Effect of anaesthetic agents on tympanometry and middle-ear effusions

2000 ◽  
Vol 114 (5) ◽  
pp. 336-338 ◽  
Author(s):  
B. M. Fish ◽  
A. R. Banerjee ◽  
C. R. Jennings ◽  
I. Frain ◽  
A. A. Narula
Keyword(s):  
Middle Ear ◽  
General Anaesthetic ◽  
Parental Consent ◽  
Type B ◽  
Middle Ear Effusion ◽  
Anaesthetic Agents ◽  
Middle Ear Fluid ◽  
Type C ◽  
Ear Effusion ◽  
Informed Parental Consent

Following informed parental consent 93 children underwent bilateral grommet insertion. Tympanometry was performed pre-operatively, and immediately prior to myringotomy. A standardized anaesthetic was used. At myringotomy the presence or absence of fluid was recorded, as well as the time since induction of the general anaesthetic.A pre-operative type B tympanogram predicted a middle-ear effusion at myringotomy in 92 per cent of patients. A pre-operative type C2 tympanogram predicted a middle-ear effusion at myringotomy in 39 per cent of patients. Sixty tympanograms (30 per cent) changed following a general anaesthetic. Fourteen type B tympanograms changed to type A and eight of these had effusions. The duration of the general anaesthetic did not influence the probability of a middle-ear effusion being present at myringotomy. A pre-operative type B tympanogram is a good predictor of middle-ear fluid. The duration of the general anaesthetic is not significant in predicting the presence of a middle-ear effusion.

scholarly journals Role of adenoid hypertrophy in causation of chronic middle ear effusion

2017 ◽  
Vol 4 (1) ◽  
pp. 203
Author(s):  
Timna C. J. ◽  
Chandrika D.
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Adenoid Hypertrophy ◽  
Age Group ◽  
Type B ◽  
Middle Ear Effusion ◽  
Type C ◽  
Grade 3 ◽  
Ear Effusion

<p>Abstract:</p><p><strong>Background</strong>: Hearing  plays  a  valid  role  in  speech  development  in  children. Otitis media with effusion is one among the commonest causes of hearing loss in children especially below 12 years. It is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection</p><p><strong>Methods</strong>: A prospective study was carried out in Lourdes Hospital, Kochi, over a period of 1 year from January 2013 to December 2013. Thirty patients with chronic middle ear effusion  below the age of 12 years were selected for the study.</p><p><strong>Results</strong>: of the 30 patients  59.5% of patients were in the age group of 5-7 years of age, 16.6 % of patients were in the age group of 9-11 years of age .13.3%  of patients  each were in  the age group of 3-5 years and 7-9 years of age.Among  the 30 patients ,60% were male children and 40% patients were female children.Among the 30 patients , 40% of them had grade 3 adenoid hypertrophy ,33.3% of them had grade 2 adenoid  hypertrophy and  30% of them had grade 4 adenoid hypertrophy and none had grade 1 adenoids. majority of them had grade 3 adenoid hypertrophy by endoscopic assessment.Among  the 30 patients ,66.6 % of them had eustachian tube blockade by the adenoid mass and  33.4% of  them didn’t have eustachian tube blockade.  100% of them  with eustachian tube blockade found to have fluid on doing myringotomy  and  there was  20% of chance of absence of  fluid ,if there is absence of  eustachian tube blockade.</p><p>            Significant association was found between  type B tympanogram and presence of fluid on myringotomy .92.5% of patients with type B tympanogram had fluid on myringotomy . 57.1 % of patients with type C tympanogram  had fluid on doing myringotomy.There were 2 patients with grade 4 adenoid hypertrophy ,without eustachian tube blockade with  bilateral type C tympanogram and  there  was  bilateral dry tap on myringotomy. This reveals that type B tympanogram  and  eustachian tube blockade  better predictor of  otitis media with effusion   than grade of adenoid hypertrophy.</p><p><strong>Conclusion:</strong></p><p>    The present  study  showed that  chronic middle ear effusion was found to be most common  in the age group of  3-5  years of age group and  relatively common in the male children. Tympanogram type B was found to be  strongly associated with fluid on myringotomy .All the children with chronic middle ear effusion in the study group were found to have  ,grade 3 grade 2,and grade 4  adenoid hypertrophy in the  descending order of frequency.Grade 3 adenoid hypertrophy was present in majority of  the children in the study group .Lateral  adenoid hypertrophy ,abutting on the nasopharyngeal orifice of Eustachian tube was present in majority of children. Eustachian tube obstruction was found to be strongly  associated with  fluid on myringotomy and grommet insertion</p><p> </p>

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
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.

