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At least 217 records · Page 12Linked to original sources
PubMed1982

Hearing loss in minor head injury.

A prospective otological and audiological study was made of 130 consecutive persons with head injuries. A comparison was made with 87 consecutive persons with traumatic injuries but without head injuries. Five (4%) of the persons with head injuries had an unsuspected temporal bone fracture evident on otoscopy but not on routine skull roentgenography. These persons had a significant sensorineural hearing loss at 4 and 8 kHz compared with other patients with head injuries. Routine otoscopic examination is considered advisable in all persons with head injuries. No significant difference in the hearing was detected in persons with head injuries without a temporal bone fracture compared with control subjects.

Adolescent↗
PubMed1982

Epidemiology of otitis media with effusion in children.

The recently accepted international classification for otitis media was applied to a study population of 898 children less than 12 years of age having otitis media with effusion persisting at least three months. Mucoid effusion was aspirated from 48% of ears, was found more often in younger than older patients, was more often bilateral, and was a more stable state during longitudinal observation than was serous otitis media or purulent otitis media (POM). Serous otitis media occurred in only 10% of ears, but was found more often than in younger patients; POM was found in only 7% of ears. Otoscopy did not distinguish among the three effusion types. Known middle-ear pathogens were cultured more often behind red and bulging tympanic membranes from these cases of chronic effusion than behind membranes lacking these characteristics. These observations provide an epidemiologic and clinical base for further investigations of these otitis media types.

Child↗
PubMed1984

Mastoid pneumatization. Evidence of the environmental theory.

Forty-one randomized, otherwise healthy children with tympanometry were observed from birth until the age of 6 years. At a total of 13 trials, tympanometry and otoscopy were performed. The tympanometric profile was correlated to the size of the mastoid air cell system, as determined by planimetric measurement of roentgenograms taken at age 6 years. There was a notable correlation between the size of the cell system and the tympanometric profile. Thus, the least affected ears with mostly normal or slightly abnormal tympanometry had considerably larger cell systems than the most affected ears with secretory otitis and tubal dysfunction. The findings support the environmental theory of pneumatization.

Acoustic Impedance Tests↗
PubMed1994

Ear disease in children with cystic fibrosis.

OBJECTIVE: To assess otitis media in children with cystic fibrosis. DESIGN: Prospective prevalence survey. SETTING: Otolaryngology and cystic fibrosis/pulmonology outpatient clinics, Children's Hospital of Pittsburgh (Pa), a regional referral center. PATIENTS: Seventy patients, aged 4 months to 17 years, with documented cystic fibrosis who presented to the cystic fibrosis/pulmonary clinic with scheduled appointments were asked to volunteer for the study. The 70 patients recruited represent approximately one fourth of the children younger than 17 years with cystic fibrosis who were followed up by the cystic fibrosis/pulmonary clinic. INTERVENTION: Ear, nose, and throat examination including pneumatic otoscopy, with tympanometry when indicated; relevant history taking. MAIN OUTCOME MEASURE: Presence or absence of otitis media. RESULTS: Seven (10%) of the 70 patients had unilateral or bilateral otitis media. CONCLUSIONS: Children with cystic fibrosis have a low prevalence of otitis media compared with normal children.

Acute Disease↗
PubMed1994

A clinical study of human type IV collagen as tympanic membrane grafting material. Preliminary noncomparative study.

OBJECTIVE: To evaluate tolerance for this middle-ear implant and its effectiveness in eardrum healing under various pathologic conditions. SETTING: A 12- to 18-month follow-up case series at an institutional referral center offering hospitalized care. PATIENTS: Twenty-six eligible volunteers suffering from tympanic perforation or tympanic pocket retraction class II and III in Tos' classification. INTERVENTION: Patients underwent implantation with the type IV collagen film (film called "MTY" from the French membrane tympanique). The surgical procedure was similar to those using the temporal aponeurosis or the tragal perichondrium. OUTCOME MEASURE: Anatomic criteria was determined by otoscopy, and functional audiometric criteria was determined by air-borne gap measurements and by effects on cochlear function. RESULTS: Twenty-two of 26 patients were completely healed after 6 months, with no subsequent evolution. Nineteen of 26 subjects underwent a 1-year postoperative audiometric follow-up examination: 13 (68%) had an air-borne gap less than 10 dB, four (21%) had between 11 and 20 dB, and two (11%) had between 21 and 30 dB. Adverse effects included one patient whose MTY fell into the middle ear, three patients with transient myringitis, and one patient with otitis media with effusion. CONCLUSIONS: A human type IV collagen film may be a possible alternative to autologous tissue in tympanic membrane reconstruction. This new biomaterial was tested on patients with various diseases common in clinical otology, and demonstrated a good biocompatibility of MTY in the different pathologic conditions of chronic otitis media. A future randomized, controlled trial will randomly allocate patients to receive either MTY collagen film or tissue from the temporal aponeurosis.

