Fractalkine (CX3CL1) and its receptor (CX3CR1) in children with hypertrophic adenoid and chronic otitis media with effusion

2019 ◽  
Vol 45 (1) ◽  
pp. 44-50
Author(s):  
Serhat Inan ◽  
Seda Türkoğlu Babakurban ◽  
Selim Sermed Erbek ◽  
Yunus Kasım Terzi ◽  
Feride Iffet Sahin
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Inflammatory Diseases ◽  
Chronic Otitis Media ◽  
Adenoid Hypertrophy ◽  
Tissue Samples ◽  
Expression Levels ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Receptor Cx3cr1

Abstract Background Adenoid hypertrophy (AH) is one of the possible causes of chronic inflammation in the middle ear. It has been suggested that CX3CL1 and its specific receptor (CX3CR1) could be related with the pathogenesis of some inflammatory diseases. The aim of the present study was to evaluate the role of CX3CL1 and CX3CR1 in the pathogenesis of AH with chronic otitis media with effusion (COME) in children. Materials and methods Adenoid tissue samples were obtained from 91 pediatric patients and divided into two groups: adenoidectomy only for AH (n: 47) and adenoidectomy in conjunction with ventilation tube insertion for AH + COME (n: 44). Expression levels of CX3CL1 and CX3CR1 genes were compared. Results Expression levels of CX3CL1 and CX3CR1 in hypertrophic adenoid tissue were not significantly different between the AH + COME and AH only groups. Although no significant difference was detected in the expression of CX3CL1 in the adenoid samples, the expression of CX3CR1 was higher in children older than 48 months. Conclusions When allergy, atopy and chronic adenoiditis does not exist to obstructive adenoid hypertrophy, inflammatory fractalkine chemokine expression levels in adenoid tissue was not observed to be increased in children with COME.

scholarly journals Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman

2019 ◽  
pp. 014556131987543
Author(s):  
Hazem M. Abdel Tawab ◽  
Salim M. Sloma Tabook
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
P Value ◽  
Adenoid Hypertrophy ◽  
Significant Relation ◽  
Adenoid Tissue ◽  
Middle Ear Fluid ◽  
A Prospective Study

Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid ( P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.

scholarly journals Chronic Otitis Media with Effusion in Chronic Sinusitis with Polyps

2018 ◽  
Vol 97 (8) ◽  
pp. E13-E18 ◽  
Author(s):  
Mary Daval ◽  
Hervé Picard ◽  
Emilie Bequignon ◽  
Philippe Bedbeder ◽  
André Coste ◽  
...  
Keyword(s):  
Otitis Media ◽  
Nasal Polyposis ◽  
Otitis Media With Effusion ◽  
Demographic Data ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Upper Airway ◽  
Control Group ◽  
Cross Sectional ◽  
Significant Difference

The relationship between otitis media with effusion (OME) and chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. We conducted a cross-sectional study of 80 consecutively presenting patients—42 males and 38 females, aged 15 to 76 years (median: 48)—who were diagnosed with CRSwNP. Our aim was to ascertain the prevalence of OME in CRSwNP patients, to determine whether the severity of CRSwNP affected OME, and to identify risk factors for OME in CRSwNP patients. The severity of CRSwNP was assessed on the basis of nasal symptoms, endoscopic nasal examinations, and Lund-Mackay staging scores. In addition to demographic data, we obtained information on each patient's history of otitis, otoscopic findings, and the results of pure-tone audiometry and tympanometry. We then compared the data between CRSwNP patients with OME (n = 20) and those without (n = 60). In the OME group, a conductive hearing loss was present in 16 patients (80.0%); all patients in the control group had normal hearing. With regard to symptoms, only rhinorrhea appeared to be more common in patients with OME than in those without, although the difference was not statistically significant. We found no significant difference in nasal polyposis grades between the two groups. Also, we found no correlations between the risk of OME and previous surgical treatment, asthma, allergy, aspirin intolerance, aspirin and/or NSAID intolerance, aspirin and/or sulfite intolerance, and aspirin-exacerbated respiratory disease. Based on our findings, we conclude that OME occurs frequently during the evolution of CRSwNP, even when the nasal disease is well controlled. This finding suggests the possible presence, in OME and/or CRSwNP, of a global inflammatory process that involves the epithelium in both the middle ear and upper airway.

scholarly journals Effect of Local versus Systemic Steroids in Treatment of Children with Otitis Media with Effusion

