scholarly journals Inflammatory cast of the tympanic membrane after acute otitis media

2013 ◽  
Vol 127 (3) ◽  
pp. 314-317
Author(s):  
J Byun ◽  
DS Massi ◽  
A Sehgal ◽  
M Saadia-Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Otitis Externa ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Patient Treatment

AbstractObjective:To describe a relatively unknown clinical entity – inflammatory cast of the tympanic membrane after acute otitis media – and its simple out-patient treatment.Study design:Retrospective review of case series.Setting:Subspecialty practice at a tertiary hospital.Patients:Seven patients diagnosed previously with acute otitis media with perforation or otitis externa, and with persistent ear discomfort.Methods:Retrospective chart review.Results:The patients presented with weeks to months of persistent hearing loss after acute otitis media with perforation or acute otitis externa. Visits to their primary care physicians had been uninformative. After comparison of the affected and unaffected tympanic membranes, a thin, hard cast was identified and removed from the affected tympanic membrane. Improvement in hearing was documented in the three patients who underwent audiometric testing; the remainder had subjective improvement without audiometric evaluation.Conclusion:Otolaryngologists should be aware of the possibility of an inflammatory cast of the tympanic membrane following acute otitis media with perforation or otitis externa, and should carefully compare the unaffected and affected ears in such cases. Treatment – removal of the rigid cast – is both simple and effective.

Post-operative complications of cochlear implantation in adults and children: five years' experience in Maastricht

2006 ◽  
Vol 121 (4) ◽  
pp. 318-323 ◽  
Author(s):  
J T F Postelmans ◽  
B Cleffken ◽  
R J Stokroos
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Retrospective Chart Review ◽  
Operative Complications ◽  
Ventilation Tubes ◽  
Adults And Children ◽  
Post Operative Complications

Although cochlear implantation is considered a safe method of rehabilitation for profoundly deaf individuals, a number of these patients suffer complications after surgery. To evaluate post-operative complications after cochlear implantation, a retrospective chart review was performed for 112 patients who had undergone implantation in the Maastricht Academic Hospital. Minor complications were defined as those that could be overcome by medical or audiological management. These occurred in 36 patients (32 per cent) and all were managed successfully. Major complications were defined as device extrusion and those requiring further surgery, and these were identified in four patients (3.6 per cent). These complications included wound infection and device failure mediated by middle-ear pathology. In cases of chronic otitis media, we recommend performance of cochlear implantation as a staged procedure. In order to reduce the post-operative incidence of acute otitis media, we recommend adenoidectomy, placement of ventilation tubes and early antibiotic treatment.

scholarly journals Otogenic Intracranial Complications in Bir Hospital; an Eight Years Retrospective Review

2018 ◽  
Vol 6 (1) ◽  
pp. 25-28
Author(s):  
Lal Kishor Yadav ◽  
Prakash Bahadur Thapa ◽  
Jayendra Pradhananga
Keyword(s):  
Otitis Media ◽  
Chart Review ◽  
Early Recognition ◽  
Sinus Thrombosis ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Lateral Sinus ◽  
Intracranial Complications

Objectives: To review our experiences on intracranial complications secondary to otitis media and to compare the results with other studies.Material and Methods: A retrospective chart review of  all patients with intracranial complications secondary to otitis media over eight years period in Bir hospital was done. Clinical presentation, radiological findings, microbiology, surgical management and antibiotics used were studied.Results: Forty eight cases were included in this study of which 23 had meningitis, 15 had brain abscess, 7 had lateral sinus thrombosis and 3 had petrositis. 37 of these were secondary to chronic otitis media and 11 were secondary to acute otitis media. Otorrhoea, headache, earache, fever, vertigo and vomiting were the main symptoms. Staphylococcus aureus was the most common bacteria isolated followed by Pneumococcus, Haemophilus influenzae and Klebsiella.Conclusion: Early recognition, multi drug treatment with broad spectrum antibiotic and multi disciplinary approach are the mainstay of management of otogenic intracranial complications.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015

