Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Otoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed2004

[Comparison of prevalence rates of secretory otitis media in Hong Kong Chinese children with western populations].

OBJECTIVE: To investigate the prevalence rate of secretory otitis media (SOM) in Hong Kong Chinese children and further compare the results with the western studies. METHODS: From 1995 to 1998, primary schools, kindergartens and nurseries were selected by stratified randomization in Hong Kong of China. Six thousand eight hundred and seventy-two children of age 2 to 7 were examined on-site in the school premises by the otolaryngologist and audiologist with otoscope and tympanometry respectively. In order to achieve standardization comparisons, our raw data were retrieved and the prevalence rates were recalculated according to the various diagnostic criteria set by the western studies. RESULTS: The prevalence of SOM in the age-groups 2-3, 4-5 and 6-7 of the present study ranged from 5.2% to 21.6% if criteria were set to clinical otoscopic findings and ranged from 7.3% to 30.7% if criteria were based on tympanometric findings. The variations in the diagnostic criteria with tympanometric findings also lead to a deviation of prevalence rates with the same set of data. Regardless of the criteria set for investigations, there are no significant differences between our findings and those of the western studies with the same age groups. Prevalence rates decrease as age increases. CONCLUSIONS: The prevalence rates of SOM in Chinese children of age 2-3, 4-5 and 6-7 in Hong Kong are not significantly different from those reported in the literature of the West.

Acoustic Impedance Tests↗
PubMed2004

[The effect of the lesion in tympanic ostium on the disfunction of Eustachian tube in patients with chronic otitis media].

OBJECTIVE: To explore the relation of tympanic ostium of Eustachian tube and Eustachian tube dysfunction in chronic otitis media. METHOD: Tympanic ostium of Eustachian tube was observed by tele-otoscope and the active and passive function of Eustachian tube were detected in 44 case of chronic otitis media (include 45 ears). RESULT: The lesion of tympanic ostium of Eustachian tube based on observation of tele-otoscope was divided into mild and serious alteration. The mild alteration revealed bony hyperplasia, mucosal swelling but tympanic ostium was open. The serious alteration revealed the serious mucosal swelling, granulation and tympanic ostium narrow. Seventeen out of 45 ears of chronic otitis media were normal tympanic ostium of Eustachian tube, whereas 18 ears and 10 ears were mild and serious alteration respectively. In 10 ears with serious alteration of tympanic ostium, 9 ears revealed the obstruction of Eustachian tube. CONCLUSION: The bony hyperplasia, mucosal swelling and granulation in tympanic ostium are usual lesion in chronic otitis media. The narrow of tympanic ostium induced by serious mucosal swelling and granulation is one of causes resulting in tube disfunction.

Adolescent↗
PubMed2005

[Acute otitis media in children].

Acute otitis media (A.O.M.) occurs mainly in children. The first peak of this disease appears between 6-18 month of life, and the second between 4-7 year of age. The younger age at which the first A.O.M. incidence is noted, the higher probability of its recurrence. In Poland 65% of children up to the 2 year of age suffer from otitis media once, and 30% more than three times. The portal of infection in a.o.m. comprises: (1) Eustachian tube (2) Blood vessels (3) External auditory meatus with perforated tympanic membrane. In ca. 30% of a.o.m. the causative agents are viruses, while in 70% the disease is due to bacteria (Streptococcus pneumoniae in 30-40%, Haemophilus influenzae ca. 20%, Moraxella catarrhalis 10-15%). A.O.M. is diagnosed basing on history, but mainly using otoscopic examination. Regarding different ear anatomy in infants, otoscopic examination may cause many difficulties. In A.O.M. due to possible dehiscence in tegmen tympani or antri may occur meningismus, and dehiscence in the facial nerve canal can occur facial nerve paresis. The treatment of choice is tympanocentesis and administration of amoxycillin in the dose of 40 mg/kg b.w. daily. After recovery, the examination of upper respiratory tract patency should be performed and following that the evaluation of the ear should be continued.

Acute Disease↗
PubMed2005

Nonsurgical home treatment of middle ear effusion and associated hearing loss in children. Part II: Validation study.

