Otitis Media—Red Flags for Management: American Academy of Otolaryngology; Head and Neck Surgery 2013 Clinical Practice Guideline for Tympanostomy Tube Insertion

2014 ◽  
Vol 24 (1) ◽  
pp. 4-10
Author(s):  
Melody Harrison

Otitis media with effusion (OME) is described as a collection of fluid in the middle ear, without signs or symptoms of acute ear infection ( Stool, Berg, Berman, & Carney, 1994). The accumulated fluid decreases the ability of both the tympanic membrane (eardrum) and the ossicles in the middle ear to vibrate, resulting in a mild conductive hearing loss. Although 28 decibels (dB) is the average hearing loss associated with OME, the range is quite wide. While some children experience no hearing loss, about 20% have hearing loss of 35 dB or greater ( Gravel, 2003).

2016 ◽  
Vol 21 (2) ◽  
pp. 62-68
Author(s):  
SM Sarwar ◽  
Masroor Rahman ◽  
Mohammad Idrish Ali ◽  
Md Morshed Alam ◽  
Md Anwar Hossain ◽  
...  

Objective: To find out the relation of conductive hearing loss in children with enlarged adenoids.Methods: Study was conducted in out patients department and Indoor wards of the Department of Otolaryngology on Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the periods of October 2005 to March 2006. 60 patients with enlarged amides were included in this study. The assessment of the patients were established on the basic of history clinical, 2 and audiological examination was done. Data were collected and analyzed using statistical package for Social Science.Results: In this study 60 patients (from 3 years to 12 years age) diagnosed as having ‘enlarged adenoids’ in the Otolaryngology and Head-Neck Surgery out patient and in patient Departments of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2005 to March 2006 are included in this series. Most of the patients presented with multiple symptoms, the commonest was the hearing impairment (58.33%). Other common symptoms were mouth breathing (50.00%), Nasal obstruction (50.00%), snoring (46.67%). Majority of them were male (62.85%) and 53.33% were in the 5-10 years age group. Middle class family occupy the lion share (58.33%). 60.00% patients live in a overcrowded condition. 50.00% patients were found with gross enlargement of adenoids. Hearing impairment was found in 58.33% ears of-patients of adenoids. Reduced middle ear pressure and compliance were found in 64.00% ears. Among the patients of enlarged adenoids otitis media with effusion was found in 58.33% (35) of patients. Among the patients of OME majority was male (62.85%). There was 77.14% (27) bilateral and 22.85% (8) unilateral cases. On otoscopy of OME patients, all patients had retraction of tympanic membrane, cone of lights were distorted in 50.00%, fluidlevels in 68.57% and bubbles were in 28.57% of ears. 71.43% OME patients had hearing loss in the range of 26-40 dB. Middle ear pressure and compliance were found reduced in 88.57% (62) ears of OME patients. There were 58.33% incidence of OME among enlarged adenoids cases. All the patients of OME with enlarged adenoids had a hearing loss between 26-55dB. Out of the 22 OME cases with gross adenoids, 16 had a middle ear pressure between -201 to-300 mm of H20 and 19 had a middle ear pressure between -101 to -200 mm of H20. On myringotomy fluid came out from all 62 (100%) ears. From majority (38) ears serous type of fluid came out.Conclusion: This is an endeavor to find out a correlation of enlarged adenoids with conductive hearing impairment in children. Otitis media with effusion is suspected in all children suffering from enlarged adenoids. All together 60 patients with enlarged adenoids were included in the study. Result of this study may not be the actual picture of overall situation due to many limitations is this study. Still it can be concluded that enlarged adenoids has a definite role in causing OME and conductive hearing impairment. So early diagnosis and treatment of enlarged adenoids can be encouraged to decrease the actual incidence, morbidity and complications of otitis media with effusion and thus conductive hearing impairment in childhood.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 62-68


2020 ◽  
Vol 22 (1) ◽  
pp. 48-52
Author(s):  
Raju Barua ◽  
Kamrul Hassan Tarafder ◽  
Mohammad Wakilur Rahman ◽  
Abu Naser Md Jamil ◽  
Farzana Haque ◽  
...  

Objective: To find out relation between enlarged adenoid and otitis media with effusion (OME), degree of hearing loss in OME cases with the size of the adenoids and degree of pressure changes in middle ear in OME cases with the size of adenoids. Method: This Prospective Study was carried out Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka and Specialized ENT Hospital of SAHIC, Mohakhali, Dhaka from September 2010 to March 2011 (7 months). Randomly selected 50 children (Age below 12 years) with enlarged adenoid in outdoor & indoor. Patient with sensorineural hearing loss and conductive hearing loss with other than enlarged Adenoids are exclude in this study. Result: In this study, 58% had hearing loss in which 38% were mild and 20% were moderate loss. 54% of ears had negative pressure. 22 cases of severe adenoids of which 72.72% had OME.10 out of 16 OME with severe adenoids cases having hearing loss were in 26-40 db range and middle ear pressure is -201 to -400 dapa. Conclusion: Early diagnosis and treatment of enlarged adenoids should be aparciated to decrease the incidence, morbidity and complications of otitis media with effusion. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 48-52


