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1
Viswanathan, Harishnath. "Mucin Gene Expression and GastricReflux in Chronic Rhinosinusitis and Otitis Media with Effusion." Thesis, University of Newcastle Upon Tyne, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499336.
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Tasker, Andrea. "Otitis media with effusion : key factors." Thesis, University of Newcastle Upon Tyne, 2003. http://hdl.handle.net/10443/1075.
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Otitis media with effusion (OME) is a disease characterised by inflammation of the middle ear and changes in middle ear mucosa from a columnar to a more secretory type epithelium, with a proliferation of goblet cells and mucus glands. There is excessive production of mucus, resulting in the accumulation of a viscous effusion in the middle ear cleft. Various factors have been implicated in the aetiology of the disease including bacteria, Eustachian tube dysfunction, allergy and craniofacial abnormalities. It has been suggested that laryngopharyngeal reflux could be an inflammatory co-factor and possible cause of many upper respiratory disorders including OME. The aims of this thesis were to examine effusions for the presence of gastric juice and were also concerned with the biochemical and rheological characterisation of effusions. Acidic proteinase (pepsin) activity measured at pH2.2 using the N-terminal assay was detected in 29% of effusions and 91% of these samples contained pepsin/pepsinogen protein at elevated levels compared to serum (using an ELISA). As other serum protein levels in effusions were of the same order as serum reference levels, the source of the activity was unlikely to be from a transudate of plasma and rather due to the reflux of gastric contents into the middle ear. The data suggests that reflux may be a primary factor in the initiation of OME in children. Middle ear effusions are mucin-rich secretions that demonstrate a lack of degradation on storage. They contained at least two distinct mucin populations, MUC5B is the major mucin and MUC5AC is present at much lower levels. MUC5B had a significant correlation with effusion specific viscosity suggesting that it is responsible for the rheological properties of the effusion. Interleukin-8 (IL-8) levels in effusions had significant correlation with MUC5AC and it may be that MUC5AC is produced in response to IL-8 in the middle ear during the inflammatory process of glue ear. Neither IL-6 nor IL-8 levels correlated with MUC5B content. It is likely that a different stimulus or other cytokine is responsible for the regulation of MUCSB. There was a significant correlation between IL-6 and IL-8 levels in effusions demonstrating that one cytokine could stimulate the secretion of the other. Further studies developing from the work presented in this thesis would involve analysis of effusions for other components of gastric juice, such as gastric lipase and intrinsic factor, to confirm the role of reflux in OME. A study following children from the diagnosis stage through the disease course and grommet insertion for glue ear with awareness of signs and symptoms of reflux would assess the proportion of children with glue ear associated with reflux. An animal model for reflux could be set up, instilling gastric juice components into the middle ear via the nasopharynx/ET to see if an effusion develops. Effusions could be analysed for other cytokines (such as IL-10 or TNF-a) to see if levels correlate with MUC5B content.
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Wilson, Rachel. "The developmental consequences of otitis media with effusion." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273453.
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Koivunen, P. (Petri). "Otitis media in children:detection of effusion and influence on hearing." Doctoral thesis, University of Oulu, 1999. http://urn.fi/urn:isbn:9514252314.
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Abstract
This study was undertaken to improve the diagnosis of otitis media and to investigate possible hearing loss caused by middle ear effusion (MEE) in small children.
The accuracy of minitympanometry in detecting MEE was evaluated in 162 children. The finding was compared with the amount of effusion found in myringotomy. Minitympanometry proved to be an accurate method to detect MEE in young children, the sensitivity and specificity values being 79% and 93% in cooperative children but it had no value in non-cooperative children. Minitympanometric examination could be performed successfully with good cooperation in 87% of a total of 206 children in paediatric outpatient clinic.
Impaired mobility of the tympanic membrane (TM) was the best sign of MEE in pneumatic otoscopy of 76 children, with sensitivity and specificity values of 75% and 90%, respectively.
The influence of nitrous oxide (N2O) on MEE was tested by weighting the effusion found in myringotomy during general anaesthesia with and without N2O in 39 and 37 children, respectively. The mean weight of the effusion in the oxygen-air group did not differ from the weight in the N2O group, and thus peroperative findings in myringotomy are reliable.
Studies on symptomatology and the temporal development of acute otitis media (AOM) during upper respiratory tract infection (URI) were based on three-month follow-up of 857 children. Symptoms of URI only were compared with symptoms of URI complicated by AOM in the same child in 138 children. The most important symptom associated with AOM was earache, with a relative risk of 21.3. Sore throat, night restlessness and fever at days 3-6 were also significantly associated with AOM, with relative risks of 3.2, 2.6 and 1.8, respectively. In 44 children under two years of age, earache, conjunctival symptoms and cloudy rhinitis were significantly associated with AOM.
Temporal development of AOM was assessed from 250 episodes in 184 children. Sixty-three per cent of cases of AOM occurred during the first week after the onset of URI, peaking on days 2 to 5. The onset of AOM in children with a history of recurrent episodes of AOM did not differ from that in those who had experienced only a few episodes of AOM. No individual tendency was noticed among children suffering more than one AOM episode during follow-up.
To assess the influence of the quantity and quality of MEE on hearing in small children, transient evoked otoacoustic emission (TEOAE) was performed under general anaesthesia before myringotomy in 185 ears of 102 children. Reduced TEOAEs indicating hearing loss were found in 83% of the ears with mucoid effusion and in 56% of the ears with non-mucoid effusion, the difference being statistically significant (p < 0.01). A significant negative correlation between the reproducibility of TEOAE responses and the amount of effusion was found (Spearman rank correlation coefficient r = -0.589, p < 0.001). Findings in minitympanometry correlated with the responses of TEOAE.
Although parents are able to predict AOM quite reliably, various symptoms and the duration of URI seems to be of little value in helping the diagnosis of AOM. Detection of effusion in OM may be improven by minitympanometry in cooperative children. Any kind of effusion may cause hearing loss in small children, which must be considered when treating OM.
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Sobol, Steven E. "Th2 cytokine expression in atopic children with otitis media with effusion." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33031.
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Background. Otitis media with effusion (OME) is more common in atopic children. Few studies have looked for the presence of inflammatory mediators in the middle ear effusions of this population.<br>Objectives. We hypothesize that atopic children with OME have a different inflammatory cell and cytokine profile than non-atopic children with the disease.<br>Methods. The atopic status of 26 children with OME was determined. Using immunocytochemistry, fluid specimens were assessed for T lymphocytes, eosinophils, neutrophils, mast cells, and basophils. The expression of IL-4, II.-5, and IFN-gamma mRNA was assessed using in-situ hybridization.<br>Results. There is a higher percentage of eosinophils, T lymphocytes and cells expressing IL-4 and IL-5 mRNA in atopic children (n = 8) compared to non-atopic controls (n = 18) (p < 0.01).<br>Conclusion. The predominance of eosinophils, T lymphocytes and Th2 mediators in the middle ear effusions of atopic children provides strong evidence that atopy plays a role in the pathogenesis of this condition.
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Nguyen, Ha-Nam Phan 1975. "Evidence linking allergic otitis media with effusion to the United airways concept." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80341.
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Otitis media with effusion (OME) is a chronic inflammatory disease of the middle ear space characterized by the accumulation of fluid. Previous investigations have found the composition of the inflammatory substrate in effusions of allergy-associated otitis media to be is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in asthma and in allergic rhinitis. In addition, there is evidence suggesting that diseases of the upper and lower airways may represent different clinical manifestations of a single inflammatory airway syndrome, or the United Airway Concept. The objective of this research is to determine if the middle ear compartment may be a component of the United Airways in allergic disease. Middle ear fluid, torus tubaris (Eustachian tube mucosa at the nasopharyngeal orifice) and adenoidal tissue biopsies were obtained from 45 patients undergoing simultaneous tympanostomy tube placement for OME and adenoidectomy for adenoid hypertrophy. The cellular and cytokine profiles of each site were investigated using immunocytochemistry (elastase, CD3, MBP) and in-situ hybridization (IL-4, IL-5, IFN-gamma mRNA). Atopic status was determined for each patient using skin-prick testing. Eleven of the 45 patients with OME (24%) were atopic. The MEE of atopics had significantly higher levels of eosinophils, T lymphocytes, IL-4 and IL-5 mRNA +cells (p < 0.01), and significantly lower levels of neutrophils and IFN-gamma mRNA +cells (p < 0.01) when compared to non-atopics. The nasopharyngeal tissue biopsies also revealed similar cellular and cytokine profiles. Therefore, the allergic inflammation in atopic patients with OME occurs on both sides of the Eustachian tube, both in the middle ear and in the nasopharynx. The results of this study support the concept that the middle ear may be part of the United Airway in atopic individuals.
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Hasebe, Seishi. "Organic change of effusion in the mastoid in otitis media with effusion and its relation to attic retraction." Kyoto University, 2001. http://hdl.handle.net/2433/150174.
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Hogan, Sarah Cecilia Mary. "The development of hearing in children : some effects of otitis media with effusion." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301869.
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Guo, Li. "Studies into mucin and its regulation in pathogenesis of otitis media with effusion." Thesis, University of Nottingham, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517658.
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Johnson, Ian J. M. "Otitis Media with Effusion - investigation into aspects of rheology biochemistry and inflammatory mediators." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287845.
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Higson, Josephine M. "Parent and professional health beliefs about Otitis media with effusion : impact on parent behaviour." Thesis, University of Nottingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299564.
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Fitzgerald, J. E. "Characterization of mucus glycoproteins in middle ear effusions from children with otitis media with effusion." Thesis, University of Newcastle Upon Tyne, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.383976.
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Hartley, Douglas E. H. "Effects of conductive hearing loss on auditory temporal resolution." Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365822.
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Aynali, Giray Yarıktaş Murat. "Deneysel efüzyonlu otitis mediada metilprednizolon, montelukast ve indometazin'in antienflamatuar etkilerinin karşılaştırılması /." Isparta: SDÜ Tıp Fakültesi, 2006. http://tez.sdu.edu.tr/Tezler/TT00274.pdf.
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Macfadyen, Carolyn Anne. "Topical treatment for chronic suppurative otitis media in developing countries." Thesis, University of Liverpool, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425437.
