Ventilation tubes after surgery for otitis media with effusion or acute otitis media and swimming. Systematic review and meta-analysis

Abstract Background Otitis media with effusion (OME) is a worldwide major health problem for both children and adult, who have a history of chronic eustachian tube dysfunction. Aim of the Work to review the effect of intratympanic injection of steroids in treatment of chronic otitis media with effusion (persistent more than 3 months after failure to medical treatment [e.g. local & systemic steroids or decongestants] or surgical ventilation tubes). Material and Methods This systematic review was done as a collective analysis of 5 retrospective and prospective cohort studies done on patients with OME. Studies on Patients who were diagnosed with chronic otitis media with effusion not responding to conventional methods of treatment. Results The data analysed and results showed an improvement of 41.2% of the cases treated with intratympanic injection of steroids compared to 11% improvement in cases treated by conventional medical methods with a relative improvement around 6.4 folds to intratympanic injection of steroids over medical treatment. All of these studies have shown that there are more advantages of directed ototopical steroid therapy over systemic therapy. Topical medications often have limited systemic effects due to their limited systemic uptake. It may be less expensive as compared to systemic medications. Conclusion Intratympanic injection of long acting steroids has good effect in management of OME resistant to medical and surgical treatment and has superior effect and high rate of recovery on local nasal steroid spray. In children combination of ventilation tubes and intratymapnic injection of steroids is the best known modality of treatment. Further studies are needed to evaluate the best medical treatment of chronic OME.

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Impact of antibiotics on pathogens associated with otitis media with effusion

The Journal of Laryngology & Otology ◽

10.1258/002221505774783476 ◽

2005 ◽

Vol 119 (11) ◽

pp. 862-865 ◽

Cited By ~ 6

Author(s):

Yukiko Hamamoto ◽

Yukako Gotoh ◽

Yoshimi Nakajo ◽

Satoko Shimoya ◽

Chikako Kayama ◽

...

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Bacterial Genome ◽

Acute Otitis Media ◽

Antibiotic Administration ◽

Ventilation Tube ◽

Tube Insertion ◽

Bacterial Dna ◽

Ventilation Tubes ◽

History Of

Objective: To further understand the roles of bacteria and antibiotics in the development of otitis media with effusion (OME).Methods: Samples of middle-ear effusion (MEE) were collected during the placement of ventilation tubes to treat chronic OME. Children with acute otitis media within the past three months were excluded from this study. We used polymerase chain reaction (PCR) to detect pathogens and to test the susceptibility of Streptococcus pneumoniae to penicillin.Results: Among MEE samples from 52 children, PCR detected bacterial DNA in 32 per cent (24/75) of them. S. pneumoniae was detected more frequently in middle ears that required ventilation tube insertion at least twice compared with those requiring ventilation tube insertion only once (5/15 versus 4/60; p = 0.013). Higher levels of S. pneumoniae were detected in MEE from children with, than without, a long history of antibiotic administration (7/10 versus 2/14; p = 0.0187). The pbp genes of all isolated S. pneumoniae contained mutations.Conclusions: Long exposure to antibiotics might significantly influence the bacterial genome in MEE.

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Randomized, Controlled Trial Comparing Longterm Sulfonamide Therapy to Ventilation Tubes for Otitis Media With Effusion

PEDIATRICS ◽

10.1542/peds.88.2.215 ◽

1991 ◽

Vol 88 (2) ◽

pp. 215-222

Author(s):

Philippe A.M. Bernard ◽

Robert J. Stenstrom ◽

William Feldman ◽

Andree Durieux-Smith

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Controlled Trial ◽

Treatment Success ◽

Acute Otitis Media ◽

Pure Tone Audiometry ◽

Success Rates ◽

P Values ◽

Long Term Treatment ◽

Ventilation Tubes

Several studies have indicated that either the surgical insertion of ventilation tubes (VTs) or long-term treatment with sulfonamide-based antibacterials is effective in the management of otitis media with effusion (OME; otherwise known as serous otitis media, secretory otitis media, and glue ear) when compared with a notreatment control or placebo. This controlled trial is the first to compare directly the effectiveness of these two treatments for long-standing OME. Outcome variables are treatment success rates, hearing thresholds, recurrent acute otitis media episodes, and side effects of medication or complications of VT placement. One hundred twenty-five children (aged 2.5 to 7 years) who met the usual indications for surgery (long-standing [>3 months] OME and conductive hearing loss) were randomly assigned to "medical" treatment (sulfisoxazole 75 mg/kg per day for 6 months) or "surgical" treatment (bilateral insertion of VTs). Subjects underwent pure-tone audiometry (500, 1000, 2000, 4000 Hz) and otomicroscopic examination at 2, 4, 6, 12, and 18 months. A significantly greater proportion of medical subjects (67%) than surgical subjects (48%) were treatment failures at 6, 12, or 18 months (P = .0208). Surgical subjects had significantly better hearing at 2 and 4 months (P values < .01) but not at 6, 12, and 18 months (P values > .2). A significantly greater proportion of surgical subjects (50%) experienced complications of treatment than did medical subjects (9%) (P < .001). Thirty-three percent of candidates for VT placement did not require surgery when treated with a 6-month course of sulfisoxazole. Given these findings, together with the low cost of sulfonamide, a 6-month trial of antimicrobial therapy is recommended for children with long-standing OME, before considering VT placement.

