Sequelae of Secretory Otitis Media: Changes in Middle Ear Biomechanics

A comparison has been made of air conduction threshold changes up to 1 year after myringotomy, aspiration of middle ear fluid, and insertion of ventilation tubes in ten patients with bilateral and 12 with unilateral secretory otitis media (SOM). Pure tone air conduction thresholds have been analyzed in three frequency groups: Low frequency (LF; 0.25, 0.5, and 1 kHz), high frequency (HF; 2,4, and 8 kHz), and extra-high frequency (EHF; 10, 12, 14, and 16 kHz). In the LF and HF ranges, significant improvement came during the first 24 hours after intubation, while in the EHF range, threshold lowering occurred gradually over the following 2 months. Possible explanations for these findings are discussed.

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

Journal of the Royal Society of Medicine ◽

10.1177/014107688407700909 ◽

1984 ◽

Vol 77 (9) ◽

pp. 754-757 ◽

Cited By ~ 17

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.

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Simulation of Pathological High Impedance Tympanograms

Journal of Speech Language and Hearing Research ◽

10.1044/jshr.2904.514 ◽

1986 ◽

Vol 29 (4) ◽

pp. 505-514 ◽

Cited By ~ 7

Author(s):

Karel J. Van Camp ◽

Janet E. Shanks ◽

Robert H. Margolis

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

High Frequency ◽

Secretory Otitis Media ◽

High Impedance ◽

The Relationship

The Vanhuyse, Creten, and Van Camp (1975) model for analyzing high frequency tympanograms predicts the shapes of conductance, susceptance, and admittance tympanograms from the relationship between resistance and reactance tympanograms at the tympanic membrane. This model has been applied primarily to low impedance middle-ear pathologies but has not been applied extensively to the more commonly occurring high impedance pathologies. The purpose of this study was to extend the Vanhuyse et al. (1975) model to high impedance pathologies and to identify tympanometric parameters associated with otosclerosis, secretory otitis media, and lateral ossicular fixation. Data from previous experiments on the shape and absolute values of resistance and reactance tympanograms were used to calculate 678-Hz admittance tympanograms that were unique to each of the three high impedance pathologies. Guidelines for differentiating among the middle-ear pathologies on the basis of high frequency tympanometric shapes are presented.

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Negative Middle Ear Pressure and Hearing Thresholds in Secretory Otitis Media: A Double-blind Crossover Study with Lunerin

Scandinavian Audiology ◽

10.3109/01050398009076351 ◽

1980 ◽

Vol 9 (3) ◽

pp. 171-176 ◽

Cited By ~ 8

Author(s):

P. Møller

Keyword(s):

Crossover Study ◽

Otitis Media ◽

Middle Ear ◽

Secretory Otitis Media ◽

Double Blind ◽

Middle Ear Pressure ◽

Hearing Thresholds ◽

Blind Crossover Study ◽

Double Blind Crossover Study

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Impedance Audiometry Suggested

PEDIATRICS ◽

10.1542/peds.54.3.384a ◽

1974 ◽

Vol 54 (3) ◽

pp. 384-384

Author(s):

John A. McCurdy

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

Otitis Media ◽

Middle Ear ◽

Verbal Ability ◽

Secretory Otitis Media ◽

Suppurative Otitis Media ◽

Significant Percentage ◽

Children With Hearing Loss ◽

Verbal Development

The findings of Kaplan et al.1 with respect to impairment of verbal ability in Alaskan children with hearing loss greater than 25 dB ISO secondary to chronic suppurative otitis media warrant renewed attention to a similar otologic problem which constitutes a threat to the verbal development of a significant percentage of all children—hearing impairment secondary to chronic secretory otitis media. Although the hearing loss in chronic secretory otitis media may fluctuate, a significant conductive impairment will persist as long as fluid remains in the middle ear.

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Acute Suppurative Otitis Media

PEDIATRICS ◽

10.1542/peds.56.2.285 ◽

1975 ◽

Vol 56 (2) ◽

pp. 285-294

Author(s):

D. Stewart Rowe

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Pathogenic Bacteria ◽

Acute Otitis Media ◽

Polymorphonuclear Cells ◽

Secretory Otitis Media ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Middle Ear Fluid ◽

Purulent Fluid

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children. DEFINITION Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below. INCIDENCE In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.

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The Immune Imbalance of Treg/Th17 in Otitis Media of Effusion Patients May Be Related to PI3K/Akt/mTOR Signaling Activation in the Middle Ear Mucosa

10.21203/rs.3.rs-94971/v1 ◽

2020 ◽

Author(s):

Zhiyuan Tang ◽

Xianhai Zeng ◽

Juanjuan Li ◽

Hua Zhang ◽

Hancheng Wu ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Rat Model ◽

Mtor Signaling ◽

Secretory Otitis Media ◽

Middle Ear Mucosa ◽

Foxp3 Mrna ◽

Abnormal Immune Response ◽

Signaling Activation ◽

Immune Imbalance

Abstract Objective: To assess whether secretory otitis media may be caused by immune imbalance of Treg/Th17 mediated by PI3K/Akt/mTOR signaling, so as to find new therapeutic target.Methods: IL-17, TGF- and IL-6, IL-10 and Th17 cytokines were detected in peripheral blood of OME patients (PC group) and healthy people (NC group) by ELISA. The expression of ROR t mRNA and Foxp3mRNA in PBMC was detected by RT-PCR. OME rat model was established and the changes of lymphocytes in middle ear mucosa and spleen and PI3K/Akt/mTOR signaling in middle ear mucosa were detected by HE staining, IHC, WB and flow cytometry.Results: The immune imbalance of Treg/Th17 in secretory otitis media (OME) was confirmed by the expression of cytokines in OME serum and analysis of ROR T and Foxp3 mRNA which was Th17 and Treg specific transcription respectively. OME rat model further confirmed that Treg/Th17 imbalance could lead to OME as demonstrated by staining of MIDDLE ear mucosa and expression of ROR T and Foxp3. PI3K, Akt, and mTOR proteins were expressed in the MIDDLE ear mucosa of OME group and CON group, respectively. Compared with CON group, the expression of P-MTOR and P-PI3K proteins in the middle ear mucosa of OME group was significantly increased.Conclusions: Treg/Th17 imbalances are found in OME patients and OME animal model and the pathogenic mechanism may be due to systemic abnormal immune response, activated PI3K/Akt/mTOR signaling, abnormal T cell differentiation, leading to middle ear mucosal hyperemia, edema and subsequent occurrence of OME.

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Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100101124 ◽

1986 ◽

Vol 100 (12) ◽

pp. 1347-1350 ◽

Cited By ~ 8

Author(s):

T. H. J. Lesser ◽

M. I. Clayton ◽

D. Skinner

Keyword(s):

Medical Treatment ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Randomised Trial ◽

Control Group ◽

Middle Ear Effusion ◽

Secretory Otitis Media ◽

Ear Effusion

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).

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