Predictive Accuracy of Wideband Absorbance at Ambient and Tympanometric Peak Pressure Conditions in Identifying Children with Surgically Confirmed Otitis Media with Effusion

2020 ◽  
Author(s):  
Venkatesh Aithal ◽  
Sreedevi Aithal ◽  
Joseph Kei ◽  
Shane Anderson ◽  
David Wright
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Peak Pressure ◽  
Predictive Accuracy ◽  
Otitis Media With Effusion ◽  
Ambient Pressure ◽  
Pressure Effects ◽  
Healthy Children ◽  
Operating Characteristics ◽  
Middle Ear Pressure

Background: Wideband absorbance (WBA) measured at ambient pressure (WBAA) does not directly accountfor middle ear pressure effects. On the other hand, WBA measured at tympanometric peak pressure(TPP) (WBATPP) may compensate for the middle ear pressure effects. To date, there are no studies thathave compared WBAA and WBATPP in ears with surgically confirmed otitis media with effusion (OME).<br />Purpose: The purpose of this study was to compare the predictive accuracy of WBAA and WBATPP inears with OME.<br />Research Design: Prospective cross-sectional study.<br />Study Sample: A total of 60 ears from 38 healthy children (mean age = 6.5 years, SD = 1.84 years) and60 ears from 38 children (mean age = 5.5 years, SD = 3.3 years) with confirmed OME during myringotomywere included in this study.<br />Data Collection and Analysis: Results were analyzed using descriptive statistics and analysis of variance.The predictive accuracy of WBAA and WBATPP was determined using receiver operating characteristics(ROC) analyses.<br />Results: Both WBAA and WBATPP were reduced in ears with OME compared with that in healthy ears.The area under the ROC (AROC) curve was 0.92 for WBAA at 1.5 kHz, whereas that for WBATPP at 1.25kHz was 0.91. In comparison, the AROC for 226-Hz tympanometry based on the static acoustic admittance(Ytm) measure was 0.93.<br />Conclusions: Both WBAA and WBATPP showed high and similar test performance, but neither test performedsignificantly better than 226-Hz tympanometry for detection of surgically confirmed OME.<br />

scholarly journals Tympanometric changes following adenoidectomy in children with adenoid hypertrophy

2018 ◽  
Vol 4 (2) ◽  
pp. 391 ◽  
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Maximum Size ◽  
Adenoid Hypertrophy ◽  
Tube Obstruction ◽  
Media Type ◽  
Middle Ear Pressure ◽  
Pressure Changes

<p class="abstract"><strong>Background:</strong> Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect  of  adenoidectomy on Otitis Media with Effusion.</p><p class="abstract"><strong>Methods:</strong> Patients showing &gt;50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied.  </p><p class="abstract"><strong>Results:</strong> Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.</p>

Clearance Function of Eustachian Tube and Negative Middle Ear Pressure

1992 ◽  
Vol 101 (9) ◽  
pp. 759-762 ◽  
Author(s):  
Haruo Takahashi ◽  
Masahiko Hayashi ◽  
Iwao Honjo ◽  
Akihiko Fujita
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Experimental Studies ◽  
Residual Volume ◽  
Ventilatory Function ◽  
Control Side ◽  
Middle Ear Pressure ◽  
Experimental Side ◽  
Tensor Veli Palatini Muscle

Two experimental studies were performed using 18 cats in order to elucidate the mechanism of the long-lasting course of otitis media with effusion. First, the middle ear (ME) pressure was monitored for 2.5 to 7 hours after filling the whole ME space with saline. On average, −150 mm H2O of negative ME pressure was induced in 3.1 hours. Second, the residual volume of saline with antibiotics, which was put into the ME space 2 to 7 days before, was compared between the side on which tubal ventilatory function was abolished (resection of tensor veli palatini muscle and hamulus pterygoideus) and the opposite, control side. The percentage of the residual volume to the original volume put into the ME was significantly higher on the experimental side (Wilcoxon's ranking test, t = 27.0, p < .05), and in one ear on the experimental side, the ME pressure showed −150 mm H2O just before the bulla was opened 2 to 7 days later. These results seem to indicate that tubal ciliary clearance function can induce negative ME pressure when there is fluid in the ME, and that the negative ME pressure induced by clearance of the ME fluid may disturb further clearance of the ME fluid. This condition may cause the long-lasting course of otitis media with effusion.

