Recovery from OME-Related Phonologic Delay Following Tube Placement

1989 ◽  
Vol 54 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Elaine Pagel Paden ◽  
Melanie L. Matthies ◽  
Michael A. Novak
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Tube Placement ◽  
Early Prediction ◽  
Pressure Equalization ◽  
Practical Possibility ◽  
Elapsed Time ◽  
Group A ◽  
First Remission ◽  
Group B

Subjects with documented histories of frequent or persistent otitis media with effusion (OME) who were judged to be below age level phonologically prior to placement of pressure equalization (PE) tubes were reassessed at 4-month intervals. Group A (n = 22) subjects caught up with their peers by the age of 4 years; Group B (n = 14) subjects' progress was delayed and phonologic intervention was advised. At initial testing the two groups were found to differ significantly in scores on postvocalic singleton obstruent omission, velar deviation, and stridency deletion. Elapsed time between initial diagnosis of OME and beginning of the first remission of 6 months or more also differed significantly, as did scores on the first phonologic reassessment. Subject scores on initial phonologic adequacy, retest adequacy, and elapsed time from diagnosis to remission appropriately classified all but 2 subjects by group. A formula is provided that appears to make early prediction of eventual need for phonologic intervention a practical possibility.

scholarly journals Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry

2016 ◽  
Vol 24 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Sharath Babu K ◽  
Jayagar Prabakaran ◽  
Shankar Radhakrishnan
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Developed Countries ◽  
Wide Field ◽  
Age Group ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B

Background :  Otitis Media with Effusion(OME) also known as  Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy. Aims and Objectives :  To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion. Materials and Methods:  A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A), adenoidectomy with bilateral grommet insertion (Group B), bilateral grommet insertion (Group C),  bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D). Result : The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.   Conclusion : Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis Media with Effusion who is at risk for speech/language/hearing loss. 

scholarly journals MYRINGOTOMY FOR THE TREATMENT OF OTITIS MEDIA WITH EFFUSION; A COMPARISON IN THE OUTCOME WITH AND WITHOUT GROMMET INSERTION

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S521-25
Author(s):  
Sunarays Akhtar ◽  
Uzma Gul ◽  
Arfat Jawaid ◽  
Khalid Azam ◽  
Muhammad Sohail Babur Niazi ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Military Hospital ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Conductive Hearing ◽  
Case Basis ◽  
Method Group

Objective: To compare the outcome of myringotomy with and without grommet insertion in the patients of otitis media with effusion in terms of improvement of hearing in a one-month follow-up. Study Design: Quasi experimental study. Place and Duration of Study: Pakistan Airforce Hospital Jacobabad and Combined Military Hospital Lahore Pakistan, from Jan to Dec 2020. Methodology: A total of 28 patients aged 4-12 years diagnosed to have conductive hearing loss due to otitis media with effusion not responding to medical treatment were included. Non probability convenience sampling was done. Children aged less than 4 years and above 12 years were not included in the study. They were randomly divided into two groups of 14 patients each using lottery method. Group A underwent myringotomy alone whereas group B underwent myringotomy with grommet insertion. Patients in both groups also underwent adenoidectomy on case-to-case basis. Both groups were compared in terms of improvement in hearing post operatively in a one-month follow-up. Results: There was statistically significant reduction in air bone gap at the end of follow up period as compared to preoperative air bone gap in group B (p=0.007). In group A there was statistically significant reduction in air bone gap at one week (p=0.002) however this improvement was not maintained at 4 weeks (p=0.386). Conclusion: Myringotomy with grommet insertion had significantly more patients with improved hearing as compared to myringotomy alone after one month.

Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion

2017 ◽  
Vol 131 (10) ◽  
pp. 907-913 ◽  
Author(s):  
A Hussein ◽  
H Fathy ◽  
S M Amin ◽  
N Elsisy
Keyword(s):  
Otitis Media ◽  
Complete Resolution ◽  
Watchful Waiting ◽  
Otitis Media With Effusion ◽  
Intranasal Steroids ◽  
Oral Steroids ◽  
Group A ◽  
Group B

AbstractObjective:To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2–11 years.Methods:A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry.Results:The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months.Conclusion:Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

Is Secretory Otitis Media a Single Disease Entity?