Adolescent↗
PubMed1987

Medical management of chronic middle-ear effusion. Results of a clinical trial of prednisone combined with sulfamethoxazole and trimethoprim.

Prednisone for seven days plus the combination drug sulfamethoxazole and trimethoprim for 30 days was assessed in treating chronic middle-ear effusion present for at least eight weeks. Pneumatic otoscopy, tympanometry, and audiology at entry into the study, and one week and one month after therapy, documented the status of the middle-ear effusion. Clearing in both ears or in one when only one was involved was called complete resolution; clearing in one of two affected ears was called partial resolution. In the initial open trial, 13 of 24 patients experienced partial or complete resolution one month after therapy. Subsequently, 28 patients were enrolled in a randomized, double-blind, placebo-controlled clinical trial in which patients whose effusion failed to clear were crossed over to the alternative regimen. In this trial, ten treated children (71%) experienced partial or complete resolution one month after therapy compared with three (21%) in the control group. Patients enrolled in both trials whose effusion cleared were followed up monthly for six months. Seven of 29 patients required referral for ventilation tubes.

Child↗
PubMed1993

Physicians treating their own children.

OBJECTIVES: To determine the types of health care interventions physicians provided to their own children, identify those conditions most often treated by physician-parents, compare the differences in treatment practices among physician groups, and explore the reasons physicians give for treating their own children. DESIGN: Questionnaire. SETTING: University-affiliated teaching hospital in Iowa City, Iowa. PARTICIPANTS: Three hundred fifty-three physicians in residency and fellowship training and faculty who were parents of children aged 18 years or younger. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: The majority of physicians reported treating their afebrile child for acute illness. Fifty-five percent of physicians reported that they rarely or never treated their febrile child (temperature > 38.3 degrees C) without consultation with the child's physician. Only 47% of physicians reported that they always performed a physical examination on their child before treating. Physician-parents were more likely to auscultate the child's chest or perform otoscopy and less likely to obtain urine samples or throat swabs for culture before treating. Sixty-two percent of physicians reported that they have never performed routine health maintenance examinations on their own children, but 29% referred their children to a specialist. Medications were prescribed for their children by 65% of physicians. Neither gender nor level of training influenced the treatment practices of physician-parents. Primary care physicians were less likely to contact the child's physician for advice in treating their febrile child than were subspecialists. Pediatricians more often treated their afebrile and febrile children, performed physical examinations and laboratory studies, and prescribed medications than did other primary care physicians. Convenience was the most important reason physicians gave for treating their own children. CONCLUSIONS: Physicians frequently treat their own ill children, prescribe medications for them, and self-refer them to specialists largely for the sake of convenience.

Adolescent↗
PubMed1998

Cigarette smoking and hearing loss: the epidemiology of hearing loss study.

CONTEXT: Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults. OBJECTIVE: To evaluate the association between smoking and hearing loss. DESIGN: Population-based, cross-sectional study. SETTING: Community of Beaver Dam, Wis. PARTICIPANTS: Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study. MAIN OUTCOME MEASURES: The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear. RESULTS: After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non-age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74). CONCLUSIONS: These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.

Aged↗
PubMed2003

Does this child have acute otitis media?

CONTEXT: Acute otitis media (AOM) is one of the most common problems in pediatrics. An accurate diagnosis of AOM can guide proper treatment and follow-up. OBJECTIVE: To systematically review the literature regarding precision and accuracy of history taking and physical examination in diagnosing AOM in children. DATA SOURCES: We searched MEDLINE for English-language articles published from 1966 through May 2002. Bibliographies of retrieved articles and textbooks were also searched. STUDY SELECTION: We located studies with original data on the precision or accuracy of history or physical examination for AOM in children. Of 397 references initially identified, 6 met inclusion criteria for analysis. DATA EXTRACTION: Two authors independently reviewed and abstracted data to calculate likelihood ratios (LRs) for symptoms and signs. DATA SYNTHESIS: Four studies of symptoms used clinical diagnosis as the criterion standard and were limited by incorporation bias. Ear pain is the most useful symptom (positive LRs, 3.0-7.3); fever, upper respiratory tract symptoms, and irritability are less useful. One study of clinical signs used tympanocentesis as the criterion standard, and we adjusted the results to correct for verification bias. A cloudy (adjusted LR, 34; 95% confidence interval [CI], 28-42), bulging (adjusted LR, 51; 95% CI, 36-73), or distinctly immobile (adjusted LR, 31; 95% CI, 26-37) tympanic membrane on pneumatic otoscopy are the most useful signs for detecting AOM. A distinctly red tympanic membrane is also helpful (adjusted LR, 8.4; 95% CI, 6.7-11) whereas a normal color makes AOM much less likely (adjusted LR, 0.2; 95% CI, 0.19-0.21). CONCLUSIONS: Although many of the studies included in this analysis are limited by bias, a cloudy, bulging, or clearly immobile tympanic membrane is most helpful for detecting AOM. The degree of erythema may also be useful since a normal color makes otitis media unlikely whereas a distinctly red tympanic membrane increases the likelihood significantly.