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Bhutta, Mahmood F. "Genetics of chronic otitis media : a mouse to man approach." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:3dacb68a-414c-4a79-bea4-c639cc01c0ff.
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Chronic otitis media (OM) is an archetypal complex disease, which is particularly prevalent in childhood. Epidemiological data suggest high heritability for disease susceptibility, but previous genetic association studies have had methodological flaws, and none have specifically focused on chronic OM phenotypes. Mouse models represent one way to ascertain candidate loci for human association testing. A number of mouse models of middle ear inflammation have been reported, but many susceptibility loci remain undiscovered. I demonstrate that oto-endoscopy is a robust and scalable phenotyping platform for OM in the mouse, and discuss its value in new model discovery. Chronic OM is also a feature of trisomy HSA21 (Down Syndrome). Through an interrogation of the mouse library of segmental trisomy models of Down Syndrome, I identify a critical trisomic region for chronic otitis media. This region may underlie OM susceptibility in Down Syndrome, but could also contribute to disease susceptibility in non-syndromic disease. Mouse models can also be used to interrogate disease mechanisms. Our previous work has shown that the chronically inflamed middle ear is hypoxic, and that hypoxia signalling is a potential therapeutic target. Exploiting the Junbo mouse model, I demonstrate that surgical ventilation of the Junbo ear improves inflammation, and that this is associated with loss of hypoxia signalling. I present preliminary results from transcript analyses of human middle ear effusions showing marked upregulation of hypoxia signalling. A systematic review of existing mouse models suggests that the loci FBXO11, EVI1, SMAD2, and TGIF1 are good candidates genes for human association testing. I detail recruitment and collection of DNA from families in the UK where a child is undergoing grommet insertion. Association testing using a variant of the transmission disequilibrium test shows susceptibility associated with polymorphisms at FBXO11, and possibly also SMAD2 and TGIF1.
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Daniel, Matija. "Otitis media with effusion : current treatment, new understanding of its aetiopathogenesis, and a novel therapeutic approach." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/28069/.
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Otitis Media with Effusion (OME) is a common childhood condition leading to hearing loss, and its treatment with ventilation tubes (VTs) is one of the commonest surgical procedures. However, aetiology of OME is poorly understood, and its current treatment requires improvement as OME frequently recurs once VTs extrude. The first, clinical part of this thesis showed that 63.6% of children randomised to VT insertion in a clinical trial will require VTs again, and even with additional adenoidectomy the need for repeat surgery remains high. Although published national guidelines set out criteria for surgery, the multicentre study presented here showed that only 32.2% of children that had VTs met these criteria, and guidelines' publication had limited impact on clinical practice. The second, laboratory part of this thesis demonstrated the importance that bacteria and biofilms play in aetiology of OME, as live bacteria were demonstrated in 91.9% of middle ear effusions (using culture and confocal microscopy). Following from this, a Staphylococcus aureus biofilm model was developed, and used to show that biofilm eradication requires antibiotic (rifampicin and lindamycin) levels 1,000 times higher than those required to inhibit planktonic bacteria, over a period of 2-3 weeks. To achieve this in the middle ear, a local delivery strategy using biodegradable poly (Iactic-coglycolic acid) antibiotic pellets was proposed. Drug release from these pellets was investigated with High Performance Liquid Chromatography and Serial Plate Transfer Testing, which demonstrated that antibiotics can be released for up to 3 weeks. Importantly, the pellets were able to eradicate biofilms in the in vitro model. This thesis has shown that current OME treatment has significant deficiencies, but better understanding of OME pathogenesis raises the possibility of rational new therapeutic strategies. Biodegradable antibiotic pellets designed to eradicate OME biofilms may be a better future treatment that could improve the lives of countless children.
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Casey, Maria Paula. "The Relationship Between 6/9 Distance Vision, Otitis Media with Effusion and Emergent Letter Name Knowledge." Thesis, University of Canterbury. Health Sciences, 2013. http://hdl.handle.net/10092/9062.
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Background: There is a need for more well-controlled research on the relationship between
vision and hearing limitations and emergent literacy to inform early literacy intervention.
Two highly prevalent difficulties of early childhood, poor distance visual acuity and otitis
media with effusion (OME), have been shown to be associated with literacy achievement.
There is little research, however, on the relationship between these conditions and emergent
literacy.
Objective: The objective of this study was to assess the relationships between (1) distance
visual acuity and emergent letter name knowledge, and (2) OME status and emergent letter
name knowledge in children at school entry.
Method: A prospective cohort of children (N=298) was recruited at school entry. Participants
were aged 5, did not require special education for high needs and spoke a nationally
recognized language of New Zealand. Distance vision and tympanometry testing was
performed and a parent report of OME was obtained. The Wechsler Individual Test of Letter
Name Knowledge and the Vocabulary and Block Design sub-tests of the Wechsler
Intelligence Scale for Children were administered. Covariates of reading achievement were
also measured.
Results: Twenty three percent of children knew fewer than 4 letters at school entry, 31.9%
had marginal distance visual acuity of 6/9 in one or both eyes and 37.2% had a history of ear
infections and/or a B tympanometry test at school entry. Logistic regression tests
demonstrated that both 6/9 vision (OR= 2.069, CI0.95=0.999-4.227) and OME status
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(OR=1.846, CI0.95=1.034-3.297) were significantly associated with low letter name
knowledge at school entry, controlling for covariates of emergent literacy. Another analysis
showed that children with 6/9 vision and/or OME at school entry were also at greater risk for
low letter knowledge (OR=2.187, CI0.95=1.067 – 4.484) than children with 6/6 vision and no
OME at school entry.
Conclusions: The results of the current study indicate that 6/9 distance vision and OME
are risk factors for low letter name knowledge at school entry. These factors warrant
greater consideration with regard to early literacy intervention, classroom teaching
practices and future research.
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Smith, Sarah C. "Measurement of quality of life, behaviour and health outcomes in children with otitis media and effusion." Thesis, University of Nottingham, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266939.
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Barnett, Catherine Margaret Eleanor. "Association of Single Nucleotide Polymorphisms in Surfactant Protein A and D with Otitis Media." The University of Waikato, 2007. http://hdl.handle.net/10289/2338.
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Otitis Media is one of the most common childhood diseases. Recurrent acute otitis media RAOM is characterized by repeated episodes of inflammation of the middle ear in conjunction with middle ear fluid, and often with an inflamed or bulging eardrum. Defective clearance by the Eustachian tube results in mucus build-up and is characteristic of otitis media with effusion (OME). Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory syncytial virus, and rhinovirus are the most common contributors to otitis media pathogenesis. In New Zealand, OME has been implicated with conductive hearing loss in childhood and has been shown to significantly impact on speech and language development. New Zealand Māori and Polynesian children have displayed significantly higher hearing test failure rates than European-Caucasian children. The collectins, Surfactant Protein (SP)-A and -D are encoded by three genes (SP-A1, SP-A2, and SP-D) and are host defense proteins present in the middle ear and Eustachian tube. Single nucleotide polymorphisms (SNPs) in SP-A1 and SP-A2 have been associated with increased or decreased susceptibility to otitis media, meningococcal disease, and range of respiratory diseases. Using allele-specific primers and real-time PCR with SYBR Green I melting curve analysis, four groups of individuals were genotyped for eleven SP-A1, SP-A2, and SP-D SNPs: European-Caucasian individuals with RAOM/OME; New Zealand Māori/Polynesian individuals with RAOM/OME; individuals with meningococcal disease; and a control group. The computer program, Haploview, was employed to perform χ2 analyses and identify statistically significant associations of alleles/haplotypes with RAOM/OME or meningococcal disease. In the European-Caucasian population, two SP-A1 alleles, one SP-A2 allele, and four haplotypes (CGAGC, 1A3, 1A9, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). Conversely, haplotypes 6A2 and 1A2 were found to be protective against susceptibility to RAOM/OME (P lt; 0.05). In New Zealand Māori and Polynesian individuals, two SP-A1 alleles, three SP-A2 alleles, one SP-D allele, and four haplotypes (6A8, 6A10, 1A3, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). An additional four haplotypes (6A2, 1A0, 1A2, and TA) were determined to be protective against susceptibility to RAOM/OME (P lt; 0.05). However, protective SPA1/SPA2/SPD haplotype 6A2-1A0-TA was significantly under-represented in the New Zealand Māori and Polynesian population (P lt; 0.05). A single allele and haplotype were associated with increased risk of meningococcal disease (P lt; 0.05). The findings of this study confirm that specific genetic variants of SP-A and SP-D are associated with either increased or decreased risk of developing RAOM and/or OME. Furthermore, it was demonstrated that New Zealand Māori and Polynesian individuals appear to exhibit more haplotypes susceptible to RAOM/OME. This may provide a partial explanation for the higher RAOM/OME-related failure rates of hearing tests in New Zealand Māori and Polynesian children. However, there are numerous socio-economic and environmental factors that also contribute to otitis media pathogenesis which were not considered in this study. The effects of the SP-A1, SP-A2, and SP-D alleles and haplotypes on the bacterial/viral binding efficiencies of SP-A and SP-D need to be investigated by further research, using a large population, to confirm the association with susceptibility or resistance with RAOM/OME.
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Thorp, Marc A. "Aluminium acetate solution in the treatment of chronic suppurative otitis media." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/2905.
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Eriksson, Per Olof. "Developing otitis media : experimental studies in particular regarding inflammatory changes in the tympanic membrane." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-180.
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Novotny, Laura A. "Design and assessment of pre-clinical vaccine candidates against otitis media due to nontypeable Haemophilus influenzae and the development of a non-invasive vaccine delivery strategy." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/390034.
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Otitis media (OM) is one of the most common bacterial diseases of childhood and include both acute and chronic forms of disease (1). Whereas acute OM (AOM) is a disease with rapid onset and is short in duration, chronic forms of OM can persist for weeks to months. The most severe form, chronic suppurative OM (CSOM) occurs upon OM with tympanic membrane rupture and is characterized by purulent drainage from the middle ear space that persists for at least 2 weeks or longer. There are 709 million cases of acute OM and 65 million to 330 million episodes of chronic suppurative OM (CSOM) occurring each year, worldwide (2, 3). Complications of CSOM result in the deaths of at least 50,000 children under 5 years of age in resource-poor regions across the world (4, 5) and morbidity associated with OM is significant for all children worldwide. Hearing loss due to OM is associated with developmental delays in behavior, language acquisition and education, all factors with profound influence that last well into adulthood (6-8). Significantly, prevention of the first incidence of OM curb extensive antibiotic prescription and surgical intervention in young children and is projected to reduce subsequent episodes, limiting the disease-related sequellae (9).