2003 ◽  
Vol 112 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Jacob Sadé ◽  
Camil Fuchs ◽  
Eyal Russo ◽  
David Cohen
Keyword(s):  
Medical History ◽  
Otitis Media ◽  
Viral Infections ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Epidemiological Studies ◽  
Secretory Otitis Media ◽  
History Of ◽  
Group A ◽  
Group B

The outcome of 809 children who had middle ear effusion (MEE) was correlated with their age and medical history and the bacteriologic and cytologic findings of the MEE. Three groups emerged. Group A (n = 384) had a medical history of relatively recent acute otitis media (AOM) with a peak prevalence of 2.6 years of age, and its MEE was hypercellular (mostly polymorphonuclear leukocytes) with a 24% rate of positive bacteriologic culture. In contrast, the peak prevalence of group B (n = 280) was approximately 5 years of age. Its MEE followed no otologic medical history and was bacteriologically sterile with relatively few cells (mostly lymphocytes typical of viral infections). Group AB (n = 145) resembled group B except that they had a history of AOM some years before hearing loss onset. Altogether, the clinical features of group A are statistically distinguishable from those of groups B and AB in most respects. These findings explain the bimodal peak prevalence distribution that was found in many available epidemiological studies of secretory otitis media (SOM) and that was also seen in our data. It appears that SOM should neither be termed nor treated as an otitis media, but as a sequela of either bacterial AOM (group A) or of insidious, asymptomatic, probably viral otitis media (groups B and AB). Our data do not support antibiotic treatment for SOM (otitis media with effusion) — especially not in chronic cases.

Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

2021 ◽  
pp. 000348942110157
Author(s):  
Jennifer L. McCoy ◽  
Ronak Dixit ◽  
R. Jun Lin ◽  
Michael A. Belsky ◽  
Amber D. Shaffer ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Private Insurance ◽  
Chronic Otitis Media ◽  
The United States ◽  
Socioeconomic Disparities ◽  
Tube Placement ◽  
Median Income ◽  
Public Insurance ◽  
Tympanostomy Tubes

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4

scholarly journals comparison of Efficacy of Topical Ciprofloxacin Ear drops (0.6%) Versus a Combination of Systemic with Topical Ciprofloxacin in Treating Chronically Discharging Ears

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Sarwat Hassan Syed ◽  
Damish Arsalan ◽  
Ghulam Murtaza ◽  
Mohammad Qamar Nasir ◽  
Muhammad Awais Amin ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Substantial Variation ◽  
Treatment Methods ◽  
Group A ◽  
Group B ◽  
Ear Drops

Objective: To compare the efficacy of topical ciprofloxacin alone, versus a combination therapy ofsystemic with topical ciprofloxacin(0.6%) in achieving dry ears in active mucosal chronic otitis media after two weeks of treatment. Methods: After obtaining permission from ethical committee of Hospital, an over-all of 150 patients (with 75 subjects each, divided into two groups) were included in this study. In Group-A: Topical Ciprofloxacin ear drops (0.6%) 3-4 drops were instilled three times a day, 8 hours apart for 2 weeks. In Group-B: Tab Ciprofloxacin 500mg was given twice a day, 12 hours apart for 14 days along with topical Ciprofloxacin ear drops (0.6%) 3 drops were used thrice a day, 8 hours apart for 14 days. Results: Patients ranged between 15-45 years of age. Mean age of the patients was 30.3±7.4 and 29.2±7.7 years. In group-A, there were 41 males (54.7%) and in group-B 49 males (65.3%). Females were 34 (45.3%) in group-A and 27 (36%) in Group-B. Mean duration of ear discharge was 5.3±1.1 months in group-A while 5.5±1.4 months in Group-B. We could not find any substantial variation among the two group in terms of efficacy (p=0.249). Stratification with regard to age, gender and duration of ear discharge was also carried out. Conclusion: Results of this study showed that topical ciprofloxacin ear drops (0.6%) were equally effective as systemic ciprofloxacin combined with topical ciprofloxacin (0.6%), for treating chronically discharging ears. Keywords: CSOM, ciprofloxacin, nature of discharge

scholarly journals Rapid maxillary expansion versus middle ear tube placement: Comparison of hearing improvements in children with resistance otitis media with effusion

