Impedance screening for otitis media with effusion in Nigerian children

AbstractTympanometry and acoustic reflex tests performed on 431 school children aged five to six years showed that eight per cent of the ears screened had type B or type C tympanograms suggestive of otitis media with effusion (1.2 per cent type B, and 6.8 per cent type C). Preliminary otoscopy revealed tympanic membrane appearances consistant with middle ear effusion in a correspondingly low proportion of ears (7.6 per cent), whilst acoustic reflex screening at 105 dB for three frequencies (0.5, 1 and 2 kHz) showed absent reflexes at one or more frequencies in 8.1 per cent of the ears. The findings indicate a relatively low prevalence of otitis media with effusion in children in Nigeria. Possible contributory factors are discussed.

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Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948409300113 ◽

1984 ◽

Vol 93 (1) ◽

pp. 52-56 ◽

Cited By ~ 83

Author(s):

Thomas F. DeMaria ◽

David J. Lim ◽

Bruce R. Briggs ◽

Nobuhiro Okazaki

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Animal Experiment ◽

Otitis Media With Effusion ◽

Type B ◽

Negative Bacterium ◽

Middle Ear Effusion ◽

Sterile Saline ◽

Inflammatory Changes ◽

Ear Effusion

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

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Significance of Adenoidectomy in the Treatment of Otitis Media with Effusion (OME)

Otolaryngology Open Access Journal ◽

10.23880/ooaj-16000198 ◽

2020 ◽

Vol 5 (2) ◽

Author(s):

Md Ashraful Islam

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Future Research ◽

Adenoid Hypertrophy ◽

Type B ◽

Middle Ear Effusion ◽

Ear Effusion ◽

Grade Iii

Background & Objectives: Adenoid hypertrophy is one of the commonest etiology for otitis media with effusion (OME). OME is a leading cause of diminished hearing in children younger than 12 years. This study compares the efficacy of adenoidectomy on OME in patients with different grades of adenoids and the connection between different position of adenoids and middle ear effusion. Methods: This is a prospective study done on 120 pediatric patients (2 to 12 years) presented with chronic otitis media with effusion and adenoid hypertrophy from 2017 to 2019. Adenoid size was graded and correlated with the type of tympanometry. All the cases were subjected to adenoidectomy with myringotomy and were observed every 3 months. Preoperative and postoperative data were collected and comparison was made to evaluate whether adenoidectomy with myringotomy is sufficient on management of OME. Results: Adenoid tissue grading showed majority of population remained in Grade III (45%) and Grade C (56.67%). There is a highly significant relation between higher adenoid grade and type B tympanometry. This study showed significant association between grade III and grade C adenoid hypertrophy and otitis media with effusion when compared with other grades of adenoid hypertrophy. This suggests that increasing grade of adenoid hypertrophy is important predictor in establishment of otitis media with effusion in patient with adenoid hypertrophy. After adenoidectomy majority of tympanometry curve was shifted from type B to type A. In case of Grade III, type B tympanometry reduced from 45 to 11 (83% to 20%) in right ears; 49 to 7 (90% to 12%) in left ears. Again, in case of Grade C, type B tympanometry reduced from 55 to 6 (80% to 8%) in right ears; 58 to 5 (85% to 7%) in left ears. This change was significant. The greater the size of the adenoid, after adenoidectomy, more improvement noticed in tympanometry curve. Conclusion: This study may not be the actual picture of overall situation due to many limitations. Still it can be concluded that enlarged adenoids has a definite role in causing OME. This research also shows a benefit of adenoidectomy in the removal of middle ear effusion in children with OME. To efficiently assess the efficacy of adenoidectomy for otitis media with effusion in children, future research is needed.

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Role of adenoid hypertrophy in causation of chronic middle ear effusion

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175626 ◽

2017 ◽

Vol 4 (1) ◽

pp. 203

Author(s):

Timna C. J. ◽

Chandrika D.