Nontypeable Haemophilus influenzae (NTHI) is a primary causative agent of OM, in addition to multiple upper and lower respiratory tract diseases (10). In children, NTHI is the predominant bacterium implicated in chronic OM, recurrent OM and OM for which treatment has failed (11-14). Moreover, whereas Streptococcus pneumoniae was the primary pathogen in OM prior to the use of pneumococcal conjugate vaccines, NTHI now also predominates during acute OM (15-17). NTHI, a typically benign commensal inhabitant of the human nasopharynx, possesses numerous determinants that facilitate its persistence, including outer membrane adhesive proteins and lipooligosaccharide (18). Perturbation of innate and/or physical immune defenses can result in disease distally, for example within the middle ear during OM, sinuses in rhinosinusitis, lungs in chronic cough and during episodes of exacerbations of chronic obstructive pulmonary disease (COPD) and cystic fibrosis (19). Moreover, the ability of this bacterium to rapidly form a biofilm, a community of bacteria that is frequently polymicrobial and is highly recalcitrant to the action of antibiotics and resistant to clearance by host immune effectors (20) promotes disease chronicity.
This compilation of my research, presented for consideration herein, describes the pre-clinical development of vaccines against NTHI-induced OM with a focus on two critical adhesive proteins expressed by NTHI, outer membrane protein P5 (OMP P5) and the Type IV pilus (Tfp), selected from my research performed over the past 22 years. Adhesin OMP P5 binds to mucin, intercellular adhesin molecule- 1 (ICAM1) and carcinoembryonic antigen-related adhesion molecule-1 (CEACAM1) (21-25), and I identified that NTHI Tfp engages ICAM1 (26). Furthermore, NTHI Tfp performs multiple biological functions which include competence, twitching motility and biofilm formation (27-31). I show that antibodies directed against the majority protein subunit of NTHI Tfp, PilA, induces active dispersal of NTHI from established biofilms, an outcome that is dependent on and coordinated with expression of the quorum signaling molecule, LuxS (29). Toward development of NTHI OMP P5 and Tfp-directed vaccine immunogens, I performed epitope mapping studies that revealed minimal immunodominant and immunoprotective domains within each native protein (32-34). These data guided the subsequent design of a novel chimeric immunogen, as a multi-component vaccine may be necessary to provide maximal protection against this heterogeneous bacterial species (35). I validated pre-clinical efficacy of each immunogen in chinchilla models of NTHI-induced experimental OM (29, 34-36).
Although immunisation via intramuscular or subcutaneous injection is wellestablished and proven to be one of the most effective strategies for disease prevention, non-invasive delivery methods have the potential to promote greater compliance, reduce costs associated with production and administration and extend the reach of vaccines to underserved regions (37). To explore this premise, I considered transcutaneous immunisation (TCI). My first efforts involved rubbing vaccine formulations on to the pinnae (or outer ears) of chinchillas (38, 39), a strategy that was later refined to utilize a small circular bandaid applied to the postauricular region behind the ear as a delivery device and administration route (40, 41). I examined the influence of adjuvantation, skin hydration and homing of antigenpresenting cell to local lymphoid tissues as essential factors toward induction of protective immunity. I characterised the durability of immunity induced by skin vaccination and validated TCI as a highly effective strategy to induce protective immune responses in experimental models of NTHI-induced OM (38-41). Improving vaccination methodologies for young children, particularly those in resource-poor regions of the world, was a key consideration in TCI conceptualization and refinement. Collectively, these data demonstrate the simplicity of bandaid immunisation which, combined with highly effective antigens, that target two critical NTHI adhesive proteins admixed with a potent adjuvant, has tremendous potential to enable greater reach of vaccines against NTHI and diseases of the respiratory tract, including OM.<br>Thesis (Professional Doctorate)<br>Doctor of Philosophy by Publication (PhD)<br>School of Medicine<br>Griffith Health<br>Full Text
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Al-Khatib, Talal. "Does pneumatic otoscopy improve the diagnostic accuracy of otitis media with effusion in clinical practice? A randomized single-blind control trial." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=92342.
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The study objective was to determine whether pneumatic otoscopy would improve the diagnostic accuracy of otitis media with effusion (OME) in clinical practice over otoscopy only. A randomized single-blind control trial was undertaken in 30 pediatric residents. Residents were randomized into pneumatic otoscopy (intervention) or otoscopy-only (control) groups. Both study groups received one hour of theory on OME; the intervention group also received a 30-minute teaching session that included both video-otoendoscopic examination (VOE) pneumatic assessments and one practice session. Each resident examined 10 ears and made a diagnosis of either normal or OME ears. Tympanograms were considered as the gold standard. The percent correct diagnoses in the intervention and control groups were 60% and 59%, respectively (p = 0.85).<br>In conclusion, pneumatic otoscopy did not significantly improve the diagnosis of otitis media with effusion in clinical settings. Further studies are needed to confirm these findings.<br>L'objectif de l'étude était de déterminer si l'apprentissage et la formation portant sur l'otoscopie pneumatique pouvaient augmenter la précision du diagnostic de l'otite moyenne séreuse (avec épanchement) en pratique clinique. Une étude de contrôle, à sélection aléatoire, à simple insu, a été entreprise auprès de 30 résidents en pédiatrie de l'Université McGill. Les résidents ont été affectés de façon aléatoire, soit au groupe d'otoscopie pneumatique (groupe d'intervention), soit au groupe d'otoscopie uniquement (groupe témoin). Les deux groupes de l'étude ont suivi un cours théorique d'une heure portant sur l'otite moyenne séreuse (avec épanchement). Le groupe d'intervention a également pris part à une séance d'enseignement de 30 minutes, y inclus une évaluation de l'examen otoendoscopique avec système vidéo et de l'otoscopie pneumatique et une séance d'entraînement. Chaque résident devait examiner 10 oreilles et poser un diagnostic, soit de normalité, soit d'otite moyenne séreuse (avec épanchement). Le tympanogramme a été utilisé comme norme d'excellence. Le pourcentage de diagnostics justes dans les groupes d'intervention et de témoin était de 60 % et de 59 % respectivement (p = 0,85). En conclusion, l'otoscopie pneumatique n'a pas augmenté la précision du diagnostic de l'otite moyenne en pratique clinique. fr
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Hurst, David S. "The middle ear : The inflammatory response in children with otitis media with effusion and the impact of atopy : clinical and histochemical studies." Doctoral thesis, Uppsala University, Department of Medical Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-558.
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<p>Otitis media with effusion (OME) is the major form of chronic relapsing inflammatory disease of the middle ear, constitutes the most common diagnosis for children under 15 years old and is the major cause of auditory dysfunction in pre-school children. OME is a disease more commonly found in allergic children. These studies sought to investigate the inflammatory response in the middle ear of patients and test the hypothesis that an allergic-like response might occur in the ear. Atopy was diagnosed by standard in vitro tests. Immunochemical techniques used to study classic allergic rhinitis and asthma were extrapolated to the evaluation of OME children whose effusion persisted beyond 2 months. Not only eosinophil cationic protein (ECP), tryptase, CD3-positive and IL-5 producing cells, but also myeloperoxidase (MPO) was found in middle ear fluid and/or mucosa in the majority of patients with OME and atopy. </p><p>Initially, levels of ECP, MPO, and tryptase were measured in effusions from 97 random OME patients whose atopic status was determined by in vitro testing to 12 inhalants and 5 foods. The response of eosinophils, neutrophils and mast cells in the middle ear was distinctly different between atopic and non-atopic patients (p<0.001) with higher levels of the cell markers in the atopic group of patients. This suggested that 1) perhaps OME was predominantly a disease of atopics and that 2) they differed in their response from non-atopics.</p><p>Tryptase was measured in middle ear effusions from 38 patients with OME, 94.7% of whom were atopic by in vitro testing. Tryptase was elevated only in the effusion of atopic patients as compared to 5 controls (p<0.01). Biopsies stained histochemically for tryptase showed evidence of mast cells in the mucosa and submucosa from 6 of 8 OME ears but absent in 4 normals.</p><p>Middle ear biopsies, embedded in a plastic resin to improve the structural preservation, from 5 patients with OME and 5 normals were evaluated for the presence of eosinophils and neutrophils with monoclonal antibodies against 4 specific granule proteins. Eosinophils and neutrophils were present in the mucosa and mucus in significantly higher numbers than in the control group.</p><p>In an effort to determine whether the middle ear itself might be involved in allergic disease, evidence that some of the cells, mediators and cytokines associated specifically with a Th-2 response were sought for in the middle ear mucosa of these children. Middle ear biopsies from 7 atopic patients with OME and 4 controls demonstrated the presence of activated eosinophils, CD-3+ T cells and IL-5 mRNA cells only in the mucosa from atopic OME children. </p><p>Conclusion: Effusion and mucosal biopsies containing ECP, tryptase, and/or IL-5 mRNA cells, CD3+ T cells, eosinophils, and mast cells indicate that many of the mediators and cells essential to the production of a Th-2 immune mediated response are present in ears with chronic effusion. The increased levels of MPO in atopic patients further suggest that the general inflammatory response to putative inciting agents such as bacterial and viral products may be altered in atopy. These studies support the hypothesis that the exaggerated inflammation within the middle ear associated with most cases of OME is possibly the result of an atopic response within the middle ear itself.</p>
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Stenton, Janice, and n/a. "The Long Term Effects of the Fluctuating, Conductive Hearing Loss Caused by Otitis Media with Effusion on Learning and Behaviour for Adolescent Students." Griffith University. School of Cognition, Language and Special Education, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040319.142844.