In this prospective follow-up investigation, we examined the efficacy of a modified Politzer device in the home treatment of persistent middle ear effusion (MEE) and associated hearing loss in children who had previously participated in a similar clinical trial. Our study group was made up of 38 patients who had been either (1) untreated control participants in the previous study whose hearing in one or both ears had not returned to normal within 11 weeks of their initial audiologic pretest ("former control group"; n = 30), or (2) active-treatment participants in the previous study whose hearing sensitivity in at least one ear had not improved to within normal limits after treatment and who elected to undergo a continuation of treatment ("extended-treatment group"; n = 8). Treatment efficacy was determined by comparing differences in pre- and posttreatment air-conduction thresholds and otoscopic findings. Following treatment, the former control group experienced significant improvements in hearing sensitivity at all frequencies; at the posttreatment test, hearing sensitivity was within normal limits in 43 of 60 ears (71.7%), and normal or moderate tympanic membrane mobility was observed in 30 of 34 otoscopically examined ears (88.2%). In the extended-treatment group, hearing sensitivity returned to within normal limits in 9 of 10 impaired ears (90.0%). These findings further substantiate the efficacy of our modified Politzer device in improving middle ear function and hearing sensitivity in children with MEE, and they support the reliability of the findings reported in our previous study. These results also indicate that many patients in whom initial treatment is not successful may benefit from extended treatment.

Acoustic Impedance Tests↗
PubMed2006

Auditory functions in children at schools for the deaf.

OBJECTIVE: To evaluate auditory functions in children at schools for the deaf in Turkey. DESIGN: A total of 218 children who were attending the school for deaf children were involved in the study. Familial and medical histories were obtained, and otoscopic examinations were performed. Immittance audiometry, acoustic reflex testing, pure tone audiometry, otoacoustic emission and auditory brain stem response tests were performed. RESULTS: The mean age of identification of hearing loss was 48 months. Impacted wax was the most common otoscopic finding that was seen in 49 (22.47%) of children. Nontype-A tympanograms were found in 18 (8.25%) of children. One-hundred-eighty-nine (86.69%) children had profound hearing loss, and 29 (10.3%) had severe hearing loss on pure tone audiometry. On auditory brain stem response testing, 192 (88.07%) children had profound hearing loss, and 26 (11.41%) had severe hearing loss. Only one child had auditory neuropathy/dys-synchrony, as his otoacoustic emission results were normal without synchronous auditory brain stem responses. The hearing threshold levels were found >105 dB in 28 children only with pure tone audiometry. CONCLUSION: Early auditory screening is necessary to identify the children at risk. All hearing disorders cannot be detected by subjective or objective audiometric tests only. Pure tone audiometry still has a role in determining hearing threshold levels. The audiological research directions should be directed towards routine pure tone audiometry, otoacoustic emission and auditory brain stem response assessment for all hearing impaired children to enable an successful treatment.

Adolescent↗
PubMed1991

Antimicrobial therapy for otitis media with effusion ('secretory' otitis media).

OBJECTIVE: To determine the effectiveness of antimicrobial treatment for otitis media with effusion ("secretory" otitis media) in children. DATA SOURCE: We report the reexamination of a previously published study by Mandel et al that evaluated the efficacy of a 2-week course of antimicrobials (amoxicillin trihydrate) with and without a 4-week course of an oral decongestant-antihistamine combination in a double-blind, placebo-controlled, randomized trial involving 518 infants and children with otitis media with effusion. DATA SYNTHESIS: At 4 weeks, amoxicillin efficacy as determined by a tympanometric criterion (P = .121) or by a measure of improvement in hearing (P = .311) was insignificant. Only by otoscopic judgment, which is shown to contain a systematic bias as used in this clinical trial, could an argument be made for a marginal efficacy of amoxicillin at the 4-week end point. Logistic regression analyses of the combined effects of treatment and prognostic factors showed no significant differences between placebo- and antibiotic-treated groups for unilateral effusions and for bilateral effusions. When subjects with unilateral and bilateral effusions were combined, the estimated efficacy of antibiotic treatment was 12.3% by otoscopy (P = .014) and 4.8% by tympanometry (P = .171). We also demonstrate the sensitivity of outcome to diagnostic measures used and provide statistical evidence questioning the validity of otoscopic observations in this study. Six weeks after the termination of amoxicillin therapy, the recurrence of effusion was two to six times higher in the amoxicillin-treated children than in those treated with placebo (P = .001), and resolution of effusion was not significantly different among antibiotic and placebo groups (13.6% and 11.3%, respectively; P = .477). CONCLUSIONS: Amoxicillin with and without decongestant-antihistamine combination is not effective for the treatment of persistent asymptomatic middle-ear effusions in infants and children.

