scholarly journals Diagnosis of the pathophysiology of chronic mucosal diseases of allergic rhinitis, asthma and otitis media as seen by an otolaryngologist

2021 ◽  
pp. 024-026
Author(s):  
Hurst David S ◽  
McDaniel Alan B
Keyword(s):  
Allergic Rhinitis ◽  
Otitis Media ◽  
Tympanostomy Tubes ◽  
Chronic Rhino Sinusitis

Otolaryngologists, like Pediatricians, often see patients with chronic rhino-sinusitis and draining ears. Surgeons can offer various procedures, from simple tympanostomy tubes to advanced sinus and turbinate operations, in which significant portions of bone and mucosa are removed. The rates of reinfection are often reduced [1] but failures occur.

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 The use of laser therapy in children with allergic rhinitis complicated by exudative otitis media

2020 ◽  
Vol 17 (5) ◽  
pp. 258-262
Author(s):  
A. G. Khrykova
Keyword(s):  
Allergic Rhinitis ◽  
Laser Therapy ◽  
Otitis Media ◽  
Primary School Children ◽  
Control Group ◽  
Repeated Treatment ◽  
Immunological Tests ◽  
Group 12 ◽  
Before And After ◽  
Conductive Component

Background. The prevalence of allergic rhinitis, which is an intermittent or permanent inflammation of the nasal mucosa caused by exposure to allergens, reaches 35%, according to different authors. Currently, this pathology is often complicated by exudative otitis media, especially in young children. Aim: to develop and justify the feasibility of using laser phoresis of sodium deoxyribonucleate for the treatment of exudative otitis media in children with allergic rhinitis. Methods. A clinical examination, a clinical blood test, rhinoscopy and otoscopy, as well as rhinocytogram, tympanometry (impedance audiometer Heinemann Titan) were performed. In diagnostics of allergic rhinitis, methods of a multifaceted otorhinolaryngological and allergological examination of the patient were used, as well as immunological tests (determination of the level of IgE and allergen-specific antibodies in the blood serum), and skin allergological tests. The examination was conducted before and after the course of treatment, as well as after 6 and 12 months. Results. With drug laser phoresis of sodium deoxyribonucleate administered endonasally and endourally, a stable result was obtained in restoring the drainage functions of the pharyngotympanic tube and reducing the symptoms of allergic rhinitis in preschool children and primary school children. Hearing is objectively improved in patients, and the conductive component is stopped, there is no fluid in the middle ear, sleep improves, the sense of smell is restored, physical performance increases, and childrens fatigue decreases in doing sports. A comparative analysis of the effectiveness of treatment in two groups showed the best results in the group of children receiving laser therapy using sodium desoxyribonucleate from medicinal non-woven textiles for up to 1 year. Repeated treatment with exacerbation of exudative otitis media was necessary to 40% of children in the control group, 12% of children after a course of laser therapy, and only one patient after a course of laser phoresis of sodium deoxyribonucleate. Conclusion. The use of laser radiation reduces the manifestations of the inflammatory process, and the allergic component.

scholarly journals Tympanostomy Tubes for Otitis Media: Quality-of-Life Improvement for Children and Parents

2005 ◽  
Vol 84 (7) ◽  
pp. 418-424 ◽  
Author(s):  
Stanley Mui ◽  
Barry M. Rasgon ◽  
Raymond L. Hilsinger ◽  
Brent Lewis ◽  
Gretchen Lactao
Keyword(s):  
Quality Of Life ◽  
Otitis Media ◽  
Chart Review ◽  
Telephone Survey ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Health Maintenance ◽  
Cost Effective Treatment ◽  
Tympanostomy Tubes

We measured quality of life issues for both children and their parents on the premise that parental quality of life should be an aspect of cost-effectiveness in otitis media treatment. The patients were less than 18 years of age and had had myringotomy with tube insertion at the head and neck surgery department of a large health maintenance organization. Quality of life for patients, parents, and caregivers was evaluated by telephone survey of parents or caregivers and by retrospective chart review of the number of pre- and postoperative healthcare visits and antibiotic usage. Chart review showed a significant postoperative reduction in the number of clinic visits and in use of antibiotic drugs after insertion of tympanostomy tubes. Improved postoperative hearing was noted, and tympanostomy tube insertion was shown to be safe. The chart-review cost analysis showed that tympanostomy tube insertion is a cost-effective treatment for otitis media in children, and the telephone survey results showed that it improves quality of life for children and their parents or other caregivers.

Tympanostomy Tubes for Prevention of Purulent Otitis Media

1985 ◽  
Vol 93 (5) ◽  
pp. 601-606 ◽  
Author(s):  
Ove Söderberg ◽  
Sten Hellström ◽  
Lars-Eric Stenfors ◽  
Magnus Thore
Keyword(s):  
Animal Model ◽  
Otitis Media ◽  
Middle Ear ◽  
Soft Palate ◽  
Serous Effusion ◽  
Individual Culture ◽  
Tympanostomy Tubes ◽  
The Individual ◽  
The Right ◽  
Culture Positive

A recently developed animal model was used to study the effect of tympanostomy tubes (TTs) on the spontaneous development of purulent otitis media. in 35 rats with soft-palate clefts a TT was inserted into the right tympanic membrane. The left ear was left intact. Serous effusion occurred in the attic space within 2 days after surgery, whether or not the middle ear cavity (MEC) was artificially ventilated. Between days 7 and 21 the intact-ear MEC was gradually filled with effusion material that turned purulent. Effusion material did not develop in the mesotympanum and hypotympanum of the intubated ears. Microbiologic examination of the effusion material showed a microflora similar to that in the nasopharynx. Ventilation through a TT reduced the number of colonized MECs (4 vs. 10) on day 21. In the individual culture-positive MEC with a TT there were fewer colonies than in the corresponding ear without a TT. These results support the contention that a TT may prevent the development of purulent otitis media.

scholarly journals Enzyme-potentiated Desensitization in Otolaryngic Allergy

2002 ◽  
Vol 81 (3) ◽  
pp. 164-167
Author(s):  
Jack L. Pulec
Keyword(s):  
Allergic Rhinitis ◽  
Food Allergy ◽  
Otitis Media ◽  
Clinical Features ◽  
Medical Practice ◽  
Preliminary Report ◽  
New Method ◽  
Effective Technique ◽  
Enzyme Potentiated Desensitization ◽  
Serous Otitis Media

This is a preliminary report of a new method of treating otolaryngic allergy with enzyme-potentiated desensitization (EPD). The nature of EPD and its use in otolaryngology are described. Thirty-six patients have been treated and followed in a private medical practice since February 1997. This article reviews the clinical features of EPD and provides six cases as examples; the clinical features described include allergic rhinitis, serous otitis media, asthma, dermatitis, fixed food allergy, and Ménière's disease. EPD is an effective technique for the treatment of otolaryngic allergy and offers advantages over conventional techniques.

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