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Children frequently experience fluctuating conductive hearing loss during and following episodes of otitis media with effusion. With the prevalence of the disease increasing in the non-Aboriginal population in Australia, many children may be at risk of long-term learning and behavioural problems. There are conflicting findings in the research literature regarding the effects of this type of hearing loss. Although it is expected that the insertion of tympanostomy tubes (grommets) will reduce the duration and prevalence of both the disease and the conductive hearing loss, this does not always happen. For some primary school aged children it appears that experience with otitis media with effusion with or without grommet insertion is associated with various education problems including poor academic achievement and inappropriate behaviour. A current concern is whether or not these possible effects would continue to influence the learning and behaviour of children as they continue into their high school years. A review of the literature suggests that multiple factors including interrelationships between experience of otitis media with effusion, family and childcare environments may be involved in explaining why some students do not achieve as expected at school (Roberts et al., 2000). The literature further suggests there may be a cumulative effect in these factors, which introduces both quantitative and qualitative aspects to the discussion. A study was undertaken to identify the impact of otitis media with effusion and its associated sequelae on the learning and behaviour of high school students. Information from parents of high school students in Years 8 and 9 was used to identify students for inclusion in the study and to provide information on their medical and educational history as well as the parents' perceptions of various aspects of the students' learning and behaviour (including social skills). Three groups were formed: a Non-OME/Non-Grommet Group (n = 28), an OME/Grommet Group (n = 17) and an OME/Non-Grommet Group (n = 32). The TORCH, WRAT 3 and the Test of Syntactic Abilities (Screening Test) were administered to the students who also provided their own perceptions of specific aspects of their own learning and behaviour on a survey form. Teachers' perceptions on these areas were also collected. School academic records as well as data from school behavioural records were used. Analysis of the results revealed a range of mild effects. These included poorer academic results particularly for girls with a history of grommets, who also exhibited a lack of confidence in their social skills. An increase in behaviour problems for boys with a history of the disease (with or without grommets) was also found. The study identifies a number of associated teaching and learning issues including noise levels in childcare environments and school classrooms, current teaching and learning methodology and the training of new teachers. It recommends a number of areas for future research including more in-depth questioning of parents regarding their awareness of hearing problems in their children, the use of more fine-grained measures to assess learning outcomes and the identification of possible gender differences associated with the disease and experiences with grommets.
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Stenton, Janice. "The Long Term Effects of the Fluctuating, Conductive Hearing Loss Caused by Otitis Media with Effusion on Learning and Behaviour for Adolescent Students." Thesis, Griffith University, 2004. http://hdl.handle.net/10072/365873.
Full textAbstract:
Children frequently experience fluctuating conductive hearing loss during and following episodes of otitis media with effusion. With the prevalence of the disease increasing in the non-Aboriginal population in Australia, many children may be at risk of long-term learning and behavioural problems. There are conflicting findings in the research literature regarding the effects of this type of hearing loss. Although it is expected that the insertion of tympanostomy tubes (grommets) will reduce the duration and prevalence of both the disease and the conductive hearing loss, this does not always happen. For some primary school aged children it appears that experience with otitis media with effusion with or without grommet insertion is associated with various education problems including poor academic achievement and inappropriate behaviour. A current concern is whether or not these possible effects would continue to influence the learning and behaviour of children as they continue into their high school years. A review of the literature suggests that multiple factors including interrelationships between experience of otitis media with effusion, family and childcare environments may be involved in explaining why some students do not achieve as expected at school (Roberts et al., 2000). The literature further suggests there may be a cumulative effect in these factors, which introduces both quantitative and qualitative aspects to the discussion. A study was undertaken to identify the impact of otitis media with effusion and its associated sequelae on the learning and behaviour of high school students. Information from parents of high school students in Years 8 and 9 was used to identify students for inclusion in the study and to provide information on their medical and educational history as well as the parents' perceptions of various aspects of the students' learning and behaviour (including social skills). Three groups were formed: a Non-OME/Non-Grommet Group (n = 28), an OME/Grommet Group (n = 17) and an OME/Non-Grommet Group (n = 32). The TORCH, WRAT 3 and the Test of Syntactic Abilities (Screening Test) were administered to the students who also provided their own perceptions of specific aspects of their own learning and behaviour on a survey form. Teachers' perceptions on these areas were also collected. School academic records as well as data from school behavioural records were used. Analysis of the results revealed a range of mild effects. These included poorer academic results particularly for girls with a history of grommets, who also exhibited a lack of confidence in their social skills. An increase in behaviour problems for boys with a history of the disease (with or without grommets) was also found. The study identifies a number of associated teaching and learning issues including noise levels in childcare environments and school classrooms, current teaching and learning methodology and the training of new teachers. It recommends a number of areas for future research including more in-depth questioning of parents regarding their awareness of hearing problems in their children, the use of more fine-grained measures to assess learning outcomes and the identification of possible gender differences associated with the disease and experiences with grommets.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Cognition, Language and Special Education<br>Full Text
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Henry, Susan Hogue. "Hourly fluctuation of middle ear pressure as a function of age in school-age children." PDXScholar, 1989. https://pdxscholar.library.pdx.edu/open_access_etds/4093.
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Tympanometry is a useful means of evaluating the status of the middle ear. For the pediatric population, tympanometry is particularly valuable for determining the presence of middle ear effusion. The test has been incorporated in many school hearing conservation programs because of its ease of administration, objectivity, and diagnostic value.
In a study by deJonge and Cummings (1985), the hourly fluctuation of middle ear pressure was reported in a group of kindergarten-age children. The variability of middle ear pressure for that group of children averaged 150 daPa. In the present study, a maturational effect of this hourly fluctuation was observed between a group of first-grade age students and sixth-grade age students. Results indicated the younger group averaged a range of 145 daPa, correlating well with the deJonge and Cummings study, while the older group averaged a range of 92 daPa. Thus, as a child matures, the hourly fluctuation of middle ear pressure decreases significantly.
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Malik, Jennifer E. "Using Computational Modeling Techniques to Identify and Target Viable Drug Delivery Protocols to Treat Chronic Otitis Media." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1534780839820268.
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Davis, Lindsey Brooke. "Efficacy of Audiologic and Otologic Outcome Measures to Predict Middle Ear Status." Miami University / OhioLINK, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=miami1050962431.
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Weckwerth, Paulo Henrique. "Etiologia e susceptibilidade à drogas de microrganismos relacionados com a otite média crônica supurativa em pacientes portadores de fissura palatal /." Botucatu : [s.n.], 2002. http://hdl.handle.net/11449/89976.
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Orientador: Carlos Alberto de Magalhães Lopes<br>Resumo: A otite média crônica supurativa (OMCS) é uma condição comum em pacientes portadores de fissura palatal e lábio-palatal não reparada. Devido a uma anormalidade muscular, existe disfunção da tuba auditiva que, por sua vez, não equilibra a pressão diferencial do ar entre o ouvido médio e a nasofaringe, ocasionando acúmulo de fluidos na cavidade do ouvido médio. Amostras efusivas de OMCS de 40 pacientes portadores de fissura lábiopalatal matriculados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) - USP - Bauru - SP, foram analisadas através de culturas bacteriológicas, e as bactérias isoladas submetidas ao padrão de susceptibilidade in vitro frente a drogas de uso clínico. Culturas positivas foram obtidas em 100% dos casos estudados. Das 57 linhagens obtidas, foram isoladas com maior freqüência as bactérias Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%). A freqüência de bacilos Gram negativos (enterobactérias e não fermentadores da glicose) isolados foi de 67%. Frente à ciprofloxacina, a Pseudomonas aeruginosa apresentou melhor sensibilidade. Frente à gentamicina, as enterobactérias apresentaram melhor sensibilidade. As linhagens de Staphylococcus aureus e de Enterococcus faecalis mostraram melhor sensibilidade frente ao imipenem e sulfazotrim, respectivamente. Acreditamos que nossos dados possam contribuir para a escolha apropriada de antibióticos quando for considerado o tratamento não cirúrgico da OMCS em pacientes portadores de fissura lábio palatal.<br>Abstract: Chronic suppurative otitis media (CSOM) is a common condition in patients with unrepaired cleft palate and cleft lip palate. The muscular abnormality leads to auditive tube malfunction which it will not equilibrate the differential air pressure between the middle ear and the nasopharynx. Consequently, it increases the fluid in the middle ear cavity. Effusive samples of CSOM from 40 patients with clef palate and cleft lippalate of the HRAC-USP-Bauru-SP, were studied. After bacterial cultures, the bacteria were isolated and submitted, "in vitro", at standard susceptibility to drugs of clinical use. Positive cultures were obtained in 100% of studied cases. Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%) were the most frequent bacteria in 57 strains. Gram negative bacilli (enteric Gram negative bacilli and nonfermentative bacilli) were observed in 67% of the samples. Pseudomonas aeruginosa shown better sensitivity to ciprofloxacin, and the enteric Gram negative baciili to gentamicin. Moreover, the S. aureus and also the E. faecalis shown hight sensitivity to imipenem and trimethoprim/sulfamethoxazole, respectively. This data will contribute to the correct choice of the antibiotic in CSOM patients with cleft palate or clef lip-palate, which the nonsurgical management is the main therapy.<br>Mestre
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Knutsson, Johan. "Morphology and biochemistry of the tympanic membrane in relation to retraction pathology." Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-842-6/.
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Lemos, Isabel Cristina Cavalcanti. "Habilidade de atenção auditiva em crianças de sete anos com fissura labiopalatina: estudo comparativo." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-19062007-093450/.
