scholarly journals Middle ear effusion: rate and risk factors in Australian children attending day care

1999 ◽  
Vol 123 (1) ◽  
pp. 57-64 ◽  
Author(s):  
S. A. SKULL ◽  
P. S. MORRIS ◽  
A. YONOVITZ ◽  
R. G. ATTEWELL ◽  
V. KRAUSE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Ear ◽  
Day Care ◽  
Clinical Importance ◽  
Speech Development ◽  
Effusion Rate ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
History Of ◽  
Ear Effusion

There have been no previous longitudinal studies of otitis media conducted in non-Aboriginal Australian children. This paper describes the rate and risk factors for middle ear effusion (MEE) in children attending day care in Darwin, Australia. A prospective cohort study of 252 children under 4 years was conducted in 9 day care centres over 12 fortnights between 24 March and 15 September 1997. Tympanometry was conducted fortnightly and multivariate analysis used to determine risk factors predicting MEE. The outcome of interest was the rate of type B tympanograms per child detected in either ear at fortnightly examinations. After adjusting for clustering by child, MEE was detected on average 4·4 times in 12 fortnights (37% of all examinations conducted). Risk factors associated with presence of effusion were younger age, a family history of ear infection, previous grommets (tympanostomy tubes), ethnicity and the day care centre attended. A history of wheeze appeared protective. These effects were modest (RR 0·57–1·70). Middle ear effusion is very common in children attending day care in Darwin. This has clinical importance, since MEE during early childhood may affect optimal hearing, learning and speech development. There is little scope for modification for many of the risk factors for MEE predicted by this model. Further study of the day care environment is warranted.

Otitis Media, Cleft Palate, and Middle Ear Ventilation

1981 ◽  
Vol 89 (2) ◽  
pp. 288-293 ◽  
Author(s):  
William L. Meyerhoff ◽  
Donald A. Shea ◽  
Craig A. Foster
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Middle Ear Ventilation ◽  
Ear Effusion

Chinchillas with unilateral tympanostomy tubes in place underwent palate-clefting in an effort to determine the histologic and bacteriologic effects of using tympanostomy tubes in the treatment of otitis media. The tympanostomy tube appeared to almost totally eliminate the occurrence of middle ear effusion but had much less, if any, effect on eliminating the middle ear inflammation which occurs in the clefted chinchilla.

scholarly journals Importance of early ventilation tubes insertion in chronic otitis media with effusion in children with congenital cleft palate

2018 ◽  
Vol 75 (3) ◽  
pp. 253-259
Author(s):  
Vladan Subarevic ◽  
Nenad Arsovic ◽  
Radoje Simic ◽  
Katarina Stankovic
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Speech Development ◽  
Middle Ear Effusion ◽  
Ventilation Tubes ◽  
Congenital Cleft ◽  
Ear Effusion

Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palate with an incidence of more than 90%, but the approach to managing this problem varies significantly among authors. The Eustachian tube dysfunction is the main factor that leads to the presence of the middle ear effusion. This is especially prominent in children with congenital cleft palate and explains the prolonged course of this process. The objective of this study was to determine the effectiveness of early ventilation tubes insertion in children with cleft palate at the time of palatoplasty by monitoring the course and duration of the disease as well as development of complications. Methods. In the prospective study with predefined regular follow-up intervals and parameters, the two groups of children were observed. The group one (E) included 45 children with congenital cleft palate who underwent the early insertion of ventilation tubes during palatoplasty, and the group two (C) had the same number of children with cleft palate who were treated conservatively on an as-needed basis. Assessment parameters were findings of otomicroscopy, tympanometry, play and pure tone audiometry. Each child was followed-up for 5 full years at total of nine follow-up examinations. Results. Result analysis showed that there were no statistically important differences between the two study groups in terms of the course and duration of the presence of the middle ear effusion, or in terms of complications and speech development. Conclusion. Based on the results obtained, we can conclude that there is no significant benefit in early ventilation tubes insertion in children with cleft palate, therefore our recommendation is watchful waiting and a conservative treatment on an as-needed basis, with the ventilation tubes insertion when a surgeon, based on his or her experience and individual findings considers it necessary.

Tympanometric Pattern Classification in Relation to Middle Ear Effusions

1975 ◽  
Vol 84 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Quinter C. Beery ◽  
Charles D. Bluestone ◽  
W. Scott Andrus ◽  
Erdem I. Cantekin
Keyword(s):  
Otitis Media ◽  
Pattern Classification ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Correct Prediction ◽  
Middle Ear Effusion ◽  
Middle Ear Pressure ◽  
Recurrent Acute Otitis Media ◽  
History Of ◽  
Ear Effusion

Tympanometric evaluation using an otoadmittance meter and X-Y plotter was performed on 129 ears of 70 children with history of recurrent acute otitis media, or evidence otoscopically of persistent middle ear effusion, or both. Myringotomy, performed immediately following the tympanometric procedure, confirmed the presence or absence of effusion. Following myringotomy, tympanometric patterns, as shown by susceptance and conductance tracings at 220 and 660 Hz, were identified and middle ear pressures and otoadmittance peak values were determined. These findings were compared and criteria were developed which best determined the presence or absence of effusion. The results revealed the following: 1) High negative middle ear pressure is not necessarily a reliable indicator of middle ear effusion. 2) Tympanometry can be used reliably as an indicator of effusion. A combination of pattern classification and susceptance criteria enabled correct prediction of effusion in 93% of these children. One pattern at B660 was found to be pathognomonic of effusion. 3) In general, otoadmittance at 660 Hz appears to be a better indicator of effusion than 220 Hz.

