Biomedical subjects

C D Bluestone

Publications and source records attributed to C D Bluestone.

225 records · Page 13Linked to original sources

PubMedDate not supplied

Effect of a topical nasal decongestant on Eustachian tube function in children with tympanostomy tubes.

The effect of a topical nasal decongestant spray on Eustachian tube function was evaluated in 40 children with tympanostomy tubes. Five parameters of tubal function were assessed employing a modified inflation-deflation test and forced response test before and after spraying the nose with either oxymetazoline hydrochloride or a placebo according to a randomized double-blind study design. The results showed no significant differences between the two treatment groups. However, all the children in the study group had severe functional tubal dysfunction, as documented by the increased resistance of the Eustachian tube during swallowing. It is possible that efficacy may be shown in subjects with less severe dysfunction of the Eustachian tube than these involved in this study. It was concluded that further studies of the efficacy of topical decongestants for secretory otitis media and related conditions of Eustachian tube dysfunction are warranted to justify the widespread use of these medications.

Adolescent↗

PubMedDate not supplied

Experimental paralysis of tensor veli palatini muscle.

In an effort to study the effects of experimental paralysis of tensor veli palatini (TVP) muscle on Eustachian tube (ET) function and middle-ear (ME) status, botulinum toxin A (Oculinum) was injected into the TVP muscles of 8 Rhesus monkeys. Tubal function was tested longitudinally in 2 animals with tympanostomy tubes using the forced-response test, while in the remaining 6 animals; ME condition was documented daily using tympanometry. The postinjection tubal function was characterized by abolished active muscular function and decreased closing pressure. Activity associated with tubal dilations gradually reappeared by the fifth week. The lack of lumen constrictions following injection suggested that the TVP muscle is the cause of constriction as well as normal dilation. In 6 animals with intact tympanic membranes, 10 of the 12 ears developed flat tympanograms associated with otitis media with effusion (OME) within 8-30 days of injection and serous effusions were recovered by tympanocentesis in seven ears. These results show that a non-traumatic reversible functional obstruction of the ET was created by injecting botulinum toxin A into the TVP muscle. This functional obstruction was associated with the development of high negative ME pressure and serous effusion.

Acoustic Impedance Tests↗

PubMedDate not supplied

Bacteriology of acute otitis media in adults.

OBJECTIVE: --The objective of this study was to determine the bacteriology of acute otitis media in adults. Although this has frequently been studied in children, no data have recently been reported from adults in the United States. Additionally, information on the prevalence of Haemophilus influenzae as a causative organism in acute otitis media in adults has not been available. DESIGN: --Middle-ear aspirates for cultures were obtained by myringotomy from adults meeting entry criteria. SETTING: --Emergency department, Eye and Ear Hospital of Pittsburgh, Pa. PATIENTS: --Thirty-four patients (volunteer sample) met the eligibility requirements. Exclusion criteria included history of chronic otitis media, recent antibiotic therapy, immunosuppressive illnesses, or prior otologic surgery. INTERVENTION: --Ten days of oral cefuroxime axetil (250 mg) was prescribed. MAIN OUTCOME MEASURES: --Patients were followed closely for at least 6 weeks. Aerobic and anaerobic cultures were incubated and evaluated per the scheduled protocol. RESULTS: --Haemophilus influenzae and Streptococcus pneumoniae were grown on culture of specimens from nine and seven patients (26% and 21%), respectively. Twenty-two percent (2/9) of the H influenzae isolates and the single isolate of Moraxella catarrhalis produced beta-lactamase (9% overall). CONCLUSIONS: --The present results suggest that, as in children, amoxicillin would be an appropriate first-line agent for empiric therapy of acute otitis media in adults. Antimicrobials inactive against H influenzae (eg, penicillin V, cephalexin, erythromycin, or tetracyclines) are not appropriate for initial therapy. Antimicrobials with efficacy against organisms producing beta-lactamase, such as cefuroxime axetil, which was used to treat the study patients, do not appear to be required for routine initial therapy in adults. However, they would be appropriate when an organism producing beta-lactamase is isolated from the middle ear or when a patient fails to improve rapidly on amoxicillin therapy.

Acute Disease↗

PubMedDate not supplied