Amoxicillin↗
PubMed1991

[Acoustic distortion products. Clinical values and limitations in the study of low frequencies].

Distortion products are otoemissions produced when the cochlea is stimulated by two pure, continuous sounds f1 and f2. The most ample distortion product in Man corresponds to a frequency of 2f1-f2. The aim of our work is to appreciate the possibilities to study the distortion products for the exploration of low frequencies in Man. Three populations of subjects have been studied: young subjects have been studied: young subjects with a normal hearing, subjects with pathological otoscopic findings in spite of a normal hearing, subjects with pathological otoscopic findings in spite of a normal audiometric study, and subjects with endocochlear perceptive deafness. The major result of this study was to demonstrate that the lowest frequency that can be explored with distortion products is 750 Hertz.

Acoustic Stimulation↗
PubMed1985

Tympanometry screening in developmentally delayed individuals.

Residents of the Huronia Regional Centre for the developmentally disabled (N:900) underwent otoscopic screening (canal "clear" vs "not clear") and tympanometric screening, including tympanometry and physical volume measures (Ss exhibiting Type B tympanograms were classified "hard positive"). Results showed that (1) by otoscopy, 53.2% of all Ss examined had canals "not clear". (2) Overall, degree of retardation was loosely related to prevalence of abnormal otoscopy. (3) The etiologies for mental retardation of "metabolism" and "chromosomal abnormalities" (including all Down's Syndrome cases) were most prone to be in the "not clear" otoscopic category. By tympanometry, 25.8% were classified "hard positive". Overall, conductive disorders as assessed by tympanometry increased significantly with degree of mental retardation. Chromosomal abnormalities yielded a significantly higher proportion of "hard positive" cases (43%) than any other etiology. Identification of sub-populations at risk for conductive disorders, such as those of chromosomal abnormalities and/or more severe developmental delays will enable the employment in the future of more efficient auditory screening techniques.

Acoustic Impedance Tests↗
PubMed1988

Persistent effusion following acute otitis media: tympanometry and pneumatic otoscopy in diagnosis.

Children aged six months to 10 years in one practice who were diagnosed with acute otitis media were examined one, three, six and 12 months after diagnosis by a general practitioner and an otolaryngologist on the same day using pneumatic otoscopy. Tympanometry and pure tone audimetry were also carried out. Tympanograms were combined with the specialist's otoscopy findings to determine whether effusion was present. The outcome categories three months or longer after diagnosis were compared with the otoscopic findings up to that stage.The tympanometry results showed that of the 29 children (31 affected ears), five had evidence of middle ear effusion on all occasions tested, while six were normal throughout, 10 fluctuated and eight followed a resolving pattern. Examination 10-14 days or one month after diagnosis was 75% accurate in predicting effusion after three months. Recommendations are made for the use of the pneumatic otoscope in follow up by general practitioners.

Acoustic Impedance Tests↗
PubMed1986

Incidence of occlusion due to impacted cerumen among mentally retarded adolescents.

The incidence of occlusion of the external auditory canal due to impacted cerumen was determined for 44 mentally retarded subjects in comparison with 44 nonretarded subjects. Otoscopic data were taken by qualified personnel for both groups and subjected to statistical analysis. Results confirmed that retarded adolescents have a significantly higher incidence of occlusion of the external auditory canal due to impacted cerumen than do nonretarded adolescents. Routine otoscopic examinations should be performed on the former group to ameliorate loss of hearing due to impacted cerumen.

Adolescent↗
PubMed1979

Reliability of the middle ear examination.

Interobserver reliability of physical signs elicited and diagnoses made on middle ear examination were studied. Effect on reliability of variation in observer knowledge, patient age and instrument were defined. Two board-certified, color-seeing pediatric specialists who worked in the same clinic examined consecutively 350 ears with the same otoscope for each case. Over a period of four months, four different otoscopes were used to examine at least 50 ears with each. The following groups of findings were graded independently by the pediatrician according to pre-set criteria: color, landmarks and light reflex. Diagnosis was also recorded. At no time did the observers discuss their findings or diagnoses. Degree of interobserver agreement was expressed by the reliability coefficient (values given below) and the K coefficient. Overall agreement on findings ranged from 0.50 for landmarks to 0.85 for air-fluid level. Overall agreement for diagnoses was 0.72. Specific agreement on physical findings ranged from 0.0 for presence of air-fluid level to 0.85 for absence of air-fluid level. Specific agreement on diagnoses ranged from 0.08 on serous otitis to 0.56 on otitis media and 0.61 on normal. After the age of one year, agreement did not increase with age. Agreement did not change significantly with different instruments or as the study progressed. We concluded that equivalence of observer knowledge strongly increases agreement, while patient age less than one year decreases agreement, and type of instrument does not affect agreement. Clinicians should be trained to recognized middle ear signs and diagnoses according to specified criteria to maximize interobserver agreement.

