Secretory Otitis Media and Mastoid Pneumatization

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 79-82 ◽  
Author(s):  
Burkhard Hussl ◽  
Kunigunde Welzl-Mueller
Keyword(s):  
Otitis Media ◽  
Morphological Changes ◽  
Pure Tone Audiometry ◽  
Functional Results ◽  
Cell System ◽  
Secretory Otitis Media ◽  
Mastoid Pneumatization ◽  
Lateral Projection ◽  
Temporal Bones ◽  
End Results

The objective of this study is to correlate in children with chronic secretory otitis media the extent of pneumatization with morphological and functional end results after therapy. For this purpose we examined 82 children and adolescents (147 ears), who 5 to 8 years previously were treated with insertion of ventilating tubes for chronic secretory otitis media. We evaluated the morphological and functional end results with otomicroscopy, pure tone audiometry, tympanometry and stapedial reflex testing. Roentgenograms of the temporal bones in a lateral projection were taken initially in 96 ears and at time of control in 145 ears. We judged the size of the mastoid air cell system by visual estimation and classified the mastoids according to the extent of pneumatization into three groups: large, middle-sized and small (sclerotic). Twenty-five percent of the ears had sclerotic mastoids at time of control. Statistically significant correlations exist between arrested pneumatization (sclerotic mastoids), major morphological changes in the tympanic membranes and unfavorable functional results. Also the correlation between sclerotic mastoids and the number of tube insertions required in the course of the disease is statistically significant. But no correlation can be established between the physical properties of secretions and the extent of pneumatization. Arrest of pneumatization leading to a small mastoid air cell system constitutes an unfavorable prognostic factor for the final outcome of chronic secretory otitis media.

The Welch Allyn Audioscope and Microtymp: their accuracy and that of pneumatic otoscopy, tympanometry and pure tone audiometry as predictors of otitis media with effusion

1992 ◽  
Vol 106 (7) ◽  
pp. 600-602 ◽  
Author(s):  
R. Vaughan-Jones ◽  
R. P. Mills
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Secretory Otitis Media ◽  
Community Screening ◽  
Poor Indicator

AbstractResults of standard audiometry and tympanometry were compared with the Welch Allyn ‘Audioscope’ and ‘Microtymp’, in the diagnosis of secretory otitis media, in 100 children.Standard pure tone audiometry had a specificity of 92 per cent and sensitivity of 51.6 per cent. The Welch Allyn ‘Audioscope’ a specificity of 84.2 per cent and sensitivity of 57.5 per cent; standard tympanometry a specificity of 71 per cent and sensitivity of 88 per cent; the Welch Allyn ‘Microtymp’ a specificity of 63 per cent and sensitivity of 90 per cent.In view of cost, portability, and speed of testing the Welch Allyn instruments would be particularly suitable for community screening.Pure tone audiometry with a pass threshold of 25 dB, at 2 and 4 kHz is a poor indicator of effusion.

Secretory Otitis Media in Adults: II. The Role of Mastoid Pneumatization as a Prognostic Factor

1997 ◽  
Vol 106 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Jacob Sadé ◽  
Camil Fuchs
Keyword(s):  
Otitis Media ◽  
Negative Pressure ◽  
Physiological Function ◽  
Pneumatic System ◽  
Secretory Otitis Media ◽  
Mastoid Pneumatization ◽  
Middle Ear Pressure ◽  
Chronic Sequelae ◽  
Gas Balance

The sequelae of secretory otitis media (SOM) were monitored in 72 adult patients with SOM who were followed up for an average of 33 months. It was found that SOM became chronic and retraction of the tympanic membrane appeared as a function of the pneumatization of the mastoid. Ears with poor pneumatization (less than 6 cm2) developed chronic SOM in 52.2% of cases, as compared with 20% in cases with well-pneumatized ears (6 cm2 and above). Atelectasis developed in 37.3% of poorly pneumatized ears, and in only 5.7% of well-pneumatized ears. These sequelae may therefore be linked pathogenetically to the extent of pneumatization, as both the SOM and the sequelae appeared many years after formation and maturation of the pneumatic system. This study supports other studies that view the mastoid pneumatic system as an organ, as a middle ear pressure buffer. Well-pneumatized ears rarely develop a negative pressure and are seldom associated with chronic sequelae. Ears with poorly pneumatized mastoids lack the physiological function of such a pressure buffer. Ears with a tendency to develop a negative gas balance, whether as a result of deficient ventilation or excessive diffusion, will therefore develop a negative pressure more readily when their pneumatic system is underdeveloped, and consequently will be more prone to develop chronic sequelae.

