scholarly journals A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations

2018 ◽  
Vol 128 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Ronald Sahyouni ◽  
Omid Moshtaghi ◽  
Mehdi Abouzari ◽  
Phuonganh Le ◽  
Jack Birkenbeuel ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Granulomatosis With Polyangiitis ◽  
Otitis Media With Effusion ◽  
False Negative ◽  
Previous History ◽  
Acute Otitis Media ◽  
Case Series ◽  
Repeated Testing ◽  
Mixed Hearing Loss

Objective: To describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations. Method: We report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition. Results: In this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments. Conclusion: GPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.

scholarly journals Long-Term Otitis Media Outcomes in Infants With Early Tympanostomy Tubes

2020 ◽  
Vol 163 (6) ◽  
pp. 1258-1263
Author(s):  
Kimberly Luu ◽  
James Park ◽  
Amber D. Shaffer ◽  
David H. Chi
Keyword(s):  
Hearing Loss ◽  
Logistic Regression ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Tertiary Care ◽  
Acute Otitis Media ◽  
Case Series ◽  
Craniofacial Anomalies ◽  
Tympanostomy Tubes

Objective To review the otologic outcomes of infants who failed the newborn hearing screen (NBHS) and received early tympanostomy tubes for otitis media with effusion (OME). Study Design Retrospective case series. Setting Tertiary care pediatric hospital. Subjects and Methods Consecutive patients (2007-2018) who failed an NBHS and required tympanostomy tubes before 6 months of age were included. Variables including hearing loss and otitis media risk factors, episodes of acute otitis media (AOM), number of subsequent tympanostomy tubes, and posttympanostomy tube audiogram results were recorded. Results The cohort included 171 patients. Median age at referral to otolaryngology was 2.7 months. Sensorineural hearing loss (SNHL) was subsequently identified in 22 (12.9%) of infants after resolution of the effusion. The peak incidence of AOM was during the second year of life (1-1.9 years), with a median of 1 episode. Ninety-five patients (55.6%) had replacement of tubes, 41 of 171 (24.0%) had 2 or more additional sets of tubes, and long-term tubes were eventually placed in 8 of 95 (8.4%) patients. Craniofacial anomalies were identified in 43.3% of patients. Tube replacement (hazard ratio, 3.00; 95% CI, 1.95-4.63; P < .01, log-rank) and AOM (β, 1.04; 95% CI, 0.43-1.65; P = .04, ordered logistic regression) were more common, and SNHL less common (odds ratio, 0.17; 95% CI, 0.031-0.61; P < .01, logistic regression), in children with craniofacial anomalies. Conclusion OME is a common cause of failed NBHS. A notable proportion was subsequently found to have SNHL, reiterating the need for postoperative hearing assessments. Infants meeting indication for early tympanostomy tubes for resolution of OME have a high incidence of recurrent AOM and require subsequent tubes.

scholarly journals Qualidade de Vida das Crianças com Otite Média e Impacto da Colocação de Tubos de Ventilação Transtimpânicos numa População Portuguesa

2018 ◽  
Vol 31 (1) ◽  
pp. 30 ◽  
Author(s):  
Ana Rita Lameiras ◽  
Deodato Silva ◽  
Assunção O´Neill ◽  
Pedro Escada
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Portuguese Version ◽  
Physical Suffering ◽  
Recurrent Acute Otitis Media

Introduction: Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children’s quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media.Material and Methods: This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure.Results: The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains ‘caregiver concerns’, ‘hearing loss’ and ‘physical suffering’ had the highest scores. The domain ‘hearing loss’ was correlated with the domain ‘speech impairment’ (rs = 0.41; p < 0.001) and the domain ‘physical suffering’ correlated with the domain ‘activity limitation’ (rs = 0.47; p < 0.001). There was a correlation between the score on ‘hearing loss’ and the presence of conduction hearing loss (χ2 (6) = 24.662; p = 0.022). Children with chronic otitis media with effusion had lower scores on the domain ‘physical suffering’, while children with recurrent acute otitis media had lower scores in the domain ‘hearing loss’ and higher scores in the domain ‘emotional distress’. There was an improvement in the quality of life in all the dimensions studied by the questionnaire after surgery. The improvement was large in 55%, moderate in 15% and small in 10% of the cases. The presence of otorrhea postoperatively did not decrease the quality of life improvement achieved with surgery.Conclusion: Otitis media has a negative impact on Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.