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A fissura labiopalatina é um indicador de risco para alterações de orelha média e estas podem prejudicar o desenvolvimento de habilidades auditivas como, por exemplo, a atenção, que é essencial para o aprendizado de novas habilidades, inclusive da comunicação oral e escrita. O estudo do processo atencional na população com fissura labiopalatina é algo recente e pouco explorado na literatura específica consultada, assim, este trabalho poderá contribuir com novos subsídios na área, uma vez que teve como objetivos: a) verificar o desempenho de crianças com essa anomalia craniofacial em dois testes, o THAAS e o teste dicótico de dígitos (etapa de escuta direcionada, que avaliaram processos de atenção auditiva); b) comparar o resultado com um grupo sem fissura labiopalatina e; c) verificar a associação entre os dois testes aplicados. Fizeram parte do estudo 55 crianças, de ambos os gêneros, na faixa etária de 7 anos a 7 anos e 11 meses, que foram distribuídas em dois grupos: a) grupo controle, formado por crianças sem fissura labiopalatina; b) grupo experimental, formado por crianças com fissura labiopalatina. Para ambos os grupos, o processo de avaliação constituiu-se em: aplicação de um questionário; bateria de testes auditivos convencionais; aplicação do teste da habilidade de atenção auditiva (THAAS) (FENIMAN, 2004) e do teste dicótico de dígitos etapa de escuta direcionada (SANTOS; PEREIRA, 1997). Foi possível observar que o desempenho do grupo com fissura labiopalatina foi inferior ao do grupo controle em todos os tipos de resposta do THAAS e diferença estatisticamente significativa ocorreu para o decréscimo da vigilâ (p=0,014). No teste dicótico de dígitos - etapa de escuta direcionada, o grupo com fissura labiopalatina apresentou porcentagens de acerto inferiores ao grupo controle, tanto para a orelha direita quanto para a orelha esquerda. A análise estatística mostrou interação estatisticamente significante entre grupo e gênero (p=0,026). Ao comparar o THAAS com o teste dicótico de dígitos, foi possível observar que existe associação entre os testes, mas, essa associação mostrou-se muito baixa (R²=0,27). As crianças com fissura labiopalatina apresentaram desempenho no THAAS inferior àquelas sem esta anomalia craniofacial, apenas para o decréscimo da vigilância. No teste dicótico de dígitos - etapa de escuta direcionada, somente as crianças do gênero feminino com fissura labiopalatina obtiveram índices de acerto inferiores às do grupo controle. Uma baixa associação foi verificada entre o THAAS e o teste dicótico de dígitos - etapa de escuta direcionada, permitindo supor que habilidades diferentes são responsáveis pelo desempenho nos dois testes.<br>Cleft lip and palate indicates risk to alterations in the middle ear. These risks may impair the development of some hearing abilities, such as attention, which is essential to learn new abilities, including oral and written communication. Studies on attention process with the population with cleft lip and palate are recent and not widely found in literature. Therefore, this study can contribute to the area. The aims of this study were to examine children with this craniofacial anomaly through two tests: The SAAAT and the Dichotic Digit test - directed hearing stage which evaluated the hearing attention processes; to compare the results with a group without cleft lip and palate; to verify the association between the two tests. 55 children, both genders, aged 7 to 7 years and 11 months old were divided in two groups to be submitted to the study. Experimental group consisted of children with cleft lip and palate and Control group consisted of children without it. Both groups were assessed through a questionnaire, conventional hearing tests battery, the Sustained Auditory Attention Ability test (SAAAT) (Feniman, 2004), and the Dichotic Digit test - directed hearing stage (Santos; Pereira, 1997). Experimental group showed lower performance than the control group in all kinds of answers of the SAAAT and, significant difference regarding decrease in vigilance (p=0,014). In the Dichotic Digit test the experimental group showed lower percentages of right answers than the control group, not only for the right ear but also for the left ear. Statistic analysis showed significant interaction between group and gender (p=0,026). When compared, the SAAAT and the Dichotic digit test had low association (R²=0,27). Experimental Group presented lower performance in the SAAAT only at the vigilance decrease. At the Dichotic Digit test female children with cleft lip and palate presented lower scores of right answers than the Control group. The SAAAT and The Dichotic Digit test - directed hearing stage - were not closely associated. Thus, it is possible to assume that different abilities are responsible for the performance in both tests.
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Weckwerth, Paulo Henrique [UNESP]. "Etiologia e susceptibilidade à drogas de microrganismos relacionados com a otite média crônica supurativa em pacientes portadores de fissura palatal." Universidade Estadual Paulista (UNESP), 2002. http://hdl.handle.net/11449/89976.
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weckwerth_ph_me_botfm.pdf: 886368 bytes, checksum: d32499aa7e3a53d555dc67c5514625a9 (MD5)<br>Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)<br>A otite média crônica supurativa (OMCS) é uma condição comum em pacientes portadores de fissura palatal e lábio-palatal não reparada. Devido a uma anormalidade muscular, existe disfunção da tuba auditiva que, por sua vez, não equilibra a pressão diferencial do ar entre o ouvido médio e a nasofaringe, ocasionando acúmulo de fluidos na cavidade do ouvido médio. Amostras efusivas de OMCS de 40 pacientes portadores de fissura lábiopalatal matriculados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) – USP – Bauru - SP, foram analisadas através de culturas bacteriológicas, e as bactérias isoladas submetidas ao padrão de susceptibilidade in vitro frente a drogas de uso clínico. Culturas positivas foram obtidas em 100% dos casos estudados. Das 57 linhagens obtidas, foram isoladas com maior freqüência as bactérias Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%). A freqüência de bacilos Gram negativos (enterobactérias e não fermentadores da glicose) isolados foi de 67%. Frente à ciprofloxacina, a Pseudomonas aeruginosa apresentou melhor sensibilidade. Frente à gentamicina, as enterobactérias apresentaram melhor sensibilidade. As linhagens de Staphylococcus aureus e de Enterococcus faecalis mostraram melhor sensibilidade frente ao imipenem e sulfazotrim, respectivamente. Acreditamos que nossos dados possam contribuir para a escolha apropriada de antibióticos quando for considerado o tratamento não cirúrgico da OMCS em pacientes portadores de fissura lábio palatal.<br>Chronic suppurative otitis media (CSOM) is a common condition in patients with unrepaired cleft palate and cleft lip palate. The muscular abnormality leads to auditive tube malfunction which it will not equilibrate the differential air pressure between the middle ear and the nasopharynx. Consequently, it increases the fluid in the middle ear cavity. Effusive samples of CSOM from 40 patients with clef palate and cleft lippalate of the HRAC-USP-Bauru-SP, were studied. After bacterial cultures, the bacteria were isolated and submitted, “in vitro”, at standard susceptibility to drugs of clinical use. Positive cultures were obtained in 100% of studied cases. Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%) were the most frequent bacteria in 57 strains. Gram negative bacilli (enteric Gram negative bacilli and nonfermentative bacilli) were observed in 67% of the samples. Pseudomonas aeruginosa shown better sensitivity to ciprofloxacin, and the enteric Gram negative baciili to gentamicin. Moreover, the S. aureus and also the E. faecalis shown hight sensitivity to imipenem and trimethoprim/sulfamethoxazole, respectively. This data will contribute to the correct choice of the antibiotic in CSOM patients with cleft palate or clef lip-palate, which the nonsurgical management is the main therapy.
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Rosito, Leticia Petersen Schmidt. "Alterações histopatológicas na orelha contralateral em ossos temporais humanos de portadores de otite média crônica." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2006. http://hdl.handle.net/10183/11354.
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Introdução: A otite média crônica é definida pela presença de alterações inflamatórias teciduais irreversíveis na fenda auditiva. A teoria do continuum a respeito da sua patogênese sugere que as fases mais precoces da otite média, aguda, serosa ou secretora podem progredir para cronificação. Desta forma, pode-se supor que a grande prevalência de bilateralidade da otite média secretora também pode ser observada na otite crônica. Objetivo: determinar a prevalência de alterações na orelha contralateral em ossos temporais humanos de portadores de otite média crônica. Metodologia: Os ossos temporais humanos foram analisados sob microscopia óptica. Definiu-se como orelha contralateral a orelha normal ou menos comprometida. As alterações histopatológicas foram classificadas por ordem crescente de gravidade. Para comparação entre as variáveis qualitativas, utilizou-se o teste de Chi-quadrado, nas correlações o coeficiente de Spearman, sendo estatisticamente significativos P≤0,05. Resultados: Foram estudados 85 pares de ossos temporais, 22,4% com colesteatoma no lado mais comprometido. A prevalência de orelhas contra laterais com alterações foi de 91,8%, sendo as principais tecido de granulação (81%), efusão (58%) e retração da membrana timpânica (35%). Não houve diferença na prevalência de alterações significativas na orelha contralateral entre os gêneros, crianças e adultos, imunossuprimidos ou não e com ou sem colesteatoma na pior orelha. Houve correlação da extensão do tecido de granulação (rS=0,345, P=0,004) e do colesteatoma (rS=0,617, P<0,0001) entre as orelhas. Conclusão: Podemos observar alta prevalência de alterações orelha contralateral. A correlação entre a extensão tanto do tecido de granulação quanto do colesteatoma entre os dois lados, sugere, corroborando a hipótese do continnuum, que as alterações constitucionais do indivíduo podem estar implicadas na cascada de eventos que leva à cronificação e que isto pode ocorrer bilateralmente.<br>Objective: To determine the prevalence of contra lateral middle ear cleft pathologic findings in human temporal bones with chronic otitis media. Study design: Transversal Material and Methods: The humam temporal bones was analised under optical microscopy. Chronic otites media was definied by the presence of irreversible inflammatory alterations in the middle ear cleft. The contralateral ear was defined as the normal or the less alterated one. The histopathologic alterations were described and classified in a crescent severity order. To compare the quantitative variables it was used the Chi square test and for correlations it was used Sperman coefficient (P≤0.05) Results: It has been studied 85 pairs of temporal bones. 22.4% had cholesteatoma in the most damaged ear. The prevalence of contra lateral ears with alterations was 91.8%. The main alterations were granulation tissue (81%), effusion (58%) and tympanic membrane retractions (35%). There was not difference between the genders, adults and children, imunossupressed or not, with or without cholesteatoma. There was a direct correlation between the both ears in relation to granulation tissue (rS=0.345, P=0.004) or cholesteatoma extension (rs=0.617, P<0.001). Conclusion: We can observe a high prevalence of contralateral ears alterations and the granulation tissue was the most frequent. The correlation between the ears about the granulation tissue and cholesteatoma extension suggest, in agreement with the continuum, that the individual constitutional alterations are involved in the sequential events that go to cronification.
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Braga, Maria Elisa Luce. "Perfil audiométrico da otite média crônica : análise de 745 orelhas." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/108327.
