilitation therapy, that is, joint sensory training, ear massage, music perception and exercise training, had a good effect on children with hearing loss caused by secretory otitis media, and could improve the children’s air conduction and bone conduction threshold levels. [ABSTRACT FROM AUTHOR]

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.

Background: To compare the outcome of myringotomy alone with myringotomy and tympanostomy tube (grommet) in otitis media with effusion (OME) in terms of improvement in hearing and tympanogram pattern. Methods: In this comparative study 60 patients diagnosed of otitis media with effusion (OME) not responding to medical treatment were included. They were divided in two groups, each of 30 patients. In first group only myringotomy was done. In second group myringotomy with tympanostomy tube insertion was done. The parameters compared were improvement of hearing and improvement in tympanogram pattern. Hearing was assessed by voice test and tuning fork tests (Rinnie’s, Webers). Patients were assessed before surgery, after two weeks, after one month and after three months. Results:Out of 60 patients 39 were males and 21 were females. Age range was from 5 to 15 years with mean age 8 years. In first group there was 48% improvement in hearing and tympanogram pattern after two weeks, 55% improvement after one month and 62% improvement after three months. In second group there was 67% improvement after two weeks, 84% after one month and 95% after three months. One patient (3%) developed post op otorrhoea which was treated by conservative management. Conclusion:Myringotomy with tympanostomy tube insertion has a better outcome in terms of hearing improvement in OME patients as compared to myringotomy alone.

Objective: To investigate the expression and clinical significance of T helper cell 1(Th1), T helper cell 2(Th2)cytokines and T lymphocyte subsets in peripheral blood of patients with secretory otitis media(SOM). Methods: 135 patients with SOM who were admitted to our hospital from January 2015 to January 2018 were selected as SOM group. According to the course of disease,the patients were divided into acute group(the duration<14 d, 49 cases), subacute group(the duration of 14-30 d, 53 cases) and chronic group(the duration>30 d, 33 cases). 100 healthy patients who had physical examination in the outpatient department of our hospital were selected as the control group. The levels of peripheral blood Th1 cytokines [interferon(INF-γ), interleukin-2(IL-2)], Th2 cytokines[interleukin-4(IL-4), interleukin-10(IL-10)] and T lymphocyte subsets [CD3+, CD4+, CD8+, CD4+/CD8+] were compared between SOM group and control group, and patients with different course of SOM. Pearson correlation analysis was performed on the correlation between IFN-γ, IL-2, IL-4, IL-10 and CD3+, CD4+, CD8+, CD4+/CD8+. Results: The levels of peripheral blood IFN-γ, IL-2, IL-4 and IL-10 in the SOM patients were higher than those of the control group(P<0.05). The levels of peripheral blood INF-γ, IL-2, IL-4 and IL-10 in the acute group were lower than those of the subacute group and the chronic group. The levels of peripheral blood INF-γ, IL-2,IL-4 and IL-10 in the subacute group were lower than those of chronic group(P<0.05). The levels of peripheral blood CD3+, CD4+and CD4+/CD8+in the SOM patients were lower than those in the control group, and the levels of CD8+were higher than those in the control group(P<0.05). The level of CD3+, CD4+and CD4+/CD8+in the acute group were higher than those in the subacute group and chronic group. The level of CD8+in the acute group were lower than that in the subacute group and chronic group. The levels of CD3+, CD4+and CD4+/CD8+in the subacute group were higher than those in the chronic group. The level of CD8+was lower than that of chronic group(P<0.05).Pearson correlation analysis showed that peripheral blood INF-γ and IL-4 were positively correlated with CD8+in the SOM patients(P<0.05), while IL-4 was negatively correlated with CD3+, CD4+(P<0.05). Conclusion: The levels of peripheral blood Th1 Th2 cytokines and T lymphocyte subsets in the SOM patients are abnormal, and their levels are associated with the occurrence and development of diseases.The monitoring of Th1 Th2 cytokines and T lymphocyte subsets helps to assess the condition of SOM patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of Intratincular injection dexamethasone combined with ambroxol hydrochloride on hearing level and immune function in patients with secretory otitis media(SOM). Methods: 240 cases of SOMpatients who were treated in our hospital from May 2017 to November 2017 were selected as the research object. The patients were divided into control group (n=120) and study group (n=120 group) according to the number table method. The control group was treated with intratincular injection dexamethasone, the study group was treated with ambroxol hydrochloride on this basis. The clinical efficacy of the two groups was cimpared, The level of air conduction at 0.5 KHz, 1.0 KHz and 2.0 KHz frequencies, tympanum pressure and CD4+, CD8+ and CD4+/CD8+ levels were compared between the two groups before and after treatment, at the same time, the two groups of adverse reactions were observed. Results: The total effective rate of the patients in the study group was 86.67% (104/120), which was significantly higher than 70.83%(85/120) of the control group(P<0.05). The level of air conduction at 0.5 KHz, 1.0 KHz and 2.0 KHz frequencies and tympanum pressure in the two groups after treatment were higher than before treatment, and the study group was higher than that of the control group (P<0.05). The CD4+ and CD4+/ CD8+ in the two groups after treatment were higher than before treatment, and the study group was higher than that of the control group (P<0.05); the CD8+ in the two groups after treatment was lower than before treatment (P<0.05); but there was no difference between the study group and the control group (P>0.05). There was no adverse reaction in the two groups during the treatment. Conclusions: Intratincular injection dexamethasone combined with ambroxol hydrochloride is effective and safe in the treatment of patients with SOM, and it can improve the immune function and hearing level of patients, which has certain clinical application value. [ABSTRACT FROM AUTHOR]