Ultrasound Characterization of Middle Ear Effusion

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P70-P70
Author(s):  
Rahul Seth ◽  
Christopher Discolo ◽  
Paul R Krakovitz
Keyword(s):  
Middle Ear ◽  
Ease Of Use ◽  
Tube Placement ◽  
Oral Antibiotic ◽  
Middle Ear Effusion ◽  
Exact Test ◽  
Pressure Equalization ◽  
Middle Ear Fluid ◽  
Specificity And Sensitivity ◽  
Ear Effusion

Objective To further 1) enhance and assess the ability to detect and characterize middle ear effusion using A-mode ultrasonography with miniature curved array transducers, and 2) identify bacterial presence in relation to effusion viscosity. Methods A prospective unblinded comparison study was performed to determine ultrasound efficacy in detecting effusion characteristics. Ultrasonographic examination using an ultrasound probe was performed on 107 patients (197 ears) scheduled to undergo bilateral myringotomy with pressure equalization tube placement. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings from the tympanic membrane and middle ear space were recorded and analyzed for viscosity. Middle ear aspirate was sent for bacterial culture. Myringotomy was then performed. Results Computer-based algorithms analyzed the waveforms and were able to detect the presence of thick, thin, and lack of fluid with a sensitivity and specificity of greater than 90%. Thin effusions had a significantly higher infection rate (64% versus 12%, p<0.01, Fisher's exact test) when cultured from ears of children not taking oral antibiotic therapy. Similar results were obtained from cultures taken of middle ear fluid in children taking antibiotics (69% versus 12%, p<0.002). Conclusions The specificity and sensitivity of ultrasound middle ear fluid detection is greater than 90%, exceeding the accuracy of tympanometry and other devices. Moreover, it can accurately predict the viscosity of an effusion, which can give insight into its likelihood of infection. Further technologies to promote ease of use will be needed.

Detection of Helicobacter Pylori in the Middle Ear Fluid of Patients with Otitis Media with Effusion

2005 ◽  
Vol 133 (5) ◽  
pp. 791-794 ◽  
Author(s):  
Setsuko Morinaka ◽  
Masayuki Tominaga ◽  
Hiroyuki Nakamura
Keyword(s):  
Helicobacter Pylori ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Rapid Urease Test ◽  
Middle Ear Effusion ◽  
Gram Staining ◽  
Middle Ear Fluid ◽  
Urease Test ◽  
Ear Effusion

OBJECTIVES: In patients with otitis media with effusion (OME), colonization of the middle ear effusion (MEE) by Helicobacter pylori (HP) was investigated. STUDY DESIGN: A prospective nonrandomized study with nonpaired, nonmatched controls. Smear preparations were immunostained with anti-HP antibody and were subjected to Gram staining and Giemsa staining. The rapid urease test (CLO) was done. RESULTS: Twelve of 15 smears for MEE were positive for HP by immunohistochemistry and 14 by Giemsa that were Gram-negative. In 3 with positive immunohistochemistry, the CLO was positive. CONCLUSION: The results suggest that HP may exist in the MEE of some patients with OME.

Impedance Tympanometry and Acoustic Reflectometry at Myringotomy

PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 475-480
Author(s):  
Thomas R. Babonis ◽  
Michael R. Weir ◽  
Patrick C. Kelly
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Type A ◽  
Tube Placement ◽  
Clinical Impression ◽  
Type B ◽  
Middle Ear Effusion ◽  
Experienced Clinician ◽  
Ear Effusion ◽  
Higher Sensitivity

A total of 220 ears undergoing myringotomy and pressure-equalizing tube placement were studied with impedance tympanometry and acoustic reflectometry in a direct comparison for detection of middle-ear effusion. Impedance tympanometry and acoustic reflectometry were equally accurate, detecting the presence or absence of middle-ear effusion in 73% and 72% of ears, respectively. The presence of effusion in ears with tympanographic patterns other than type A and type B was not consistently and reliably predicted. The higher sensitivity of impedance tympanometry (90%) compared with that for acoustic reflectometry (58%) contrasted with the opposite findings for specificities (54% vs 88%). It is concluded that impedance tympanometry and acoustic reflectometry measure different events at the tympanic membrane and their utility lies in the fact that they complement each other. These instruments can aid the experienced otoscopist in confirming a clinical impression and assist the less experienced clinician in validating or improving otoscopic skills.

