Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children

2020 ◽  
pp. 1-4
Author(s):  
B Demir ◽  
C Batman
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Line Treatment ◽  
Ventilation Tube ◽  
First Line ◽  
Tube Insertion ◽  
The Mean ◽  
Group 2 ◽  
Balloon Eustachian Tuboplasty ◽  
First Line Treatment

Abstract Objective This study aimed to compare the outcomes of ventilation tube insertion and balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children. Method This was a retrospective evaluation of 62 children, 30 cases that underwent balloon Eustachian tuboplasty (group 1) and 32 cases that underwent ventilation tube insertion (group 2), from July 2016 to April 2018. Results The pre-operative air–bone gap of patients who underwent balloon Eustachian tuboplasty was 15–35 dB (mean: 27.6 ± 8.2 dB). The mean pre-operative air–bone gap decreased to 9.6 dB after a mean of 14.4 months (p < 0.05). The air–bone gap decreased from 25.6 dB to 17.6 dB in the ventilation tube group. There was a significant improvement in the air–bone gap values in both groups; however, this decrease was significantly higher in the balloon Eustachian tuboplasty group (p = 0.043). Conclusion Balloon Eustachian tuboplasty may be an effective and safe method for use as a first-line treatment of otitis media with effusion in children.

Otitis Media

1994 ◽  
Vol 15 (3) ◽  
pp. 93-93
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Pediatric Population ◽  
Acute Otitis Media ◽  
Line Treatment ◽  
First Line ◽  
Tympanostomy Tubes ◽  
First Line Treatment

A reader questioned Dr. Howie's article on otitis media (PIR 1993;14: 320-323) on three counts: 1. His recommendation not to use amoxicillin as first-line treatment for acute otitis media; 2. His discussion of otitis media with perforation; and 3. His recommendation to place tympanostomy tubes in "any youngster who has otitis media with effusion that persists for 6 to 12 weeks." Dr. Howie responds: "I share with you the frustration of the ever-present challenge of otitis media with effusion (OME), whether acute, recurrent acute, or persistent, in the pediatric population that we serve. The `relapsogenic nature' of aminopenicillins (eg, ampicillin and amoxicillin) seems to be part and parcel of the problem.

Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate

2017 ◽  
Vol 55 (4) ◽  
pp. 590-595 ◽  
Author(s):  
Kitirat Ungkanont ◽  
Panrasee Boonyabut ◽  
Chulaluk Komoltri ◽  
Archwin Tanphaichitr ◽  
Vannipa Vathanophas
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Cumulative Incidence ◽  
Otitis Media With Effusion ◽  
Hearing Level ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Hearing Outcome ◽  
Significant Difference ◽  
The Mean

Objective: To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Design: Retrospective cohort study in the tertiary care center. Patients: Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Main outcome measures: Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Results: Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Conclusion: Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

PS01.095: BENIGN ESOPHAGEAL STRICTURE: A RECAP OF OUR EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 76-76
Author(s):  
Keat How Teoh ◽  
Kelvin Voon ◽  
Shyang Yee Lim ◽  
Premnath Nagalingam
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Stricture ◽  
Endoscopic Dilatation ◽  
Line Treatment ◽  
First Line ◽  
Benign Esophageal Stricture ◽  
Anastomotic Strictures ◽  
Esophageal Strictures ◽  
The Mean ◽  
First Line Treatment

Abstract Background Caustic injury remains the commonest cause of benign esophageal strictures in Asia. Others include gastroesophageal reflux, iatrogenic, radiation, autoimmune or idiopathic causes. Treatment goals are relief of dysphagia and prevention of recurrence. This study aims to evaluate the experience with benign esophageal stricture in Penang Hospital, a tertiary hospital in Northern region of Malaysia. Methods A retrospective review of 12 patients with benign esophageal strictures between year 2012 - 2017. Results The mean age was 53.5 and two thirds were female. Half of these patients were of Chinese ethnicity while the other half were Indian. The commonest cause was caustic ingestion (41.7%), followed by reflux stricture (25%) and anastomotic stricture (25%). There was one case of dystrophic epidermolysis bullosa. More than half of the patients had complex and multiple strictures. 41.7% of patients had proximal strictures that were located within 20cm from the incisors. Endoscopic dilatation was the first line treatment with either Savary Gilliard or balloon dilators. A total of 97 dilatation sessions were done with a mean dilatation frequency of 2.3 ± 1.5 times for anastomotic strictures, 8 ± 8.2 times for reflux strictures and 8.0 ± 6.6 times for corrosive strictures. The mean dilatation interval was 2.5 ± 1.2 weeks. 58.3% of patients had successful endoscopic treatment. The success rate was higher in non-corrosive stricture (83% vs 40%). There was one dilatation related complication in which the patient had pneumomediastinum without overt mediastinitis. This however, resolved with conservative management. 41.7% of patients had refractory strictures that failed endoscopic dilatation. Surgery including esophagectomy (40%), revision of anastomosis (20%) and gastrostomy (40%) were done for this group of patients. Proximal strictures, complex strictures and multiple strictures were associated with failed endoscopic dilatation (P < 0.05). Conclusion Endoscopic dilatation is the first line treatment for benign esophageal strictures. Surgery is reserved for refractory strictures with failed endoscopic treatment. Predictor scoring systems for refractory stricture and individualized approaches are the key to success. Disclosure All authors have declared no conflicts of interest.

