scholarly journals Assessment of Ossicular Necrosis in Tubotympanic (Mucosal) Type of Chronic Otitis Media

2021 ◽  
Vol 10 (36) ◽  
pp. 3127-3131
Author(s):  
Sakshi Chawla ◽  
Amresh Kumar Saxena ◽  
Sanjay Kumar
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Surgical Intervention ◽  
Chronic Otitis Media ◽  
Positive Association ◽  
Radiological Findings ◽  
Middle Ear Mucosa ◽  
X Ray ◽  
Duration Of Disease ◽  
Hrct Temporal Bone

BACKGROUND We wanted to study the preoperative clinical, audiological, radiological findings & compare them with the perioperative findings of ossicular necrosis. METHODS 100 patients were clinically diagnosed as mucosal chronic otitis media (COM). They underwent a thorough clinical, audiological & radiological examination. X-ray mastoid Schuller's view on both sides was done in all patients & HRCT temporal bone was done in 51 patients. They were then posted for surgery & findings were compared with the perioperative ossicular necrosis. RESULTS 42 patients had ossicular defects perioperatively. Incus was found to be the most commonly necrosed ossicle & malleus was the most resistant ossicle. There was a positive association found between duration of disease, posterior perforations, large central & subtotal perforations, polypoidal middle ear mucosa, granulations over margins of perforations & audiological findings with the perioperative ossicular defects. HRCT was the most reliable investigation to predict ossicular necrosis. CONCLUSIONS From the study, it was concluded that all patients with mucosal COM can be assessed preoperatively for ossicular erosion. HRCT gives us a preoperative picture of the extent of ossicular necrosis & helps the surgeon in planning the surgical intervention. KEY WORDS COM, HRCT, Ossicular Necrosis, Mucosal, PTA

S224 – Efficacy of Long Silastic Sheet in COM Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P150-P150
Author(s):  
Hyong-Ho Cho ◽  
Hyun-Seok Choi ◽  
Chul-Ho Jang ◽  
Yong-Bum Cho
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Middle Ear Mucosa ◽  
Hearing Result ◽  
Staged Operation ◽  
Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

scholarly journals Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media

JAMA ◽  
2006 ◽  
Vol 296 (2) ◽  
pp. 202 ◽  
Author(s):  
Luanne Hall-Stoodley ◽  
Fen Ze Hu ◽  
Armin Gieseke ◽  
Laura Nistico ◽  
Duc Nguyen ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Direct Detection ◽  
Chronic Otitis Media ◽  
Bacterial Biofilms ◽  
Middle Ear Mucosa

scholarly journals High Human Papillomavirus DNA loads in Inflammatory Middle Ear Diseases

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 224 ◽  
Author(s):  
Nicola Malagutti ◽  
John Charles Rotondo ◽  
Luca Cerritelli ◽  
Claudio Melchiorri ◽  
Monica De Mattei ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Dna Sequences ◽  
Direct Sequencing ◽  
Chronic Otitis Media ◽  
Human Papillomaviruses ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Ear Diseases ◽  
Hpv Dna

Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. We investigated HPVs in non-tumor middle ear diseases, including chronic otitis media (COM). Methods. COM specimens (n = 52), including chronic suppurative otitis media (CSOM) (n =38) and cholesteatoma (COMC) (n = 14), as well as normal middle ear (NME) specimens (n = 56) were analyzed. HPV sequences and DNA loads were analyzed by quantitative-PCR. HPV genotyping was performed by direct sequencing. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) of NME (p > 0.05). Specifically, HPV DNA sequences were found in 26.3% (10/38) of CSOM and in 14.3% (2/14) of COMC (p > 0.05). Interestingly, the HPV DNA load was higher in COMC (mean 7.47 copy/cell) than in CSOM (mean 1.02 copy/cell) and NME (mean 1.18 copy/cell) (P = 0.03 and P = 0.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. These data suggest that HPV may infect the middle ear mucosa, whereas HPV-positive COMCs are associated with higher viral DNA loads as compared to NME.

scholarly journals Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ercan Kaya ◽  
Ilknur Dag ◽  
Armagan Incesulu ◽  
Melek Kezban Gurbuz ◽  
Mustafa Acar ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Tissue Samples ◽  
Scanning Electron

