Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media

ABSTRACT Objective Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered. Materials and methods The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status. Results ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram. Conclusion Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS. How to cite this article Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013;5(3):133-138.

Download Full-text

Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/aijoc-6-1-1 ◽

2014 ◽

Vol 6 (1) ◽

pp. 1-6

Author(s):

Sunali Khanna ◽

R Rangasayee

Keyword(s):

Hearing Loss ◽

Down Syndrome ◽

Otitis Media ◽

Eustachian Tube ◽

Conductive Hearing Loss ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Predisposing Factor ◽

Lateral Cephalometry ◽

Conductive Hearing

Download Full-text

A study on correlation of size and site of tympanic membrane perforation with degree of conductive hearing loss in chronic otitis media

MedPulse International Journal of ENT ◽

10.26611/10161632 ◽

2020 ◽

Vol 16 (3) ◽

pp. 29-32

Author(s):

Lavanya M ◽

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Otitis Media ◽

Conductive Hearing Loss ◽

Chronic Otitis Media ◽

Tympanic Membrane Perforation ◽

Membrane Perforation ◽

Conductive Hearing

Download Full-text

Evaluating the Frequency of Ear Problems in Patients with Cleft Lip and Palate

Journal of Iranian Medical Council ◽

10.18502/jimc.v4i1.5742 ◽

2021 ◽

Author(s):

Fatemeh Mirashrafi ◽

Babak Saedi ◽

Mahtab Rabbani Anari ◽

Gholamreza Garmaroudi ◽

Roja Toosi ◽

...

Keyword(s):

Hearing Loss ◽

Cleft Palate ◽

Otitis Media ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Conductive Hearing Loss ◽

Otitis Media With Effusion ◽

Pure Tone Audiometry ◽

Hearing Disorders ◽

Conductive Hearing

Background: Orofacial cleft is one of the most common congenital malformations of craniofacial region. Otitis media with effusion causing conductive hearing loss is a considerable challenge for many children with cleft lip and palate. The aim of this study was to evaluate the prevalence of hearing disorders and associated malformations in these patients. Methods: The research population consisted of patients with cleft palate, between years 2012 and 2014, who were referred to Children’s Medical Center and Vali-e-Asr hospital in Tehran, Iran. Otoscopic examination, tympanometry, pure tone audiometry and echocardiography were performed for each patient. Results: Among patients with cleft palate, 73% suffered from hearing disorders. There was no relationship between prevalence of hearing loss and sex, presence of other congenital anomalies and degree of cleft, but middle ear diseases were significantly higher in children younger than 2 years. Among patients with cleft lip or palate, 10% suffered from cleft lip, 63% suffered from cleft palate and 27% suffered from cleft lip and palate. There was at least one congenital anomaly in 53% of patients. Conclusion: This study demonstrates high prevalence of otitis media with effusion and conductive hearing loss in patients with cleft. However, audiologic problems are alleviated when patients become older.

Download Full-text

EFFECT OF CHRONIC OTITIS MEDIA ON LANGUAGE AND SPEECH DEVELOPMENT

PEDIATRICS ◽

10.1542/peds.43.5.833 ◽

1969 ◽

Vol 43 (5) ◽

pp. 833-839 ◽

Cited By ~ 1

Author(s):

Vanja A. Holm ◽

LuVern H. Kunze

Keyword(s):

Hearing Loss ◽

Language Development ◽

Otitis Media ◽

Conductive Hearing Loss ◽

Chronic Otitis Media ◽

Speech Development ◽

Socioeconomic Background ◽

Verbal Language ◽

Conductive Hearing ◽

Experimental Group

Two groups of children were compared in order to determine the effect on language and speech development of the fluctuating conductive hearing loss which accompanies chronic otitis media. The experimental group consisted of 16 children, aged 5 to 9 years, with chronic otitis media and with hearing fluctuations documented by audiograms. The control group was matched for age, sex, and socioeconomic background. The language performances of the groups were compared by means of the Illinois Test of Psycholinguistic Abilities, the Peabody Picture Vocabulary Test, the Templin-Darley Picture Articulation Screening Test, and the Mecham Verbal Language Development Scale. The result shows that the experimental group was delayed to a statistically significant degree in all language skills requiring the receiving or processing of auditory stimuli or the production of verbal responses. No significant differences were found in tests measuring primarily visual and motor skills. This would suggest that the fluctuating hearing loss accompanying chronic otitis media was the cause of the delay in language development found in the experimental group. Physicians, parents, and educators need to be aware of the implication of this language handicap, as it might affect performance. Further studies are needed to evaluate the influence on permanent language ability by the periodic lack of sensory stimulation experienced during conductive hearing loss due to frequent episodes of otitis media.