Otologic Disease in Patients with Acquired Immunodeficiency Syndrome

1988 ◽  
Vol 97 (6) ◽  
pp. 636-640 ◽  
Author(s):  
Darius Kohan ◽  
Stephen G. Rothstein ◽  
Noel L. Cohen
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Acquired Immunodeficiency Syndrome ◽  
Opportunistic Infections ◽  
Otitis Media With Effusion ◽  
Medical Center ◽  
Acute Otitis Media ◽  
New York University ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

A 5-year retrospective study evaluating otologic disease in patients with acquired immunodeficiency syndrome (AIDS) was conducted at the New York University Medical Center-Bellevue Hospital Center. Twenty-six patients with documented otologic disease who met the Centers for Disease Control criteria for AIDS were identified and their charts were analyzed according to presenting complaints, physical examination, diagnostic modalities, pathologic condition, management, and outcome. A marked diversity of otologic diseases of varying severity was noted. The majority of patients complained of hearing loss and otalgia during their hospitalization for treatment of AIDS-related opportunistic infections. The most frequent diagnoses were otitis externa, acute otitis media, and otitis media with effusion. Sensorineural hearing loss frequently appeared to be related to ototoxic medications and neurologic infections.

Labyrinthine involvement and multiple perforations of the tympanic membrane in acute otitis media due to group A streptococci

2000 ◽  
Vol 114 (1) ◽  
pp. 47-49 ◽  
Author(s):  
Takeharu Kanazawa ◽  
Hideo Hagiwara ◽  
Ken Kitamura
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Systemic Steroid ◽  
Group A Streptococci ◽  
Tympanic Membrane Perforations ◽  
Mixed Hearing Loss ◽  
Group A ◽  
Bilateral Sensorineural Hearing Loss

We present here three cases of acute otitis media caused by a virulent group A streptococcal infection that rapidly led to deterioration in hearing. Two of the three cases presented with severe sensorineural and mixed hearing loss with multiple tympanic membrane perforations, and the third presented with severe bilateral sensorineural hearing loss following acute otitis media involving group A streptococci. All patients were treated with systemic (piperacillin) and topical antibiotics (ofloxacin ear drops): one patient also received a systemic steroid (betamethasone). Deafness persisted in one patient but in the other two, hearing gradually recovered. Severe cytotoxicity was considered to have occurred in all patients, resulting in multiple perforations of the tympanic membrane and necrosis in the middle ear.

Quality Assessment of the Clinical Practice Guideline for Tympanostomy Tubes in Children

2018 ◽  
Vol 159 (5) ◽  
pp. 914-919 ◽  
Author(s):  
Joshua J. Sturm ◽  
Phillip Huyett ◽  
Amber Shaffer ◽  
Dennis Kitsko ◽  
David H. Chi
Keyword(s):  
Clinical Practice ◽  
Otitis Media ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Otitis Media With Effusion ◽  
Tertiary Care ◽  
Acute Otitis Media ◽  
Case Series ◽  
Annual Number ◽  
Tympanostomy Tubes

Objectives To determine the association between the introduction of statements 6 and 7 in the 2013 clinical practice guideline (CPG) for tympanostomy tubes in children and the identification of preoperative middle ear fluid (acute otitis media / otitis media with effusion [AOM/OME]) in children undergoing bilateral myringotomy and tube (BMT) placement. Study Design Case series with chart review. Setting Tertiary care children’s medical center. Subjects and Methods Patients who underwent BMT for recurrent AOM were retrospectively reviewed. We examined 240 patients before (BG; 2012) and 240 patients after (AG; 2014) the introduction of the CPG. Results The baseline characteristics of the 2 groups were comparable. The total annual number of BMT placements performed at our institution decreased from 3957 (BG) to 3083 (AG). There was no significant increase in the rate of preoperative AOM/OME identification following CPG introduction (BG 78.3% vs AG 83.3%, P = .164). The rate of identification of AOM/OME in the operating room (OR) increased from 54.2% (BG) to 71.3% (AG, P < .001). The rate of identification of AOM/OME both in the clinic and in the OR increased from 55.1% (BG) to 71.3% (AG, P < .001). Cases with concordant clinic and OR AOM/OME occurred among younger children ( P = .045), those with fewer episodes of AOM ( P = .043), and those with shorter time between the clinic and OR dates ( P = .008). Conclusions Following the introduction of the CPG, there was no change in the rate of identification of AOM/OME prior to recommending BMT placement in children with recurrent AOM. The lack of improved compliance with statements 6 and 7 may be related to multiple clinician- and patient-derived factors.

scholarly journals MIDDLE EAR DISORDERS AMONG CLEFT LIP AND PALATE IN CHILDREN: A CONJOINT EXPOSITION

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S457-61
Author(s):  
Saba Islam ◽  
Nazia Mumtaz ◽  
Ghulam Saqulain
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Rehabilitation Medicine ◽  
Sample Population ◽  
Cross Sectional

Objective: To analyze the frequency of middle ear disorders among the cleft lip and palate and association with hearing Loss. Study Design: Cross Sectional analytical study. Place and Duration of Study: Audiology Department of Cleft Hospital, Gujrat and ENT department of National Institute of Rehabilitation Medicine, Islamabad, from Oct 2018 to Mar 2019. Methodology: We recruited a sample of 100 cleft lip and palate children of both genders, aged 3 month to 12 years, using nonprobability sampling. Screening was performed with otoscopy, tympanometry and hearing assessment. Results: Out of sample population, 62% were males and 38% females with a mean age of 2.27 ± 2.73 years. The middle ear disorders were found to be 70%. Among these otitis media with effusion was the most common 43 (61.43%), followed by Acute otitis media 8 (11.43%) and Eustachian tube dysfunction 6 (8.57%). Tympanosclerosis and dry tympanic membrane perforation were the least common. Statistically significant association of hearing loss was found with the middle ear disorders (p<0.001). Conclusion: Middle ear disorders especially otitis media with effusion are common in cleft lip/ palate children.