Acute Disease↗
PubMed2006

Holoprosencephaly: clinical evaluation on audiological and brainstem electrophysiological profiles.

This study evaluated audiological and electrophysiological profiles in 13 patients with holoprosencephaly. All patients had imaging evaluation by magnetic resonance imaging and molecular screening for the genes SHH, GLI2, and SIX3. Each patient underwent clinical (otological and vestibular antecedents, otoscopy) and instrumental (tympanometry, auditory brainstem response--ABR) evaluation to compare hearing and the electrophysiological profile possibly occurring in patients with these mutations. To our knowledge there are no systematic studies correlating molecular/imaging and evoked potentials in patients with HPE. Here, we discuss the audiological and electrophysiological profiles of patients and the possible role of the genes studied on the overall findings.

Acoustic Impedance Tests↗
PubMed1978

Serous otitis media associated with sensorineural hearing loss in children.

The effect of a conductive hearing loss secondary to serous otitis media in children with sensorineural hearing loss was seen to be an increase in threshold and in one case a decrease in speech discrimination. The diagnosis of the conductive component can be made by means of measurement of impedance, middle ear pressure, the recording of a tympanogram and otoscopy. It is likely that a conductive component can lead to delay in the diagnosis of an underlying sensorineural hearing loss in some children which could result in exacerbation of speech and language deficits. Correction of the conductive component can convert a profound hearing loss to a severe hearing loss, or a severe hearing loss to a moderate hearing loss, and it may also increase speech discrimination.

Adolescent↗
PubMed1996

Otomycosis--a clinico-mycological study and efficacy of mercurochrome in its treatment.

A total of 110 patients of symptomatic otomycosis was investigated, prospectively. Aural swabs were collected on 1st, 7th and 14th day and examined by direct microscopy and culture for fungi. Of these, 80 patients found to be having pure fungal infection, were taken up for mycological and therapeutic study. Fungi belonging to genus Aspergillus were isolated in 76 (95.0%) patients of which Aspergillus niger was the commonest isolate in 46 (57.5%), followed by A. flavus in 27 (33.7%), A. fumigatus in 3 (3.7%), Candida species in 3 (3.7%) and Mucor in 1 (1.2%). The patients were of all age groups but majority were between 21 and 30 years and the male-female ratio was equal. Of the total of 40 male patients, twenty-one were Sikhs using turban. Before developing the symptoms, forty five patients used oil, mixture of oil and garlic juice, antibiotics, steroids, antiseptics or wax solvent as ear drops. Only two patients were diabetic. No patient had fungal infection elsewhere in the body. The patients were called for regular follow-up for three weeks. In forty cases mercurochrome was applied as the antifungal agent after cleaning the external auditory canal, in twenty-three clotrimazole and in rest of the seventeen patients miconazole was used. On 7th day, only 11 (13.7%) patients grew different fungi in culture. They became symptom-free on 14th day and no fungal material could be seen on otoscopy, direct microscopy or culture. Mercurochrome was found to be most effective in these patients.

Adult↗
PubMed1982

Chronic myringitis and chronic suppurative otitis media.

Thirty-four chronic myringitis cases were examined by otoscopy, pure tone audiometry, tympanometry, skull X-rays, and bacteriologic study of otorrhea. Five atypical cases are presented in detail. Three of these five cases had a perforation of the tympanic membrane preceding the appearance of typical chronic myringitis. The remaining two cases showed a transient small tympanic membrane perforation during the long course of chronic myringitis. These cases suggest that chronic myringitis could occur in some chronic suppurative otitis media and that myringitis could cause tympanic membrane perforation.

Adult↗
PubMed1998

Multicenter, randomized, double-blind comparison of erythromycin estolate versus amoxicillin for the treatment of acute otitis media in children. AOM Study Group.

