Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

1984 ◽  
Vol 93 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Thomas F. DeMaria ◽  
David J. Lim ◽  
Bruce R. Briggs ◽  
Nobuhiro Okazaki

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Md Ashraful Islam

Background & Objectives: Adenoid hypertrophy is one of the commonest etiology for otitis media with effusion (OME). OME is a leading cause of diminished hearing in children younger than 12 years. This study compares the efficacy of adenoidectomy on OME in patients with different grades of adenoids and the connection between different position of adenoids and middle ear effusion. Methods: This is a prospective study done on 120 pediatric patients (2 to 12 years) presented with chronic otitis media with effusion and adenoid hypertrophy from 2017 to 2019. Adenoid size was graded and correlated with the type of tympanometry. All the cases were subjected to adenoidectomy with myringotomy and were observed every 3 months. Preoperative and postoperative data were collected and comparison was made to evaluate whether adenoidectomy with myringotomy is sufficient on management of OME. Results: Adenoid tissue grading showed majority of population remained in Grade III (45%) and Grade C (56.67%). There is a highly significant relation between higher adenoid grade and type B tympanometry. This study showed significant association between grade III and grade C adenoid hypertrophy and otitis media with effusion when compared with other grades of adenoid hypertrophy. This suggests that increasing grade of adenoid hypertrophy is important predictor in establishment of otitis media with effusion in patient with adenoid hypertrophy. After adenoidectomy majority of tympanometry curve was shifted from type B to type A. In case of Grade III, type B tympanometry reduced from 45 to 11 (83% to 20%) in right ears; 49 to 7 (90% to 12%) in left ears. Again, in case of Grade C, type B tympanometry reduced from 55 to 6 (80% to 8%) in right ears; 58 to 5 (85% to 7%) in left ears. This change was significant. The greater the size of the adenoid, after adenoidectomy, more improvement noticed in tympanometry curve. Conclusion: This study may not be the actual picture of overall situation due to many limitations. Still it can be concluded that enlarged adenoids has a definite role in causing OME. This research also shows a benefit of adenoidectomy in the removal of middle ear effusion in children with OME. To efficiently assess the efficacy of adenoidectomy for otitis media with effusion in children, future research is needed.


PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 332-332
Author(s):  
DAVID W. TEELE ◽  
BERNARD ROSNER ◽  
JEROME O. KLEIN

In Reply.— We appreciate Chamberlin's thoughtful comments about the associations between otitis media with effusion and development of speech and language and his concern about results that are statistically significant but may not be "clinically significant." We share his view that measurements of the sequelae of disease should include those that are meaningful to the child. We reported results of tests of speech and language that indicated that children who had spent many days with middle ear effusion during the first years of life scored significantly lower than did children who had not spent such time.


1986 ◽  
Vol 100 (12) ◽  
pp. 1347-1350 ◽  
Author(s):  
T. H. J. Lesser ◽  
M. I. Clayton ◽  
D. Skinner

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).


1992 ◽  
Vol 102 (9) ◽  
pp. 1037???1042 ◽  
Author(s):  
Junko Nakata ◽  
Masashi Suzuki ◽  
Hideyuki Kawauchi ◽  
Goro Mogi

2003 ◽  
Vol 123 (3) ◽  
pp. 383-387 ◽  
Author(s):  
Manabu Nonaka ◽  
Manabu Nonaka ◽  
Manabu Nonaka ◽  
Manabu Nonaka ◽  
Manabu Nonaka ◽  
...  

1982 ◽  
Vol 90 (6) ◽  
pp. 837-843 ◽  
Author(s):  
Joel M. Bernstein ◽  
Diane Dryja ◽  
Erwin Neter

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.


2016 ◽  
Vol 7 (1) ◽  
pp. 17-22
Author(s):  
Ho Sandra ◽  
David J Kay

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.


1997 ◽  
Vol 16 (8) ◽  
pp. 816-817 ◽  
Author(s):  
Christopher J. Harrison ◽  
Stephen A. Chartrand ◽  
William Rodriguez ◽  
Richard Schwartz ◽  
Jay Pollack ◽  
...  

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 282-287 ◽  
Author(s):  
David W. Teele ◽  
Jerome O. Klein ◽  
Bernard A. Rosner ◽  

To determine the association between time spent with middle ear effusion and development of speech and language, 205 three-year-old children were studied. Each child had been followed prospectively from birth to record the number of episodes of middle ear disease and to document time spent with middle ear effusion. Standardized tests of speech and language were administered at age 3 years to children who had spent much time with middle ear effusion and to children who had spent little or no time with middle ear effusion. Children who had spent prolonged periods of time with middle ear effusion had significantly lower scores when compared with those who had spent little time with middle ear disease. The correlation was strongest in children from higher socio-economic strata. Time spent with middle ear effusion in the first 6 to 12 months of life was most strongly associated with poor scores.


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