Consultation with the Specialist

1992 ◽  
Vol 13 (1) ◽  
pp. 23-24
Author(s):  
Gerald B. Healy
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Disease Process ◽  
Care Physician ◽  
Ear Canal ◽  
Patient Groups ◽  
Partially Occluded

Otitis media with effusion (OME) offers the primary care physician both a diagnostic and a therapeutic challenge. The tympanic membrane of a child frequently is difficult to assess, especially in the uncooperative patient whose ear canal is partially occluded by cerumen. However, if the ear canal can be cleared to allow an unobscured view of the tympanic membrane, then pneumatic otoscopy and tympanometry can be extremely valuable in both the diagnosis and follow-up after initiation of treatment. Patient Groups The pediatrician usually is faced with two groups of patients in this disease process. The first group includes the young child who has recurrent episodes of acute otitis media. Frequently, affected patients can be subdivided into those who clear their middle ear space of fluid between episodes and those who do not. The second group consists of children who have asymptomatic chronic effusion, usually leading to persistent hearing loss. These children tend to be slightly older but are no less troublesome for the clinician. Treatment Controlled clinical trials have been extremely important in providing information about both of these groups. These studies have shown that chemoprophylaxis is extremely useful in managing the patient who has recurring acute suppurative episodes not complicated by persistent effusion during the interval periods.

The follow up of Acute Otitis Media general practice

1995 ◽  
Vol 81 (2) ◽  
pp. 127-134
Author(s):  
A P Newton
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Care Team ◽  
Primary Care Team ◽  
Common Condition ◽  
Glue Ear

AbstractAcute Otitis Media is a common condition of childhood which potentially has a number of significant sequelae including the development of Otitis Media with Effusion (‘Glue Ear’). A general practice based study is described which assesses the implementation of a protocol for the follow up of Acute Otitis Media by the primary care team. The results of this study show that following the introduction of a follow up protocol a significantly improved rate of followup was achieved with resultant improvements in the identification of ‘Glue Ear’ and hence more appropriate referral for ENT care.

scholarly journals A Myringotomy and Ventilating Tube Applicator: New Look at a Five-Century-Old Procedure

2015 ◽  
Vol 30 (2) ◽  
pp. 50-55
Author(s):  
Jay Pee M. Amable ◽  
Lily L. Sia-Vargas
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Study Design ◽  
Private Hospital ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Tube Insertion ◽  
Polyethylene Tube ◽  
Egg Membrane ◽  
Single Instrument

Objective: To fabricate a single instrument that can be used to perform myringotomy and insert a pressure equalizing tube at almost the same time.   Methods: Study Design: Surgical Instrumentation Setting: Tertiary Private Hospital Subject: A chicken egg membrane was used as a tympanic membrane model   Result: The fabricated instrument was able to perforate the egg membrane and apply the modified polyethylene pressure equalizing tube in less than one minute without complications.   Conclusion: The prototype applicator can facilitate myringotomy and pressure equalizing (PE) tube insertion at only a fraction of the time it usually takes to do the standard myringotomy and subsequent ventilating tube insertion.   Keywords: Myringotomy, pressure equalizing tube, ventilating tube, acute otitis media, otitis media with effusion, polyethylene tube

Workshop on Effects of Otitis Media on the Child

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 639-652
Author(s):  
Charles D. Bluestone ◽  
Jerome O. Klein ◽  
Jack L. Paradise ◽  
Heinz Eichenwald ◽  
Fred H. Bess ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Current Knowledge ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Signs And Symptoms ◽  
Middle Ear Effusion ◽  
Ear Effusion

GOALS, DEFINITIONS, AND CLASSIFICATION OF OTITIS MEDIA —Charles D. Bluestone, MD The goal of this Workshop was to assess current knowledge concerning the effects of otitis media on the child. Experts in pediatrics, infectious disease, otolaryngology, audiology, speech, linguistics, and psychology met in Chicago on Aug 25, 1982 to participate in this Workshop. A summary of the discussions is presented here. Otitis media is broadly defined as an inflammation of the middle ear without reference to etiology or pathogenesis.1 Otitis media with effusion is an inflammation of the middle ear in which a collection of liquid (i.e., middle ear effusion) is present in the middle ear space (no perforation of the tympanic membrane is present). Atelectasis of the tympanic membrane, which may or may not be associated with otitis media, is defined as either collapse or retraction of the tympanic membrane. Acute otitis media implies a rapid and short onset of signs and symptoms lasting approximately 3 weeks. From 3 weeks to 3 months, the process may be resolving or subacute. If middle ear effusion persists beyond 3 months, the condition is classified as chronic otitis media with effusion. Many terms have been used for acute otitis media, such as "suppurative," "purulent," or "bacterial" otitis media; however, a "serous" effusion may also have an acute onset. Otitis media with effusion unaccompanied by signs and symptoms of acute inflammation has also had a plethora of other names: "serous," "secretory," "nonsuppurative," and "glue ear" have been the most commonly used. EPIDEMIOLOGY AND NATURAL HISTORY OF OTITIS MEDIA

scholarly journals The validity of topical drug therapy for otitis media with effusion