Download Full-text

Monitoring of conductive hearing loss due to because of eustachian tube dysfunction preservative treated with the Otovent pneumotherapy method.

Journal of Medical Science ◽

10.20883/jms.2018.302 ◽

2018 ◽

Vol 87 (3) ◽

pp. 133-137

Author(s):

Małgorzata Nowak ◽

Beata Wolnowska ◽

Alicja Sekula

Keyword(s):

Hearing Loss ◽

Eustachian Tube ◽

Research Group ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Control Group ◽

Tube Obstruction ◽

Before And After ◽

Conductive Hearing

INTRODUCTION. A conductive hearing loss is a very common problem in childhood. It is possible to indicate many reasons for the problem, but most of the times it is caused by the infectious process, as well as the typical adenoid hypertrophy in children. Very often this disease is associated with obstruction of the eustachian tube.OBJECTIVE. In this study, the authors present the results of the hearing tests of patients who underwent the treatment of the eustachian tube obstruction by pneumotherapy with otovent. The aim of the work was to monitor the effectiveness of this method of OME treatment.RESEARCH GROUP AND METHODOLOGY. The research group consisted of 54 children aged 4 to 15 years, including 23 girls and 31 boys. The control group consisted of 16 children. Pure tone audiometry and impedance audiometry were performed before and after the therapy, for all of the participants.RESULTS. Obtained results of the study showed improvement in hearing in children correctly using the Otovent set. Hearing improvement was recorded both in the results of pure tone audiometry and impedance audiometry.CONCLUSIONS. The obtained results showed the effectiveness of the pneumotherapy method. In the case of the research group, 81.4% of children achieved the auditory norm (44 people). In the case of the control group, after a fixed period of application of the Otovent set, this value was 0%. The intergroup comparative analysis clearly shows that the research group obtained significantly better results within all of the parameters assessed, than the control group.

Download Full-text

Results, Hearing Rehabilitation, and Follow-up with Magnetic Resonance Imaging after Tympanomastoid Exenteration, Obliteration, and External Canal Overclosure for Severe Chronic Otitis Media

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940711600914 ◽

2007 ◽

Vol 116 (9) ◽

pp. 705-711 ◽

Cited By ~ 12

Author(s):

Katrien Ketelslagers ◽

Thomas Somers ◽

Bert De Foer ◽

Andrzej Zarowski ◽

Erwin Offeciers

Keyword(s):

Magnetic Resonance Imaging ◽

Hearing Loss ◽

Magnetic Resonance ◽

Otitis Media ◽

Cochlear Implantation ◽

Conductive Hearing Loss ◽

Chronic Otitis Media ◽

Resonance Imaging ◽

Conductive Hearing

Objectives: We sought to evaluate the results, auditory rehabilitation, and follow-up with magnetic resonance imaging (MRI) after tympanomastoid exenteration with obliteration of the mastoid cavity and overclosure of the external ear canal in patients with severe chronic otitis media that was resistant to medical therapy and conventional surgery and was associated with a profound sensorineural or severe conductive hearing loss. Methods: Twenty-nine patients were analyzed and underwent this surgical technique. Twelve patients had, during the same or later stage, either cochlear implantation, fixture implantation for a bone-anchored hearing aid, or middle ear implantation. For follow-up control of the obliterated cavity, delayed gadolinium-enhanced, T1-weighted MRI in combination with non-echo planar imaging diffusion weighted sequences were used. Results: No patient had recurrent otorrhea after an average follow-up period of 4.75 years. One patient had a residual cholesteatoma as shown by new MRI techniques, and this was successfully resected. One patient developed complications 6 months after 1-stage tympanomastoid exenteration and cochlear implantation. Conclusions: This technique is very useful in selected patients with severe chronic otitis media that is resistant to medical therapy and surgery and is associated with a profound sensorineural or severe conductive hearing loss. New sequences in MRI are used for postoperative follow-up of these obliterated cavities and seem reliable for the detection of residual or recurrent cholesteatoma. Middle ear implantation and cochlear implantation can be relatively safely performed in these patients in a second stage.