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A systematic review and meta-analysis of antimicrobial resistance in paediatric acute otitis media

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2019.04.041 ◽

2019 ◽

Vol 123 ◽

pp. 102-109 ◽

Cited By ~ 6

Author(s):

Michael W. Mather ◽

Michael Drinnan ◽

John D. Perry ◽

Steven Powell ◽

Janet A. Wilson ◽

...

Keyword(s):

Systematic Review ◽

Antimicrobial Resistance ◽

Otitis Media ◽

Meta Analysis ◽

Acute Otitis Media

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Tympanostomy in young children with recurrent otitis media. A long-term follow-up study

The Journal of Laryngology & Otology ◽

10.1017/s0022215100143592 ◽

1999 ◽

Vol 113 (3) ◽

pp. 207-211 ◽

Cited By ~ 13

Author(s):

Hannu Valtonen ◽

Yrjö Qvarnberg ◽

Juhani Nuutinen

Keyword(s):

Young Children ◽

Otitis Media ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

Safe Procedure ◽

Tube Extrusion ◽

Final Study ◽

Recurrent Acute Otitis Media ◽

Long Term Follow Up ◽

Ventilation Tubes

AbstractA total of 305 children, five to 16 months of age, were treated from 1983–1984 with ventilation tubes – Shah vent Teflon tube – inserted under local anaesthesia for recurrent acute otitis media (RAOM) or otitis media with effusion (OME). The final study group comprised 281 children (92.1 per cent) monitored prospectively for five years, 185 in the OME-group and 96 in the RAOM-group. For the first insertion of tubes the average ventilation period was 15.4 months. Re-tympanostomy, with adenoidectomy simultaneously at the first time was performed in 99 ears (35.2 per cent); once in 27.0 per cent, twice in five per cent, and three times in 3.2 per cent. Mastoidectomy due to otorrhoea was performed in three ears (1.1 per cent). The children in the OME-group were at higher risk of repeated post-tympanostomy otorrhoea episodes than children in the RAOM-group. These episodes of otorrhoea during the first insertion of ventilation tubes significantly increased both the tube extrusion rate and the need for subsequent re-tympanostomies. No major complications were caused by the tympanostomy procedure as such. It is concluded that early tympanostomy is a safe procedure in young children with RAOM or OME. However, parents should be carefully informed of risks of post-tympanostomy otorrhoea and recurrent disease after insertion of ventilation tubes necessitating subsequent tube insertion, especially in children with OME.

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Association Between Helicobacter pylori Infection and Otitis Media With Effusion Risk in Children: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599820921861 ◽

2020 ◽

Vol 163 (4) ◽

pp. 654-661

Author(s):

Xiaohui Wu ◽

Yun Zheng ◽

Xingqiang Gao ◽

Gang Li ◽

Qiuxue Cao

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Otitis Media ◽

Otitis Media With Effusion ◽

Meta Analysis ◽

Helicobacter Pylori Infection ◽

Cochrane Library ◽

Case Group ◽

Asian Populations ◽

H Pylori

Objective To investigate the potential correlation between Helicobacter pylori infection and otitis media with effusion (OME) risk in children. Data Sources Electronic databases were searched, including Cochrane Library, PubMed, Embase, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang Database, and China National Knowledge Infrastructure Database. Review Methods A systematic review and meta-analysis were conducted with Revman 5.3 software. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate infection-disease association. Results In total, 11 studies from 9 articles regarding H pylori infection and OME risk were enrolled in this meta-analysis. A significant association between H pylori infection and OME was detected for both adenoid samples from the case group (OR, 2.75; 95% CI, 1.43-5.30; P = .002) and middle ear fluid samples from the case group (OR, 4.45; 95% CI, 2.52-7.88; P < .00001). Subgroup analyses suggested a stronger correlation in African and Asian populations. Conclusion This study indicated the correlation between H pylori infection and increased risk of OME in children, especially in African and Asian populations. Further well-designed studies regarding the white population are strongly recommended in the future.

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