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Dentre as doenças infecciosas que causam algum grau de comprometimento auditivo, a otite média é a mais prevalente. Esta é a patologia que mais frequentemente leva crianças ao atendimento médico. Quando não tratada adequadamente, suas complicações e sequelas podem persistir até a idade adulta, tornando-se crônica. Objetivo: comparar a perda auditiva resultante da Otite Média Crônica Supurativa (OMCS) colesteatomatosa e não colesteatomatosa entre crianças e adultos; comparar os valores de via aérea nas frequências de 250 a 8000Hz, entre crianças e adultos com OMCNC e OMCC; comparar os valores de via óssea nas frequências de 500 a 4000 Hz, entre crianças e adultos com OMCNC e OMCC; comparar os valores de gap aéreo-ósseos, nas frequências de 500 à 4000Hz, entre crianças e adultos com OMCNC e OMCC. Método: estudo transversal, observacional, comparativo e contemporâneo, com dados subindividuais (orelhas), tendo como sujeitos em estudo crianças e adultos com diagnóstico de OMCC ou OMCNC. Resultados e conclusões: os limiares de VA nas OMCNC nas frequências de 250 a 8000 Hz apresentaram-se significativamente menores nos pacientes pediátricos. No grupo de adultos, não houve diferença significativa nos limiares auditivos de VA. Os limiares de VO nas frequências de 500 a 4000 Hz apresentaram-se igualmente maiores no grupo dos adultos. No grupo pediátrico, não se observou diferença estatisticamente significativa entre os valores de VO. No grupo de crianças com OMCNC, os valores dos gap aéreo-ósseos nas frequências de 500 e 1000 Hz foram significativamente menores. Nos demais grupos, independentemente da faixa etária e do diagnóstico de OMCS, não foram encontradas diferenças estatisticamente significativas em nenhuma frequência testada entre os gap aéreo-ósseos. Considerando-se que o tempo de sintoma entre os adultos é maior, os resultados sugerem maior agressividade da OMCC entre as crianças em termos auditivos.<br>Among the infectious diseases that causes some degree of hearing loss, otitis media is the most predominant. This is the pathology that most often leads children to medical care and, if not treated properly, complications and sequels may persist into adulthood. Objective: Compare the values of air conduction thresholds (at frequencies from 250 to 8000Hz), bone conduction thresholds and air bone gap ( at frequencies from 500 to 4000Hz) among children and adults with Chronic suppurative otitis media (CSOM) with cholesteatoma (CCOM) and without cholesteatoma (NCCOM). Methods: Cross-sectional study, with 525 children and adults diagnosed with CCOM or NCCOM, submitted to pure tone audiometry. Results and Conclusions: The air conduction thresholds at frequencies of 250 to 8000 Hz were significantly lower in pediatric patients with NCCOM . Between adult groups, there was no significant difference in hearing in air bone threshold. The bone conduction thresholds at 500 to 4000 Hz were also higher in both adult groups. Between pediatric groups no statistically significant difference in bone conduction thresholds was observed. In the group of children with NCCOM values of air-bone gap at 500 and 1000 Hz were significantly lower. In the other groups, regardless of age and diagnosis of CSOM, no statistically significant differences were found in any frequency tested between the air-bone gap. Considering that the time of symptom among adults is higher, the results could suggest a more aggressive CCOM among children in hearing terms.
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Eriksson, Charlotte, and Britt Linnå. "Flaskmatning och andra faktorer som påverkar mellanörats miljö hos barn : -Stödjande hälsoundervisning till närstående." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-33440.
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Introduktion: Sekretorisk media otit (SOM) är den vanligaste öronsjukdomen och uppkommer oftast i efterförloppet till akut media otit (AOM). Om barnet får SOM leder det till hörselnedsättning som kan påverka språklig utveckling och ge beteendeproblem. Etiologin bakom SOM anses vara multifaktoriell. Barnets tryck i mellanörat kan påverkas vid flaskmatning. Allergier, bakteriella/virus infektioner och inflammationer har också betydelse för utvecklandet av SOM. Syfte: att studera frekvensen av att använda nappflaska och liggande position vid flaskmatning relaterat till sekretorisk media otit och akut media otit i samband med rörbehandling. Metod: En deskriptiv tvärsnittsstudie med kvantitativ ansats. Datainsamling skedde via enkäter som besvarades av närstående till barn 2- 5 år som genomgått rörinsättning på öronoperation. Resultat: 103 barn med närstående deltog i studien. 87% av barnen som genomgick rörinsättning använde eller hade använt nappflaska och av dessa barn låg 55% i planläge. Hereditet gällande SOM kunde skönjas. Konklusion: Studien visade hög frekvens av flaskmatning där lite mer än hälften, 55% låg i planläge men studiens begränsning kunde inte åskådligöra samband med planläge och SOM. Det är av vikt att belysa faktorer som har betydelse för utveckling av SOM för att minska behov av rörbehandling. Dessa faktorer kan sjuksköterskan informera närstående om via hälsoundervisning för att öka barn och närståendes empowerment.<br>Introduction: Otitis Media with Effusion (OME) is the most common ear disease and arises mostly in the end of akut media otit (AOM). If a child contracts OME, it will result in a hearing loss which can affect the verbal development and may lead to behavior difficulties. The etiology behind OME is considered to be multifactorial. A child’s middle ear pressure may be affected by bottle nursing. Furthermore, the development of OME may be caused by allergies, bacterial/virus infections and inflammations. Purpose: To study the frequency of using a feeding bottle while the child is lying down related to OME and AOM when tube insertion. Method: A descriptive cross-sectional study with a quantitative approach. A survey data collection was used wherein the people who were surveyed were close family to two to five year old children, who have had ear tubes inserted. Result: 103 children with their close family participated in the study. 90% of these children who went through an ear tube insertion used or had used a feeding bottle and 50% of them lied down as they were fed. The heredity regarding SOM could be picked out. Conclusion: The study showed a high frequency of bottle nursing where just over the half (55%) lied down, but the restriction of the study could however not visualize the relation between lying down and SOM. Moreover, it is important to bring up the factors that are significant for the development of SOM to decrease the need of ear tube treatment/insertion. The nurse can inform close family about these factors through health education in order to increase children and close family´s empowerment.
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Villa, Priscila Cruvinel. "Habilidades auditivas verbais e temporais em crianças de 6 a 10 anos com e sem episódios comprovados de perda auditiva condutiva flutuante recorrente, nos primeiros anos de vida." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/17/17151/tde-19032014-100632/.
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A otite média, afecção comum na infância, acarreta uma perda auditiva condutiva flutuante, pois uma vez tratada os limiares auditivos voltam aos valores normais. Preocupação ocorre quando estes episódios tornam-se recorrentes levando a criança a receber uma estimulação sonora inconsistente do sistema nervoso auditivo central, dificultando a percepção dos sons da fala. O objetivo do presente estudo foi investigar se crianças com episódios recorrentes e comprovados de otite média com efusão apresentam alterações das habilidades auditivas que compõe o processamento auditivo. Foram avaliadas 59 crianças com idade entre 6 e 10 anos, divididas em dois grupos: grupo experimental composto por 29 crianças de ambos os gêneros com histórico documentado de otite media com efusão, perda auditiva condutiva nos primeiros anos de vida e com e sem história de cirurgia para colocação de tubo de ventilação na idade pré-escolar e escolar; e grupo controle, composto por 30 crianças, pareadas em idade e gênero com o grupo experimental, mas sem história da afecção. Na avaliação das habilidades auditivas que compõe o processamento auditivo foram utilizados o teste fala com ruído (TFR), teste dicótico de dígitos (TDD) e teste Gaps-in-noise (GIN). Todas as crianças no momento da avaliação estavam livres de perda auditiva condutiva. Os resultados mostraram que: os dois grupos não apresentavam diferenças dos limiares tonais, no momento da avaliação; o grupo experimental apresentou resultados inferiores no TFR e GIN, tanto na análise quantitativa quanto na qualitativa; o TDD apenas na análise qualitativa diferenciou os dois grupos. Pode-se concluir, no presente estudo, , que crianças com história de otite média com efusão recorrente e persistente, nas fases pré-escolar e escolar, apresentaram transtorno do processamento auditivo.<br>Otitis media, a common affection in childhood, causes a fluctuating conductive hearing loss, because once treated the hearing thresholds back to normal values. Concern occurs when these episodes become recurring leading the child to receive an inconsistent sound stimulation auditory central nervous system, it difficult for the perception of speech sounds. The aim of this study was to investigate whether children with recurrent episodes of proven otitis media with effusion present alterations of auditory skills that composes the auditory processing. We evaluated 59 children with ages between 6 and 10 years, divided into two groups: the experimental group comprised of 29 children of both genders with documented history of otitis media with effusion, conductive hearing loss in the early years of life and with and without history of surgery for ventilation tube placement in preschool and school age; and the control group, consisting of 30 children, paired in age and gender with the experimental group, but no history of the disease. In the assessment of auditory skills that make up the auditory processing was used Speech in Noise Test (SNT), Dichotic Digits Test (DDT) and Gaps in Noise test (GIN). All children had at the time of assessment were free of conductive hearing loss. The results showed that: the two groups showed no differences in tonal thresholds, at the time of the assessment; the experimental group showed results below the SNT and GIN, both in qualitative and in quantitative analysis; DDT only in qualitative analysis differentiated the two groups. It can be concluded, with the results of the work, that children with a history of otitis media with effusion recurrent and persistent, pre-school and school phases, may have auditory processing disorder.
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Pereira, Maria Beatriz Rotta. "Determinação de prevalência de bactérias na efusão da orelha média de crianças submetidas à mmiringotomia." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2003. http://hdl.handle.net/10183/2907.