Objective To evaluate the impact of tympanostomy ventilation tube material (silicone vs fluoroplastic) and shape (short vs long) regarding time to extrusion, occurrence of otorrhea, occlusion, tube removal and occurrence of persistent perforation. Methods and material Four different types of ventilation tubes were used; Long Armstrong tubes, Donaldson tubes, Shepard tubes and straight tubes, representing four specific combinations of VT material (silicone or fluoroplastic) and shape (short, double flanged or long, single flanged). Four hundred children scheduled for bilateral tube insertion were included in a randomized trial. The patients received one type of tube in the right ear and another type in the left ear. The incidence of tube extrusion and complications were monitored postoperatively every third month by an otolaryngologist. Results Twenty-two children were excluded during surgery. Out of the studied 378 children the mean age was 35.3 months. 63.8% were boys. Short tubes extruded earlier than long tubes; hazard ratio (HR) 4.84 (95% CI 3.50–6.69, p < 0.001). Long Armstrong tubes were least prone to extrude. Silicone tubes resulted in significantly longer time to first infection in a VT ear, HR 1.68 (95% CI 1.03–2.76, p = 0.039). Donaldson tubes rendered the longest mean time to first infection (p = 0.025). Infections did not affect tube extrusion rates significantly (p = 0.879). No significant differences were found regarding tube occlusion, tube extraction or persistent perforation. Conclusions Long tubes are less prone to extrude early. Long Armstrong tubes have the least propensity to extrude early. Silicone tubes render significantly longer time to first infection. Donaldson tubes result in least infections. Infection does not affect extrusion rates significantly. Level of evidence 1b [ABSTRACT FROM AUTHOR]

Background: To compare the outcome of myringotomy alone with myringotomy and tympanostomy tube (grommet) in otitis media with effusion (OME) in terms of improvement in hearing and tympanogram pattern. Methods: In this comparative study 60 patients diagnosed of otitis media with effusion (OME) not responding to medical treatment were included. They were divided in two groups, each of 30 patients. In first group only myringotomy was done. In second group myringotomy with tympanostomy tube insertion was done. The parameters compared were improvement of hearing and improvement in tympanogram pattern. Hearing was assessed by voice test and tuning fork tests (Rinnie's, Webers). Patients were assessed before surgery, after two weeks, after one month and after three months. Results:Out of 60 patients 39 were males and 21 were females. Age range was from 5 to 15 years with mean age 8 years. In first group there was 48% improvement in hearing and tympanogram pattern after two weeks, 55% improvement after one month and 62% improvement after three months. In second group there was 67% improvement after two weeks, 84% after one month and 95% after three months. One patient (3%) developed post op otorrhoea which was treated by conservative management. Conclusion:Myringotomy with tympanostomy tube insertion has a better outcome in terms of hearing improvement in OME patients as compared to myringotomy alone. [ABSTRACT FROM AUTHOR]

