scholarly journals Management of tympanic membrane retractions: a systematic review

2021 ◽  
Author(s):  
Ahmed B. Bayoumy ◽  
Christianne C. A. F. M. Veugen ◽  
Erwin L. van der Veen ◽  
Jan-Willem M. Bok ◽  
Jacob A. de Ru ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tympanic Membrane ◽  
Observational Studies ◽  
Tube Placement ◽  
Ventilation Tube ◽  
Military Population ◽  
Level Of Evidence ◽  
Surgical Interventions ◽  
Wait And See ◽  
Tympanic Membrane Retraction

Abstract Importance Tympanic membrane retraction (TMR) is a relatively common otological finding. However, no consensus on its management exists. We are looking especially for a treatment strategy in the military population who are unable to attend frequent follow-up visits, and who experience relatively more barotrauma at great heights and depths and easily suffer from otitis externa from less hygienic circumstances. Objective To assess and summarize the available evidence for the effectiveness of surgical interventions and watchful waiting policy in patients with a tympanic membrane retraction. Evidence review The protocol for this systematic review was published at Prospero (207859). PubMed, Embase, and the Cochrane Database of Systematic Reviews were systematically searched from inception up to September 2020 for published and unpublished studies. We included randomized trials and observational studies that investigated surgical interventions (tympanoplasty, ventilation tube insertion) and wait-and-see policy. The primary outcomes of this study were clinical remission of the tympanic membrane retraction, tympanic membrane perforations and cholesteatoma development. Findings In total, 27 studies were included, consisting of 1566 patients with TMRs. We included data from 2 randomized controlled trials (76 patients) and 25 observational studies (1490 patients). Seven studies (329 patients) investigated excision of the TMR with and without ventilation tube placement, 3 studies (207 patients) investigated the wait-and-see policy and 17 studies (1030 patients) investigated tympanoplasty for the treatment of TMRs. Conclusions and relevance This study provides all the studies that have been published on the surgical management and wait-and-policy for tympanic membrane retractions. No high level of evidence comparative studies has been performed. The evidence for the management of tympanic membrane retractions is heterogenous and depends on many factors such as the patient population, location and severity of the TMR and presence of other ear pathologies (e.g., perforation, risk of cholesteatoma and serous otitis media).

scholarly journals External ear canal cholesteatoma after ventilation tube insertion and mastoidectomy

2012 ◽  
Vol 69 (4) ◽  
pp. 363-366 ◽  
Author(s):  
Dragoslava Djeric ◽  
Milan Jovanovic ◽  
Ivan Baljosevic ◽  
Srbislav Blazic ◽  
Milanko Milojevic
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Membrane Surface ◽  
Tube Placement ◽  
External Ear ◽  
Ventilation Tube ◽  
Ear Canal ◽  
Tube Insertion ◽  
Tissue Mass ◽  
External Ear Canal

Introduction. Etiopathogenetically, there are two types of chollesteatomas: congenital, and acquired. Numerous theories in the literature try to explain the nature of the disease, however, the question about cholesteatomas remain still unanswered. The aim of the study was to present a case of external ear canal cholesteatoma (EEC) developed following microsurgery (ventilation tube insertion and mastoidectomy), as well as to point ant possible mechanisms if its development. Case report. A 16-yearold boy presented a 4-month sense of fullness in the ear and otalgia on the left side. A year before, mastoidectomy and posterior atticotomy were performed with ventilation tube placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy examination, audiology and computed tomography (CT) findings. CT showed an obliterative soft-tissue mass completely filled the external ear canal with associated erosion of subjacent the bone. There were squamous epithelial links between the canal cholesteatoma and lateral tympanic membrane surface. They originated from the margins of tympanic membrane incision made for a ventilation tube (VT) insertion. The position of VT was good as well as the aeration of the middle ear cavity. The tympanic membrane was intact and of normal appearance without middle ear extension or mastoid involvement of cholesteatoma. Cholesteatoma and ventilation tube were both removed. The patient recovered without complications and shortly audiology revealed hearing improving. Follow-up 2 years later, however, showed no signs of the disease. Conclusion. There could be more than one potential delicate mechanism of developing EEC in the ear with VT insertion and mastoidectomy. It is necessary to perform routine otologic surveillance in all patients with tubes. Affected ear CT scan is very helpful in showing the extent of cholesteatoma and bony defects, which could not be assessed by otoscopic examination alone.