A comparison of speech audiometry and pure tone audiometry in patients with secretory otitis media

1993 ◽  
Vol 107 (9) ◽  
pp. 787-789 ◽  
Author(s):  
M. B. Pringle ◽  
A. Thompson ◽  
K. Reddy
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Speech Audiometry ◽  
Secretory Otitis Media ◽  
Parental Concern ◽  
Pure Tone Audiogram ◽  
Hearing Ability

AbstractSpeech audiometry was performed on 15 children with secretory otitis media pre-and post-operatively and the findings compared with the pre-and post-operative pure tone audiograms. The results showed that in 30 per cent of cases pre-operatively the speech audiogram suggested a significantly worse hearing ability than that suggested by the pure tone audiogram (PTA). Where a PTA gives a borderline threshold disproportionate parental concern should be taken seriously as the hearing ability may well be worse than the PTA suggests.

scholarly journals Efficacy of Grommet Insertion for Improvement in Hearing among Patients of Secretory Otitis Media

2021 ◽  
Vol 15 (7) ◽  
pp. 1857-1859
Author(s):  
Bakht Zada ◽  
Tahir Muhammad ◽  
Muhammad Habib ◽  
Zafar Iqbal ◽  
Rehan Saleem ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Secretory Otitis Media ◽  
Media Study ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Right ◽  
Surgery Department

Aim: To determine the improvement of hearing after grommet insertion in patients with secretory otitis media. Study Design:A Quasi-Experimental study. Place and Duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of two years from February 2019 to February 2021. Methods: The study was performed on 48 ears with secretory otitis media. Before the operation,evaluation of both ears along with tympanmontometry and Pure Tone Audiometry were performed. Documentation ofhearing loss was done pre-operatively. During the operation accomplished under GA, a grommetwas placed in the anterior inferior quadrant of the tympanic membrane. After the surgery, PTA was repeated in the postoperative period before the patient was discharged from the hospital. Results:Our study included 28 patients with secretory otitis media and a total of 48 ears. Of the ears, 27 (56.25%) were male and 21 (43.75%) were female. Both ears were affected in 21 patients. Two patients had unilateral ear involvement. The right ear was affected in 26 cases (51.1%) and the left ear in 22 cases (48.9%). 7-55 years was the age range of the patients and 14.10 ± 9.11 years was the mean age. The degree of preoperative hearing loss was mild (20-40 dB) in 5 (10.41%) ears, moderate (40-60 dB) in 37 (77.1%) ears and severe (60-80 dB) in 6 (12.5%) ears. The degree of postoperative hearing loss was mild (20-40 dB) in 36 ears (75%), moderate (40-60 dB) in 11 ears (22.9%) and severe (60-80 dB) in one ear (2.1%). Hearing improvement was not seen in 8 (16.6%) ears, an improvement of 5-10 dB in 34 (70.8%) ears, and an improvement of 10-20 dB in 6 (12.5%) ears. There was a statistically significant difference between preoperative and postoperative hearing loss in the ears, the hearing loss was significantly less after grommet insertion; p = 0.017. Conclusion:The insertion of Grommet provides a significant improvement in hearing in patients with secretory otitis media. Keywords:Pure tone audiometry, Tympanometry, Middle ear, Secretory otitis Media and Grommets.

Eustachian Tube Lumen: Comparison between Normal and Inflamed Specimens

1989 ◽  
Vol 98 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Jacob Sadé ◽  
Michal Luntz
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Sectional Area ◽  
Secretory Otitis Media ◽  
Cross Sectional ◽  
Tube Lumen ◽  
Luminal Area ◽  
The Mean ◽  
Temporal Bones

This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube.

scholarly journals A clinical study to determine the effects of adenoidectomy in cases of secretory otitis media in school going children

2020 ◽  
Vol 5 (8) ◽  
pp. 200-206
Author(s):  
Dr. B Krishna Santosh ◽  
◽  
Dr. K Krishna Sumanth ◽  
Dr. Panda Veeranjaneyulu ◽  
Dr. B Deepthi ◽  
...  
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Secretory Otitis Media ◽  
Female Ratio ◽  
Impedance Audiometry ◽  
Tube Obstruction ◽  
The Past ◽  
Male Female Ratio ◽  
Ear Effusion