Objective: Children with a Cleft Palate (CLP) and with or without cleft lips (non-syndromic) universally present with Secretory Otitis Media (SOM). The purpose of this study was to determine the incidence of secretory otitis media that occurs in patients with cleft palates and to confirm the existence of these manifestations by doing a Basic Audiologic Evaluation (BAE). Material and Methods: A retrospective study was done on forty four male and female children who were within the 2 to 14 years age range, with non-syndromic cleft palates with or without cleft lips, with the symptoms of SOM. Otoscopy examinations were done in all the cases. X-rays of the mastoids (both sides) were done in all the cases to detect the pneumatization of the mastoid air cell system. The Basic Audiologic Evaluation (BAE) includes an evaluation by tympanometry of the middle ear function and an evaluation by pure tone audiometry to establish the type of hearing loss. Results: A majority of the patients (47.27%) were in the age group of eight-to-fourteen (8-14) years. The Basic Audiologic Evaluation (BAE) revealed that 77.27% of the children had presented with normal hearing; 13.6% had conductive hearing loss and 2.2% had presented with a mixed hearing loss. We noticed that 68.2% of the children had type A curves; 21.2% of the children had type C tympanometry curves; 7.1% had type B curves and 3.5% had Ad curves. The contralateral acoustic reflex was present in 54.5% of the children and 45.5% did not have this reflex. A majority of the patients (46%) showed sclerotic changes in their mastoid air cell systems in the X-rays of the mastoids. Conclusion: The significantly higher prevalence of SOM in the children with cleft was confirmed by the study. Also, the hearing loss which was associated with SOM was evident and it demonstrated that there was a high prevalence of a mild conductive hearing loss when SOM was present. The cleft palate contributed to the occurrence of the secretory otitis media and it required proper ENT and audiological follow ups.

Background: Eosinophilic otitis media (EOM) is an intractable disease characterized by a remarkably viscous effusion and accumulation of numerous eosinophils in both the middle ear effusion and the mucosa. The key factors in EOM pathogenesis remain unclear. The purpose of this study is to identify the important factors involved in EOM pathogenesis. Methods: Middle ear effusion samples were collected from 12 patients with EOM and 9 patients with secretory otitis media (SOM), as controls. Multiple cytokines in the effusion were measured using a Bio-Plex™ Human Cytokine 27-Plex panel. Eosinophil-derived neurotoxin (EDN) and elastase were measured by ELISA. The concentrations of EDN, elastase, and each cytokine were compared between the EOM and SOM groups. Furthermore, in the EOM group, each cytokine was examined for correlation with EDN and elastase. Results: EDN and elastase concentrations were significantly higher in the EOM group than in the SOM group (p

Objective To compare four different types of tympanostomy ventilation tubes (VT); long-shaft and short-shaft silicone tubes and long-shaft and short-shaft fluoroplastic tubes, regarding time to extrusion and events of otorrhea. Methods A prospective randomized controlled trial in children with bilateral recurrent acute otitis media or secretory otitis media; four hundred children were randomized to receive one type of VT in the right ear and another type in the left ear. Postoperatively the children were assessed every third month by an otolaryngologist to monitor the incidence of otorrhea and tube extrusion. Results Out of the 400 children, 22 were excluded during surgery. Mean age was 35.3 months. A majority (63.8%) were boys. Forty-eight children were lost to follow up during the first year. Significantly more short-shaft VTs were extruded after 12 months compared to long-shaft VTs, regardless of material. Significantly higher incidence of otorrhea was found in the fluoroplastic VT ears compared to the silicone ones, regardless of length of tube. Conclusion Long-shaft VTs last longer in the eardrum during the first year of treatment. Silicone tubes render a reduced risk of otorrhea during the first year of treatment. [ABSTRACT FROM AUTHOR]

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

This study presents the treatment of 68 children with secretory otitis media. Children underwent adenoid vegetations, nasal speech, conductive hearing loss, ventilation disturbance in Eustachian tube. In all children adenoidectomy was indicated.38 boys and 30 girls at the age of 3-17 were divided in two main groups: * 29 children without hypertrophic (enlarged) adenoids, * 39 children with enlarged (hypertrophic) adenoids.The surgical treatment included insertion of ventilation tubes and adenoidectomy where there where hypertrophic adenoids.Clinical material was analyzed according to hearing threshold, hearing level, middle ear condition estimated by pure tone audiometry and tympanometry before and after treatment. Data concerning both groups were compared.The results indicated that adenoidectomy combined with the ventilation tubes facilitates secretory otitis media heeling as well as decrease of hearing impairments. That enables prompt restoration of the hearing function as an important precondition for development of the language, social, emotional and academic development of children.

