Eosinofilik Otitis Media

2020 ◽  
Vol 5 (2) ◽  
pp. 498
Author(s):  
Putri Sari Ivanny ◽  
Effy Huriyati ◽  
Yan Edward

<div class="WordSection1"><p class="Body"><strong>Abstrak</strong><strong></strong></p><p><strong>Pendahuluan: </strong>Eosinofilik otitis media (EOM) merupakan otitis media yang sulit disembuhkan dengan karakteristik adanya cairan efusi berwarna kuning pada telinga tengah dengan viskositas tinggi yang mengandung akumulasi eosinofil yang luas. Onset EOM terjadi pada dekade kelima dengan perbandingan prevalensi eosinofilik otitis media pada wanita dan pria, yaitu sebesar 2 : 1. Pasien dengan EOM akan menunjukkan penurunan pendengaran yang bertahap atau cepat. <strong>Tujuan:</strong>Mengetahui dan memahami EOM.<strong>Tinjauan Pustaka:</strong>EOM dikaitkan dengan pasien yang menderita asma bronkial, polip nasal dan pasien dengan intoleransi aspirindengan ditemukannya peningkatan jumlah IgE pada mukosa telinga tengah. Pada EOM, eosinofil yang teraktivasi akan melepaskan protein sitotoksik yang disebut dengan <em>eosinophilic cationic protein </em>(ECP). Eosinofil dapat bermigrasi dan merusak telinga bagian dalam melalui <em>round window</em>. <strong>Kesimpulan: </strong>Ditemukannya eosinofil pada mukosa dan cairan efusi telinga tengah akan menyebabkan degranulasi dan dilepaskannya ECP. Produksi berlebihan dari IgE pada mukosa telinga tengah berhubungan dengan kondisi patologis dari EOM sebagai respon tipe lambat yang dimediasi IgE. Kondisi ini dapat menyebabkan kerusakan telinga bagian dalam dan berujung pada gangguan pendengaran berupa tuli sensorineural.<strong>Kata Kunci:</strong>Eosinofilik otitis media, eosinofil, IgE, ECP, tuli sensorineural</p><p class="Body"> </p><p class="Body"><strong><em>Abstract</em></strong><strong><em></em></strong></p><p class="Body"><strong><em>Introduction:</em></strong><em>Eosinophilic otitis media (EOM) is an intractable otitis media characterized by the presence of a highly viscous yellow effusion with extensive accumulation of eosinophils in the middle ear. The age at the onset of EOM is approximately in the fifties and the  female and male ratio is about 2 : 1. Eosinophilic otitis media patients show gradual or sudden deterioration of hearing.</em><strong><em>Objective: </em></strong><em>Determining and understanding the EOM. </em><strong><em> Literature Review:</em></strong><em>EOM associated with adults with bronchial asthma, nasal polyps and aspirin-intolerance by finding the elevation of IgE accumulation in the middle ear mucosa. In EOM patient, eosinophil releases cytotoxic protein called </em><em>eosinophilic cationic protein (ECP).</em><em>Eosinophil will migrate and eventually cause inner ear damage through round window. </em><strong><em>Conclusion:</em></strong><em></em><em>Most of eosinophils in the middle ear mucosa and middle ear effusion were activated, resulting in degranulation and release of ECP. Local IgE over production indicating that the intractable inflammation is closely associated with IgE-mediated late phase response. This condition will damage inner ears and can cause<strong></strong>sensorineural hearing loss.<strong> </strong></em></p><p class="Body"><strong><em>Keywords</em></strong><strong>:<em></em></strong><em>Eosinophilic otitis media, eosinophil, IgE, ECP, sensorineural hearing loss</em></p></div>

1998 ◽  
Vol 107 (10) ◽  
pp. 876-884 ◽  
Author(s):  
Yoshiharu Ohno ◽  
Yoshihiro Ohashi ◽  
Hideki Okamoto ◽  
Yoshikazu Sugiura ◽  
Yoshiaki Nakai

The effect of platelet activating factor (PAF) was studied to elucidate its role in the pathogenesis of otitis media and sensorineural hearing loss. The PAF alone did not induce a reduction of ciliary activity of the cultured middle ear mucosa. However, a dose-dependent decrease in ciliary activity was observed in the presence of the medium containing both PAF and macrophages. Intravenous injection of PAF did not induce dysfunction of the mucociliary system or morphologic changes of epithelium in the tubotympanum, but cytoplasmic vacuolization and ballooning were observed in the inner ear within 1 hour after injection of PAF. In contrast, intratympanic injection of PAF induced mucociliary dysfunction and some pathologic changes in the tubotympanum. Intratympanic inoculation of PAF induced no pathologic findings in the inner ear. These results suggest that PAF is at least partially involved in the pathogenesis of certain middle ear diseases such as otitis media with effusion. Additionally, PAF might be involved in the pathogenesis of some types of unexplained sensorineural hearing loss.


Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 946
Author(s):  
Dong Ho Shin

This report describes the design of a new piezoelectric transducer for round window (RW)-driven middle ear implants. The transducer consists of a piezoelectric element, gold-coated copper bellows, silicone elastomer (polydimethylsiloxane, PDMS), metal cylinder (tungsten), and titanium housing. The piezoelectric element is fixed to the titanium housing and mechanical resonance is generated by the interaction of the bellows, PDMS, and tungsten cylinder. The dimensions of PDMS and the tungsten cylinder with output characteristics suitable for compensation of sensorineural hearing loss were derived by mechanical vibrational analysis (equivalent mechanical model and finite element analysis (FEA)). Based on the results of FEA, the RW piezoelectric transducer was implemented, and bench tests were performed under no-load conditions to confirm the output characteristics. The transducer generates an average displacement of 219.6 nm in the flat band (0.1–1 kHz); the resonance frequency is 2.3 kHz. To evaluate the output characteristics, the response was compared to that of an earlier transducer. When driven by the same voltage (6 Vp), the flat band displacement averaged 30 nm larger than that of the other transducer, and no anti-resonance was noted. Therefore, we expect that the new transducer can serve as an output device for hearing aids, and that it will improve speech recognition and treat high-frequency sensorineural hearing loss more effectively.


1973 ◽  
Vol 82 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Richard R. Gacek

Since the risk of sensorineural hearing loss from persistent chronic otitis media and mastoiditis is greater than the risk to loss of labyrinthine function from carefully performed surgery, it is felt that the best treatment for chronic suppurative middle ear disease in an only-hearing ear is surgical removal of disease. Between the years 1961 to 1970 14 cases of chronic otitis media and mastoiditis in only-hearing ears were treated surgically at the Massachusetts Eye and Ear Infirmary. Five cases presented with resistant foul otorrhea, while five patients presented with increasing hearing loss and four with vertigo. The patients with hearing loss and vertigo were subjected to surgery at the earliest possible date. Wide-field surgical exposure of the mastoid and middle ear spaces with thorough removal of diseased tissue was carried out. Particular attention to avoid injury to the labyrinth, either directly or indirectly, must be kept in mind and it is recommended that surgery in only-hearing ears be performed by only the most experienced and capable otologic surgeon. All 14 ears have remained dry after surgery. Hearing was significantly improved in ten cases, while two were unchanged and two were made worse, as regards the conductive loss only. In all 14 cases postoperative discrimination scores were normal, so that even those cases that did not achieve serviceable hearing levels from surgery were able to use amplification. The results in this series confirm the feeling that carefully performed and timed surgery is effective in controlling chronic suppurative disease, while preserving function in only-hearing ears.


1998 ◽  
Vol 66 (1) ◽  
pp. 343-346 ◽  
Author(s):  
Frank Engel ◽  
Rosemarie Blatz ◽  
Reinhard Schliebs ◽  
Michael Palmer ◽  
Sucharit Bhakdi

ABSTRACT The passage of radioiodinated streptolysin-O (SLO) and albumin through the round window membrane (RWM) was studied in vivo. When applied to the middle ear, SLO became quantitatively entrapped in this compartment and no passage to the cochlea occurred. However, flux of radioiodinated albumin through the toxin-damaged RWM was observed. We propose that the passage of noxious macromolecules, such as proteases, from a purulent middle-ear effusion may be facilitated by pore-forming toxins, resulting in cochlear damage and sensorineural hearing loss.


2021 ◽  
pp. 014556132110091
Author(s):  
Robin Rupp ◽  
Joachim Hornung ◽  
Matthias Balk ◽  
Matti Sievert ◽  
Sarina Müller ◽  
...  

Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center. Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. A retrospective chart review was conducted concerning method of round window membrane sealing, intraoperative findings during CI, postoperative imaging, and hearing results. Results: Twenty one patients (9 females; 8 right ears; 54.3 years [± 12.9 years]) underwent ExT with sealing of the round window membrane with subsequent CI after 26.6 months (± 32.9 mo) on average. During CI, in 76% of cases (n = 16), the round window niche was blocked by connective tissue due to the previous intervention but could be removed completely in all cases. The connective tissue itself and its removal had no detrimental effects on the round window membrane. Postoperative computed tomography scan showed no electrode dislocation. Mean postoperative word recognition score after 3 months was 57.4% (± 17.2%) and improved significantly to 73.1% (± 16.4%, P = .005) after 2 years. Conclusion: Performing CI after preceding ExT, connective tissue has to be expected blocking the round window niche. Remaining tissue can be removed safely and does not alter the round window membrane allowing for a proper electrode insertion. Short- and long-term hearing results are satisfactory. Consequently, ExT with sealing of the round window membrane in patients with sudden sensorineural hearing loss does not impede subsequent CI that can still be performed safely.


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