Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 46 (4) ◽  
pp. 647-647
Author(s):  
Jerome O. Klein
Keyword(s):  
Clinical Review ◽  
Otitis Media ◽  
Middle Ear ◽  
Respiratory Infections ◽  
Acute Otitis Media ◽  
Type A ◽  
Type B ◽  
Hemophilus Influenzae ◽  
Hemophilus Influenzae Type B

Dr. Strauss has concisely summarized present considerations of the role of encapsulated and nonencapsulated Hemophilus influenzae in infection and disease. A recent clinical review by Turk and May1 documents the predominance of Hemophilus influenzae type B in suppurative disease. In a survey of reports of cases of meningitis due to this agent, the authors found only 24 cases due to Hemophilus influenzae other than type B(type A = 6, type E = 1, type F = 3, and non-typable 14). The role of nonencapsulated Hemophilus influenzae strains in the pathogenesis of respiratory infections and otitis media is still unclear. The majority of H. influenzae strains isolated from the middle ear fluids of children with acute otitis media are nonencapsulated.2,3

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

scholarly journals Relationship between Acute Suppurative Otitis Media and Chronic Secretory Otitis Media: Role of Antibiotics

1984 ◽  
Vol 77 (9) ◽  
pp. 754-757 ◽  
Author(s):  
Robert Mills ◽  
Ann Uttley ◽  
Michelle McIntyre
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Secretory Otitis Media ◽  
Sensitivity Testing ◽  
Suppurative Otitis Media ◽  
In Vitro Sensitivity ◽  
Resistance To Penicillin

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.

scholarly journals Influence of middle ear alterations on children's balance

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Joana Ferreira ◽  
Carla Matos Silva ◽  
Inês Araújo
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Postural Balance ◽  
Sensory Integration ◽  
Type A ◽  
Clinical Test ◽  
Type B ◽  
Balance Performance ◽  
Balance Disorders

Abstract Background Postural instability is a possible symptom in children with otitis media, which often occurs in this population. The child with balance disorders usually has intolerance to sudden movements, difficulties in moving in the dark, nausea, vomiting and numerous fall events. To verify whether changes in the middle ear can influence the balance postural in children from 3 to 5 years. Methods The sample consisted of 31 children of both sexes, aged between 3 and 5 years. To collect data, a tympanogram was used to analyze the integrity of the tympanic membrane and the Modifid Clinical Test of Sensory Integration and Balance (MCTSIB), with four different sensory conditions, to assess static postural balance. Results Regarding the tympanogram, it was verified that the majority of the sample showed no changes, 45.2% of which were type A and 32.3% of type C1. Regarding the type B and C2 tympanogram, it was found that 12.9% of the sample had type B tympanogram and 9.7% type C2. When comparing these values with the MCTSIB results, there were no significant differences between the tympanogram with changes (B and C2) and the tympanogram without changes (A and C1), regarding the child's balance performance. Conclusions In this study, it was concluded that the alterations of the middle ear, proved through the tympanogram, did not influence the postural balance. However, it was found that the unilateral changes reported by the tympanogram, suggest higher values of postural oscillation, compared to bilateral changes.

scholarly journals Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

2016 ◽  
Vol 54 (9) ◽  
pp. 2373-2379 ◽  
Author(s):  
Saara Sillanpää ◽  
Sami Oikarinen ◽  
Markku Sipilä ◽  
Lenka Kramna ◽  
Markus Rautiainen ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Moraxella Catarrhalis ◽  
Acute Otitis Media ◽  
Pcr Analysis ◽  
Considerable Proportion ◽  
Bacterial Dna ◽  
Content Type ◽  
Conventional Culture

According to studies based on bacterial cultures of middle ear fluids,Streptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalishave been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence ofS. pneumoniae,H. influenzae,M. catarrhalis,Alloiococcusotitidis,Staphylococcus aureus, andPseudomonas aeruginosa. One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis,M. catarrhalisresults were positive in 42 (47%) samples,H. influenzaein 30 (33%),S. pneumoniaein 27 (30%),A. otitidisin 6 (6.7%),S. aureusin 5 (5.6%), andP. aeruginosain 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, andM. catarrhaliswas detected in most (85%) of those cases. Fifteen signals forM. catarrhaliswere strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even thoughM. catarrhalisis often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen.

The Role of Bacterial Enzymes in Inducing Inflammation in the Middle Ear Cavity

1979 ◽  
Vol 87 (6) ◽  
pp. 859-870 ◽  
Author(s):  
Seth H. Lowell ◽  
S. K. Juhn
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bacterial Infections ◽  
Current Knowledge ◽  
Acute Otitis Media ◽  
Bacterial Enzymes ◽  
Infectious Process ◽  
The Third ◽  
Host Tissues

Current knowledge of the pathophysiology of bacterial infections is elementary. The initial events leading to the invasion of host tissues are a matter of conjecture for many bacterial organisms. This is particularly true for pneumococci, the most frequent causative organisms of acute otitis media. Bacterial enzymes may account for the initial disruption of host tissues, and this study explored their role in the infectious process. As a first step, pneumococcal cultures were analyzed, and significant levels of the enzymes lipase and hyaluronidase were demonstrated. Secondly, the presence of these enzymes in middle ear effusions was explored in an animal model of acute otitis media. The enzymes reached peak levels at seven days. The third and most important portion of the study examined the significance of these enzymes in producing inflammation and alterations in the middle ear cavity of normal experimental animals. This portion was a histologic comparison of temporal bone specimens and demonstrated that marked acute and chronic changes can be induced by placing solutions of these enzymes in the middle ear cavity. This study concludes that bacterial enzymes play an important role in the induction of acute otitis media.