Introduction: We evaluated the usability of short-term (approximately 3 minutes) T2 sequence temporal bone magnetic resonance imaging (MRI) in the diagnosis of serous otitis media (SOM) in our study., Methods: A prospective study. Otoscopic examination and audiometry-tympanometry were performed on all 73 patients included in the study. All patients underwent short-term T2 sequence temporal bone MRI before the paracentesis procedure., Results: The mean age of 73 patients (30 female and 43 male) was 7.78 ± 3.01 (3 to 17 years). A total of 134 ear paracentesis operations were performed. As a result of the intraoperative paracentesis procedure, 107 Type B tympanogram and 13 Type C tympanogram were found out of 120 ears that had fluid in the middle ear. Out of 14 ears without fluid flow in the middle ear, five were found to be Type B tympanogram and nine to be Type C tympanogram. The sensitivity of the type B tympanogram in the diagnosis of SOM was 89.1%, the specificity was 64.2%, the positive predictive value was 95.5%, and the negative predictive value was 40.9%. The sensitivity and specificity of short-term T2 sequence MRI in diagnosing SOM were found to be 100% and 100%., Conclusion:   Among the available methods, the short-term T2 sequence temporal MRI is the most effective method for evaluating fluid in mastoid cells., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bulut et al.)

Objective: To observe the effect of loratadine combined with intratympanic dexamethasone injection on the secretory otitis media. Methods: 116 patients with secretory otitis media who were treated in our hospital from June 2013 to June 2014 were selected and randomly divided into two groups. The patients in the control group were treated with the intratympanic dexamethasone injection, while the patients in the observation group were treated with the loratadine on the basis of dexamethasone intratympanic injection. Then the clinical effects and the recovery of eustachian tube function in the two groups were observed and compared before and after the treatment. Results: After the treatment, the dysfunction of eustachian tube rates in the two groups were significantly lower than before (P<0.05). The recovery rate of eustachian tube function in the observation group was significantly higher than that of the control group, and the air bone gap was higher than that of the control group (P<0.05). The total effective rates in the observation group were higher than those of the control group on 1st week and 1st month after treatment (P<0.05). Conclusion: Loratadine combined with dexamethasone intratympanic injection could reduce middle ear effusion retention, improve the inflammatory function of eustachian tube of patients with secretory otitis media and promote the recovery of hearing. [ABSTRACT FROM AUTHOR]

Objective To study the clinical efficacy of the treatment in secretory otitis media （SOM） by ambroxol with the mode of retrograde eustachian tube and tympanic membrane puncture. Methods 179 cases were randomly divided into 3 groups. The 1st observation group was giuen the mode of retrograde eustachian tube for tympanic cavity irrigation with ambroxol， the 2st observation group was giuen the mode of tympanic membrane puncture for irrigation with ambroxol，and the control group was giuen the mode of tympanic membrane puncture for irrigation with dexamethasone. The changes of language frequency threshold of three groups were compared before and after treatment， and the complications after treatment were evaluated statistically. Results The language frequency hearing was improved after treatment in the three groups （ < 0.05） . The effect of the 1st and 2st observation groups were all higher than that of control group （ < 0.05）， but there was no difference between two observation groups （ > 0.05） . Conclusion Ambroxol is clinically effective to treat SOM，and retrograde eustachian tube insertion is safe and reliable， so the method is worth clinical application． [ABSTRACT FROM AUTHOR]

Conclusion: Electromyography of the tensor veli palatine (TVP) was abnormal and showed mainly myogenic impairment in patients with nasopharyngeal carcinoma (NPC) with secretory otitis media (SOM) after radiotherapy. The diseased ears showed impairment in opening functions of the eustachian tubes (ETs). Objectives: To characterize electrophysiology of the TVP muscle using electromyography (EMG) in patients with SOM after radiotherapy of NPC. Methods: Twenty healthy volunteers and 20 patients with NPC and SOM after radiotherapy were chosen for assessment of EMG of the TVP during swallowing. Results: The measurements of average duration and amplitude of action potential, swallowing contraction duration, and peak voltage in NPC patients with both SOM ( n = 25) and healthy ears ( n = 6) were significantly lower than those of ears ( n = 38) in healthy controls ( p < 0.01). In patients with NPC, the average action potential duration and swallowing contraction duration in ears with SOM were lower than those of subjects with healthy ears ( p < 0.05), whereas no significant difference was found in average amplitude of action potential and peak voltage between them. [ABSTRACT FROM AUTHOR]

Objective To discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children. M ethods A total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group A1, group B1, and group C1 matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and A1 accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and C1 accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared. Results The control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times. Conclusion SOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate. [ABSTRACT FROM AUTHOR]

