scholarly journals The Cephalic Index is not different among groups of children aged 36–48 months with chronic otitis media with effusion, recurrent acute otitis media and controls

2013 ◽  
Vol 77 (3) ◽  
pp. 334-337 ◽  
Author(s):  
Margaretha L. Casselbrant ◽  
J. Douglas Swarts ◽  
Ellen M. Mandel ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Cephalic Index ◽  
Recurrent Acute Otitis Media

Management of Otitis Media Using Agency for Health Care Policy and Research Guidelines

1998 ◽  
Vol 118 (4) ◽  
pp. 437-443 ◽  
Author(s):  
Griffith S. Hsu ◽  
Samuel C. Levine ◽  
G. Scott Giebink
Keyword(s):  
Health Care ◽  
Otitis Media ◽  
Health Care Policy ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Care Policy ◽  
Research Guidelines ◽  
Recurrent Acute Otitis Media ◽  
History Of

Increased costs of managing otitis media and its complications may result from delays in diagnosis and treatment. The Agency for Health Care Policy and Research developed guidelines to assist in the management of chronic otitis media with effusion. We examined the medical care adherence to Agency for Health Care Policy and Research guidelines in 59 consecutive patients referred because of chronic otitis media with effusion and recurrent acute otitis media. Patient history and examination data were collected prospectively. In the group with chronic otitis media with effusion, the rate of adherence to Agency for Health Care Policy and Research guidelines was 0%; in those with recurrent acute otitis media, adherence was 5%. Delayed referral occurred in 34% of patients; 25% of patients were referred early. The average duration of effusion in patients with chronic otitis media with effusion was 5.2 months; the duration of recurrent acute otitis media immediately before referral was 9.3 months. Eighteen patients (47%) in the chronic otitis media with effusion group had a history of recurrent chronic otitis media with effusion spanning an average of 22.7 months. On referral, hearing loss was discovered in 92% of all patients, and in 69% the tympanogram was flat. The complication and sequelae rate was 49.1%, and speech delay was the most frequent at 16.9%. We conclude that in our study patients there is a significant referral delay, long history of chronic otitis media with effusion in patients before referral, high rate of hearing loss, and high complication rate. Continued efforts should be directed toward improving education of all clinicians so that diagnostic tools and timely otolaryngologic referral are better used.

scholarly journals Qualidade de Vida das Crianças com Otite Média e Impacto da Colocação de Tubos de Ventilação Transtimpânicos numa População Portuguesa

2018 ◽  
Vol 31 (1) ◽  
pp. 30 ◽  
Author(s):  
Ana Rita Lameiras ◽  
Deodato Silva ◽  
Assunção O´Neill ◽  
Pedro Escada
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Portuguese Version ◽  
Physical Suffering ◽  
Recurrent Acute Otitis Media

Introduction: Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children’s quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media.Material and Methods: This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure.Results: The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains ‘caregiver concerns’, ‘hearing loss’ and ‘physical suffering’ had the highest scores. The domain ‘hearing loss’ was correlated with the domain ‘speech impairment’ (rs = 0.41; p < 0.001) and the domain ‘physical suffering’ correlated with the domain ‘activity limitation’ (rs = 0.47; p < 0.001). There was a correlation between the score on ‘hearing loss’ and the presence of conduction hearing loss (χ2 (6) = 24.662; p = 0.022). Children with chronic otitis media with effusion had lower scores on the domain ‘physical suffering’, while children with recurrent acute otitis media had lower scores in the domain ‘hearing loss’ and higher scores in the domain ‘emotional distress’. There was an improvement in the quality of life in all the dimensions studied by the questionnaire after surgery. The improvement was large in 55%, moderate in 15% and small in 10% of the cases. The presence of otorrhea postoperatively did not decrease the quality of life improvement achieved with surgery.Conclusion: Otitis media has a negative impact on Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.

scholarly journals Comparative Analysis of the Humoral Immune Response to Moraxella catarrhalis and Streptococcus pneumoniae Surface Antigens in Children Suffering from Recurrent Acute Otitis Media and Chronic Otitis Media with Effusion

2012 ◽  
Vol 19 (6) ◽  
pp. 914-918 ◽  
Author(s):  
Suzanne J. C. Verhaegh ◽  
Kim Stol ◽  
Corné P. de Vogel ◽  
Kristian Riesbeck ◽  
Eric R. Lafontaine ◽  
...  
Keyword(s):  
Immune Response ◽  
Otitis Media ◽  
Humoral Immune Response ◽  
Moraxella Catarrhalis ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Content Type ◽  
Humoral Immune ◽  
Recurrent Acute Otitis Media

ABSTRACTA prospective clinical cohort study was established to investigate the humoral immune response in middle ear fluids (MEF) and serum against bacterial surface proteins in children suffering from recurrent acute otitis media (rAOM) and chronic otitis media with effusion (COME), using Luminex xMAP technology. The association between the humoral immune response and the presence ofMoraxella catarrhalisandStreptococcus pneumoniaein the nasopharynx and middle ear was also studied. The levels of antigen-specific IgG, IgA, and IgM showed extensive interindividual variation. No significant differences in anti-M. catarrhalisand anti-S. pneumoniaeserum and MEF median fluorescence intensity (MFI) values (anti-M. catarrhalisand antipneumococcal IgG levels) were observed between the rAOM or COME groups for all antigens tested. No significant differences were observed forM. catarrhalisandS. pneumoniaecolonization and serum IgG levels against theMoraxellaand pneumococcal antigens. Similar to the antibody response in serum, no significant differences in IgG, IgA, and IgM levels in MEF were observed for allM. catarrhalisandS. pneumoniaeantigens between OMM. catarrhalis-orS. pneumoniae-positive and OMM. catarrhalis-orS. pneumonia-negative children suffering from either rAOM or COME. Finally, results indicated a strong correlation between antigen-specific serum and MEF IgG levels. We observed no significantin vivoexpressed anti-M. catarrhalisor anti-S. pneumoniaehumoral immune responses using a range of putative vaccine candidate proteins. Other factors, such as Eustachian tube dysfunction, viral load, and genetic and environmental factors, may play a more important role in the pathogenesis of OM and in particular in the development of rAOM or COME.

Delayed Onset Post-Tympanotomy Otorrhea

1988 ◽  
Vol 98 (2) ◽  
pp. 111-115 ◽  
Author(s):  
George A. Gates ◽  
Christine Avery ◽  
Thomas J. Prihoda ◽  
G. Richard Holt
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Delayed Onset ◽  
Tympanostomy Tubes ◽  
Care Costs

Otorrhea is the most frequent complication of the use of tympanostomy tubes. When it occurs after the immediate postoperative period, otorrhea is probably the result of external contamination of the middle ear or acute otitis media. We analyzed data from 627 operations upon 1248 ears of 491 children with chronic secretory otitis media and found that delayed onset (longer than 7 weeks) postoperative otorrhea occurred after 26.4 percent of the 382 operations in which tympanostomy tubes were used. The average number of episodes of otorrhea per case was 1.46 and ranged from 1 to 9. The rate of otorrhea occurrence in patients with tubes in place was significantly higher in the summer months. Otorrhea also occurred after 9.0 percent of 245 myringotomy procedures. The average number of episodes was 1.32 and ranged from 1 to 3. Treatment of postoperative otorrhea increases the health care costs of surgical treatment of chronic otitis media with effusion; this problem should be included in the calculation of cost-effectiveness.

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