Otitis Media with Effusion: Results of Treatment with a Short Course of Oral Prednisone or Intranasal Beclomethasone Aerosol

A short course of prednisone suspension given in a decreasing dosage schedule for up to ten days was often effective (68%) in resolving mucoid otitis media with effusion (OME, middle ear effusion). No significant side effects were noted. Concommitant administration of sulfisoxazole suspension may have reduced the likelihood of activation of a quiescent infection of the middle ear. During an eight-month mean follow-up period, reaccumulation of the effusion was detected in 21% of the successfully treated children. Preliminary results of an unrelated, pilot project using intranasal beclomethasone dipropionate aerosol suggests that this novel method also may be efficacious in the treatment of OME.

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Importance of early ventilation tubes insertion in chronic otitis media with effusion in children with congenital cleft palate

Vojnosanitetski pregled ◽

10.2298/vsp160708240s ◽

2018 ◽

Vol 75 (3) ◽

pp. 253-259

Author(s):

Vladan Subarevic ◽

Nenad Arsovic ◽

Radoje Simic ◽

Katarina Stankovic

Keyword(s):

Cleft Palate ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Speech Development ◽

Middle Ear Effusion ◽

Ventilation Tubes ◽

Congenital Cleft ◽

Ear Effusion

Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palate with an incidence of more than 90%, but the approach to managing this problem varies significantly among authors. The Eustachian tube dysfunction is the main factor that leads to the presence of the middle ear effusion. This is especially prominent in children with congenital cleft palate and explains the prolonged course of this process. The objective of this study was to determine the effectiveness of early ventilation tubes insertion in children with cleft palate at the time of palatoplasty by monitoring the course and duration of the disease as well as development of complications. Methods. In the prospective study with predefined regular follow-up intervals and parameters, the two groups of children were observed. The group one (E) included 45 children with congenital cleft palate who underwent the early insertion of ventilation tubes during palatoplasty, and the group two (C) had the same number of children with cleft palate who were treated conservatively on an as-needed basis. Assessment parameters were findings of otomicroscopy, tympanometry, play and pure tone audiometry. Each child was followed-up for 5 full years at total of nine follow-up examinations. Results. Result analysis showed that there were no statistically important differences between the two study groups in terms of the course and duration of the presence of the middle ear effusion, or in terms of complications and speech development. Conclusion. Based on the results obtained, we can conclude that there is no significant benefit in early ventilation tubes insertion in children with cleft palate, therefore our recommendation is watchful waiting and a conservative treatment on an as-needed basis, with the ventilation tubes insertion when a surgeon, based on his or her experience and individual findings considers it necessary.

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Determining Otitis Media Severity from Middle Ear Fluid Analysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894941030s512 ◽

1994 ◽

Vol 103 (5_suppl) ◽

pp. 43-45 ◽

Cited By ~ 30

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.

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To Tube or Not to Tube: That Continues to Be the Question

PEDIATRICS ◽

10.1542/peds.76.2.332a ◽

1985 ◽

Vol 76 (2) ◽

pp. 332-332

Author(s):

DAVID W. TEELE ◽

BERNARD ROSNER ◽

JEROME O. KLEIN

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Speech And Language ◽

Clinically Significant ◽

Ear Effusion

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.

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Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100101124 ◽

1986 ◽

Vol 100 (12) ◽

pp. 1347-1350 ◽

Cited By ~ 8

Author(s):

T. H. J. Lesser ◽

M. I. Clayton ◽

D. Skinner

Keyword(s):

Medical Treatment ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Randomised Trial ◽

Control Group ◽

Middle Ear Effusion ◽

Secretory Otitis Media ◽

Ear Effusion

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).

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Experimental Otitis Media With Effusion Induced by Middle Ear Effusion

The Laryngoscope ◽

10.1288/00005537-199209000-00014 ◽

1992 ◽

Vol 102 (9) ◽

pp. 1037???1042 ◽

Cited By ~ 9

Author(s):

Junko Nakata ◽

Masashi Suzuki ◽

Hideyuki Kawauchi ◽

Goro Mogi

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948409300113 ◽

1984 ◽

Vol 93 (1) ◽

pp. 52-56 ◽

Cited By ~ 83

Author(s):

Thomas F. DeMaria ◽

David J. Lim ◽

Bruce R. Briggs ◽

Nobuhiro Okazaki

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Animal Experiment ◽

Otitis Media With Effusion ◽

Type B ◽

Negative Bacterium ◽

Middle Ear Effusion ◽

Sterile Saline ◽

Inflammatory Changes ◽

Ear Effusion

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.

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IL-5 and Eotaxin Levels in Middle Ear Effusion and Blood from Asthmatics with Otitis Media with Effusion

Acta Oto-Laryngologica ◽

10.1080/0036554021000028117 ◽

2003 ◽

Vol 123 (3) ◽

pp. 383-387 ◽

Cited By ~ 35

Author(s):

Manabu Nonaka ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

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

Otolaryngology ◽

10.1177/019459988209000628 ◽

1982 ◽

Vol 90 (6) ◽

pp. 837-843 ◽

Cited By ~ 10

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.

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Tympanostomy Tube Selection: A Review of the Evidence

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1259 ◽

2016 ◽

Vol 7 (1) ◽

pp. 17-22

Author(s):

Ho Sandra ◽

David J Kay

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

The United States ◽

Tube Placement ◽

Tympanostomy Tube ◽

Middle Ear Effusion ◽

Surgeon Experience ◽

Ear Effusion

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.

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