Tympanic membrane/middle ear pathologic correlates in chronic otitis media

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.

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Efficacy of Acoustic Reflectometry in Detecting Middle Ear Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948609500507 ◽

1986 ◽

Vol 95 (5) ◽

pp. 472-476 ◽

Cited By ~ 9

Author(s):

Christine A. Avery ◽

George A. Gates ◽

Thomas J. Prihoda

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Sensitivity And Specificity ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Lower Sensitivity ◽

Middle Ear Effusion ◽

Receiver Operator Characteristics ◽

Ear Effusion

The acoustic otoscope measures the amount of sound reflected from the tympanic membrane. Since the amount of reflected sound is increased by fluid in the middle ear, it seemed likely that the acoustic otoscope could be used for detection of otitis media. We compared acoustic reflectometry with over 4,000 tympanometric and otoscopic examinations in 451 children who were examined at regular intervals following surgery for chronic otitis media with effusion. The data indicate a lower sensitivity and specificity of acoustic reflectometry than had been reported previously. The receiver-operator characteristics of this device are discussed.

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Anterior epitympanic attic antrum space obstruction and symptom onset associated with myringosclerosis in benign chronic suppurative otitis media

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202235 ◽

2020 ◽

Vol 8 (6) ◽

pp. 2013

Author(s):

Zulfikar Naftali ◽

Suprihati . ◽

Dharmana E. ◽

Setyawan H.

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Symptom Onset ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Control Group ◽

Chi Square ◽

Suppurative Otitis Media ◽

Control Approach

Background: The AAA (Anterior epitympanic, Attic, and Antrum) space is the space between the mastoid and middle ear which functions to balance the pressure in both organs (buffer). Pathological tissue in the AAA cavity due to chronic infection would disrupt the buffer function and could change the morphology of the mucosa in the tympanic membrane and middle ear. Obstruction in the AAA space measured subjectively by observing the smoothness of the flow using saline solution has been shown to be associated with a plaque in the tympanic membrane (myringosclerosis) in Chronic Otitis Media (COM) patients. This study aims to determine the relationship between AAA space obstructions with myringosclerosis using CT-Scan for an objective result.Methods: Retrospective study with case-control approach used in this study. Case criterias are Chronic Suppurative Otitis Media (CSOM) patients with myringosclerosis, both men and women and age 15-50 years, while the control group are benign CSOM patients without myringosclerosis. Data were analyzed with the chi-square test to prove the association between the AAA space status and length of symptom onset with myringosclerosis.Results: During January 2017-December 2019 there were 33 respondents, 19 cases and 14 controls, 21 men and 12 women with an average age of 35 years (cases) and 23.5 years (control). The length of symptom onset more than 5 years (p <0.05, OR 6.94 with CI 0.5-1.5) and AAA space obstruction (p <0.05 OR 34.25 with CI 0.8-1.8) has been shown to be associated with myringosclerosis in people with benign CSOM.Conclusions: AAA space obstruction and symptom onset more than 5 years significantly associated with myringosclerosis.

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A comparative study of tragal cartilage and autologous incus for ossicular chain reconstruction in type IIB tympanoplasty at Dr. Hedgewar Hospital, Aurangabad

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195693 ◽

2019 ◽

Vol 6 (1) ◽

pp. 78

Author(s):

Bharat G. Deshmukh ◽

Deepak Bhisegaonkar ◽

Akanksha Bakre

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Ossicular Chain ◽

Suppurative Otitis Media ◽

High Incidence ◽

Ossicular Chain Reconstruction ◽

Small Bones ◽

Set Up

Background: Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear. Chronic otitis media is a very common condition of middle ear which not only has a high incidence in the world but also in our set up. So, in view of this, we decided to conduct a study on the surgical management of CSOM-tubotympanic type.Methods: We conducted this study at ENT department of Dr. Hedgewar Rugnalaya, Aurangabad to compare air bone gap closure by using tragal cartilage and autologous incus in type IIB tympanoplasty in patients with chronic suppurative otitis media, (tubotympanic). 66 patients with central perforation of tympanic membrane, necrosed incus and mobile stapes requiring type IIB tympanoplasty, were included as a part of the study.Results: We performed type IIB tympanoplasty with a routine post-aural incision in 66 patients. According to our observation, both incus and cartilage are good materials for ossiculoplasty, tragal cartilage being better.Conclusions: After conducting this study we concluded that incus and tragal cartilage both are excellent materials for ossiculoplasty.

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Workshop on Effects of Otitis Media on the Child

PEDIATRICS ◽

10.1542/peds.71.4.639 ◽

1983 ◽

Vol 71 (4) ◽

pp. 639-652

Author(s):

Charles D. Bluestone ◽

Jerome O. Klein ◽

Jack L. Paradise ◽

Heinz Eichenwald ◽

Fred H. Bess ◽

...

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Current Knowledge ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

Chronic Otitis Media ◽

Signs And Symptoms ◽

Middle Ear Effusion ◽

Ear Effusion

GOALS, DEFINITIONS, AND CLASSIFICATION OF OTITIS MEDIA —Charles D. Bluestone, MD The goal of this Workshop was to assess current knowledge concerning the effects of otitis media on the child. Experts in pediatrics, infectious disease, otolaryngology, audiology, speech, linguistics, and psychology met in Chicago on Aug 25, 1982 to participate in this Workshop. A summary of the discussions is presented here. Otitis media is broadly defined as an inflammation of the middle ear without reference to etiology or pathogenesis.1 Otitis media with effusion is an inflammation of the middle ear in which a collection of liquid (i.e., middle ear effusion) is present in the middle ear space (no perforation of the tympanic membrane is present). Atelectasis of the tympanic membrane, which may or may not be associated with otitis media, is defined as either collapse or retraction of the tympanic membrane. Acute otitis media implies a rapid and short onset of signs and symptoms lasting approximately 3 weeks. From 3 weeks to 3 months, the process may be resolving or subacute. If middle ear effusion persists beyond 3 months, the condition is classified as chronic otitis media with effusion. Many terms have been used for acute otitis media, such as "suppurative," "purulent," or "bacterial" otitis media; however, a "serous" effusion may also have an acute onset. Otitis media with effusion unaccompanied by signs and symptoms of acute inflammation has also had a plethora of other names: "serous," "secretory," "nonsuppurative," and "glue ear" have been the most commonly used. EPIDEMIOLOGY AND NATURAL HISTORY OF OTITIS MEDIA

