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.

Otitis Media

PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 948-949
Author(s):  
Charles M. Ginsburg
Keyword(s):  
Otitis Media ◽  
Viral Infections ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Medical Personnel ◽  
Medical Attention ◽  
Common Symptom ◽  
Upper Respiratory Tract ◽  
Primary Responsibility ◽  
Printed Materials

Earache, a common symptom in children, causes many parents to seek medical attention. Aside from trauma and the discomfort that often accompanies viral infections of the upper respiratory tract, acute otitis media with effusion is the commonest cause of otalgia in infants and children. Proper management requires a team effort between the physician and the child's parents or caretaker. The physician must transmit to the parents a concise but thorough overview of the problem and a plan for management. This should include information on the pathophysiology of ear disease, its incidence, therapy and the potential adverse effects, and any measures that the parents may take to prevent recurrence. The primary responsibility for transmittal of this information lies with the physician. Ancillary medical personnel and communication aids (videotapes, computers, printed materials) should be utilized, if available, to reinforce the physician's "message.'

Delayed Onset Post-Tympanotomy Otorrhea

1988 ◽  
Vol 98 (2) ◽  
pp. 111-115 ◽  
Author(s):  
George A. Gates ◽  
Christine Avery ◽  
Thomas J. Prihoda ◽  
G. Richard Holt
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Delayed Onset ◽  
Tympanostomy Tubes ◽  
Care Costs

Otorrhea is the most frequent complication of the use of tympanostomy tubes. When it occurs after the immediate postoperative period, otorrhea is probably the result of external contamination of the middle ear or acute otitis media. We analyzed data from 627 operations upon 1248 ears of 491 children with chronic secretory otitis media and found that delayed onset (longer than 7 weeks) postoperative otorrhea occurred after 26.4 percent of the 382 operations in which tympanostomy tubes were used. The average number of episodes of otorrhea per case was 1.46 and ranged from 1 to 9. The rate of otorrhea occurrence in patients with tubes in place was significantly higher in the summer months. Otorrhea also occurred after 9.0 percent of 245 myringotomy procedures. The average number of episodes was 1.32 and ranged from 1 to 3. Treatment of postoperative otorrhea increases the health care costs of surgical treatment of chronic otitis media with effusion; this problem should be included in the calculation of cost-effectiveness.

Management of Otitis Media Using Agency for Health Care Policy and Research Guidelines

1998 ◽  
Vol 118 (4) ◽  
pp. 437-443 ◽  
Author(s):  
Griffith S. Hsu ◽  
Samuel C. Levine ◽  
G. Scott Giebink
Keyword(s):  
Health Care ◽  
Otitis Media ◽  
Health Care Policy ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Care Policy ◽  
Research Guidelines ◽  
Recurrent Acute Otitis Media ◽  
History Of

Increased costs of managing otitis media and its complications may result from delays in diagnosis and treatment. The Agency for Health Care Policy and Research developed guidelines to assist in the management of chronic otitis media with effusion. We examined the medical care adherence to Agency for Health Care Policy and Research guidelines in 59 consecutive patients referred because of chronic otitis media with effusion and recurrent acute otitis media. Patient history and examination data were collected prospectively. In the group with chronic otitis media with effusion, the rate of adherence to Agency for Health Care Policy and Research guidelines was 0%; in those with recurrent acute otitis media, adherence was 5%. Delayed referral occurred in 34% of patients; 25% of patients were referred early. The average duration of effusion in patients with chronic otitis media with effusion was 5.2 months; the duration of recurrent acute otitis media immediately before referral was 9.3 months. Eighteen patients (47%) in the chronic otitis media with effusion group had a history of recurrent chronic otitis media with effusion spanning an average of 22.7 months. On referral, hearing loss was discovered in 92% of all patients, and in 69% the tympanogram was flat. The complication and sequelae rate was 49.1%, and speech delay was the most frequent at 16.9%. We conclude that in our study patients there is a significant referral delay, long history of chronic otitis media with effusion in patients before referral, high rate of hearing loss, and high complication rate. Continued efforts should be directed toward improving education of all clinicians so that diagnostic tools and timely otolaryngologic referral are better used.