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

scholarly journals Comparative evaluation of mastoid pneumatization pattern using X-ray mastoid and high-resolution computed tomography temporal bone in unilateral squamosal chronic otitis media

2020 ◽  
Vol 6 (8) ◽  
pp. 1469
Author(s):  
Akanksha Dhiman ◽  
Ankur Gupta ◽  
Nishi Sharma ◽  
Akhilandeswari Prasad
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Anatomical Variations ◽  
High Resolution Computed Tomography ◽  
Mastoid Pneumatization ◽  
X Ray ◽  
Hrct Temporal Bone

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.</p><p class="abstract"><strong>Methods:</strong> Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT.  </p><p class="abstract"><strong>Results:</strong> Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.</p><p class="abstract"><strong>Conclusions:</strong> HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations.  </p>

scholarly journals Status of contralateral ear in chronic otitis media and role of diagnostic otoendoscopy in it’s assessment

2019 ◽  
Vol 5 (3) ◽  
pp. 650
Author(s):  
Sweta Soni ◽  
Nandita Nath
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Critical Evaluation ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Suppurative Otitis Media ◽  
Field Of Vision ◽  
Contralateral Ear ◽  
The Individual ◽  
Hrct Temporal Bone

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media doesn’t seem to be an isolated event that occurs in a particular patient. It seems rather be the product of a series of events constitutional of the individual. The precise and critical evaluation of both ears plays a fundamental role in the prognostic evaluation of the patient. Otoendoscopy is an upcoming day care procedure in the field of otology. It has several advantages over routine otoscopy for e.g. better resolution, wider field of vision, camera connectivity etc. We aimed to study the status of contralateral ear in chronic otitis media patients and evaluate the usefulness of diagnostic otoendoscopy.</p><p class="abstract"><strong>Methods:</strong> A prospective study was done on CSOM patients attending ENT dept, SMCH using otoendoscopy, schuller radiography, pure tone audiometry, tympanometry and HRCT temporal bone. Data collected was analysed.  </p><p class="abstract"><strong>Results:</strong> A total of 80 patients were evaluated out of which 70% were male, otoendoscopy revealed features of a diseased contralateral middle ear in 80% of them, PTA suggested hearing loss in opposite ear in 80% of them, schuller’s radiography showed sclerosed opposite mastoid in 22.5% and CT scan needed to be done in 24 patients of which 10 had disease in opposite middle ear.</p><p class="abstract"><strong>Conclusions:</strong> It is imperative from this study that evaluation of contralateral ear in chronic otitis media is important to unmask the hidden pathology and otoendoscopy is very useful in diagnosing it.</p>

Characterization of mucins in human middle ear and Eustachian tube

2001 ◽  
Vol 280 (6) ◽  
pp. L1157-L1167 ◽  
Author(s):  
Jizhen Lin ◽  
Vladimir Tsuprun ◽  
Hirokazu Kawano ◽  
Michael M. Paparella ◽  
Zhiqiang Zhang ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Middle Ear Mucosa ◽  
Pathological Conditions ◽  
Mucin Expression ◽  
Mucin Genes ◽  
Human Middle Ear

Mucins are important glycoproteins in the mucociliary transport system of the middle ear and Eustachian tube. Little is known about mucin expression within this system under physiological and pathological conditions. This study demonstrated the expression of MUC5B, MUC5AC, MUC4, and MUC1 in the human Eustachian tube, whereas only MUC5B mucin expression was demonstrated in noninflamed middle ears. MUC5B and MUC4 mucin genes were upregulated 4.2- and 6-fold, respectively, in middle ears with chronic otitis media (COM) or mucoid otitis media (MOM). This upregulation of mucin genes was accompanied by an increase of MUC5B- and MUC4-producing cells in the middle ear mucosa. Electron microscopy of the secretions from COM and MOM showed the presence of chainlike polymeric mucin. These data indicate that the epithelium of the middle ear and Eustachian tube expresses distinct mucin profiles and that MUC5B and MUC4 mucins are highly produced and secreted in the diseased middle ear. These mucins may form thick mucous effusion in the middle ear cavity and compromise the function of the middle ear.

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