Pharmacokinetics of Cefaclor in Chronic Middle Ear Effusions

1981 ◽  
Vol 90 (3_suppl2) ◽  
pp. 44-47 ◽  
Author(s):  
Torben Lildholdt ◽  
Charles D. Bluestone ◽  
Erdem I. Cantekin ◽  
Dale D. Rohn ◽  
Gabriel Marshak ◽  
...  
Keyword(s):  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Peak Level ◽  
Oral Route ◽  
Diffusion Method ◽  
Aerobic Bacteria ◽  
Middle Ear Effusion ◽  
Disk Diffusion Method ◽  
Tympanostomy Tubes ◽  
Ear Effusion

Fifty children aged 1 to 13 years with chronic or recurrent otitis media with effusion received a single dose of cefaclor (15 mg/kg body weight) by the oral route 30 minutes to seven hours before the removal of middle ear effusion and insertion of tympanostomy tubes. Serum and middle ear aspirate concentrations of the antibiotic were determined employing a microbiological assay technique by a disk diffusion method. Middle ear specimens were also cultured for aerobic bacteria. The mean peak serum concentration level (8.49± 7.89 μg/ml) was observed after 30 minutes, whereas the middle ear peak level (0.47± 0.78 μg/ml) occurred after one hour. Of the 87 middle ear specimens, 37 had cefaclor concentrations which were detectable within the resolution of the bioassay method (>0.16 μg/ml). There was no correlation between the type of middle ear effusion (mucoid or serous) and the concentration of cefaclor in the middle ear. Only 18% of the middle ear cultures were positive for aerobic bacteria; Hemophilus influenzae was the most common organism.

The nasopharynx and under-aeration of the middle-ear

1987 ◽  
Vol 101 (11) ◽  
pp. 1144-1150 ◽  
Author(s):  
Stephen Metcalfe
Keyword(s):  
Haemophilus Influenzae ◽  
Nasal Obstruction ◽  
Middle Ear ◽  
Middle Ear Effusion ◽  
Adenoid Tissue ◽  
Significant Incidence ◽  
History Of ◽  
Ear Effusion ◽  
Or History

SummaryThis study compared nasopharyngeal sepsis with under-aeration ear disease. Nasopharyngeal sepsis was assessed by culture taken directly from the surface of removed adenoid tissue. 156 cases were studied; 100 showed varying degrees of middle-ear under-aeration and 56 had no active ear disease or history of it. In addition, an assessment of post-nasal obstruction was made and this too was compared with middle-ear status.The conclusions suggested that, whilst normal ears can exist in the presence of accepted nasal pathogens, diseased ears are rarely seen in the absence of nasal sepsis. The degree of post-nasal obstruction seemed irrelevant.The commonest nasopharyngeal pathogen was Haemophilus influenzae and when found alone this had a particularly detrimental affect on middle-ear aeration, causing a significant incidence of mucoid middle-ear effusion in this group.

In Reply: Dry Myringotomies and Impedance Testing

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 152-153
Author(s):  
Jack L. Paradise ◽  
Clyde C. Smith ◽  
Charles D. Bluestone
Keyword(s):  
Middle Ear ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Impedance Testing ◽  
Ear Effusion

The first issue raised by Gordon—the "problem of the [unexpectedly] dry myringotomy" suggests a misreading of the stated conditions of our study. The subjects were not our patients, but were patients whose cases were being managed by other physicians who allowed us to study them. And the diagnostic assessments—both otoscopic and tympanometric—were carried out immediately preoperatively. Thus few of the "dry taps" were unexpected: rightly or wrongly, most of them were performed knowingly in order to insert tympanostomy tubes in an effort to prevent recurrence of acute otitis media1 rather than to remove middle ear effusion.

Tympanometric Patterns Found in Middle Ear Effusions

1977 ◽  
Vol 86 (4_suppl2) ◽  
pp. 16-20 ◽  
Author(s):  
Erdem I. Cantekin ◽  
Quinter C. Beery ◽  
Charles D. Bluestone
Keyword(s):  
Pattern Classification ◽  
Middle Ear ◽  
Acoustic Impedance ◽  
Acute Otitis Media ◽  
Middle Ear Effusion ◽  
Recurrent Acute Otitis Media ◽  
History Of ◽  
Correct Association ◽  
Ear Effusion

In 120 ears of 67 children with a history of recurrent acute otitis media or otoscopic evidence of persistent middle ear effusion, or both, tympanograms were obtained using an otoadmittance meter and an electro-acoustic impedance bridge. Myringotomy was performed immediately following the tympanometric evaluation confirming the presence or absence of middle ear effusion. The comparison of myringotomy findings with a tympanometric pattern classification revealed 85.8% overall correct association with the presence or absence of a middle ear effusion for both instruments. In 83.3% of the cases, there was agreement in the classification of the tympanogram between the otoadmittance meter and the electro-acoustic bridge.

Analysis of risk factors for childhood persistent middle ear effusion

2005 ◽  
Vol 125 (10) ◽  
pp. 1051-1054 ◽  
Author(s):  
S Hammarén-Malmi ◽  
J Tarkkanen ◽  
P. S Mattila
Keyword(s):  
Risk Factors ◽  
Middle Ear ◽  
Middle Ear Effusion ◽  
Ear Effusion
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