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Introdução: A etiologia da otite média com efusão ainda não está completamente estabelecida, mas agentes infecciosos podem contribuir para sua patogênese. Demonstrou-se que a reação em cadeia da polimerase (PCR) é superior ao exame cultural para detectar espécies bacterianas. O conhecimento sobre a epidemiologia bacteriana da otite média com efusão em áreas geográficas distintas é essencial para a implementação de tratamentos racionais, quando necessários. Objetivos: Determinar a prevalência do Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis e Alloiococcus otitidis nas efusões de orelha média de crianças com otite média recorrente e otite média com efusão crônica que foram submetidas à miringotomia, comparar os resultados obtidos por cultura e PCR, comparar os achados bacteriológicos em crianças menores e maiores de dois anos e determinar o perfil de resistência à penicilina dos germes isolados. Métodos: Analisaram-se 128 amostras de efusões de orelha média de 75 crianças entre 11 meses e 9 anos e 4 meses de idade (média = 34,7 meses). Pacientes com otite média recorrente tinham efusão documentada por ≥ 6 semanas e aqueles com otite média com efusão crônica, por ≥3 meses. Os pacientes não tinham sinais de otite média aguda ou infecção do trato respiratório e não estavam sob antibioticoterapia no momento do procedimento. A aspiração do material foi realizada por timpanocentese, utilizando-se um coletor de Alden-Senturia. Os estudos bacteriológicos foram iniciados em menos de 15 minutos após a obtenção da efusão e uma parte da amostra foi armazenada a -20oC para análise posterior pela PCR. Utilizou-se um método de PCR simultânea para a detecção de quatro patógenos. A análise estatística foi efetivada com o teste χ2 de McNemar, teste χ2 com correção de Yates e teste exato de Fisher, quando apropriados. Resultados: Cultivaram-se bactérias em 32 (25,1%) das 128 amostras e os patógenos principais foram encontrados em 25 (19,6%). O A. otitidis não foi isolado em cultura. A PCR identificou bactérias em 110 (85,9%) das amostras, e os resultados positivos foram: 67 (52,3%) para A. otitidis, 50 (39,1%) para H. influenzae, 16 (12,5%) para S. pneumoniae e 13 (10,2%) para M. catarrhalis. Todas as amostras positivas por cultura foram positivas pela PCR, mas 85 (77,2%) das efusões com resultado positivo pela PCR foram negativas por cultura, para os germes estudados. A PCR foi significativamente mais sensível que a cultura (P<0,001). O S. pneumoniae foi encontrado mais freqüentemente em otite média recorrente do que em otite média com efusão crônica (P=0,038) e o H. influenzae foi encontrado mais vezes em crianças menores de dois anos (P=0,049). Quanto ao perfil de resistência, 100% das M. catarrhalis, 62,5% dos S. pneumoniae e 23% dos H. influenzae eram resistentes à penicilina. Conclusões: A prevalência das bactérias na otite média com efusão em um grupo de crianças brasileiras é semelhante àquelas relatadas em outros países, sendo o H. influenzae o mais encontrado dentre os patógenos principais da orelha média. Essa prevalência sugere que bactérias podem desempenhar um papel na patogênese da otite média com efusão. Os resultados mostram que a PCR é mais sensível na detecção de bactérias na efusão da orelha média, comparada com cultura, e é essencial para a identificação do A. otitidis. O elevado percentual de detecção do A. otitidis sugere mais investigações sobre sua atuação no início e no prolongamento de doenças da orelha média. O S. pneumoniae foi mais freqüente em otite média recorrente do que em otite média com efusão crônica e o H. influenzae foi mais encontrado em crianças menores de dois anos. A resistência à penicilina por parte do pneumococo e da moraxela é semelhante à relatada em outros países, ao passo que a produção de β-lactamase pelo hemófilo é mais baixa que aquela referida em bactérias isoladas em amostras de efusões de otite média com efusão.<br>Background: The etiology of otitis media with effusion is still unclear but infective agents may contribute to its pathogenesis. Polymerase chain reaction (PCR) has been shown to have a superior ability in detecting bacterial species, when compared to conventional culture methods. The knowledge of the bacteriological epidemiology of otitis media with effusion in different geographical areas is crucial for the implementation of rational treatment in selected cases. Objectives: To determine the prevalence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Alloiococcus otitidis in the middle ear effusion of children with recurrent otitis media and chronic otitis media with effusion undergoing miryngotomy, to compare the results obtained by culture and PCR, to compare the bacteriological findings in children younger and older than two years of age, and to determine the susceptibility to penicillin of the bacterial isolates. Methods: A total of 128 middle ear effusion samples from 75 children aged 11 months to 9 years and 4 months (mean = 34.7 months) were analyzed. Patients with recurrent otitis media had documented middle ear effusion for ≥ 6 weeks, and chronic otitis media with effusion for ≥ 3 months. Patients had no signs of acute otitis media or respiratory tract infection and were not on antibiotics. Aspiration was done through tympanocentesis with an Alden-Senturia trap. Bacteriological studies were initiated in less than 15 minutes after acquisition of the effusion and a part of the sample was stored frozen at -20oC for latter PCR analysis. Multiplex PCR methods for the detection of four pathogens were used. Statistical analyses were done using McNemar´s χ2 test, χ2 test with Yates’ correction, and Fisher’s exact test, when appropriate. Results: Bacteria were cultured in 32 (25.1%) of the 128 samples and the major pathogens were found in 25 (19.6%). A. otitidis was not detected by culture. PCR yielded positive for bacteria in 110 (85.9%) of the samples and these positive PCR results were: 67 (52.3%) for A. otitidis, 50 (39.1%) for H. influenzae, 16 (12.5%) for S. pneumoniae, and 13 (10.2%) for M. catarrhalis. All the culture-positive samples were PCR-positive but 85 (77.2%) of the PCR-positive specimens were culture-negative. PCR was significantly more sensitive than culture (P<0.01). S. pneumoniae was more frequently found in samples from recurrent otitis media when compared to chronic otitis media with effusion (P=0.038) and H. influenzae was more prevalent in children younger than two years when compared to the older group (P=0.049). The resistance to penicillin was: M. catarrhalis = 100%; S. pneumoniae = 62.5% and H. influenzae = 23% of the isolates. Conclusions: The prevalence of bacteria in otitis media with effusion in a group of Brazilian children is similar to that reported from other countries, and H. influenzae is the most frequently found microorganism among the main middle ear pathogens. This prevalence suggests that bacteria may play a role in the pathogenesis of otitis media with effusion. Also PCR is more sensitive in detecting bacteria in the middle ear effusion, compared to conventional culture methods, and is essential for the detection of A. otitidis. The high recovery rate of A. otitidis warrants further investigation of its role in initiating or prolonging middle ear disease. S. pneumoniae was more frequently found in recurrent otitis media compared to chronic otitis media with effusion and H. influenzae was more prevalent in children younger than two years of age. Pneumococcal and moraxella´s resistance to penicillin is similar to but hemophillus’ β-lactamase production is lower than that reported from other countries when bacteria isolated from middle ear effusion samples of otitis media with effusion were analyzed.
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Pohl, Friederike [Verfasser]. "Stenting of the Tuba auditiva Eustachii as a valid treatment concept in chronic otitis media, chroinic auditory tube dysfunction and ists sequelae : implementation of a large animal model / Friederike Pohl." Hannover : Bibliothek der Tierärztlichen Hochschule Hannover, 2016. http://d-nb.info/1125396989/34.
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Silva, Denis Lessa da. "Estudo da orelha contralateral na otite média crônica : avaliação auditiva." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/67520.
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Uma das condições mais comuns responsável pela perda auditiva durante a infância é a Otite Média (OM). A OM ainda é considerada “questão de saúde pública” devido à sua alta prevalência e distribuição mundial. Há poucos estudos na literatura que relatam as alterações na orelha contralateral (OCL) em pacientes com otite média crônica (OMC). Para enfatizar esses conceitos e analisar com mais profundidade a prevalência de bilateralidade na OMC, há vários anos iniciamos uma linha de pesquisa, focalizando três cenários diferentes: a histopatologia (ROSITO, COSTA, SCHARCHEN, 2007); o padrão clínico e otoscópico (COSTA et al., 2008) e a fisiologia (função auditiva) no presente estudo. Objetivo: Avaliar a função auditiva da OCL em pacientes com OMC através do gap aéreo-ósseo. Comparar os dados audiométricos da OCL levando em conta se o paciente apresenta Otite Média Crônica não Colesteatomatosa (OMCNC) ou Otite Média Crônica Colesteatomatosa (OMCC) na orelha principal (OP). Métodos: Estudo transversal, comparativo e contemporâneo, com 1000 pacientes com diagnóstico de OMC submetidos a exame otorrinolaringológico, videotoscopia e audiometria tonal liminar (ATL). Resultados: A prevalência de gap aéreo-ósseo foi de aproximadamente 40%, tanto na amostra total e na análise estratifica por tipo de OM (na amostra geral houve 392 (39,2%) pacientes, no grupo com OMCNC houve 279 (40,8%), e no grupo com OMCC foram 113 (37,17%). Conclusões: Assim como os achados de estudos clínicos e histopatológicos, a prevalência de alterações audiológicas na OCL foi elevada, evidenciando o caráter bilateral na OMC.<br>Otitis media (OM) is one of the leading causes of hearing loss in childhood. Due to its high prevalence and worldwide distribution, OM is still regarded as a public health issue. Nevertheless, few studies have assessed involvement of the contralateral ear (CLE) in patients with chronic otitis media (COM). To demonstrate the bilateral nature of COM, we designed three distinct studies, which focused on histopathology and anatomy, clinical findings and physiology (both previously published), and, finally, auditory function. Objective: To measure auditory function in the CLE in a sample of COM patients by means of air-conduction thresholds, bone-conduction thresholds, and the air-bone gap, and to compare CLE audiometry findings in patients with non-cholesteatomatous (NC-COM) or cholesteatomatous chronic otitis media (CCOM). Methods: This was a cross-sectional, contemporary and comparative study of 1000 patients with a diagnosis of COM. Clinical ear examination, video otoscopy, and pure-tone audiometry (PTA) were performed. Results: The overall prevalence rate of air-bone gap was approximately 40%, both in the total sample and after stratification by type of OM (393 [39.2%] patients overall, 279 [40.3%] in the NC-COM group, 113 [37.17%] in the CCOM group). Conclusions: As did clinical and histopathology findings in previous studies, audiological evaluation revealed a substantial prevalence of CLE involvement, providing evidence of the bilateral nature of COM.
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Berling, Holm Katarina. "The Chorda Tympani Nerve : Role in Taste Impairment in Middle Ear Disease and after Ear Surgery." Doctoral thesis, Uppsala universitet, Centrum för klinisk forskning, Västerås, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-316591.