Acute Epiglottitis in Children

1980 ◽  
Vol 88 (6) ◽  
pp. 665-669 ◽  
Author(s):  
William H. Briggs ◽  
Mark M. Altenau
Keyword(s):  
Type A ◽  
Blood Cultures ◽  
Type B ◽  
Acute Epiglottitis ◽  
Ampicillin Resistance ◽  
Hemophilus Influenzae ◽  
Hemophilus Influenzae Type B

Hemophilus influenzae type B (30 cases), untyped (two cases), and type A (one case), and H parainfluenzae (one case) were recovered in blood cultures from 44 cultures of 53 children with acute epiglottitis. These patients were managed by observation, tracheotomy, or intubation, with intubation being the most satisfactory. Both ampicillin and chloramphenicol have been employed recently because of the emergence of ampicillin resistance, which was 18.7% of all cases in 1977.

Role of Leukotriene B4 and Interleukin-8 in Acute Bacterial and Viral Otitis Media

1996 ◽  
Vol 105 (12) ◽  
pp. 968-974 ◽  
Author(s):  
Janak A. Patel ◽  
Tommy Sim ◽  
Tasnee Chonmaitree ◽  
Roberto Garofalo ◽  
Mary J. Owen ◽  
...  
Keyword(s):  
Viral Infection ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Infection ◽  
Acute Otitis Media ◽  
Leukotriene B4 ◽  
Interleukin 8 ◽  
Pmn Functions ◽  
Pharmacologic Agents

In order to evaluate the role of polymorphonuclear leukocytes (PMNs) in acute otitis media (AOM), levels of leukotriene B4 (LTB4), a potent inflammatory product of PMNs, and interleukin-8 (IL-8), a PMN chemotactic cytokine, were measured in 271 middle ear fluid (MEF) samples from 106 children with AOM. Forty-two percent of the patients had evidence of respiratory viral infection. At the time of diagnosis, levels of both LTB4 and IL-8 were higher in the MEFs from patients with AOM associated with bacterial or bacterial and viral infection than those MEFs containing no pathogen (p < .05). Antibiotic treatment was not associated with a significant change in levels of LTB4 or IL-8 in the MEFs obtained 2 to 5 days into treatment, compared to those obtained at diagnosis. Bacteriologic failure after 2 to 5 days of treatment was associated with high LTB4 levels in the initial MEFs (p = .05). Recurrence of AOM within 1 month was associated with high IL-8 levels in the initial MEF (p = .04). Our findings suggest that LTB4 and IL-8 are produced during acute infection of the middle ear, and these PMN-related inflammatory substances may play an important role in delaying recovery or in recurrence of AOM. Effective treatment of AOM may require eradication of bacteria by antibiotics, as well as pharmacologic agents that modulate PMN functions.

Efficacy of Ceftibuten for Acute Otitis Media Caused by Hemophilus Influenzae: an Animal Study

1993 ◽  
Vol 102 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Richard M. Rosenfeld ◽  
William J. Doyle ◽  
James Seroky ◽  
J. Douglas Swarts ◽  
Israel Greene
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Lower Prevalence ◽  
Middle Ear Effusion ◽  
Oral Cephalosporin ◽  
Hemophilus Influenzae ◽  
Days Of Therapy ◽  
The Mean ◽  
Ear Effusion

Ceftibuten is a new oral cephalosporin with an unusual stability to β-lactamases that can hydrolyze other extended-spectrum cephalosporins. Using the chinchilla animal model, we compared the efficacy of ceftibuten (n = 33) with that of saline (n = 34), ampicillin (n = 32), and cefixime (n = 31) for the treatment of acute otitis media caused by β-lactamase—producing nontypeable Hemophilus influenzae. Ceftibuten was superior to ampicillin regarding the time necessary to sterilize the middle ear (p < .001) and eliminate effusion (p < .001). The mean days of therapy required for bacteriologic cure were 2.57 for ceftibuten, 2.95 for cefixime, 7.95 for ampicillin, and 8.16 for saline. At the conclusion of therapy, chinchillas treated with ceftibuten had a significantly lower prevalence of positive cultures and middle ear effusion than did animals treated with ampicillin. No significant differences were observed between ceftibuten and cefixime. The results of this randomized, investigator-blinded experiment warrant further consideration of ceftibuten as a second-line agent for acute otitis media caused by ampicillin-resistant H influenzae.

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