Adult-onset otitis media with effusion: results following ventilation tube insertion

2001 ◽  
Vol 115 (11) ◽  
pp. 874-878 ◽  
Author(s):  
M. W. Yung ◽  
R. Arasaratnam
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Previous History ◽  
Endoscopic Examination ◽  
Lateral Nasal Wall ◽  
Adult Onset ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Prick Test ◽  
History Of

The outcome of otitis media with effusion (OME) in children is generally good. However, it is less clear in adults. All adult patients who had a ventilation tube inserted for OME at the Ipswich Hospital between 1996 and 1997 were studied. Of 53 patients studied, 28 had had a previous history of ventilation tube insertion. Furthermore, at 15–27 months following ventilation tube insertion, the ventilation tube had already extruded in 31 patients and the OME had already recurred in 19 of these. Endoscopic examination revealed that many patients still had evidence of inflammation at the lateral nasal wall (26.4 per cent) and at the eustachian tube orifice (51 per cent). There is also a strong history of atopy in the studied group and the skin prick test was positive in 57 per cent of the patients. This study shows that many patients with adult-onset OME have underlying pathology that could lead to recurrence of OME following ventilation tube extrusion.

scholarly journals Can endovascular repair be the first-line treatment option in abdominal aortic aneurysms during COVID-19 pandemic?

2021 ◽  
Vol 30 (2) ◽  
pp. 107-114
Author(s):  
Kaptanıderya Tayfur ◽  
Melih Ürkmez
Keyword(s):  
Treatment Option ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Line Treatment ◽  
Rt Pcr ◽  
First Line ◽  
Abdominal Aortic ◽  
Significant Difference ◽  
The Mean ◽  
First Line Treatment

Objectives: This study aims to investigate the effectiveness of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: A total of 22 patients (17 males, 5 females; mean age: 76.7±7.1 years; range, 66 to 90 years) who underwent EVAR for AAAs in our center between March 2020 and December 2020 were retrospectively analyzed. All patients underwent reverse transcriptase- polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. All EVAR procedures were performed under spinal anesthesia in the elective setting in the angiography laboratory. Results: The RT-PCR test result was positive in six patients with asymptomatic infection. The mean AAA diameter was 74.7±5.5 (range, 68.50 to 85.60) mm. Stent-graft implantation was successfully performed in all patients. There was no significant relationship between the mean age and examined variables (p>0.050). The mean AAA diameter was 83.95 mm in the COVID-19-positive patients and 71.50 mm in the COVID-19-negative patients, indicating a significant difference (p=0.001). No mortality, stent migration or thrombotic events were observed during the first 30 days of follow-up. Conclusion: The operation can be delayed in patients requiring open surgical repair or in those with small AAAs. Based on our findings, the EVAR can be used as the first-line treatment option during the pandemic, as it does not require intubation and requires a low number of staff and is cost-effective with minimum necessity for intensive care unit stay and less use of healthcare resources.

scholarly journals Outcome of Injection Botulinum Toxin in Blepharospasm

2021 ◽  
Vol 13 (1) ◽  
pp. 40-49
Author(s):  
Malita Amatya ◽  
Ben Limbu ◽  
Purnima Rajkarnikar ◽  
Hom Bahadur Gurung ◽  
Rohit Saiju
Keyword(s):  
Botulinum Toxin ◽  
Hemifacial Spasm ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Line Treatment ◽  
First Line ◽  
Essential Blepharospasm ◽  
Meige Syndrome ◽  
The Mean ◽  
First Line Treatment

Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods:  It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared.  Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site.  Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

EVALUATING THE RESULTS OF TREATMENT FOR OTITIS MEDIA WITH EFFUSION BY VENTILATION TUBE INSERTION

2016 ◽  
pp. 81-86
Author(s):  
Phuoc Minh Hoang ◽  
Thanh Thai Le
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Clinical Intervention ◽  
Normal Function ◽  
Common Disease ◽  
Age Group ◽  
Ventilation Tube ◽  
Tube Insertion