scholarly journals Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Damiana Lima Costa ◽  
Tamires Daros dos Santos ◽  
Amanda Albiero Real ◽  
Graciele Sbruzzi ◽  
Adriane Schmidt Pasqualoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sore Throat ◽  
Observational Studies ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Smoke Inhalation ◽  
Level Of Evidence ◽  
Manual Search ◽  
Lung Injuries ◽  
Enclosed Space

Abstract Introduction: Lung injuries from toxic smoke inhalation are the main causes of death in fire victims; however, information regarding the acute effects on the respiratory system after smoke inhalation and its constituents in closed environments are still scarce in literature. Objective: To investigate the acute clinical manifestations observed in victims of smoke inhalation during enclosed-space fires by means of systematic review. Methods: A systematic search was conducted in the following databases: MEDLINE (via PubMed), Lilacs, Scopus and Web of Science. There were no appliedrestrictions in terms of thepublication date. In addition, a manual search was performed on the references of published studies. Observational studies assessing the prevalence of acute clinical manifestations in victims of toxic smoke inhalation in closed environments were included. Results: Of the 4,603 articles identified, eight were included, comprising a total of 233 patients. The signs and symptoms were identified and ranked according to frequency. Dyspnea (58.80%, six studies), carbonaceous sputum (54.51%, four studies), hoarseness (39.91%, three studies), wheezing (34.33%, five studies) and sore throat (33.90%, two studies) were the most frequent acute clinical manifestations of smoke inhalation. Besides these, chest pain and pulmonary edema were observed, respectively in 13.30%, 5.15% of the studies. Conclusion: The results suggest that dyspnea, carbonaceous sputum, hoarseness, wheezing and sore throat were the most frequent acute clinical manifestations in victims of smoke inhalation. Further studies of a higher level of evidence and greater methodological rigor are required.

scholarly journals Feasibility of an Innovative Absorbable Ventilation Tube Designed to Provide Intermediate-Term Middle Ear Ventilation: Clinical Human Proof-of-Concept

2021 ◽  
Author(s):  
Sandra M Skovlund ◽  
Shelagh Cofer ◽  
Heather Weinreich
Keyword(s):  
Tympanic Membrane ◽  
Feasibility Study ◽  
Middle Ear ◽  
Surgical Procedure ◽  
Therapeutic Response ◽  
Tube Placement ◽  
Proof Of Concept ◽  
Ventilation Tube ◽  
Middle Ear Ventilation ◽  
Duration Of Ventilation

Myringotomy with ventilation tube placement is a common surgical procedure performed in children and adults to remove fluid build-up behind the tympanic membrane. However, retention of tubes beyond achievement of therapeutic response increases risk for complications and additional intervention. This small feasibility study was conducted to demonstrate proof-of-concept of a novel bioabsorbable ventilation tube (BVT) that provides the necessary duration of ventilation with absorption shortly thereafter in human adult patients. BVTs were placed in 15 ears of 14 patients meeting indications for short or intermediate-duration of middle ear ventilation. Two independent examiners documented eardrum status. BVT patency and BVT absorption status at 3, 6, and 12 week intervals until absorption was complete. Results indicate that average ventilation time was 12 weeks (range 3 weeks to 18 months). There was no observation of blockage. These findings support the safety and utility of a novel bioabsorbable ventilation tube.

scholarly journals The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature

2021 ◽  
Vol 15 (8) ◽  
pp. e0009722
Author(s):  
Ana Carolina Tardin Martins ◽  
Amanda Ramos de Brito ◽  
Patrícia Shu Kurizky ◽  
Rodrigo Gurgel Gonçalves ◽  
Yago Ranniere Teixeira Santana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Observational Studies ◽  
Treatment Options ◽  
Sufficient Evidence ◽  
Tissue Destruction ◽  
Adequate Treatment ◽  
Surgical Interventions ◽  
Surgical Extraction ◽  
Quantitative Descriptive