Age Factors↗
PubMed1984

Cholesteatoma medial to an intact tympanic membrane in 34 young children.

Thirty-five cholesteatomas medial to intact eardrums were treated in 34 children between 1976 and 1982. Six (18%) children had never had a documented episode of otitis media. Seventeen (50%) children, in whom the lesion was diagnosed at an early stage, underwent simple excision of the cholesteatoma without the need for extensive middle ear surgery. Findings from postoperative audiograms were normal for all such children. Cholesteatoma has recurred in eight (23%) children to date. Most recurrences were diagnosed 15 months or less after surgery. Routine careful otoscopic examination is essential in order to discover cholesteatoma at an early stage and to avoid hearing loss and the need for extensive otomastoid surgery. In order to perform an accurate examination of the eardrum, a halogen-illuminated otoscope and pneumo-otoscopy should be used by the pediatrician routinely. Particular attention should be paid to the posterior-superior quadrant of the tympanic membrane where a cholesteatoma is usually located.

Audiometry↗
PubMed1982

Modified schema for classifying positive-pressure tympanograms.

Tympanograms with peaks located in the high-positive air pressure range (greater than or equal to 50 mm H2O) are infrequently recorded in clinical practice and have been little discussed in the literature. Such tympanograms accounted for 1.2% of a series of 8,011 tympanograms recorded at various times from 1,556 subjects ranging in age from 7 months through 12 years. Correlations between otoscopic diagnoses and tympanometric findings in the case of 65 of the high-positive air pressure tympanograms form the basis of the present report. Of the 65 high-positive air pressure tympanograms, 51 showed relatively high compliance (less than or equal to 5.5 Madsen units), and of these 46 (90%) were associated with ears considered normal otoscopically. Fourteen of the high-positive air pressure tympanograms showed low compliance (greater than 5.5 Madsen units), and of these, six (43%) were associated with ears considered normal, six (43%) with ears showing signs of acute infection, and two (14%) with ears in which the presence of effusion seemed probable. A previously presented zonal schema for classifying tympanograms has been modified on the basis of these findings.

Acoustic Impedance Tests↗
PubMed1980

Correlation between micro-otoscopy, micropneumatoscopy and otoadmittance tympanometry.

The micro-otoscopic, audiometric and tympanometric findings were correlated in 204 ears seen in a Veterans Administration Hospital ear clinic. Otoscopy, audiometry and tympanometry were done during the same clinical visits. In most cases pneumo-otoscopy with the microscope also was performed. Because we were unable to standardize pressures, we found pneumo-otoscopy of limited value. The data in this series were analyzed from two different points of view to determine the accuracy of the tympanometer in detecting and identifying ear disease. First the otoscopic results were compared with the tympanometric findings. Second, the procedure was reversed and various tympanometric findings were compared to the otologic diagnosis. Otophotographs were obtained in many of the ears to record findings. An otologic evaluation consists in physical and functional examinations and is not complete without both elements. It is important to remember that the tympanogram does not measure hearing loss. Tympanic membrane abnormalities can invalidate measurements of acoustic impedance and lead to a false interpretation of tympanometric findings.

Acoustic Impedance Tests↗
PubMed1993

Evaluation of the diagnostic value of pneumatic otoscopy in primary care using the results of tympanometry as a reference standard.