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An Assistive Role of a Machine Learning Network in Diagnosis of Middle Ear Diseases

Journal of Clinical Medicine ◽

10.3390/jcm10153198 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3198

Author(s):

Hayoung Byun ◽

Sangjoon Yu ◽

Jaehoon Oh ◽

Junwon Bae ◽

Myeong Seong Yoon ◽

...

Keyword(s):

Machine Learning ◽

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Diagnostic Process ◽

Ear Diseases ◽

Learning Network ◽

Resident Physicians

The present study aimed to develop a machine learning network to diagnose middle ear diseases with tympanic membrane images and to identify its assistive role in the diagnostic process. The medical records of subjects who underwent ear endoscopy tests were reviewed. From these records, 2272 diagnostic tympanic membranes images were appropriately labeled as normal, otitis media with effusion (OME), chronic otitis media (COM), or cholesteatoma and were used for training. We developed the “ResNet18 + Shuffle” network and validated the model performance. Seventy-one representative cases were selected to test the final accuracy of the network and resident physicians. We asked 10 resident physicians to make diagnoses from tympanic membrane images with and without the help of the machine learning network, and the change of the diagnostic performance of resident physicians with the aid of the answers from the machine learning network was assessed. The devised network showed a highest accuracy of 97.18%. A five-fold validation showed that the network successfully diagnosed ear diseases with an accuracy greater than 93%. All resident physicians were able to diagnose middle ear diseases more accurately with the help of the machine learning network. The increase in diagnostic accuracy was up to 18% (1.4% to 18.4%). The machine learning network successfully classified middle ear diseases and was assistive to clinicians in the interpretation of tympanic membrane images.

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Neglected microphone in the ear: About a case

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1285 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

Sefrioui Taha Ismail ◽

◽

Ait Taleb Hajar ◽

Boumendil Ikram ◽

Nitassi Sophia ◽

...

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

External Auditory Canal ◽

Microscopic Examination ◽

Chronic Otitis Media ◽

Simple Extraction

Stranger bodies (EC) of the middle ear are among the emergencies least encountered by otolaryngologists (ENT). A 16-year-old patient with no otological history had seen a right chronic otorrhee with otalgia and hypoacousia for 6 months. Microscopic examination of the diseased ear had resulted in purulent secretions with inflammation of the external auditory canal. After aspiration, a blackish appearance was observed occupying the lower quadrants of the eardrum with associated myringitis. The gentle mobilization with the suction cannula and a spike revealed a fixed, painful CE, impacting the tympanic membrane and deeply introduced into the middle ear. The extraction of the EC could be carried out without difficulty (Figure 1), completed by myringoplasty with an aponevrotic graft. The first observation of a Tallic CE of the middle ear has been neglige for more than 20 years reported to you in 1883 by Lucius Holland [4]. Since then, few cases have been written down. Syms and Nelson reported 4 cases of EC in the middle ear with chronic otitis media [2]. Average EC penetrants from the ear are relatively rare. They may go unnoticed, especially in children, to reveal themselves later by complications. Hence the interest of prevention and diagnosis precoce allowing a simple extraction.

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Tympanic Membrane Perforations and Tympanostomy Tubes

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894941030s508 ◽

1994 ◽

Vol 103 (5_suppl) ◽

pp. 27-30 ◽

Cited By ~ 16

Author(s):

Sam Levine ◽

Kathleen Daly ◽

G. Scott Giebink

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Tympanic Membrane Perforations ◽

Tympanostomy Tubes ◽

Preoperative Factor ◽

Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

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Long-term middle-ear ventilation with subannular tubes

The Journal of Laryngology & Otology ◽

10.1017/s0022215110000897 ◽

2010 ◽

Vol 124 (9) ◽

pp. 945-949 ◽

Cited By ~ 6

Author(s):

A Daudia ◽

S Yelavich ◽

P J D Dawes

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Case Series ◽

Chronic Otitis Media ◽

Tympanic Membrane Perforation ◽

Retrospective Case ◽

The Mean

AbstractObjective:Long-term tympanostomy tubes are associated with a significant rate of complications, particularly persistent perforation. We describe the outcomes of 57 subannular ventilation tube insertions in 45 consecutive patients.Design:Retrospective case series.Subjects:We studied 45 consecutive patients with chronic otitis media with effusion and hearing loss (n = 54 cases), associated with adhesive otitis media (n = 7), tympanic membrane retraction (n = 17) and tympanic membrane perforation (n = 3). The mean follow up was 48 months (range, nine to 95 months).Results:The mean duration of ventilation for tubes still in situ was 22 months (range, one to 76 months; n = 29), and for tubes which extruded or were removed 23 months (range, one to 85 months; n = 28). The mean improvement in air–bone gap was 14 dB (range, −14 to 35 dB). Complications included blockage (16 per cent), perforation after extrusion (9 per cent), granulation (5 per cent) and infection (4 per cent).Conclusion:Subannular ventilation tubes provide an effective option for management of intractable middle-ear effusion and eustachian tube dysfunction.

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