2021 ◽  
pp. 80-84
Author(s):  
S. V. Morozova ◽  
K. V. Eremeeva ◽  
W. H.A. Suaifan
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Age Groups ◽  
Acute Otitis Media ◽  
Combination Drug ◽  
Initial Stage ◽  
Topical Analgesics ◽  
Anti Inflammatory ◽  
Inflammatory Effect

Otitis media with effusion is difficult to diagnose, since the course of the disease is mostly asymptomatic, while the initial stage of the disease is very similar to Eustachiitis or the pre-perforative stage of acute otitis media. At this stage, dysfunction of the auditory tube and negative pressure in the tympanic cavity creates the conditions for the production of transudate, which clinically, in addition to hearing loss, is accompanied by soreness, a feeling of congestion, pressure, fluid transfusion in the ear. When conducting local medical procedures, they are primarily guided by the condition of the mucous membrane of the eustachian tube, nasopharynx and nasal cavity, but changes in the eardrum are no less important. Thus, the use of topical analgesics with an anti-inflammatory effect becomes no less relevant in the treatment.A literature review was carried out with an analysis of scientific research data on the use of a topical combination drug that has a local anesthetic and anti-inflammatory effect in the treatment of diseases of the external and middle ear.Analysis of the literature showed that the use of lidocaine-phenazone-containing drops promotes rapid regression of the inflammation in the external auditory canal and the tympanic membrane, as well as relieving of pain. It can be used both in children (including newborns) and in adults who are suffering from otitis media but with intact tympanic membrane, including otitis media with effusion.Combined topical drugs containing lidocaine-phenazone demonstrate efficacy and safety in the treatment of catarrhal and otitis media with effusion in all age groups.

Tympanic Membrane Perforations and Tympanostomy Tubes

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Sam Levine ◽  
Kathleen Daly ◽  
G. Scott Giebink
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Preoperative Factor ◽  
Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

Revision myringoplasty

1997 ◽  
Vol 111 (6) ◽  
pp. 517-520 ◽  
Author(s):  
Gilead Berger ◽  
Dov Ophir ◽  
Eliezer Berco ◽  
Jacob Sadé
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Long Term Results ◽  
Short And Long Term ◽  
Graft Necrosis

AbstractThis retrospective study was undertaken to review the short- and long-term results of 70 revision and 16 re-revision myringoplasty operations. Of the former, 43 cases (61.4 per cent) had initial success, six weeks following surgery. The leading causes of immediate failure (27 cases) were associated with a complete no- take of thegraft, infection with graft necrosis and poor anterior adaptation of the graft in decreasing order. Six out of the 43 patients developed late re-perforations during the follow-up period, thus reducing the success rate of revision myringoplasty to 52.8 per cent. Late re-perforations were attributed to insidious atrophy of the tympanic membrane or episodes of acute otitis media. Sixteen patients underwent re-revision myringoplasty and their success rate was 62.5 per cent. The overall success rate of revision and re-revision myringoplasty was 54.7 per cent. It has been concluded that results of revision myringoplastywere independent of patients' age, location and size of perforation and the seniority of the surgeon.

scholarly journals Otologic Findings Based on no Complaints in a Pediatric Examination

2018 ◽  
Vol 23 (01) ◽  
pp. 036-040
Author(s):  
Emine Demir ◽  
Sevgi Topal ◽  
Gorkem Atsal ◽  
Mehmet Erdil ◽  
Zerrin Coskun ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
General Practitioners ◽  
Outpatient Clinic ◽  
Otitis Media With Effusion ◽  
Close Contact ◽  
Acute Otitis Media ◽  
Retraction Pocket ◽  
General Evaluation ◽  
Surgical Treatments

Introduction the otological evaluation is highly significant in those branches of medicine in which the general evaluation of the patient is conducted by general practitioners and pediatricians. Objectives To investigate the otologic findings and their incidences in the sample, which consisted of patients who presented to the pediatric outpatient clinic with non-otologic complaints. Methods Patients, aged between 2 and 16 years, who had neither otorhinolaryngological complaints nor history of surgery by the otolaryngology (ear, nose and throat, ENT) department were included in the present study. The findings detected in the external auditory system and in the tympanic membranes as well as the otorhinolaryngologists' otologic examination findings of the referred patients were recorded from the files of each patient along with the applied medical and surgical treatments, and diagnostic investigations. Results Of a total of 973 patients evaluated, 129 (13.2%) were referred to the ENT outpatient clinic due to any otologic pathology. In the otorhinolaryngological examinations, false positivity was detected in 12 (1.2%) patients, and pathological findings were detected in 117 (12%) patients who received the following diagnoses: 68 (6.9%) had otitis media with effusion(OME); 37 (3.8%) had cerumen impactions; 8 (0.8%) had acute otitis media (AOM); 2 (0.2%) had ticks in the external auditory canal; 2 (0.2%) had a retraction pocket in tympanic membrane; 1 (0.1%) had unilateral central dry perforation of the tympanic membrane; and 1(0.1%) had congenital cholesteatoma. Conclusion Any complications and sequelae that may develop due to any pathologies and predominantly infections can be prevented by an early diagnosis, which can be made by means of a simple examination, performed merely with an otoscope. Pediatricians and general practitioners should be in close contact with otorhinolaryngologists regarding the pathologies they identify.