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A G Shafik ◽  
M S Hassabalah ◽  
A M Maarouf ◽  
M K Elghobashy
Keyword(s):  
Allergic Rhinitis ◽  
Otitis Media ◽  
Clinical Symptoms ◽  
Otitis Media With Effusion ◽  
University Hospital ◽  
Adjunctive Treatment ◽  
Oral Steroid ◽  
Adenoid Hypertrophy ◽  
Systemic Steroids ◽  
Significant Difference

Abstract Background otitis media with effusion (OME) or glue ear is the collection of fluid behind the tympanic membrane without inflammatory signs present for 6 weeks. Aim of the Work comparing the effect of intra nasal versus systemic steroids in treatment of children with Otitis media with effusion as regard: Improvement of clinical symptoms and Audiological findings. Subjects and Methods this study is a prospective, case control study on the effects of intranasal versus systemic steroids on children with otitis media with effusion. This thesis study was conducted on 30 patients diagnosed according to clinical and audiological assessment recruited from otorhinolaryngology outpatient clinic Ain Shams university hospital from October 2017 to July 2018. An informed consent was obtained from each patient or control or their legal guardians before enrolment in the study. Results however, statistically there is no significant relation between the occurrence of complete resolution of OME and the route of administration of steroid (either intranasal or systemic), whatever the cause either allergic rhinitis or adenoid hypertrophy. So we can use either intranasal or systemic steroids in management of otitis media with effusion in children with either allergic rhinitis or adenoid hypertrophy or both. Conclusion both topical intranasal and oral steroids are effective adjunctive treatment for OME in children in the short term, without significant difference between the two methods, and thus oral steroid complications could be avoided using local steroid spray.

Neutrophil Elastase and its Complex with Alpha1-Antitrypsin in the Pathogenesis of Chronic Suppurative Otitis Media

1992 ◽  
Vol 101 (10_suppl) ◽  
pp. 26-31 ◽  
Author(s):  
Yukiyoshi Hamaguchi ◽  
Yasuo Sakakura
Keyword(s):  
Otitis Media ◽  
Neutrophil Elastase ◽  
Bacterial Infections ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Mean Value ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Significant Difference ◽  
The Mean

Neutrophil elastase (NE) and its complex with α1-antitrypsin were quantified in ear discharges from 15 patients with chronic suppurative otitis media (CSOM), and their levels were compared to those in middle ear effusions from 10 pediatric patients with chronic otitis media with effusion (OME). The localization of immunoreactive NE was also examined by immunocytologic study. The mean value of total NE was 161.8 ± 29.5 μg/mL in CSOM, which was significantly higher than that in OME (16.5 ± 6.7 μg/mL). The mean value of NE–α1-antitrypsin complex was 13.7 ± 8.8 μg/mL in CSOM and 7.8 ± 4.0 μg/mL in OME. There was no significant difference between culture-positive and culture-negative samples in CSOM. Immunoreactive NE could be observed in the neutrophils of ear discharges, and extracellular release of NE was also observed. Ear discharges in CSOM contain a considerable amount of uncomplexed NE, of which the level does not depend on active bacterial infections. Uncomplexed NE seems to play a role in the chronicity of CSOM.

scholarly journals Adenoid Vegetations – Reservoir of Bacteria for Chronic Otitis Media with Effusion and Chronic Rhinosinusitis

PRILOZI ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Marina Davcheva-Chakar ◽  
Ana Kaftandzhieva ◽  
Beti Zafirovska
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Otitis Media ◽  
Pathogenic Bacteria ◽  
Otitis Media With Effusion ◽  
Pediatric Population ◽  
Chronic Otitis Media ◽  
Microbiological Analysis ◽  
Adenoid Tissue ◽  
Tissue Specimens