The aim of this study was to determine the value of pneumatic otoscopy in diagnosing otitis media with effusion in primary care. Pneumatic otoscopy was carried out for 111 children aged one to 16 years and the results obtained compared with those obtained from tympanometry. The children were those who had attended for a regular ear, nose and throat check up in the health centre of a school for the deaf during the period November 1989 to January 1990. Pneumatic otoscopy and tympanometry with the GSI 28 instrument (Grason-Stadler) were carried out by a trained ear, nose and throat nurse. All relevant features determined using otoscopy--the colour, position and mobility of the tympanum--and an overall assessment were recorded. The results of tympanometry were evaluated independently of the otoscopic findings. In the population examined the predictive values of positive and negative results of pneumatic otoscopy for diagnosing effusion were high; the sensitivity was low. Serious retraction of the eardrum and absence of mobility under positive pressure were the most predictive features but the colour of the tympanum did not show any relation to effusion. In the youngest age group (one to five years) 56% of the children had abnormal otoscopic findings in either one or both ears (odds ratio for this group versus remaining children 3.75; 95% confidence interval (CI) 1.75 to 15.2). The odds ratios of past and present history of upper respiratory tract infection with respect to abnormal results from otoscopy were 2.41 (95% CI 1.05 to 5.53) and 2.95 (95% CI 1.17 to 7.45), respectively. Pneumatic otoscopy carried out by an experienced health care worker is of high diagnostic value when compared with the results of tympanometry. Pneumatic otoscopy can improve the diagnostic capabilities of general practitioners and other primary care workers with regard to otitis media with effusion.

Acoustic Impedance Tests↗
PubMed1996

[Acute otitis media in a pediatrics consulting office].

OBJECTIVE: To know the incidence and natural development of acute otitis media (AOM) in a pediatric outpatient office. PATIENTS AND METHODS: A descriptive study was performed on a population of 867 children, between the ages of 3 months and 7 years, diagnosed with AOM in a pediatric consultation room. The following data were recorded: age, gender, month, type of episode, number of visits to the consulting room and number of referrals to the ear, nose and throat specialist, as well as the symptoms and otoscopic signs that they showed. Observations were made after 15, 30 and 60 days. RESULTS: Of this population, 146 children were diagnosed as having AOM. The incidence was 12.1% and 71.92% were new cases. The age with the larger number of AOM cases was 5 years (20.55%). February was the month with the most cases. The most frequent symptom was nasal congestion. Among the otoscopic signs, the most frequent were hyperaemia and convincing of the tympanic membrane. CONCLUSIONS: Because the study was conducted on a select population, that attended by this outpatient service, the found incidence could be lower than if the study had been conducted on the general population.

Acute Disease↗
PubMedDate not supplied

Comparison of tympanometry and otoscopy in establishing pass/fail referral criteria.

Impedance tests, pure tone screening, and pneumatic otoscopy were performed on two groups of children. For the second group, two physicians, one an otolaryngologist and the other a pediatrician, performed the otoscopic examination. Agreement between tympanometry and otoscopy was not influenced by the presence or absence of acoustic reflexes or passing or failing the pure tone screening, but did depend on the criteria used in classifying the tympanograms. Tympanograms classified as having significant negative pressure were those showing the poorest agreement between tympanometry and otoscopy. Between examiners, agreement in otoscopic findings was generally poor. Results are discussed as they apply to establishing pass/fail criteria for screening with impedance.

Auscultation↗
PubMed2001

Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media.

BACKGROUND: The distinction between acute suppurative otitis media (AOM) and otitis media with effusion (OME) is important for antibiotic treatment decisions. Tympanocentesis may be useful in the diagnosis of AOM in selected patients. OBJECTIVES: To assess physician accuracy in diagnosing AOM and OME from physical examination findings and technical competence in performing tympanocentesis. DESIGN AND SUBJECTS: Five hundred fourteen pediatricians and 188 otolaryngologists viewed 9 different videotaped pneumatic otoscopic examinations of tympanic membranes during a continuing medical education course. Diagnostic differentiation of AOM, OME, and a normal tympanic membrane was ascertained. An infant mannequin model was used to assess the technical proficiency of performing tympanocentesis on artificial tympanic membranes. RESULTS: Overall, the average correct diagnosis by pediatricians was 50% (range, 25%-73%) and by otolaryngologists was 73% (range, 48%-88%). Pediatricians and otolaryngologists correctly recognized the absence of normality 89% to 100% and 93% to 100% of the time, respectively, but overdiagnosed AOM in 7% to 53% (mean, 27%) and in 3% to 23% (mean, 10%) of examinations. Performance of tympanocentesis was optimally performed by 89% of otolaryngologists and by 83% of pediatricians. CONCLUSIONS: The use of video-presented examinations to assess diagnostic ability suggests that AOM and OME may be misdiagnosed often. Interactive continuing medical education courses with simulation technology may enhance skills and improve diagnostic accuracy and treatment paradigms.

Clinical Competence↗