Acute otitis media and otitis media with effusion in children with bacterial meningitis

1997 ◽  
Vol 111 (10) ◽  
pp. 913-916 ◽  
Author(s):  
M. P. Richardson ◽  
A. Reid ◽  
T. J. Williamson ◽  
M. J. Tarlow ◽  
P. T. Rudd
Keyword(s):  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Auditory Brainstem Responses ◽  
Acute Bacterial Meningitis ◽  
Controlled Study ◽  
Conductive Hearing

AbstractAcute otitis media and otitis media with effusion (OME) have often been observed in children with bacterial meningitis. OME has also been proposed as the mechanism of reversible hearing loss after meningitis. In this controlled study, children with acute bacterial meningitis were studied using auditory brainstem responses (ABR), otoacousticemissions, tympanometry and otoscopy. An age- and sex- matched control was recruited for each patient and the incidence of acute otitis media and OME was compared between the twogroups. One hundred and twenty-four children with meningitis were studied. Ninety-two children (74 per cent) had meningococcal meningitis. Five patients (4 per cent) had conductive hearing loss (ABR threshold≥30 dB HL) at the time of discharge from hospital. None of the patients or controls had acute otitis media. Patients and controls were well matched for risk factors for OME and the prevalence of middle ear effusion in patients and controls was 7.2 per cent and 11.3 per cent respectively. The relative risk of OME in the children with meningitis was 0.64 (95 per cent confidence interval 0.29 to 1.42). After nine months, three of the five children with meningitis and conductive hearing loss had regained normal hearing.In contrast to previous reports, there was no relationship between bacterial meningitis and acute otitis media or OME in this study. Nevertheless, coincidental conductive hearing defects were identified as the cause of reversible hearing loss in three patients.

scholarly journals Otological Presentation of Obstructive Nasal Lesions: A Study of 50 Cases

2021 ◽  
Vol 27 (2) ◽  
pp. 159-169
Author(s):  
Md Zahidul Islam ◽  
Md Shafiul Akram ◽  
Mashuque Mahmud ◽  
Md Shahjahan Sarker ◽  
Mahmudul Hasan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Nasal Obstruction ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Septal Deviation ◽  
Eustachian Tube Dysfunction ◽  
Upper Respiratory Tract ◽  
Tube Dysfunction

Purpose: To analyze and realize the importance of the Eustachian tube dysfunction (ETD) in the pathogenesis of the middle ear infections as to raise the awareness amongst the Otolaryngologists consider the tubal dysfunctions in the management of the otitis media. Materials and methods: 50 patients of aural discharge, aural fullness, aural pain, hearing loss and tinnitus along with nasal obstruction were selected from July 2013 upto December 2013 in the outpatient department (OPD) of Otorhinolaryngology - Head and Neck Surgery dept. of Dhaka Medical College Hospital under a specific prospective study protocol. All patients of aural fullness, hearing loss, aural pain, tinnitus, aural discharge along with nasal obstruction with or without sore throat were included; patients of sensorineural hearing loss, primary external ear pathology, ear malignancy and congenital ear diseaseswere excluded. Results: 58% patients were below 20 years, 50% were children, 64% were male and 36% female. 62% patients got aural fullness, 60% hearing loss 40% mild, 14% moderate, 6% severe conductive and 8% mixed), 26% tinnitus, 32% aural discharge and 30% aural pain and amongst the patients of otitis media with effusion (OME), 100% got hearing loss, 73% aural fullness, 33% tinnitus, 27% aural pain and 13% dizziness. 78% patients got septal deviation, 58% hypertrophied inferior turbinates (HIT), 32% enlarged adenoids (EA), 62% allergic rhinitis, 26% acute upper respiratory tract infection (URTI), 4% nasal polyps and 48% sinusitis/mucosal thickening and amongst the children, 64% got enlarged adenoids, 56% HIT, 76% septal deviation (SD), 24% acute URTI, 4% antrochoanal polyp, 20% adenoid with HIT and 44% adenoid with SD. Regarding findings in the patients of enlarged adenoid, 37.5% patients got eustachian tube dysfunction (ETD) and 62.5% got hearing loss due to OME as well as acute otitis media (AOM), chronic otitis media (COM) and it showed that mild adenoid caused ETD occasionally on URTI but mild adenoid with HIT caused OME. Conclusion: The obstructive nasal lesions are intermingled with otitis media, so this association should be sought out and underlying nasal lesions must be managed if any as a part of treatment of the otitis media. Bangladesh J Otorhinolaryngol 2021; 27(2): 159-169

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

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