Background: Otitis media with effusion (OME) is a common disease especially in children. Objective: To study clinical, tympanometry, audiometry and the results of ventilation tube insertion. Materials and methods: Prospective study with clinical intervention in 114 ears of 76 patients with OME. Results: The most common age group was ≤ 6 years of age (39.5%). Common symptoms in ≤6 years of age group are nasal obstruction (73.3%), rhinorrhea (66.7%); in > 6 years of age group are tinnitus (78.3%), hearing loss (76.1%). Tympanic membrane findings: completed opaque (40.4%), air-fluid level (64.1%), retraction (44.7%), losing cone of light (87.7%). Tympanograme type B was 78.1%. Audiograme was conductive hearing loss with PTA > 20 db (100%). Ventilation tube insertion one or both side associated with or without adenoidectomy. After 6 months of follow-up, postoperative average PTA was 28.4±1.6 dB. Most of cases have dry ear, hearing improvement, tubes on the tympanic membrane. Common complications were otorrhea and extrusion. Conclusion: OME is asymptomatic especially in children. Tympanograme plays a key role in diagnosis. Ventilation tube insertion improves the hearing and restores the normal function of the middle ear.

Single-agent docetaxel (TXT) as first-line treatment in metastatic breast cancer (MBC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11515-11515
Author(s):  
D. Guarneri ◽  
R. Ratti ◽  
A. Venturino ◽  
G. Addamo ◽  
Z. Coccorullo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Single Agent ◽  
Metastatic Breast ◽  
Line Treatment ◽  
First Line ◽  
Group 2 ◽  
Agent Treatment ◽  
First Line Treatment ◽  
Group 1

11515 Background: Historically anthracyclines have been considered the most active agents in metastatic breast cancer (MBC). Docetaxel (TXT) has challenged this belief. Aims: Evaluate response rates, toxicity and time to progression in patients with MBC receiving single agent TXT as first line treatment. Methods: MBC patients received first line single agent treatment according to one of the following schedules: TXT 35 mg/m2 iv weekly for 6 wks q 8 wks (Group 1) or TXT 100 mg/m2 iv day 1 q 3 weeks (Group 2). Adjuvant chemotherapy was FAC (600,50,600) day 1 q 21 days for 6 courses in all cases so treated. Results: Conclusions: It appears that results with single agent TXT obtained in clinical practice are comparable to those reported in Phase II-III trials (Group 1 and Group 2, respectively ) using the same regimens. [Table: see text] No significant financial relationships to disclose.

DTIC and GM-CSF in the treatment of patients with metastatic melanoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19045-e19045
Author(s):  
Beth Barber ◽  
Zhongyun Zhao ◽  
Song Wang ◽  
Volker Jean Wagner
Keyword(s):  
Metastatic Melanoma ◽  
Charlson Comorbidity Index ◽  
Treatment Duration ◽  
Line Treatment ◽  
First Line ◽  
Gm Csf ◽  
Comorbidity Index ◽  
The Mean ◽  
First Line Treatment

e19045 Background: To describe patients with metastatic melanoma being treated with mono-therapy, dacarbazine (DTIC) or granulocyte-macrophage colony-stimulating factor (GM-CSF). Methods: Using a large U.S. medical claims database, patients were identified between 2005 and 2010 using ≥2 melanoma diagnoses (ICD-9-CM: 172.xx, V10.82) and ≥2 diagnoses for metastasis (ICD-9-CM: 197.xx, 198.xx). Patients who received mono-therapy with DTIC or GM-CSF as the first documented drug therapy after metastatic diagnosis were identified. Patient demographic and clinical characteristics and treatment duration were compared between patients treated with DTIC and those who received GM-CSF. Furthermore, comparisons were also made between the two treatment groups after 1-to-1 matching on age, gender, and baseline comorbidities. Results: A total of 81 patients with metastatic melanoma receiving first-line DTIC and 24 patients with metastatic melanoma receiving first-line GM-CSF were included in this analysis. On average, DTIC patients were 8.5 years older (p = 0.009) and had higher baseline Charlson Comorbidity Index scores (D0.43, p = 0.005) than GM-CSF patients. The mean duration of first line treatment was 94 days on DTIC and 135 days on GM-CSF. The mean length of follow-up from the start of first line was 257 days on DTIC and 451 days on GM-CSF. After each GM-CSF patient was matched with a DTIC patient on age, gender, and baseline Charlson Comorbidity Index score, the mean duration of first line treatment was 79 days on matched DTIC and 135 days on GM-CSF, and the mean length of follow-up from the start of first line was 317 days on matched DTIC and 451 days on GM-CSF. Conclusions: Patients with metastatic melanoma who received DTIC treatment were older and had higher comorbidity index scores but shorter treatment duration than those who received GM-CSF; the difference in treatment duration remained after DTIC patients were matched with GM-CSF patients on age, gender and comorbidity index scores.

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