Background Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extraction to the use of oral and topical medications. We aimed to perform a systematic review to assess the efficacy of topical, oral and surgical interventions for the treatment of tungiasis. Methodology/Principal findings The present review is registered in PROSPERO (CRD42021234741). On September 1, 2020, we searched PubMed, EMBASE, Scopus, Web of Science, Science Direct, Scielo and LILACS BVS. We included clinical trials and longitudinal observational studies that evaluated any topical, systemic or mechanical treatment for tungiasis. We used the Revised Cochrane Risk of Bias (RoB) Tool for Randomized Trials for clinical trial analysis. Qualitative and quantitative descriptive syntheses were performed. Our search strategy resulted in 3376 references. Subsequently, 2568 titles/abstracts and 114 full texts were screened. We finally included 19 articles; 9 were classified as clinical trials. Two and 3 articles presented low and some RoB, respectively, according to the tool. Only two articles tested the efficacy of oral medications (niridazole, ivermectin), with discouraging results. Six clinical trials evaluated topical products for the treatment of tungiasis; 2 evaluated dimeticone-based compounds and reported positive results in lesion reduction and cure. None reported significant adverse reactions. Surgical extraction was evaluated only in observational studies. Conclusions/Significance We conclude that, although surgical extraction is the most commonly used treatment, there is sufficient evidence supporting the use of occlusive agents, especially manufactured dimeticone-based products.

Salivary Biomarkers in Denture Stomatitis: A Systematic Review

2019 ◽  
Vol 4 (4) ◽  
pp. 312-322 ◽  
Author(s):  
M.F. Khiyani ◽  
M. Ahmadi ◽  
J. Barbeau ◽  
J.S. Feine ◽  
R.F. de Souza ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Methodological Quality ◽  
Control Group ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Denture Stomatitis ◽  
Salivary Biomarkers ◽  
Tnf Α ◽  
Significant Difference

Objective Denture stomatitis (DS) is an oral biofilm–associated inflammation of the denture-bearing mucosa. The objective of this review was to identify and evaluate the quality of evidence on the association between the levels of salivary biomarkers and DS among adults with and without palatal DS. Materials and methods: Following the PRISMA guidelines, Medline, PubMed, EMBASE, and the Cochrane Central Register for Controlled Trials were searched for eligible studies from the beginning of the archives until December 2018. Experimental and observational studies with adult participants were included that had a control group or subgroup analysis and provided data on salivary biomarkers and DS. Articles in languages other than English or French were excluded. The level of evidence and grades of recommendation were established with the 2011 scale of the Oxford Centre for Evidence-Based Medicine. Additionally, the assessment of methodological quality was conducted with the STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) and graded according to the Olmos scale. Results: From 1,008 citations, 9 studies were included in the systematic review (8 observational, 1 clinical trial). Seven studies suggested a statistically significant difference in the levels of salivary cytokines (IL-6, CCL3, TGF-β, CXCL8, GM-CSF, and TNF-α) between participants with DS and controls ( P < 0.05). In contrast, 2 studies concluded that the difference in the levels of several salivary cytokines (IL2, IL12, IFN-g, IL-4, IL-8, IL-10, IL-17, TNF-α, and ICAM-1) between the groups was not statistically significant. The level of evidence for the majority of studies was 3, while the grade of recommendation for all the studies was B, interpreted as “favorable.” In terms of methodological quality, most studies met 50% to 80% of STROBE criteria and were graded B. Conclusion: Palatal inflammation in DS is significantly associated with the levels of salivary cytokines. Knowledge Transfer Statement: The results of this study identified altered levels of specific salivary biomarkers associated with denture stomatitis, which may aid in the early diagnosis and treatment of this disease.