Download Full-text

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215106003343 ◽

2006 ◽

Vol 121 (3) ◽

pp. 219-221 ◽

Cited By ~ 11

Author(s):

H Yasan

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Middle Ear ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Pure Tone Audiometry ◽

Stapes Footplate ◽

Predictive Role ◽

Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

Download Full-text

A study to evaluate bone and cartilage ossiculoplasty in patients of ossicular disruption due to chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20214903 ◽

2021 ◽

Vol 8 (1) ◽

pp. 69

Author(s):

Hema Mehra ◽

Sushma Mahich ◽

Navneet Mathur ◽

Mahima Singh

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Prospective Observational Study ◽

Tertiary Care ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Suppurative Otitis Media ◽

Hearing Gain ◽

Conductive Hearing ◽

And Cartilage

Background: Ossiculoplasty for ossicualar disruption in patients of chronic otitis media (COM) can be done by using either bone or cartilage. The present study was planned to compare bone and cartilage ossiculoplasty in patients of ossicular disruption due to COM.Methods: The prospective observational study was carried out in patients, who were admitted in the department of otorhinolaryngology of a tertiary care teaching hospital of Rajasthan during two years from November 2017 to November 2019. All patients with ossicular disruption due to COM and conductive hearing loss more than 40db were included in the study. Patients with sensorineural hearing loss were excluded from the study. Pure tone audiometry (PTA) was done before surgery. Hearing improvement was assessed 3, 6 and 12 months after surgery. Results: In the present study 20 patients underwent bone ossiculoplasty using autologous incus and autologous cartilage was used in 80 patients for ossiculoplasty. Post-operative hearing gain was significantly more in autologous incus patients (22.7±4.2 db) compared to autologous cartilage (19.5±3.4 db) (p=0.002).Conclusions: The present study concluded that post-operative hearing gain was significantly better with autologous incus compared to autologous cartilage although both showed good results in terms of hearing gain.

Download Full-text

Relationship between tympanic membrane perforation and conductive hearing loss in patients with chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175606 ◽

2017 ◽

Vol 4 (1) ◽

pp. 11

Author(s):

Amjed H. Ali ◽

Isam M. Alshareda

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Surface Area ◽

Otitis Media ◽

Conductive Hearing Loss ◽

Chronic Otitis Media ◽

Tympanic Membrane Perforation ◽

P Value ◽

Membrane Perforation ◽

Conductive Hearing

Background: Study performed to evaluate relationship between surface area of tympanic membrane perforation and degree of hearing loss and the effect of perforation site on that relationship in patients with chronic otitis media. Methods: Seventy-five perforated tympanic membranes from 63 patients aged between 14-45 years with inactive mucosal chronic otitis media included in this study. Rigid endoscope (0 degree) used to take an image for each perforation that analyzed by Autodesk Design Review 2013 program. Degree of hearing loss assessed by pure tone audiometry. Surface area of perforation classified into four groups according to its percentage. Perforation site categorized into three groups regarding its relation to handle of malleus. Data analysis carried out with SPSS program version 17. Results: We studied 34 females and 29 males with different surface area and site of perforations. It observed that with increment of surface area of tympanic membrane perforation, the degree of conductive hearing loss increases (P value=0.000). This relationship expressed in a logarithmic equation. The mean hearing loss of posterior perforation was 1.7±0.5 dB for each 1% of perforation but in anterior perforation was 1.5±0.6 dB for each 1% of perforation (p value 0.185). Conclusions: In chronic otitis media, there is a quantitative logarithmic relationship between surface area of tympanic membrane perforation and degree of conductive hearing loss. The site of perforation does not play a significant role in determining degree of conductive hearing loss.

Download Full-text

Evaluation of the contralateral ear in patients with unilateral chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194941 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1641

Author(s):

Krupal A. Pardhi ◽

Netra A. Pathak ◽

Kiran J. Shinde

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Pure Tone ◽

Radiographic Finding ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Study Results ◽

Contralateral Ear ◽

A Prospective Study ◽

Conductive Hearing

Background: Unilateral chronic otitis media (COM) is a condition likely to affect the other side also caused by various etiological factors. If diagnosed and intervened in time, the progression of the disease can be prevented and ear can be protected from various sequelae. Hence, it is important to assess and evaluate the contralateral ear (CLE) completely.Methods: A prospective study of 12 months was conducted in the Otorhinolaryngology department, enrolling 80 patients with unilateral chronic otitis media. The CLE defined as the asymptomatic ear without ear discharge or any other complaints. Otoscopy, pure tone audiometry, tympanometry and X-ray mastoid done on patients. The results were recorded and analysed. Results: On otoscopic findings 76.36% patients in mucosal and 88% patients in squamosal showed abnormalities in CLE. Pure tone audiometry (PTA) showed 75% patients had hearing loss in CLE 46.25% conductive hearing loss (HL), 11.25% sensorineural HL and 17.5% mixed HL in CLE. In squamosal type of COM 76% patients had hearing impairment as compared to mucosal type 74.54%. In tympanometry findings 58.75% patients had type B curve in CLE. Radiographic finding of CLE showed sclerotic mastoid air cells 32% in squamosal and 9.09% in mucosal type.Conclusions: Approximately 80% patients with unilateral COM have abnormal ear findings in CLE. Squamosal type of unilateral COM had more chances of abnormalities in CLE. In this study results showed that the CLE can also be affected in unilateral COM.

Download Full-text