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Adenoid Hypertrophy ◽

Age Group ◽

Type B ◽

Middle Ear Effusion ◽

Type C ◽

Grade 3 ◽

Ear Effusion

Abstract:Background: Hearing plays a valid role in speech development in children. Otitis media with effusion is one among the commonest causes of hearing loss in children especially below 12 years. It is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infectionMethods: A prospective study was carried out in Lourdes Hospital, Kochi, over a period of 1 year from January 2013 to December 2013. Thirty patients with chronic middle ear effusion below the age of 12 years were selected for the study.Results: of the 30 patients 59.5% of patients were in the age group of 5-7 years of age, 16.6 % of patients were in the age group of 9-11 years of age .13.3% of patients each were in the age group of 3-5 years and 7-9 years of age.Among the 30 patients ,60% were male children and 40% patients were female children.Among the 30 patients , 40% of them had grade 3 adenoid hypertrophy ,33.3% of them had grade 2 adenoid hypertrophy and 30% of them had grade 4 adenoid hypertrophy and none had grade 1 adenoids. majority of them had grade 3 adenoid hypertrophy by endoscopic assessment.Among the 30 patients ,66.6 % of them had eustachian tube blockade by the adenoid mass and 33.4% of them didn’t have eustachian tube blockade. 100% of them with eustachian tube blockade found to have fluid on doing myringotomy and there was 20% of chance of absence of fluid ,if there is absence of eustachian tube blockade. Significant association was found between type B tympanogram and presence of fluid on myringotomy .92.5% of patients with type B tympanogram had fluid on myringotomy . 57.1 % of patients with type C tympanogram had fluid on doing myringotomy.There were 2 patients with grade 4 adenoid hypertrophy ,without eustachian tube blockade with bilateral type C tympanogram and there was bilateral dry tap on myringotomy. This reveals that type B tympanogram and eustachian tube blockade better predictor of otitis media with effusion than grade of adenoid hypertrophy.Conclusion: The present study showed that chronic middle ear effusion was found to be most common in the age group of 3-5 years of age group and relatively common in the male children. Tympanogram type B was found to be strongly associated with fluid on myringotomy .All the children with chronic middle ear effusion in the study group were found to have ,grade 3 grade 2,and grade 4 adenoid hypertrophy in the descending order of frequency.Grade 3 adenoid hypertrophy was present in majority of the children in the study group .Lateral adenoid hypertrophy ,abutting on the nasopharyngeal orifice of Eustachian tube was present in majority of children. Eustachian tube obstruction was found to be strongly associated with fluid on myringotomy and grommet insertion

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To Tube or Not to Tube: That Continues to Be the Question

PEDIATRICS ◽

10.1542/peds.76.2.332a ◽

1985 ◽

Vol 76 (2) ◽

pp. 332-332

Author(s):

DAVID W. TEELE ◽

BERNARD ROSNER ◽

JEROME O. KLEIN

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Speech And Language ◽

Clinically Significant ◽

Ear Effusion

In Reply.— We appreciate Chamberlin's thoughtful comments about the associations between otitis media with effusion and development of speech and language and his concern about results that are statistically significant but may not be "clinically significant." We share his view that measurements of the sequelae of disease should include those that are meaningful to the child. We reported results of tests of speech and language that indicated that children who had spent many days with middle ear effusion during the first years of life scored significantly lower than did children who had not spent such time.

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Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100101124 ◽

1986 ◽

Vol 100 (12) ◽

pp. 1347-1350 ◽

Cited By ~ 8

Author(s):

T. H. J. Lesser ◽

M. I. Clayton ◽

D. Skinner

Keyword(s):

Medical Treatment ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Randomised Trial ◽

Control Group ◽

Middle Ear Effusion ◽

Secretory Otitis Media ◽

Ear Effusion

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).

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Experimental Otitis Media With Effusion Induced by Middle Ear Effusion

The Laryngoscope ◽

10.1288/00005537-199209000-00014 ◽

1992 ◽

Vol 102 (9) ◽

pp. 1037???1042 ◽

Cited By ~ 9

Author(s):

Junko Nakata ◽

Masashi Suzuki ◽

Hideyuki Kawauchi ◽

Goro Mogi

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

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IL-5 and Eotaxin Levels in Middle Ear Effusion and Blood from Asthmatics with Otitis Media with Effusion

Acta Oto-Laryngologica ◽

10.1080/0036554021000028117 ◽

2003 ◽

Vol 123 (3) ◽

pp. 383-387 ◽

Cited By ~ 35

Author(s):

Manabu Nonaka ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

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The Role of Coagulase-Negative Staphylococci in Chronic Otitis Media With Effusion

Otolaryngology ◽

10.1177/019459988209000628 ◽

1982 ◽

Vol 90 (6) ◽

pp. 837-843 ◽

Cited By ~ 10

Author(s):

Joel M. Bernstein ◽

Diane Dryja ◽

Erwin Neter

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Antibiotic Sensitivity ◽

Middle Ear Effusion ◽

Coagulase Negative Staphylococci ◽

Heterogenous Group ◽

Ear Effusion

Twenty-eight middle ear effusions from 27 patients with chronic otitis media with effusion were studied for the presence of bacteria. The most common isolates were coagulase-negative staphylococci. However, biochemical and antibiotic sensitivity patterns demonstrated that these organisms represented a heterogenous group. At least three subtypes of coagulase-negative staphylococci were identified from the middle ear effusions, and in only one instance was the isolate from the ear canal identical with that of the middle ear effusion. The data presented suggest that coagulase-negative staphylococci from the middle ear effusions may not be contaminants; however, it cannot be determined from this study whether these organisms play a role as pathogens or as the result of indolent colonization.

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Tympanostomy Tube Selection: A Review of the Evidence

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1259 ◽

2016 ◽

Vol 7 (1) ◽

pp. 17-22

Author(s):

Ho Sandra ◽

David J Kay

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

The United States ◽

Tube Placement ◽

Tympanostomy Tube ◽

Middle Ear Effusion ◽

Surgeon Experience ◽

Ear Effusion

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

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