Bacterial attachment in vivo to epithelial cells of the nasopharynx during otitis media with effusion

1992 ◽  
Vol 106 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Lars-Eric Stenfors ◽  
Simo Räisänen
Keyword(s):  
Epithelial Cells ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bacterial Attachment ◽  
Control Group ◽  
Healthy Children ◽  
Ciliated Cells ◽  
Middle Ear Effusion ◽  
Ear Effusion

AbstractEpithelial cells were obtained by swabbing the posterior wall of the nasopharynx (NPH) of 15 patients (age one to 6 8/12; years; eight males, seven females) undergoing ENT-surgery under general anaesthesia for otitis media with effusion (OME). Individually matched, ear healthy children served as controls. Bacteria attached to the non-ciliated cells were calculated according to a method described. Furthermore, quantitative and qualitative bacteriological analyses were performed on samples obtained from mucoid middle ear effusion material as well as from the NPH. All patients and controls harboured middle ear pathogens (S. pneumoniae, H. influenzae, B. catarrhalis, or S. aureus) in the NPH. Only 33 per cent of the patients harboured middle ear pathogens in the middle ear effusion and the same pathogen was invariably found in the corresponding NPH Attachment of bacteria to the non-ciliated cells of the NPH diminished significantly with growing age in the ear healthy control group but not in the OME group. OME is closely correlated tothe presence of middle ear pathogens in the NPH and to attachment of bacteria to the epithelial cells in the NPH.

Nebulized surfactant as a treatment choice for otitis media with effusion: an experimental study in the rabbit

2001 ◽  
Vol 115 (5) ◽  
pp. 363-368 ◽  
Author(s):  
Muhsin Koten ◽  
Cem Uzun ◽  
Recep Yaǧiz ◽  
Mustafa Kemal Adali ◽  
Ahmet Rifat Karasalihoglu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Physiological Saline ◽  
Control Group ◽  
Eustachian Tube Function ◽  
Middle Ear Pressure ◽  
Tube Function ◽  
Experimentally Induced

Exogenous surfactant can improve eustachian tube function in experimentally induced otitis media with effusion (OME). Performing tympanometric recordings, the efficacy of inhaled nebulized surfactant, as compared with inhaled nebulized physiological saline was investigated, for the treatment of OME experimentally induced in the rabbit by intrabullar inoculation of heat-killed Streptococcus pneumoniae. In addition, the histological changes in middle ears after the treatment were investigated in order to establish whether the pathological findings correlated with the results.Middle-ear pressure values before, and after, treatment were analyzed by the Wilcoxon statistical method, and the Mann-Whitney U test was used to compare the post-treatment values between groups. In all ears with OME in the affected animals, which were treated with nebulized surfactant inhalation, a positively significant (p<0.05) increase of pressure more than 20 daPa was recorded. In the control group, after inhalation of nebulized physiological saline, there was no positive increase in the affected middle-ear pressures; on the contrary, more negative pressure changes were recorded. In the histological evaluation, middle-ear epithelia and sub-epithelial space were normal in surfactant-treated ears with OME, whereas mucosal thickening with an oedematous sub-epithelial space containing occasional inflammatory cells and increases in connective tissue and vascularity, and effusions on the epithelial surface were present in the ears with OME in the control group. The significant improvement in the negative middle-ear pressure after nebulized surfactant treatment and the histological findings shown in our study can support the theory that surface-active agents are of importance in eustachian tube function even under pathologic conditions, such as OME.