scholarly journals Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media

2018 ◽  
Vol 58 (1) ◽  
pp. 60-65 ◽  
Author(s):  
David L. Brinker ◽  
Erina L. MacGeorge ◽  
Nicole Hackman
Keyword(s):  
Physical Examination ◽  
Otitis Media ◽  
Chart Review ◽  
Watchful Waiting ◽  
Acute Otitis Media ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Central Pennsylvania ◽  
Current Guidelines ◽  
Prescription Behavior

Current guidelines recommend “watchful waiting” (WW) as an alternative to immediate antibiotic treatment. Continued high rates of antibiotic use suggest that WW may be underutilized. We conducted a retrospective chart review of 474 pediatric acute otitis media (AOM) cases at a clinic in central Pennsylvania. We assessed physical examination findings, diagnostic behavior, WW utilization, prescription writing, and filling in cases of pediatric AOM to evaluate the underutilization of WW. We evaluate diagnostic consistency with published guidelines and rates of antibiotic prescription resulting from misdiagnosis. We report WW instructions and compliance, and prescription filling behaviors. Fifty percent of AOM diagnoses in this sample were not supported by physical examination findings. The majority of these AOM diagnoses received antibiotic prescriptions, suggesting that unsupported diagnoses translated to injudicious prescribing. WW instructions corresponded to 57% fewer filled prescriptions and longer fill delay. We discuss the implications and recommendations to improve antibiotic stewardship.

Conditions of the external and middle ear: an overview of presentation, management and associated complications

2017 ◽  
Vol 103 (1) ◽  
pp. 49-55
Author(s):  
R Shukla ◽  
R Easto ◽  
R Williams
Keyword(s):  
Primary Care ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Externa ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Appropriate Treatment ◽  
Military Patients ◽  
Nose And Throat

AbstractEar, nose and throat (ENT) presentations to primary care are common and frequently affect military patients. Many patients can be managed in primary care with appropriate treatment, but some presentations require appropriate, timely, and occasionally emergency onward referral for hospital management. This paper discusses the management of common otological presentations including otitis externa (OE), acute otitis media, chronic suppurative otitis media (including cholesteatoma), tympanic membrane (TM) perforations and pinna haematoma.

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

Cofactors of Pediatric Tinnitus: A Look at the Whole Picture

2018 ◽  
Vol 58 (3) ◽  
pp. 320-327
Author(s):  
Jessica Levi ◽  
Krystyne Basa ◽  
Kevin Wong ◽  
Thierry Morlet ◽  
Robert O’Reilly
Keyword(s):  
General Population ◽  
Otitis Media ◽  
Chart Review ◽  
Noise Exposure ◽  
Historical Data ◽  
Age Distribution ◽  
Retrospective Chart Review ◽  
Psychiatric Diagnoses ◽  
Laboratory Results ◽  
Tube Dysfunction

Retrospective chart review of 248 children (1-19 years old) with tinnitus who presented to a tertiary pediatric hospital between 2006 and 2011, looking at which cofactors are predictors of pediatric tinnitus. In our review, we extracted demographics, symptoms, historical data, imaging, and laboratory results; we compared with the general population. Eighty-seven percent had normal hearing. Age distribution, noise exposure, and frequency of psychiatric diagnoses in our cohort were consistent with previous reports. We found a lower incidence of otitis media and the same prevalence of dizziness, asthma, and hearing loss as the general population, a lower prevalence of Eustachian tube dysfunction, otitis media, headaches, and higher incidence of rhinosinusitis. Lack of patient reporting and objective testing complicate the ability to detect pediatric tinnitus. We revealed a gap in the literature regarding rhinosinusitis as a cofactor, imaging during diagnosis, and if psychiatric diagnoses are associated with tinnitus in younger children.

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