scholarly journals Clinical features contributing to the sit-to-stand transfer in people with Parkinson’s disease: a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Charmaine Pearl Da Cunha ◽  
Pratiksha Tilak Rao ◽  
Suruliraj Karthikbabu
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Trunk Flexion ◽  
Case Control Studies ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Joint Torques ◽  
Sit To Stand

Abstract Introduction The aim of this systematic review is to present the existing literature on the clinical motor, and non-motor factors contributing to sit-to-stand transfer in individuals with Parkinson's disease. Data synthesis Five databases (PubMed, PEDro, Cochrane, SCOPUS, and Ovid) were searched for literature on the contributing factors to sit-to-stand performance in Parkinson's disease. A quality check of these observational studies was done using the 'strengthening the reporting of observational studies in epidemiology' (STROBE) statement and the tool of the 'National Heart, Lung, and Blood Institute' (NHLBI). Descriptive and quantitative data were extracted and compiled, and a meta-analysis was performed to compute the standardised mean difference. Results Thirteen studies were selected; a majority of them provided a high-to-moderate level of evidence. Ten were cross-sectional, while the other three were case–control studies. Collectively, individuals with Parkinson's disease had a prolonged transfer time than those of age-matched healthy peers, particularly from peak horizontal velocity phase to seat-off phase, implying bradykinesia. A reduction in peak and rate to peak joint torques was also related to the decreased pace and stability of the sit-to-stand movement in individuals with Parkinson's disease. Additionally, they demonstrated exaggerated trunk flexion as a postural stabilisation strategy, allowing them to maintain and manoeuvre the relative positions of their centre of mass through the transitional phase of the transfer. Conclusion As per the existing literature, an alteration in strength, overall body bradykinesia, balance, posture, as well as cognition may result in an impaired sit-to-stand transfer in individuals with Parkinson's disease.

scholarly journals Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review

2021 ◽  
Author(s):  
Danúbia da Cunha De Sá-Caputo ◽  
Ana Carolina Coelho-Oliveira ◽  
Anelise Sonza ◽  
Laisa Liane Paineiras-Domingos ◽  
Redha Taiar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
English Language ◽  
Face Mask ◽  
Risk Of Bias ◽  
Bacterial Suspension ◽  
Level Of Evidence ◽  
Airborne Contamination ◽  
Different Types ◽  
The Face

Background: The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. Methods: PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. Results: The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. Conclusion: It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.

scholarly journals SEDENTARY BEHAVIOR AND NUTRITIONAL STATUS AMONG OLDER ADULTS: A META-ANALYSIS

2018 ◽  
Vol 24 (4) ◽  
pp. 310-315 ◽  
Author(s):  
Bruno de Freitas Camilo ◽  
Talita Inácio Martins Resende ◽  
Édimo Fernando Alves Moreira ◽  
Renata Damião
Keyword(s):  
Systematic Review ◽  
Nutritional Status ◽  
Sedentary Behavior ◽  
Exposure Time ◽  
Observational Studies ◽  
Web Of Science ◽  
Meta Analysis ◽  
Level Of Evidence ◽  
Level Ii ◽  
Modernization Process

ABSTRACT The accelerated modernization process has entailed changes in the lifestyle of people, such as exposure to sedentary behavior, and this in turn may affect the nutritional status. The aim of this systematic review with meta-analysis was to analyze observational studies that assessed the association between exposure time to sedentary behavior and nutritional status (overweight/malnutrition) in individuals aged ≥60 years. BVS, PubMed and Web of Science were the databases used in the search for observational studies, published until November 28, 2017, which have examined the association between exposure time to sedentary behavior and nutritional status. Two authors undertook the reading of titles and abstracts and applied the STROBE checklist independently. The Odds Ratio was calculated using the random effects model. Eight studies were included in this meta-analysis and involved 21415 individuals. All the studies covered most of the items suggested by the STROBE checklist. Of the total, four studies showed association between sedentary behavior and nutritional status. Longer exposure to sedentary behavior did not increase the odds of overweight and/or obesity (OR 1.32; 95%; CI 0.95-1.84). It is suggested that further studies with standardized criteria for measuring sedentary behavior and nutritional status are undertaken. Level of Evidence II; Systematic review of level II studies.