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.

scholarly journals Impact of antibiotics on pathogens associated with otitis media with effusion

2005 ◽  
Vol 119 (11) ◽  
pp. 862-865 ◽  
Author(s):  
Yukiko Hamamoto ◽  
Yukako Gotoh ◽  
Yoshimi Nakajo ◽  
Satoko Shimoya ◽  
Chikako Kayama ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Bacterial Genome ◽  
Acute Otitis Media ◽  
Antibiotic Administration ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Bacterial Dna ◽  
Ventilation Tubes ◽  
History Of

Objective: To further understand the roles of bacteria and antibiotics in the development of otitis media with effusion (OME).Methods: Samples of middle-ear effusion (MEE) were collected during the placement of ventilation tubes to treat chronic OME. Children with acute otitis media within the past three months were excluded from this study. We used polymerase chain reaction (PCR) to detect pathogens and to test the susceptibility of Streptococcus pneumoniae to penicillin.Results: Among MEE samples from 52 children, PCR detected bacterial DNA in 32 per cent (24/75) of them. S. pneumoniae was detected more frequently in middle ears that required ventilation tube insertion at least twice compared with those requiring ventilation tube insertion only once (5/15 versus 4/60; p = 0.013). Higher levels of S. pneumoniae were detected in MEE from children with, than without, a long history of antibiotic administration (7/10 versus 2/14; p = 0.0187). The pbp genes of all isolated S. pneumoniae contained mutations.Conclusions: Long exposure to antibiotics might significantly influence the bacterial genome in MEE.

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.

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.

Pharmacologic Compliance with Antibiotic Therapy for Acute Otitis Media: Influence on Subsequent Middle Ear Effusion

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 619-622
Author(s):  
Richard H. Schwartz ◽  
William J. Rodriquez ◽  
Kenneth M. Grundfast
Keyword(s):  
Otitis Media ◽  
Antibiotic Treatment ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Secretory Otitis Media ◽  
The Relationship ◽  
Serous Otitis Media ◽  
Positive Results ◽  
Urine Specimens ◽  
Ear Effusion

The frequency of otitis media with effusion (serous otitis media, secretory otitis media) detected after conventional antibiotic treatment of acute otitis media is approximately 50%. The relationship between pharmacologic compliance and the frequency of otitis media with effusion was studied. A Micrococcus lutea bioinhibition test was used to detect the presence of substances in the urine that inhibited the growth of this antibiotic-sensitive organism. On the fourth, seventh, and tenth days of antibiotic treatment for acute otitis media urine specimens were collected. Otitis media with effusion was detected in 53% of 66 children who had positive results for M lutea bioinhibition compliance tests for all three urine specimens. Electro-acoustic impedance measurements (tympanograms) confirmed the presence of effusion in all children in the effusion group tested by this method. The M lutea bioinhibition assay is a practical, in-office method to validate periodically, during treatment, pharmacologic compliance with antibiotics used for treatment of acute otitis media.

Seroepidemiology ofStrongyloides stercoralisin Dhaka, Bangladesh

Parasitology ◽  
2012 ◽  
Vol 139 (11) ◽  
pp. 1513-1520 ◽  
Author(s):  
YASMIN SULTANA ◽  
GWENDOLYN L. GILBERT ◽  
BE-NAZIR AHMED ◽  
ROGAN LEE
Keyword(s):  
Strongyloides Stercoralis ◽  
Epidemiological Studies ◽  
Igg Subclasses ◽  
Personal Hygiene ◽  
Individual Risk ◽  
Slum Dwellers ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Group B

SUMMARYHuman strongyloidiasis is a neglected tropical disease with global distribution and this infection is caused by the parasitic nematodeStrongyloides stercoralis. The aim of this study was to determine the prevalence of strongyloidiasis in Dhaka, Bangladesh. Sera from 1004 residents from a slum (group A) and 299 from city dwellers (group B) were tested for total IgG and IgG subclasses toStrongyloidesantigen. There was a significant difference (P < 0·001) in IgG seroprevalence between group A (22%) and group B (5%). Reactive IgG subclasses (IgG1 and IgG4) were also higher in group A (P < 0·05). The seroprevalence of strongyloidiasis in group A increased with age but was unrelated to sex. The presence of reactive IgG toStrongyloidesantigen had no correlation with either socio-economic or personal hygiene factors. However, a history of diarrhoea in a family member, in the past 6 months, but not in the respondents was associated with detection of antibodies toS. stercoralis(P < 0·01). None of the sera from either group had an HTLV-I reaction. This study demonstrates that strongyloidiasis is prevalent in Dhaka, especially among slum dwellers, but concurrent infection with HTLV-I was not found. Future epidemiological studies should identify individual risk factors and other communities at risk so that appropriate interventions can be planned.

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