Abstract Introduction: Otitis media and rhinosinusitis are commonly encountered illnesses in pediatric population. Literature reports have documented the association between the occurrence of these two conditions and even their almost identical microbiological findings. Until recently, the key factor in the association of these two conditions was considered to be the hypertrophic adenoid tissue, but within the past few years there have been evidences in the literature about the presence of bacterial biofilms on the adenoids suggesting biofilms to be also responsible for both conditions, chronic otitis media with effusion and chronic rhinosinusitis. Aim: The aim of this study was to make a microbiological analysis of the adenoid tissue specimens taken from patients with chronic otitis media with effusion and chronic or recurrent rhinosinusitis and to determine their potential for biofilms formation. Methods: After the surgical intervention, adenoidectomy, microbiological evaluation and analysis of the adenoid tissue specimens taken from 20 patients were made. Having in mind the disease history, chronic otitis media with effusion was diagnosed in all 20 patients and chronic rhinosinusitis in 9 patients. Results: The results obtained from the microbiological analyses showed many potentially pathogenic bacteria in the adenoids that were almost identical with the most common organisms incorporated in the etiopathogenesis of both conditions, in chronic otitis media with effusion and in chronic rhinosinusitis. In 7 (35%) patients Haemophylus influenzae was isolated, in 6 (30%) Streptococcus pneumoniae, in 4 (20%) Moraxella catаrrhalis, in 2 (10%) patients Staphylococcus aureus and in 1 (5%) patient Streptococcus pyogenes - group A was isolated. One bacterium was isolated from all adenoid vegetations, except in one case when two bacteria (Haemophylus influenzae and Staphylococcus aureus) were concurrently isolated. Conclusion: Our results have shown that the key role in adenoid vegetations in chronic otitis media with effusion and chronic rhinosinusitis is not only the mechanism of rhinopharyngeal obstruction, but also the presence of bacterial strains with a large potential for formation of biofilms adhered to their surface, especially in cases with symptoms of chronic otitis media with effusion and chronic rhinosinusitis that were resistant to antibiotic therapy.

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.

scholarly journals The P.E.A.N.U.T. Method: Update on an Integrative System Approach for the Treatment of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 134
Author(s):  
Henrik Szőke ◽  
Márta Maródi ◽  
Jan Vagedes ◽  
Balázs Székely ◽  
István Magyarosi ◽  
...  
Keyword(s):  
Otitis Media ◽  
System Approach ◽  
Conventional Treatment ◽  
Otitis Media With Effusion ◽  
Real Life ◽  
Chronic Otitis Media ◽  
Adenoid Hypertrophy ◽  
Surgical Interventions ◽  
Integrative Method ◽  
Analgesic Use

Background and objectives: Based on our previous single-center study on optimization of treatment of chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) in children using a noninvasive system approach to lower the necessity of antibiotics, analgesic use, and surgical interventions, we proceeded to perform a multicenter investigation in an outpatient setting. The purpose of the previous prospective study in 2013–2015 was to compare outcomes in the treatment of COME and AH using the noninvasive multimodal integrative method (IM) versus conventional treatment practice (COM). Materials and Methods: In this paper, we retrospectively analyze the data of patients treated with the integrative method between 2017 and 2020 in a multicenter setting and compared the outcomes with data from 2013–2015 in order to evaluate generalizability. In both periods, all eligible and willing participants were included and treated with the IM protocol under real-life conditions. The treatment involved pneumatization exercises, education, an antiallergic diet, nasal hygiene, useful constitutional therapy, and thermal interventions (P.E.A.N.U.T.). A total of 48 versus 28 patients, aged 1–8, were assessed, presenting with COME and AH, with moderate to severe hearing impairment at entry. Results: The significant improvement found in both audiometric measures (intact hearing) and tympanometric measures (normal A-type curve) was similar in both datasets with respect to conventional treatment. The new data confirms that the P.E.A.N.U.T. method results in a significant reduction of antibiotics, analgesic use, and surgical interventions. Conclusion: In this multicenter trial, we confirm the effectiveness of the noninvasive system approach for the treatment of COME in lowering the need for antibiotics and analgesic use and elective surgery. This could be especially important with respect to a generally observed increase in antibiotic resistance. The method is easy to perform in different clinical settings and is effective, safe, and well-tolerated.

Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

2021 ◽  
pp. 000348942110157
Author(s):  
Jennifer L. McCoy ◽  
Ronak Dixit ◽  
R. Jun Lin ◽  
Michael A. Belsky ◽  
Amber D. Shaffer ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Private Insurance ◽  
Chronic Otitis Media ◽  
The United States ◽  
Socioeconomic Disparities ◽  
Tube Placement ◽  
Median Income ◽  
Public Insurance ◽  
Tympanostomy Tubes

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4

scholarly journals Determinants of chronic otitis media with effusion in preschool children: a case–control study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Rebecca E. Walker ◽  
Jim Bartley ◽  
David Flint ◽  
John M. D. Thompson ◽  
Edwin A. Mitchell
Keyword(s):  
Preschool Children ◽  
Otitis Media ◽  
Case Control Study ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Case Control ◽  
Control Study
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