S220 – Characteristics of Fluid and Tympanometry Profiles in OME

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P149-P149
Author(s):  
Seung-Hwan Lee ◽  
Youngseok Lee ◽  
Yunjeong Kim ◽  
Bum-Suk Kim ◽  
Seung-Won Jeong ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Otitis Media ◽  
Middle Ear ◽  
Peak Pressure ◽  
Otitis Media With Effusion ◽  
Objective Measure ◽  
T Test ◽  
Type B ◽  
Middle Ear Fluid ◽  
Curve Maximum

Objectives The aim of this study was to compare the characteristics of the type B tympanogram curve (maximum admittance, tympanometric peak pressure) to the volume and viscosity of middle ear fluid. Methods We conducted preoperative tympanometry from 175 ears in 94 children with otitis media with effusion. The volume and viscosity of middle ear fluid collected during myringotomy were classified into 3 groups respectively. We analysed the correlations between the characteristcs of middle ear fluid and tympanometric profiles such as maximum admittance, tympanometric peak pressure. Student t test was used for statistical analysis. Results No correlation was found between peak pressure of the tympanogram and the characteristics of middle ear fluid. However, as the volume of middle ear fluid increases, the viscosity and the straight type B tympanogram increased significantly (p<0.001, p=0.002 respectively). And as the volume and the viscosity of the middle ear fluid increased, the Admmax significantly decreased (p<0.001). Conclusions Characteristics of type B tympanogram curve were correlated with the volume and viscosity of middle ear fluid. And it can be suggested that tympanometry may be used as an objective measure to estimate the characteristics of the middle ear fluid.

scholarly journals Correlation of Enlarged Adenoids with conductive hearing impairment in children under twelve

2016 ◽  
Vol 21 (2) ◽  
pp. 62-68
Author(s):  
SM Sarwar ◽  
Masroor Rahman ◽  
Mohammad Idrish Ali ◽  
Md Morshed Alam ◽  
Md Anwar Hossain ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Neck Surgery ◽  
Middle Ear Pressure ◽  
Medical University ◽  
Conductive Hearing ◽  
Head Neck Surgery

Objective: To find out the relation of conductive hearing loss in children with enlarged adenoids.Methods: Study was conducted in out patients department and Indoor wards of the Department of Otolaryngology on Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the periods of October 2005 to March 2006. 60 patients with enlarged amides were included in this study. The assessment of the patients were established on the basic of history clinical, 2 and audiological examination was done. Data were collected and analyzed using statistical package for Social Science.Results: In this study 60 patients (from 3 years to 12 years age) diagnosed as having ‘enlarged adenoids’ in the Otolaryngology and Head-Neck Surgery out patient and in patient Departments of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2005 to March 2006 are included in this series. Most of the patients presented with multiple symptoms, the commonest was the hearing impairment (58.33%). Other common symptoms were mouth breathing (50.00%), Nasal obstruction (50.00%), snoring (46.67%). Majority of them were male (62.85%) and 53.33% were in the 5-10 years age group. Middle class family occupy the lion share (58.33%). 60.00% patients live in a overcrowded condition. 50.00% patients were found with gross enlargement of adenoids. Hearing impairment was found in 58.33% ears of-patients of adenoids. Reduced middle ear pressure and compliance were found in 64.00% ears. Among the patients of enlarged adenoids otitis media with effusion was found in 58.33% (35) of patients. Among the patients of OME majority was male (62.85%). There was 77.14% (27) bilateral and 22.85% (8) unilateral cases. On otoscopy of OME patients, all patients had retraction of tympanic membrane, cone of lights were distorted in 50.00%, fluidlevels in 68.57% and bubbles were in 28.57% of ears. 71.43% OME patients had hearing loss in the range of 26-40 dB. Middle ear pressure and compliance were found reduced in 88.57% (62) ears of OME patients. There were 58.33% incidence of OME among enlarged adenoids cases. All the patients of OME with enlarged adenoids had a hearing loss between 26-55dB. Out of the 22 OME cases with gross adenoids, 16 had a middle ear pressure between -201 to-300 mm of H20 and 19 had a middle ear pressure between -101 to -200 mm of H20. On myringotomy fluid came out from all 62 (100%) ears. From majority (38) ears serous type of fluid came out.Conclusion: This is an endeavor to find out a correlation of enlarged adenoids with conductive hearing impairment in children. Otitis media with effusion is suspected in all children suffering from enlarged adenoids. All together 60 patients with enlarged adenoids were included in the study. Result of this study may not be the actual picture of overall situation due to many limitations is this study. Still it can be concluded that enlarged adenoids has a definite role in causing OME and conductive hearing impairment. So early diagnosis and treatment of enlarged adenoids can be encouraged to decrease the actual incidence, morbidity and complications of otitis media with effusion and thus conductive hearing impairment in childhood.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 62-68

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