First Forty-Eight Hours of Developing Otitis Media: An Experimental Study

2003 ◽  
Vol 112 (6) ◽  
pp. 558-566 ◽  
Author(s):  
Per Olof Eriksson ◽  
Cecilia Mattsson ◽  
Sten Hellström
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Light And Electron Microscopy ◽  
Acute Otitis Media ◽  
Clinical Appearance ◽  
Filamentous Material ◽  
Type 3 ◽  
Inflammatory Changes

The early inflammatory changes in the tympanic membrane were explored in 2 rat models. Acute otitis media was induced by instillation of Streptococcus pneumoniae type 3 into the middle ear cavity, and otitis media with effusion was induced by blockage of the eustachian tube. Otomicroscopic examination was performed before the rats were painlessly sacrificed at 3, 6, 9, 12, 18, 24, or 48 hours after initiation of the otitis media conditions. The tympanic membrane was studied by light and electron microscopy. Both acute otitis media and otitis media with effusion caused early inflammatory changes of the tympanic membrane, and the pars flaccida was the portion that reacted first. The inflammatory alterations were most pronounced in the acute otitis media model. The course of inflammation showed a bimodal pattern with an early deposition of a filamentous material with a band pattern, typical of fibrin. Despite a fluid-filled middle ear cavity, the inflammatory changes in the otitis media with effusion model were moderate, as was consistent with the clinical appearance of the tympanic membrane.

scholarly journals Association of Receipt of Antibiotics with Patient Satisfaction for Caregivers of Children Presenting to Urgent-Care Settings

2020 ◽  
Vol 41 (S1) ◽  
pp. s134-s135
Author(s):  
Diane Liu ◽  
NORA FINO ◽  
Benjamin Haaland ◽  
Adam Hersh ◽  
Emily Thorell ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Otitis Media ◽  
Respiratory Infections ◽  
Otitis Media With Effusion ◽  
Multivariable Analysis ◽  
Acute Otitis Media ◽  
Skewed Distribution ◽  
Urgent Care ◽  
Provider Type ◽  
Patient Dissatisfaction

Background: The Press Ganey (PG) Medical Practice Survey is a commonly used questionnaire for measuring patient experience in healthcare. Our objective was to evaluate the PG surveys completed by caregivers of children presenting for urgent care evaluation of acute respiratory infections (ARIs) to determine any correlation with receipt of antibiotics during their visit. Methods: We evaluated responses to the PG urgent-care surveys for encounters of children <18 years presenting with ARIs (ie, sinusitis, bronchitis, pharyngitis, upper respiratory infection, acute otitis media, or serous otitis media with effusion) within 9 University of Utah urgent-care centers. Scores could range from 0 to 100. Because the distributions of scores followed right- skewed distribution with a high ceiling effect, we defined scores as dissatisfied with their care (≤25th percentile) and satisfied with their care (scores >25th percentile). Univariate and multivariable generalized mixed-effects logistic regression was used to assess correlates of patient dissatisfaction. Random intercepts were included for each provider to account for correlation within the same provider. Separate models were used for each PG component score. Multivariable models adjusted for receipt of antibiotics, age, gender, race, ethnicity, and provider type. Results: Overall, 388 of 520 responses (74.6%) indicated satisfaction and 132 responses (25.4%) indicated dissatisfaction. Among patients who did not receive antibiotics, 87 of 284 responses (30.6%) indicated dissatisfaction versus 45 of 236 (19.1%) who did receive antibiotics. Among patients who were dissatisfied with their clinician, raw clinician PG scores were higher among patients who received antibiotics (mean, 64.5; standard deviation [SD], 16.9) versus those who did not receive antibiotics (mean, 54.7; SD, 24.4; P = .015) (Table 1). In a multivariable analysis, receipt of antibiotics was associated with a reduction in patient dissatisfaction overall (odds ratio, 0.55; 95% CI, 0.36–0.85). Conclusions: Overall, most responses for patients seen for ARIs in pediatric urgent care were satisfied. However, a significantly higher proportion of responses for patients who did not receive antibiotics were dissatisfied than for those patients who received antibiotics. Antibiotic stewardship strategies to communicate appropriate prescribing while preserving patient satisfaction are needed in pediatric urgent-care settings.Funding: NoneDisclosures: None

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