Impedance tympanometry and the home environment in seven-year-old children

1990 ◽  
Vol 104 (1) ◽  
pp. 4-8 ◽  
Author(s):  
David P. Strachan
Keyword(s):  
Home Environment ◽  
Middle Ear ◽  
Important Determinant ◽  
Population Sample ◽  
Age Group ◽  
Type B ◽  
Middle Ear Effusion ◽  
Gas Cooking ◽  
Random Population Sample ◽  
Ear Effusion

AbstractThe distribution of tympanogram types among 872 seven-year-old children from a random population sample was related to 14 features of the home environment reported by parents in a questionnaire. Parental smoking was an important determinant of middle ear underpressure and effusion, and accounted for much of the associations observed with dampness, crowding and rented accommodation. Gas cooking was associated with a higher prevalence of effusion, but a lower prevalence of underpressure; this may deserve further study.After adjustment for seasonal variation, tenure and household smokers, the weekly mean temperature in the bedrooms of 34 children with Type B tympanograms was 18.2°C, compared to 17.9°C for 190 children with Type A tympanograms. The equivalent figures for bedroom relative humidity were 51.8 percent and 52.7 per cent. It is unlikely that heating or ventilation of the home is an important determinant of middle ear effusion and underpressure in this age-group.

scholarly journals Significance of Adenoidectomy in the Treatment of Otitis Media with Effusion (OME)

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Md Ashraful Islam
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Future Research ◽  
Adenoid Hypertrophy ◽  
Type B ◽  
Middle Ear Effusion ◽  
Ear Effusion ◽  
Grade Iii

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.

Impedance screening for otitis media with effusion in Nigerian children

1988 ◽  
Vol 102 (11) ◽  
pp. 986-988 ◽  
Author(s):  
F. O. Ogisi
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Type B ◽  
Middle Ear Effusion ◽  
Acoustic Reflex ◽  
Nigerian Children ◽  
Contributory Factors ◽  
Type C ◽  
Low Prevalence ◽  
Ear Effusion

AbstractTympanometry and acoustic reflex tests performed on 431 school children aged five to six years showed that eight per cent of the ears screened had type B or type C tympanograms suggestive of otitis media with effusion (1.2 per cent type B, and 6.8 per cent type C). Preliminary otoscopy revealed tympanic membrane appearances consistant with middle ear effusion in a correspondingly low proportion of ears (7.6 per cent), whilst acoustic reflex screening at 105 dB for three frequencies (0.5, 1 and 2 kHz) showed absent reflexes at one or more frequencies in 8.1 per cent of the ears. The findings indicate a relatively low prevalence of otitis media with effusion in children in Nigeria. Possible contributory factors are discussed.

Gas Tension and pH in Middle Ear Effusion

1975 ◽  
Vol 84 (2) ◽  
pp. 198-202 ◽  
Author(s):  
Sven Ingelstedt ◽  
Björn Jonson ◽  
Hans Rundcrantz
Keyword(s):  
Middle Ear ◽  
Mastoid Process ◽  
Middle Ear Effusion ◽  
Average Value ◽  
Middle Ear Fluid ◽  
Mucous Membranes ◽  
Clinical Consequences ◽  
Serous Otitis Media ◽  
Air Cells ◽  
Ear Effusion

The composition of gases and the gas tension in middle ear effusion in patients with serous otitis media have been investigated. By using a specially designed micro-method, very small amounts of middle ear fluid could be analyzed. The effusion was obtained by puncturing the air cells of the mastoid process. The average value of Po2 was 41 mm Hg; Pco2 was 58 mm Hg, pH 7.24. The possible mechanism for the impaired perfusion of the mucous membranes is discussed as well as some clinical consequences.

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