scholarly journals Treatment with a neutrophil elastase inhibitor and ofloxacin reduces P. aeruginosa burden in a mouse model of chronic suppurative otitis media

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
K. M. Khomtchouk ◽  
L. I. Joseph ◽  
B. B. Khomtchouk ◽  
A. Kouhi ◽  
S. Massa ◽  
...  

AbstractChronic suppurative otitis media (CSOM) is a widespread, debilitating problem with poorly understood immunology. Here, we assess the host response to middle ear infection over the course of a month post-infection in a mouse model of CSOM and in human subjects with the disease. Using multiparameter flow cytometry and a binomial generalized linear machine learning model, we identified Ly6G, a surface marker of mature neutrophils, as the most informative factor of host response driving disease in the CSOM mouse model. Consistent with this, neutrophils were the most abundant cell type in infected mice and Ly6G expression tracked with the course of infection. Moreover, neutrophil-specific immunomodulatory treatment using the neutrophil elastase inhibitor GW 311616A significantly reduces bacterial burden relative to ofloxacin-only treated animals in this model. The levels of dsDNA in middle ear effusion samples are elevated in both humans and mice with CSOM and decreased during treatment, suggesting that dsDNA may serve as a molecular biomarker of treatment response. Together these data strongly implicate neutrophils in the ineffective immune response to P. aeruginosa infection in CSOM and suggest that immunomodulatory strategies may benefit drug-tolerant infections for chronic biofilm-mediated disease.

Author(s):  
Mahesh B Mawale ◽  
Abhaykumar Kuthe ◽  
Anupama M Mawale ◽  
Sandeep W Dahake

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.


2021 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ercan Kaya ◽  
Ilknur Dag ◽  
Armagan Incesulu ◽  
Melek Kezban Gurbuz ◽  
Mustafa Acar ◽  
...  

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.


1990 ◽  
Vol 104 (6) ◽  
pp. 460-462 ◽  
Author(s):  
K. G. S. Raju ◽  
P. Unnykrishnan ◽  
R. C. Nayar ◽  
S. Dutt ◽  
R. Macaden

AbstractConventional external ear swab cultures were compared with cultures obtained from the middle ear, in 25 cases of tubotympanic type (‘safe’), chronic suppurative otitis media. These cultures were identical in 22 of the 25 cases.Anaerobic organisms were isolated in only one case. Mixed infections of both gram-positive and gramnegative organisms were seen in nine cases (36 per cent).Staphylococcus aureus was the commonest single agent isolated (16 cases). Multidrug resistance was seen in 12 of these isolates.


2011 ◽  
Vol 32 (8) ◽  
pp. e61-e62 ◽  
Author(s):  
Massimo Fusconi ◽  
Giovanni Ralli ◽  
Marco de Vincentiis ◽  
Antonio Greco ◽  
Massimiliano Mancini ◽  
...  

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Jacky Munilson ◽  
Tuti Nelvia

Abstrak Operasi mastoid berkembang sebagai penanganan terhadap Otitis Media Supuratif Kronik (OMSK). Mastoidektomi revisi dilakukan bila tujuan operasi pertama tidak tercapai. Kegagalan operasi mastoid bisa disebabkan oleh berbagai hal, diantaranya penanganan air cell yang tidak adekuat, facial ridge yang tinggi, kegagalan membuang semua kolesteatom, meatoplasti yang tidak adekuat dan ketidakpatuhan pasien untuk kontrol setelah operasi. Operasi mastoid revisi biasanya lebih sulit dan berbahaya karena anatomi telinga tengah menjadi tidak jelas, landmark dapat hilang dan struktur berbahaya sudah terpapar. Dilaporkan satu kasus operasi mastoid revisi pada seorang laki-laki berumur 25 tahun, yang ditatalaksana dengan timpanomastoidektomi dinding runtuh.Kata kunci: otitis media supuratif kronik, mastoidektomi revisi, kolesteatom, meatoplasti Abstract Surgery of the mastoid developed as a treatment for chronic suppurative otitis media. Revision mastoid surgery done if the aim of first surgery not achieved. Failure of  mastoid operation may caused by many things, including handling of air cells are not adequate, high facial ridge,  failure to remove all cholestetoma  meatoplasty in adequate and non adherence of patient to control after surgery. Revision  mastoid surgery is usually more difficult and dangerous, because anatomy of the middle ear may be altered, some of the important landmarks can be loss and dangerous  structure has been exposed. It was reported one case revision mastoid surgery in a man aged 25 years old, management with canal wall down tympanomastoidectomy.Keywords: chronic suppurative otitis media, revision mastoidectomy, cholesteatoma, meatoplasty


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