2009 ◽  
Vol 88 (4) ◽  
pp. 874-879 ◽  
Author(s):  
Karen Leong ◽  
Marian M. Haber ◽  
Venu Divi ◽  
Robert T. Sataloff

Neuroendocrine adenoma of the middle ear (NAME) is a rare tumor. We report a case of NAME, the clinical and pathologic findings of which illustrate the biologic behavior of adenomatous tumors of the middle ear and their relationship with rare carcinoid tumors of the middle ear. A 29-year-old man presented with a history of recurrent otitis media, right conductive hearing loss, and aural fullness. The tumor was removed in its entirety. Otolaryngologists should be familiar with this unusual but important entity.


Author(s):  
Fatemeh Mirashrafi ◽  
Babak Saedi ◽  
Mahtab Rabbani Anari ◽  
Gholamreza Garmaroudi ◽  
Roja Toosi ◽  
...  

Background: Orofacial cleft is one of the most common congenital malformations of craniofacial region. Otitis media with effusion causing conductive hearing loss is a considerable challenge for many children with cleft lip and palate. The aim of this study was to evaluate the prevalence of hearing disorders and associated malformations in these patients. Methods: The research population consisted of patients with cleft palate, between years 2012 and 2014, who were referred to Children’s Medical Center and Vali-e-Asr hospital in Tehran, Iran. Otoscopic examination, tympanometry, pure tone audiometry and echocardiography were performed for each patient. Results: Among patients with cleft palate, 73% suffered from hearing disorders. There was no relationship between prevalence of hearing loss and sex, presence of other congenital anomalies and degree of cleft, but middle ear diseases were significantly higher in children younger than 2 years. Among patients with cleft lip or palate, 10% suffered from cleft lip, 63% suffered from cleft palate and 27% suffered from cleft lip and palate. There was at least one congenital anomaly in 53% of patients. Conclusion: This study demonstrates high prevalence of otitis media with effusion and conductive hearing loss in patients with cleft. However, audiologic problems are alleviated when patients become older.


1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 200-206 ◽  
Author(s):  
Thomas J. Fria ◽  
Diane L. Sabo

Auditory brainstem responses (ABR) were recorded in 14 infants and toddlers and 12 school-age children with a previous history of recurrent otitis media with effusion (OME), or otoscopic and tympanometric evidence of persistent OME, or both. ABR tests were performed immediately before and after myringotomy and tympanostomy tube insertion in the younger subjects. For the school-age children, ABR tests were performed following otoscopy, tympanometry, and pure tone audiometry. The results demonstrate that the latency of both wave I and wave V of the ABR was sensitive (82% and 100%, respectively) to the presence of OME. Wave I also identified the absence of OME (specificity = 100%) whereas wave V did not (specificity = 25%). ABR latency was significantly decreased postoperatively in ears found to have OME, but not in ears found to have no OME. In the school-age subjects the ABR was used to predict the conductive hearing loss at 4000 Hz with less than a 20 dB error in virtually all subjects. The ABR latency delay was also found to be related to conductive hearing impairment at lower pure tone frequencies and to the average conductive loss at a variety of pure tone frequencies. Predictions of the presence of a conductive hearing loss from these relationships promise to be impressively accurate. The results suggest that the ABR can be a valuable tool for detecting the presence of conductive hearing impairment in infants and young children suspected to have OME and perhaps as an estimate of the degree of impairment.


1986 ◽  
Vol 95 (4) ◽  
pp. 429-433 ◽  
Author(s):  
Susan G. Phillips ◽  
Richard T. Miyamoto

Acrocephalosyndactyly (Apert syndrome) is a rare cranlosynostotic syndrome characterized by acrocephaly, syndactyly of the hands and feet, and—occasionally—-conductive hearing loss. We report three cases of conductive hearing loss in Apert syndrome. One patient was found to have bilateral stapes fixation. His daughter (the second case) had chronic bilateral otitis media with effusion. The third case involved a fixed Incus and hypomobile stapes. The management of these patients and a review of the literature are presented.


2006 ◽  
Vol 121 (3) ◽  
pp. 219-221 ◽  
Author(s):  
H Yasan

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.


1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 59-61 ◽  
Author(s):  
Lisa L. Hunter ◽  
Robert H. Margolis ◽  
G. Scott Giebink

Hearing loss is the most common complication of otitis media. Hearing loss secondary to otitis media has increasingly been associated with significant developmental and educational problems. However, not enough is known about the peripheral auditory effects of otitis media. The young age of most children affected by otitis media makes detailed audiologic assessment challenging. This paper presents a brief synopsis of audiologic strategies that may be employed to assess the hearing status of infants and children with otitis media with effusion. Data pertaining to the risk of hearing loss recurrence after tympanostomy tube insertion are presented from a prospective longitudinal study of hearing in children with chronic otitis media with effusion.


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