Treatment of Suppurative Otitis Media in Paediatric Patients

1975 ◽  
Vol 3 (6) ◽  
pp. 371-379
Author(s):  
Luis Limon y Limon ◽  
Carlos A Tirado Tirado ◽  
Francisco Flores-Mercado ◽  
Emma Galindo-Hernandez ◽  
Renato Rasquel-Pagasartundua ◽  
...  

Thirty-nine paediatric patients with suppurative otitis media were studied. General principles of treatment were followed and sodium cefazolin ( a new cephalosporin effective even on β- lactamase-producing organisms) was given intramuscularly at a dose of 25 mg/kg every 12 hours. Clinical effectiveness was excellent, since 100% of patients were cured by the 7th day of treatment at the latest and 80% within 48 hours. Drug levels in the blood and purulent matter from the middle ear were determined in five cases, and it was found that cefazolin concentrates 2.5 times more in this secretion than in the blood. The need for myringotomy in the early stages of the disease, as well as for daily aspiration of secretion, is stressed, as is the use of an antimicrobial agent resistant to the inhibiting effect of penicillinase and cephalosporinase since, in our environment, 41% of bacteria causing this pathology produce these enzymes.

PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 35-42
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone ◽  
Herman Felder

Bilateral secretory (serous) or suppurative otitis media was found without exception in 50 infants with cleft palate who were 20 months of age or younger. Middle ear disease probably develops in all cleft palate infants during the first few months of life, and appears to be best managed by myringotomy with insertion of plastic tubes. Unless drainage and aeration of the middle ear are accomplished, irreparable damage to middle ear structures may develop in some patients; and, in all of them, hearing impairment will probably persist throughout infancy or longer, with adverse effects on well-being and function and with serious implications for intellectual, speech, and emotional development. Further studies are required to assess the long-range effectiveness of surgical management.


1984 ◽  
Vol 77 (9) ◽  
pp. 754-757 ◽  
Author(s):  
Robert Mills ◽  
Ann Uttley ◽  
Michelle McIntyre

A total of 204 chronic middle ear effusions from 122 children have been studied. Bacteria were isolated from 30 effusions. The commonest species found were Strep. pneumoniae and H. influenzae. These are also the commonest organisms causing acute otitis media (AOM). A similar pattern of serotypes was also demonstrated. In vitro sensitivity testing showed that most of the organisms isolated were sensitive to most commonly-used antibiotics. The main exception was resistance to penicillin amongst strains of H. influenzae and Staph. aureus. It is suggested that some cases of chronic secretory otitis media (SOM) may arise as a result of incomplete resolution of AOM and that the use of penicillin to treat AOM may be one factor in this process.


1984 ◽  
Vol 22 (14) ◽  
pp. 53-54

Acute suppurative otitis media (AOM) is a common, painful condition affecting 20% of children under 4 years at least once a year,1 and perhaps more in infancy when clinical examination is most difficult. Infectious complications such as mastoiditis, meningitis and cerebral abscess are now rare, but chronic middle ear effusion and hearing loss remain common. Hearing loss may persist long after the infective episode,2 and may impair learning.


Author(s):  
Mahesh B Mawale ◽  
Abhaykumar Kuthe ◽  
Anupama M Mawale ◽  
Sandeep W Dahake

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.


2021 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma


PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 384-384
Author(s):  
John A. McCurdy

The findings of Kaplan et al.1 with respect to impairment of verbal ability in Alaskan children with hearing loss greater than 25 dB ISO secondary to chronic suppurative otitis media warrant renewed attention to a similar otologic problem which constitutes a threat to the verbal development of a significant percentage of all children—hearing impairment secondary to chronic secretory otitis media. Although the hearing loss in chronic secretory otitis media may fluctuate, a significant conductive impairment will persist as long as fluid remains in the middle ear.


PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 285-294
Author(s):  
D. Stewart Rowe

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children. DEFINITION Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below. INCIDENCE In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.


1980 ◽  
Vol 89 (5_suppl) ◽  
pp. 43-46 ◽  
Author(s):  
James B. Snow

Evidence for the clinical effectiveness of adenoidectomy or tonsillectomy and adenoidectomy in the management of children with persistent middle ear effusions is incomplete and what evidence there is in the literature is not convincing. In the first year after tonsillectomy and adenoidectomy there is less otitis media. The beneficial effects of tonsillectomy and adenoidectomy on the incidence of otitis media declines in the second year after the operation. The prevailing opinion is that adenoidectomy is not indicated in the vast majority of children in whom a middle ear effusion has persisted for six weeks or more in spite of antibiotic therapy. Factors favoring an adenoidectomy would be persistent nasal obstruction, persistent purulent rhinorrhea and persistent adenoiditis. The role of tonsillectomy is even less clear, but the decision regarding tonsillectomy is made by most clinicians on the basis of the amount of intercurrent or chronic tonsillitis rather than on the basis of the middle ear effusion per se.


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