2016 ◽  
Vol 86 (5) ◽  
pp. 761-767 ◽  
Author(s):  
Nihat Kılıç ◽  
Özgür Yörük ◽  
Songül Cömert Kılıç ◽  
Gülhan Çatal ◽  
Sezgin Kurt
Keyword(s):  
Otitis Media ◽  
Null Hypothesis ◽  
Otitis Media With Effusion ◽  
Tube Placement ◽  
Control Group ◽  
Ventilation Tube ◽  
Maxillary Expansion ◽  
Control Groups ◽  
Hearing Thresholds ◽  
Maxillary Constriction

ABSTRACT Objective:  To test the null hypothesis that there are significant differences in hearing improvements of children with resistance otitis media with effusion (OME) who undergo a rapid maxillary expansion (RME) procedure or ventilation tube placement. Methods:  Forty-two children between 4.5 and 15 years old were divided into three groups: RME, ventilation tube, and control groups. The RME group consisted of 15 children with maxillary constriction and resistance OME that indicated ventilation tube placement. The ventilation tube group consisted of 16 children for whom ventilation tube placement was indicated but no maxillary constriction. The control group consisted of 11 children with no orthodontic and/or rhinologic problems. Hearing thresholds were evaluated with three audiometric records: (1) before RME/ventilation tube placement (T0); (2) after RME/ventilation tube placement (T1), and (3) after an observation period of 10 months (T2). The control group was matched to these periods, except T1. Results:  Hearing thresholds decreased significantly in both the RME and ventilation tube groups (P &lt; .001). Hearing thresholds decreased approximately 15 and 17 decibels in the RME and ventilation tube groups, respectively, but differences in improvements were insignificant between the two study groups (P &gt; .05). Slight changes were observed in the control groups. Conclusion:  The null hypothesis was rejected. RME showed similar effects as ventilation tube placement for release of otitis media and improvement of hearing thresholds levels. RME should be preferred as a first treatment option for children with maxillary constriction and resistance OME.

scholarly journals Tympanostomy Tube Selection: A Review of the Evidence

2016 ◽  
Vol 7 (1) ◽  
pp. 17-22
Author(s):  
Ho Sandra ◽  
David J Kay
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
The United States ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Surgeon Experience ◽  
Ear Effusion

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

Efficacy of Acetic Acid Irrigation in Management of Chronic Suppurative Otitis Media “A Prospective Study

2021 ◽  
Vol 15 (10) ◽  
pp. 3300-3303
Author(s):  
Nasir Riaz ◽  
Shakaib Faiz ◽  
Danish Hassnain ◽  
Ayesha Fayyaz ◽  
Tarique Khan ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Acid Versus ◽  
Acid Irrigation ◽  
Group A ◽  
Group B ◽  
A Prospective Study ◽  
Systemic Antibiotics

Background: Prior to surgical management of chronic suppurative otitis media (CSOM) for the dry ear medical management is necessary. CSOM is a biofilm disease and due to this has antibiotic resistance. The pillar of its treatment included aural cleaning according to standard protocols, application of topical germ free antiseptic and use of antimicrobials. Acetic acid due to its ability in reducing the pH may be effective in reducing the growth of microorganisms. Objective: The aim of the study was to compare the efficacy of irrigation with acetic acid versus systemic antibiotics in CSOM patients. Materials & Methods: A total of 134 patients, who came to the ENT department of Sheikh Zayed Hospital, Lahore between 1st April 2020 to 30th September 2020, who had CSOM, of age 15 to 55 years and both genders were included in the study. The patients were divided randomly into two groups. Group A patients received aural toilets and irrigation with acetic acid and Group B received 500 mg of ciprofloxacin twice a day for 2 weeks. Results: The mean age (in years) of the patients in Group A was 37.45±7.32 and in Group B, it was 37.96±7.57. The efficacy of irrigation with acetic acid versus systemic antibiotics was 89.55% and 68.66% respectively and this difference between the two groups was found to be statistically significant (p=0.003). Conclusion: Irrigation with acetic acid was better than systemic antibiotics in managing patients with CSOM. Key words: Acetic acid, CSOM, Middle ear

scholarly journals Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Edoardo Bernkopf ◽  
Andrea Lovato ◽  
Giulia Bernkopf ◽  
Luciano Giacomelli ◽  
Giovanni Carlo De Vincentis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Otitis Media ◽  
Skin Test ◽  
Acute Otitis Media ◽  
Adenoid Hypertrophy ◽  
Test Results ◽  
Recurrent Acute Otitis Media ◽  
Group A ◽  
Group B ◽  
Dental Malocclusion

Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p<0.0001) and multivariate analysis (p=0.001). Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.

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