Introduction: Secretory Otitis media (SOM) is the leading cause of hearing loss in children. Despitenumerous studies on the prevention and treatment of SOM during the past decades, itsmanagement remains challenging and controversial. A study was conducted to find the effect ofadenoidectomy in cases of SOM with hypertrophied adenoids and to determine the effect ofadenoidectomy on hearing as assessed by the pure tone and impedance audiometry. Material andMethods: Children aged 5 – 12 years, diagnosed as SOM with adenoid hypertrophy were included.The study was conducted from April 2019 to May 2020, in the department of ENT, GSL MedicalCollege. A detailed history and clinical examination were done. Investigations such as pure toneaudiogram, impedance audiometry, X-ray nasopharynx, and diagnostic nasal endoscopy were carriedout to confirm the diagnosis. Results: Out of the 50 participants, a maximum (60%) belonged tothe 5 – 7 years age group, the male-female ratio was 1.2. Hard of hearing was a common symptomin 66%, tonsillitis, and sinusitis in 36% and 18% respectively. On pure tone audiometry, the averagehearing loss was 24.95dB. Conclusion: Adenoidectomy in children having hypertrophied adenoidswith SOM, not only relieves Eustachian tube obstruction but also removes the source of infection.This leads to clearance of middle ear effusion and improvement in hearing postoperatively.

Secretory Otitis Media in Adults: I. The Role of Mastoid Pneumatization as a Risk Factor

1996 ◽  
Vol 105 (8) ◽  
pp. 643-647 ◽  
Author(s):  
Jacob Sade ◽  
Camil Fuchs
Keyword(s):  
Risk Factor ◽  
Otitis Media ◽  
Normal Population ◽  
Adult Life ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Upper Respiratory Tract ◽  
Secretory Otitis Media ◽  
Mastoid Pneumatization

We analyzed clinically 102 ears with secretory otitis media (SOM) belonging to 72 adult patients who during their adult life had not suffered previously from ear disease. As in children, most of the cases (63%) could be traced directly to an upper respiratory tract infection. The most striking finding was the preponderance of poorly pneumatized mastoids—which were measured planimetrically — among our SOM cohort. This was found in adult SOM ears compared to contralateral healthy ears (4.59 versus 7.88 cm2), as well as when all 102 SOM ears were compared with values of the normal population (5.41 versus 12.9 cm2). This study showed that poorly pneumatized mastoids are a significant risk factor as far as adult SOM is concerned.

Middle Ear Ventilation in Secretory Otitis Media

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 178-181 ◽  
Author(s):  
Jörgen Holmquist ◽  
Ulf Renvall
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Cell System ◽  
Eustachian Tube Function ◽  
Secretory Otitis Media ◽  
Pressure Equalization ◽  
Middle Ear Ventilation ◽  
Tube Function ◽  
Equalization Technique

The Eustachian tube function was determined repeatedly in 42 patients during as well as after the course of secretory otitis media. Air pressure equalization technique and impedance audiometry were used. Also the size of the mastoid air cell system was determined. It was found that poor tubal function and a small mastoid air cell system are significant findings in these ears.

Evaluation of the mastoid air cell system by high resolution computed tomography: three-dimensional multiplanar volume rendering technique

2003 ◽  
Vol 117 (8) ◽  
pp. 595-598 ◽  
Author(s):  
Ahmet Koç ◽  
Gazanfer Ekinci ◽  
A. Mert Bilgili ◽  
Ihsan N. Akpinar ◽  
Hamdi Yakut ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Volume Rendering ◽  
Three Dimensional ◽  
Cell System ◽  
Mastoid Cavity ◽  
High Resolution Computed Tomography ◽  
Mastoid Pneumatization ◽  
Temporal Bones

The mastoid air cell system is an important contributor to the pathophysiology of middle-ear inflammatory disease. The mastoid cavity is not only an air reservoir, but also an active space for gas exchange. Various methods of temporal bone imaging have been designed to investigate mastoid pneumatization. In this study, we examined 100 normal temporal bones for the evaluation of mastoid pneumatization. Mastoid air cell systems were measured by reconstructed axial and coronal high resolution computed tomography (HRCT) images. The reconstructions were made by a three-dimensional multiplanar volume rendering (3D MPVR) technique. The mean volume of the mastoid air cell pneumatization was 7.9 cm3 (4.0-14.0 cm3, SD = 2.3 cm3). The ears were allocated to the groups with respect to measured mastoid air cell pneumatization. Twenty-eight per cent of the ears have small pneumatization with an aircell system not exceeding 6 cm3. Fifty-two per cent had an air cell system between six and 10 cm3, and 20 per cent had an air cell system exceeding 10 cm3. With its excellent imaging quality and the ability to eliminate bone and soft tissue, HRCT is the best method for evaluating the mastoid air cell system. The 3D MPVR technique must be used tomeasure the temporal bone/mastoid pneumatization for the best results.

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