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The chorda tympani nerve, also known as the taste nerve, runs uncovered through the middle ear cavity, a localization that exposes the nerve to pathological processes and surgical trauma in the middle ear. People operated on for otosclerosis tend to complain more about postoperative taste disturbances than those operated on for chronic otitis media. It has been suggested that this difference may be explained by gradual deterioration of chorda tympani nerve function caused by chronic otitis media infection and that further impairment caused by surgery is less noticeable in these patients. This thesis aimed to evaluate the function of the chorda tympani nerve, the effects of middle ear disease on taste and complications resulting from ear surgery for chronic otitis media or otosclerosis. This information will help to improve the ear surgeon’s ability to predict the prognosis of iatrogenic taste disturbances in patients with middle ear disease and after ear surgery. Taste was assessed using electrogustometry and the filter paper disc method before and after surgery for chronic otitis media or otosclerosis. Patients also completed questionnaires about symptoms and quality of life. The status of the chorda tympani nerve upon surgical opening of the ear and grading of the trauma to the nerve during the surgery were recorded. The ultrastructure of the chorda tympani nerve from healthy ears and from ears with chronic otitis media was examined. Electrogustometry and the filter paper disc method were evaluated. The results of electrogustometry and the filter paper disc method were highly reproducible, although their correlation was moderate. Patients with chronic otitis media, patients with a more traumatized nerve, female patients and younger patients were more likely to report postoperative taste disturbances. Most of the patients recovered their taste after 1 year. The quality of life study showed only minor changes after surgery. Electron microscopic observations of nerves from ears with chronic otitis media showed signs of structural degeneration, although signs of regeneration, such as sprouting were also observed. This results may explain the recovery of taste postoperatively and indicate that the nerve should be carefully handled during surgery.
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Subtil, João Eduardo Castro Campos Brito. "Postoperative cares after tympanostomy tubes for chronic otitis media with effusion." Doctoral thesis, 2019. http://hdl.handle.net/10362/60499.
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A pedido do Autor o conteúdo publicado em revistas com reserva de direitos<br>ABSTRACT: Tympanostomy tube insertion is the second most common surgery in children, and is mostly indicated for recurrent otitis media, or for chronic otitis media with effusion (OME). Almost every surgeon prescribes water precautions after surgery because of fear of water causing middle ear inflammation. These precautions include at least wearing ear plugs and head bands while swimming, showering or bathing.
However, the evidence for such pleas has been questioned. Some authors, weighting also the impact on quality of life, economic burden, and the weak evidence of benefice from such precautions, have been dropping these measures.
We proposed to evaluate how deep must one submerge the head to allow water passing through the tube in the tympanic membrane; to evaluate whether such precautions have relevant effect on quality of life; and whether there is any difference between prescribing water precautions or not.
Using a computerized fluid dynamics model, we found that on reasonable depths and common conditions, water is not passing the ventilation tube. With this model we determined that including the auditory (pharyngotympanic) tube mechanism in the model is critical. Secondarily, we also learned, using the model, that on surface conditions, increasing the external auditory canal (external acoustic meatus) pressure pushes the liquids on the external auditory canal through the tube, and this is enlightening to the understanding of topical therapy with ear drops.
With a randomized controlled trial, we compared two groups with and without protection when exposed to water, and found that children with OME operated with ventilation tube insertion improved their global quality of life. This improvement is significant, irrespective of the season of surgery, water activities frequency, or gender. It is also significant whether water protection is prescribed or not, and both groups (with and without protection) improved quality of life significantly after surgery, and with no observed statistical difference, meaning no impact from protection cares.
Also, from this randomized controlled trial, we did not observe a difference in the prevalence of otorrhea after myringotomy with tubes for otitis media with effusion when prescribing or not water protection. And otorrhea incidence shows no apparent association with water exposure in our study population, but it does so with upper respiratory tract infection.
These results support the recent guidelines from the American Academy of Otorhinolaryngology, which discourages the routine use of water protections in children with tympanostomy tubes.
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Philips, Margeaux. "The role of chiropractic manipulative therapy in the treatment of chronic/persistent Otitis media with effusion in children." Thesis, 2009. http://hdl.handle.net/10210/2647.
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"Otitis media with effusion in Chinese pre-school and school children in Hong Kong: is the disease different from that in the West?" 2000. http://library.cuhk.edu.hk/record=b6073230.
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by Michael Chi Fai Tong.<br>"Revised March 2000."<br>Thesis (M.D.)--Chinese University of Hong Kong, 2000.<br>Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.<br>Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.<br>Mode of access: World Wide Web.
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Ashhurst-Smith, Christopher I. J. "The role of Alloiococcus otitidis in otitis media." Thesis, 2011. http://hdl.handle.net/1959.13/927978.
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Research Doctorate - Doctor of Philosophy (PhD)<br>Ear infections are a major problem worldwide. In 1995, the annual cost of medical and surgical treatment of otitis media (OM) in the United States was estimated between US$3-4 billion. These infections are a particular problem among Indigenous Australians and lead to problems of hearing loss, impairment of learning, development of speech, and social skills. An epidemiological study of microorganisms present in middle ear effusions of Indigenous and non-Indigenous children with otitis media with effusion (OME) found the major isolate was a rarely isolated species, Alloiococcus otitidis. This collection of isolates (n = 39) provided a unique opportunity to: characterise this “new” pathogen; determine if current routine diagnostic techniques were sufficient to identify A. otitidis; assess antibiotic susceptibilities; determine if it really is “fastidious” and difficult to isolate; assess potential virulence in a model system employing the human monocytic cell line THP-1. This is the first report of A. otitidis in an Australian population. It is the first description of different phenotypes of this species. It refuted the dogma that the organism is fastidious. It assessed the largest number of isolates to date for antibiotic susceptibilities and found a significant proportion (>33%) resistant to macrolide antibiotics. Slow growth of the organism and presence of β-lactamase producing otopathogens (with which it is often identified in ear effusions by molecular methods) might allow it to survive routine antibiotic treatment for ear infections. In contrast to previous reports using type culture collection isolates, the study provided the only assessment of induction of pro-inflammatory cytokines using recent clinical isolates. The findings have implications for future research on the role of A. otitidis in the aetiology of both acute and chronic otitis media; it also has implications for diagnostic microbiology, appropriate treatment of these infections, and development of vaccines against this species.
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Tseng, Yi-Ju, and 曾憶如. "The Rationality of Prescription Patterns on Simple Otitis Media with effusion among Children." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/25246142105349909290.
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碩士<br>國立陽明大學<br>衛生福利研究所<br>93<br>Objectives: The 2004 clinical practice guideline on otitis media with effusion(OME), first developed by Agency for Healthcare Policy and Research (AHPR), and updated by American Academy of Pediatrics, American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery on May, 2004. “Manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if know), or from the date of diagnosis (if onset if unknown).” It also suggested that antihistamines and decongestants are ineffective for OME and should not be used for treatment; antimicrobials and corticosteroids do not have long-term efficacy and should not be used for routine management. The objectives of this study were to understand the prescription pattern of children with simple OME and identify the factors contributing to the inappropriate prescribing. This study particularly focused on the use of antibacterials, corticosteroids, antihistamines, decongestants.
Methods: The data of this study was based on outpatient claim database in 2002 from BNHI (Bureau of National Health Insurance). The study subjects were 5,869 children with simple OME who were under 12 years old during January to December of 2002.
Results: There were 76.60% of inappropriate prescriptions out of the total prescription according to the criteria established for this study. It is most likely to happen among patients aged 7-12 years old, male patients, and the physician aged 41-45 years old, ENT specialty, and primary care clinics. The top three drug categories according to ATC are antihistamine for systemic use, antibacterials for systemic use and cough and cold preparations. Logistic regression analysis indicate significant attributing factors of odds ratio by doctors’ age group of 41-45 (OR 0.690, 95% CI 0.573-0.830), pediatrics specialty (OR 1.489, 95% CI 1.173-1.891), academic medical center(OR 0.185, 95% CI 0.155-0.221), metropolitan hospital (OR 0.198, 95% CI 0.163-0.240), and local community hospital(OR 0.266, 95% CI 0.193-0.368).
Conclusion: The treatment of simple OME among children in Taiwan has certain discrepancy to that recommended by corresponding American professional societies. We suggest the responsible government agency should establish a Taiwanese version of OME clinical practice guideline, and to encourage hospitals to endeavor the auditing of irrational prescription patterns. Future studies could be conducted by reviewing medical records or questionnaire interview to identify the reasons and the group that is subject to higher risk.
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Ramada, Ana Beatriz Brites. "Risk factors of otitis media with effusion on children in a portuguese population." Master's thesis, 2018. https://hdl.handle.net/10216/114045.
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Ramada, Ana Beatriz Brites. "Risk factors of otitis media with effusion on children in a portuguese population." Dissertação, 2018. https://hdl.handle.net/10216/114045.
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Lee, So Yoon. "Clinical approaches for understanding the expression levels of pattern recognition receptors in otitis media with effusion." Thesis, 2013. https://hdl.handle.net/2144/17154.
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OBJECTIVES: Bacterial infections in the normally sterile environment of the middle ear cavity
usually trigger host immune response, whereby the innate immune system plays
a dominant role as the host’s first line of defense. In this study we evaluated the
expression levels of Toll-like receptors (TLRs) -2, -4, -5, -9, and nucleotidebinding
oligomerization domain-containing proteins (NODs) -1 and -2, all of which
are related to bacterial infection in pediatric patients with otitis media with
effusion (OME).
METHODS: The study sample consisted of 46 pediatric patients with OME, all of whom had
ventilation tubes inserted. The expression levels of TLR-2, -4, -5, -9, NOD-1 and
-2 mRNA in middle ear effusion were assessed by polymerase chain reaction.
RESULTS: All effusion fluid samples collected from patients with OME showed expression of
TLR-2, -4, -5, -9, NOD-1, and -2 mRNA. However, we found no correlations
among expression levels of pattern recognition receptors (PRRs) in relation to
characteristics of exudates, presence of bacteria, or frequencies of ventilation
tube insertion (p>0.05).
CONCLUSION: Our findings suggest that exudates of OME patients show PRR expressions that
are related to the innate immune response regardless of the characteristics of
effusion fluid, presence of bacteria in exudates, or frequency of ventilation tube
insertion.