Immunoglobulin E in Chronic Middle Ear Effusions

1978 ◽  
Vol 87 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Daniel M. Lewis ◽  
James L. Schram ◽  
Herbert G. Birck ◽  
David J. Lim ◽  
Gerald Gleich
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Immunoglobulin E ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Causative Factor ◽  
Serum Samples ◽  
Double Antibody ◽  
Paired Serum

To investigate the possible role of allergy in otitis media with effusion (OME), the immunoglobulin E (IgE) content of 138 middle ear effusions (MEE) and paired serum samples from patients with chronic otitis media with effusion was determined. The initial 62 paired specimens were assayed for IgE by the radioimmunosorbent test (RIST), while the later 76 paired specimens were assayed for IgE by the paper radioimmunosorbent test (PRIST). When the results obtained by these two techniques were compared, it was noted that the PRIST procedure gave significantly lower IgE values for effusions than the RIST method. When the effusion-to-serum ratios (E/S ratios) were computed from the PRIST data, the E/S ratio was less than one, while RIST data gave an E/S ratio greater than one. The results obtained with the PRIST procedure were confirmed by double antibody radioimmunoassay for IgE. Thus, the PRIST procedure appears to measure the IgE content of MEE more accurately, and the results obtained by this procedure fail to support the concept of allergy as a major causative factor in OME.

The Role of Coagulase-Negative Staphylococci in Chronic Otitis Media With Effusion

1982 ◽  
Vol 90 (6) ◽  
pp. 837-843 ◽  
Author(s):  
Joel M. Bernstein ◽  
Diane Dryja ◽  
Erwin Neter
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Antibiotic Sensitivity ◽  
Middle Ear Effusion ◽  
Coagulase Negative Staphylococci ◽  
Heterogenous Group ◽  
Ear Effusion

Twenty-eight middle ear effusions from 27 patients with chronic otitis media with effusion were studied for the presence of bacteria. The most common isolates were coagulase-negative staphylococci. However, biochemical and antibiotic sensitivity patterns demonstrated that these organisms represented a heterogenous group. At least three subtypes of coagulase-negative staphylococci were identified from the middle ear effusions, and in only one instance was the isolate from the ear canal identical with that of the middle ear effusion. The data presented suggest that coagulase-negative staphylococci from the middle ear effusions may not be contaminants; however, it cannot be determined from this study whether these organisms play a role as pathogens or as the result of indolent colonization.

scholarly journals MICROORGANISMS IN CHRONIC OTITIS MEDIA WITH EFFUSION

2003 ◽  
Vol 41 (142) ◽  
pp. 314-317
Author(s):  
Anil Kumar Jha ◽  
J B Singh ◽  
S P Raut
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Negative Pressure ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Bacterial Cultures ◽  
Middle Ear Fluid ◽  
Nature Ofthe

A total of 100 patient with otitis media effusion obtained from patients suffering fromchronic otitis media with effusions was examined for bacterial smear and culture. Inmucoid effusion 82% showed positive bacterial smear, only 35% yielded positivebacterial culture. Bacterial cultures rate was higher in serous (50%) effusion. Theisolation of common pathogens accounted for the remaining 42%. The high incidenceof microorganisms in the middle ear effusions in the present study indicates bacterialcontribution in many cases of otitis media effusion. Concerning the sterile nature ofthe middle ear fluid some investigators suggested that the effusions are transudatesand are created by a negative pressure in the tympanum due to a malfunctioningEustachian tube.2It was suggested that failure to isolate organisms may be partly dueto the antimicrobial characteristics of effusions. The purpose of this study is to showpossible role of bacteria in Middle Ear Effusions.Key Words: Otitis Media, Effusion, Microorganisms.

Determining Otitis Media Severity from Middle Ear Fluid Analysis

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 43-45 ◽  
Author(s):  
Steven K. Juhn ◽  
William J. Garvis ◽  
Chap T. Le ◽  
Chris J. Lees ◽  
C. S. Kim
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Complex Nature ◽  
Fluid Analysis ◽  
Factor Α ◽  
Necrosis Factor ◽  
Ear Effusion ◽  
Chemical Mediators

Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukrn-1β and tumor necrosis factor α) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation.

Bacteriology of chronic otitis media with effusion

1989 ◽  
Vol 103 (4) ◽  
pp. 369-371 ◽  
Author(s):  
C. Diamond ◽  
P. R. Sisson ◽  
A. M. Kearns ◽  
H. R. Ingham
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Anaerobic Bacteria ◽  
Chronic Otitis Media

AbstractSamples of middle ear effusions from 102 children with serous and mucoid otitis media were cultured for mycoplasmas and bacteria. No sample yielded mycoplasmas but bacteria were cultured from 48 (47 per cent). Organisms commonly regarded as pathogens were present in 25 samples (Haemophilus influenzae 17, Streptococcus pneumoniae four, other streptococci four). The only sample from which anaerobic bacteria were isolated was from a patient with cholesteatoma.

Antimicrobial Factors and Bacterial Correlation in Chronic Otitis Media with Effusion

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 145-151 ◽  
Author(s):  
Raymond W. Lang ◽  
David J. Lim ◽  
Yea S. Liu ◽  
Herbert G. Birck
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Local Production ◽  
Isolation Rate ◽  
Rare Exception

Analyses of effusions and sera from patients with otitis media with effusion demonstrated local production in the middle ear of lysozyme, IgA and IgG. The effusion IgM was markedly elevated in some patients, also indicating local production. Complement C3 with rare exception was significantly lower in effusions than sera, suggesting utilization of complement in the middle ear, perhaps in conjunction with antibodies. The presence of high levels of lysozyme and immunoglobulins in effusions correlates with the low isolation rate of microorganisms in culture and may influence survival of organisms in the middle ear.

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

Chronic Secretory Otitis Media: Effects of Surgical Management

1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Surgical Management ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Tympanostomy Tubes ◽  
The Mean ◽  
First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

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