scholarly journals Influence of middle ear alterations on children's balance

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Joana Ferreira ◽  
Carla Matos Silva ◽  
Inês Araújo
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Postural Balance ◽  
Sensory Integration ◽  
Type A ◽  
Clinical Test ◽  
Type B ◽  
Balance Performance ◽  
Balance Disorders

Abstract Background Postural instability is a possible symptom in children with otitis media, which often occurs in this population. The child with balance disorders usually has intolerance to sudden movements, difficulties in moving in the dark, nausea, vomiting and numerous fall events. To verify whether changes in the middle ear can influence the balance postural in children from 3 to 5 years. Methods The sample consisted of 31 children of both sexes, aged between 3 and 5 years. To collect data, a tympanogram was used to analyze the integrity of the tympanic membrane and the Modifid Clinical Test of Sensory Integration and Balance (MCTSIB), with four different sensory conditions, to assess static postural balance. Results Regarding the tympanogram, it was verified that the majority of the sample showed no changes, 45.2% of which were type A and 32.3% of type C1. Regarding the type B and C2 tympanogram, it was found that 12.9% of the sample had type B tympanogram and 9.7% type C2. When comparing these values with the MCTSIB results, there were no significant differences between the tympanogram with changes (B and C2) and the tympanogram without changes (A and C1), regarding the child's balance performance. Conclusions In this study, it was concluded that the alterations of the middle ear, proved through the tympanogram, did not influence the postural balance. However, it was found that the unilateral changes reported by the tympanogram, suggest higher values of postural oscillation, compared to bilateral changes.

Impedance Tympanometry and Acoustic Reflectometry at Myringotomy

PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 475-480
Author(s):  
Thomas R. Babonis ◽  
Michael R. Weir ◽  
Patrick C. Kelly
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Type A ◽  
Tube Placement ◽  
Clinical Impression ◽  
Type B ◽  
Middle Ear Effusion ◽  
Experienced Clinician ◽  
Ear Effusion ◽  
Higher Sensitivity

A total of 220 ears undergoing myringotomy and pressure-equalizing tube placement were studied with impedance tympanometry and acoustic reflectometry in a direct comparison for detection of middle-ear effusion. Impedance tympanometry and acoustic reflectometry were equally accurate, detecting the presence or absence of middle-ear effusion in 73% and 72% of ears, respectively. The presence of effusion in ears with tympanographic patterns other than type A and type B was not consistently and reliably predicted. The higher sensitivity of impedance tympanometry (90%) compared with that for acoustic reflectometry (58%) contrasted with the opposite findings for specificities (54% vs 88%). It is concluded that impedance tympanometry and acoustic reflectometry measure different events at the tympanic membrane and their utility lies in the fact that they complement each other. These instruments can aid the experienced otoscopist in confirming a clinical impression and assist the less experienced clinician in validating or improving otoscopic skills.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 46 (4) ◽  
pp. 647-647
Author(s):  
Jerome O. Klein
Keyword(s):  
Clinical Review ◽  
Otitis Media ◽  
Middle Ear ◽  
Respiratory Infections ◽  
Acute Otitis Media ◽  
Type A ◽  
Type B ◽  
Hemophilus Influenzae ◽  
Hemophilus Influenzae Type B

Dr. Strauss has concisely summarized present considerations of the role of encapsulated and nonencapsulated Hemophilus influenzae in infection and disease. A recent clinical review by Turk and May1 documents the predominance of Hemophilus influenzae type B in suppurative disease. In a survey of reports of cases of meningitis due to this agent, the authors found only 24 cases due to Hemophilus influenzae other than type B(type A = 6, type E = 1, type F = 3, and non-typable 14). The role of nonencapsulated Hemophilus influenzae strains in the pathogenesis of respiratory infections and otitis media is still unclear. The majority of H. influenzae strains isolated from the middle ear fluids of children with acute otitis media are nonencapsulated.2,3

Simulation of Pathological High Impedance Tympanograms

1986 ◽  
Vol 29 (4) ◽  
pp. 505-514 ◽  
Author(s):  
Karel J. Van Camp ◽  
Janet E. Shanks ◽  
Robert H. Margolis
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
High Frequency ◽  
Secretory Otitis Media ◽  
High Impedance ◽  
The Relationship

The Vanhuyse, Creten, and Van Camp (1975) model for analyzing high frequency tympanograms predicts the shapes of conductance, susceptance, and admittance tympanograms from the relationship between resistance and reactance tympanograms at the tympanic membrane. This model has been applied primarily to low impedance middle-ear pathologies but has not been applied extensively to the more commonly occurring high impedance pathologies. The purpose of this study was to extend the Vanhuyse et al. (1975) model to high impedance pathologies and to identify tympanometric parameters associated with otosclerosis, secretory otitis media, and lateral ossicular fixation. Data from previous experiments on the shape and absolute values of resistance and reactance tympanograms were used to calculate 678-Hz admittance tympanograms that were unique to each of the three high impedance pathologies. Guidelines for differentiating among the middle-ear pathologies on the basis of high frequency tympanometric shapes are presented.

Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

1984 ◽  
Vol 93 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Thomas F. DeMaria ◽  
David J. Lim ◽  
Bruce R. Briggs ◽  
Nobuhiro Okazaki
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Animal Experiment ◽  
Otitis Media With Effusion ◽  
Type B ◽  
Negative Bacterium ◽  
Middle Ear Effusion ◽  
Sterile Saline ◽  
Inflammatory Changes ◽  
Ear Effusion

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

Tympanic membrane/middle ear pathologic correlates in chronic otitis media

1999 ◽  
Vol 109 (5) ◽  
pp. 712-716 ◽  
Author(s):  
Vikram J. Jaisinghani ◽  
Michael M. Paparella ◽  
Patricia A. Schachern ◽  
Chap T. Le
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media

scholarly journals The Impact of a Submaximal Level of Exercise on Balance Performance in Older Persons

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Hani Asilah Alias ◽  
Maria Justine
Keyword(s):  
Sensory Integration ◽  
Older Persons ◽  
Community Dwelling ◽  
Rank Test ◽  
Clinical Test ◽  
Older Individuals ◽  
Balance Performance ◽  
Eyes Closed ◽  
Soft Surface ◽  
The Impact

Objective. The purpose of this study was to determine the impact of a submaximal level of exercise on balance performance under a variety of conditions.Material and Method. Thirteen community-dwelling older persons with intact foot sensation (age = 66.69 ± 8.17 years, BMI = 24.65 ± 4.08 kg/m2, female,n=6) volunteered to participate. Subjects’ balance performances were measured using the Modified Clinical Test of Sensory Integration of Balance (mCTSIB) at baseline and after test, under four conditions of stance: (1) eyes-opened firm-surface (EOF), (2) eyes-closed firm-surface (ECF), (3) eyes-opened soft-surface (EOS), and (4) eyes-closed soft-surface (ECS). The 6-minute walk test (6MWT) protocol was used to induce the submaximal level of exercise. Data was analyzed using the Wilcoxon Signed-Rank Test.Results. Balance changes during EOF (z=0.00,P=1.00) and ECF (z=-1.342,P=0.180) were not significant. However, balance changes during EOS (z=-2.314,P=0.021) and ECS (z=-3.089,P=0.02) were significantly dropped after the 6MWT.Conclusion. A submaximal level of exercise may influence sensory integration that in turn affects balance performance, particularly on an unstable surface. Rehabilitation should focus on designing intervention that may improve sensory integration among older individuals with balance deterioration in order to encourage functional activities.

scholarly journals A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Operative Findings

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 

scholarly journals Acute Mastoiditis in Children: Susceptibility Factors and Management

2007 ◽  
Vol 7 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Spremo ◽  
Biljana Udovčić
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Acute Mastoiditis ◽  
Middle Ear Mucosa ◽  
Susceptibility Factors ◽  
Intravenous Antibiotics ◽  
Intracranial Complications

The objective was to review our experience with clinical course, diagnostic and therapeutic profile of children treated for acute mastoiditis, and to investigate for possible susceptibility factors. Study was designed as retrospective review of pediatric patients presenting with acute mastoiditis secondary to acute otitis media over the last 6 years, from 2000 to 2006. The study involved children aged from 1 to 16 years treated for acute mastoiditis and subsequent intratemporal and intracranial complications in Clinic for otorhinolaryngology, Clinic Center Banja Luka. Selected clinical parameters, mastoid coalescence and risk factors for necessity of surgical intervention were analyzed. Medical history review of a total of 13 patients with acute mastoiditis was analyzed. Acute coalescent mastoiditis occurred 11 patients (84%) while noncoalescent form of acute mastoiditis occurred in 2 cases (16%). Intracranial complication occurred in 3 patients (2 meningitis and 1 peridural intracranial abscess), while 2 patients had intratemporal complication (subperiostal abscess) associated to coalescent mastoiditis. We observed clinical profile of acute mastoiditis in regard to pathology found on the tympanic membrane, middle ear mucosa and destructions on the bony wall of the middle ear and mastoid. The main signs of progressive infection were tympanic membrane perforation, pulsatile suppurative secretion from the mucosa, and intratemporal abscess. All patients with coalescent mastoiditis required mastoidectomy, while noncoalescent mastoiditis was treated conservatively with broad-spectrum intravenous antibiotics and myringotomy. In conclusion acute mastoiditis is uncommon but serious complication of acute otitis media in children associated with significant morbidity. Coalescent mastoiditis concomitant with subperiostal abscess, intracranial complications and mastoiditis not responsive after 48 hours to intravenous antibiotics should urge clinician to timely mastoid surgery.

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