Feasibility of an Innovative Absorbable Ventilation Tube Designed to Provide Intermediate-Term Middle Ear Ventilation

2021 ◽  
pp. 019459982110265
Author(s):  
Sandra Skovlund ◽  
Shelagh Cofer ◽  
Heather Weinreich
Keyword(s):  
Tympanic Membrane ◽  
Feasibility Study ◽  
Middle Ear ◽  
Surgical Procedure ◽  
Therapeutic Response ◽  
Tube Placement ◽  
Proof Of Concept ◽  
Ventilation Tube ◽  
Middle Ear Ventilation ◽  
Duration Of Ventilation

Myringotomy with ventilation tube placement is a common surgical procedure performed in children and adults to remove fluid buildup behind the tympanic membrane. However, retention of tubes beyond achievement of therapeutic response increases risk for complications and additional intervention. This small feasibility study was conducted to demonstrate proof of concept of a novel bioabsorbable ventilation tube that provides the necessary duration of ventilation with absorption shortly thereafter. Tubes were placed in 15 ears of 14 patients meeting indications for short or intermediate duration of middle ear ventilation. Two independent examiners documented tube patency and tube absorption status at 3, 6, and 12 weeks or until absorption was complete. Results indicate that average ventilation time was 12 weeks (range, 3 weeks to 18 months). There was no observation of blockage. These findings support the feasibility of a novel bioabsorbable ventilation tube.

scholarly journals Systematic Review of the Effectiveness of Thermal Annular Procedures in Treating Discogenic Low Back Pain

2009 ◽  
Vol 1;12 (1;1) ◽  
pp. 207-232 ◽  
Author(s):  
Standiford Helm II
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Observational Studies ◽  
Low Back ◽  
Level Of Evidence ◽  
Level Ii ◽  
Discogenic Low Back Pain ◽  
One Year

Background: Chronic discogenic low back pain is a common problem with significant personal and societal costs. Thermal annular procedures (TAPs) have been developed in an effort to provide a minimally invasive treatment for this disorder. Multiple techniques utilized are intradiscal electrothermal therapy (IDET), radiofrequency annuloplasty, and intradiscal biacuplasty (IDB). However, these treatments continue to be controversial, coupled with a paucity of evidence. Study Design: A systematic review of the literature evaluating the efficacy or effectiveness of TAPs. Objective: To determine the effectiveness of TAPs in reducing low back pain in patients with intradiscal disorders. Methods: A comprehensive evaluation of the literature relating to TAPs was performed. The literature was evaluated according to Cochrane Review criteria for randomized controlled trials (RCTs) and according to the Agency for Healthcare Research and Quality (AHRQ) criteria for observational studies. The level of evidence was classified as Level I, II, or III based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, and return to work. Data sources included relevant literature of the English language identified through searches of PubMed, EMBASE, the Cochrane Library, and the Database of Reviews of Effectiveness (DARE). Outcome Measures: Short-term effectiveness was defined as one-year or less and long-term effectiveness was defined as greater than one-year. Results: Systematic review of IDET identified 2 RCTs and 16 observational studies with an indicated evidence of Level II-2. Systematic review of radiofrequency annuloplasty identified no RCTs but 2 observational studies with an uncertain evidence of Level II-3. Systematic review of IDB identified one pilot study. The level of evidence is lacking with Level III. Limitations: The limitations of this review include paucity of the literature and lack of evidence with internal validity and generalizability. Conclusion: IDET offers functionally significant relief in approximately one-half of appropriately chosen chronic discogenic low back pain patients. There is minimal evidence supporting the use of radiofrequency annuloplasty and IDB. Key words: Chronic low back pain, degenerative disc disease, internal disc disruption, intervertebral disc, thermal annular procedures, intradiscal electrothermal therapy, radiofrequency ablation, intradiscal biacuplasty, radiofrequency annuloplasty

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