A fairly quite rare case of osseous tumor arising from the Eustachian tube (ET) is described. A 56-year-old man presented with a smooth bulky mass in the nasopharynx and secretory otitis media in the right ear. Computed tomography and magnetic resonance imaging indicated a solid tumor-like region occupying the nasopharynx with apparent extension to the right ET. Transnasal endoscopic surgery demonstrated that the tumor had originated from the ET, and the tumor was partially removed in the area where it had expanded into the nasopharynx. The pathological diagnosis was an osseous hamartoma consisting of bony tissue, fat cells and fibroblasts. To our knowledge, this is the first reported case of osseous hamartoma arising from the ET in the world literature. The patient presented symptoms of nasal obstruction and unilateral aural fullness. Reduction surgery and tympanostomy tube insertion were useful for accurate diagnosis and resolution of the symptoms.

Objective: Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET.Study Design: A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up.Setting: Regional Academic Center.Subjects and Methods: Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy.Results: All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41).Conclusion: The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures. [ABSTRACT FROM AUTHOR]

Objective: Children with a Cleft Palate (CLP) and with or without cleft lips (non-syndromic) universally present with Secretory Otitis Media (SOM). The purpose of this study was to determine the incidence of secretory otitis media that occurs in patients with cleft palates and to confirm the existence of these manifestations by doing a Basic Audiologic Evaluation (BAE). Material and Methods: A retrospective study was done on forty four male and female children who were within the 2 to 14 years age range, with non-syndromic cleft palates with or without cleft lips, with the symptoms of SOM. Otoscopy examinations were done in all the cases. X-rays of the mastoids (both sides) were done in all the cases to detect the pneumatization of the mastoid air cell system. The Basic Audiologic Evaluation (BAE) includes an evaluation by tympanometry of the middle ear function and an evaluation by pure tone audiometry to establish the type of hearing loss. Results: A majority of the patients (47.27%) were in the age group of eight-to-fourteen (8-14) years. The Basic Audiologic Evaluation (BAE) revealed that 77.27% of the children had presented with normal hearing; 13.6% had conductive hearing loss and 2.2% had presented with a mixed hearing loss. We noticed that 68.2% of the children had type A curves; 21.2% of the children had type C tympanometry curves; 7.1% had type B curves and 3.5% had Ad curves. The contralateral acoustic reflex was present in 54.5% of the children and 45.5% did not have this reflex. A majority of the patients (46%) showed sclerotic changes in their mastoid air cell systems in the X-rays of the mastoids. Conclusion: The significantly higher prevalence of SOM in the children with cleft was confirmed by the study. Also, the hearing loss which was associated with SOM was evident and it demonstrated that there was a high prevalence of a mild conductive hearing loss when SOM was present. The cleft palate con tributed to the occurrence of the secretory otitis media and it required proper ENT and audiological follow ups. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine the long-term hearing following surgical treatment of chronic OME in early childhood (myringotomy or ventilation tube) and to determine the impact of the occurrence and the extension of specific eardrum pathology on the hearing level. Patients and methods: In 1977–1978, 224 consecutive children (91 girls and 133 boys) with chronic bilateral OME were enrolled and treated by adenoidectomy, bilateral myringotomy and insertion of a ventilation tube on the right side only. In 2002, a follow-up examination included otomicroscopy and audiometry. Hearing thresholds were compared to an age- and gender-matched normative data set. For the determination of the impact of specific eardrum pathology on the hearing, multiple linear regression modelling was used in adjustment for age and concomitant eardrum pathologies. Results: Long-term hearing after chronic OME and associated treatment is not different from age and gender-matched normal hearing. Treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. The regression analyses showed that the presence of myringosclerosis is associated with an overall hearing loss in myringotomised ears (4–5dB), but not in tubed ears, for which only high frequencies were affected. Conversely, tensa atrophy is associated with an overall hearing loss in tubed ears (3–4dB), but not in myringotomised ears, for which only high frequencies were affected. Conclusions: Hearing 25 years after surgical treatment of chronic OME is not different from age and gender matched normal hearing. In addition, treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. However, atrophy is associated with a hearing loss in tubed ears, whereas myringosclerosis is associated with a hearing loss in myringotomised ears. The hearing loss associated with pathology is of limited magnitude (up to about 5dB PTA). Even though pathology does occur more frequently and more extensively in tubed ears, the effect on the hearing at the group level is too small to have an impact. It is important to note, that this may be due to a type 2-error (number of patients too small to show an effect). [Copyright &y& Elsevier]