Erythromycin is frequently prescribed in Germany for acute otitis media, but well-designed clinical trials under present epidemiological conditions are lacking. Therefore, a double-blind, randomized, multicenter trial was performed to compare the clinical efficacy and safety of erythromycin estolate versus amoxicillin in children with acute otitis media and to identify the risk factors associated with clinical failure. Investigators from 19 centers throughout Germany recruited 302 children with clinical, otoscopic, and tympanometric evidence of acute otitis media. In a double-blind fashion, patients were allocated randomly to a 10-day course of erythromycin estolate at 40 mg/kg/day in two divided doses or amoxicillin at 50 mg/kg/day in two divided doses. Clinical examinations, otoscopy, and tympanometry were performed at baseline, day 3-5, day 9-11, and at 5 weeks. Clinical outcome was assessed on day 9-11. Two-hundred eighty children were evaluable for efficacy (erythromycin group, 141; amoxicillin group, 139). Both groups were comparable with respect to demographic data and severity of disease at entry. Treatment was successful in 94% of the erythromycin-treated patients and in 96% of the amoxicillin-treated patients. Clinical outcome was statistically equivalent between groups within a range of 7 percentage points. Clinical recurrence was seen in eight erythromycin-treated children (5.7%) and in seven amoxicillin-treated children (5.0%) (P=0.81). Patients with bilateral disease at entry were at higher risk of unfavourable outcome, whereas age and presence/absence of otorrhea at entry were not associated with outcome. Treatment-related adverse events were recorded in eight (5.3%) of 151 erythromycin-treated patients and in 11 (7.3%) of 151 amoxicillin-treated patients. In this study in an outpatient setting in Germany, erythromycin estolate was as safe and effective as amoxicillin in the treatment of acute otitis media. Both drugs can be administered in a convenient twice-daily dosage schedule.

Acute Disease↗
PubMedDate not supplied

Middle ear effusion in children.

Acute otitis media (AOM) and otitis media with effusion (OME) in children can present with a variety of middle ear effusions (MEE). Even though the character of the effusion may vary, the underlying pathogenesis is often similar. In the last decade, there has been an abundance of new information in the fields of immunobiology and immunochemistry to explain the chronicity of MEE. There are also studies examining the efficacy of vaccination and immunoprophylaxis for recurrent AOM. Diagnosis of otitis media (OM) in a child can be difficult but good visualization by pneumatic otoscopy improves the accuracy of diagnosis of OME. The development of increasing bacterial resistance to antimicrobial therapy reinforces the need to be more rational in treating AOM and OME. The variability of the natural history and the long term sequelae of OME makes medical management more difficult. All children with chronic MEE should have audiologic evaluation. Surgery is recommended should the condition be refractory to medical therapy or if the complications of MEE develop.

Acute Disease↗
PubMed1988

Otitis media.

Otitis media with effusion is a common disorder in children and occurs more frequently in adults than has been generally appreciated. Laboratory tools have permitted a more specific characterization of this disorder by objective means. These laboratory tests include specific ear tests (pneumatic otoscopy, pure tone, and impedance audiometry), nasal tests (inflammatory cytology), functional tests for obstruction (airway resistance measurements), and anatomic tests of obstruction and inflammation (radiographic of nose and paranasal sinuses). Immunologic tests define the presence of hypersensitivity (skin testing, RAST) and immunodeficiency in this disorder.

Adolescent↗
PubMed1998

[Exposed superior bulb of the internal jugular vein. Differential hearing loss diagnosis with pulse synchronous tinnitus].

A case report is presented of a 54-year-old woman with tinnitus synchronous with her pulse and an ipsilateral conductive hearing loss. Otoscopy showed a pulsatile structure behind the right eardrum. Imaging with high-resolution computed tomography of the temporal bone showed an enlarged jugular vein bulb. Magnetic resonance imaging could not be performed because of an implanted pacemaker. Since a glomus jugulare tumor could not be excluded right diagnostic tympanoscopy was performed and revealed a high jugular bulb that filled nearly a third of the tympanum.

Diagnosis, Differential↗
PubMed2001

[Middle ear adenoma. Long-term course of a rare neoplasm].

Adenomas of the middle ear are rare benign glandular neoplasms arising from the middle ear mucosa. After previous operations 25 and 15 years before, a 67-year-old female complained about dizziness, tinnitus, and unilateral hearing loss on the left side. A tumor in the tympanum that was revealed by otoscopy could be removed completely. Histological examinations showed an adenoma of the middle ear with cholesteatoma. This was inconsistent with the histological result of the operation in 1983, which had described a hidradenoma. An exact analysis of the preparations confirmed that a middle ear adenoma had already been present in 1983. Hidradenoma is one of the most important differential diagnoses. The characteristic histological sign of middle ear adenomas in contrast to hidradenomas is the lack of myoepithelial cells. In addition, it is very difficult to differentiate middle ear adenoma and adenocarcinoma using histopathological and clinical methods. Therefore, thorough follow-up is mandatory for patients after surgical treatment of middle ear adenomas.

Adenoma, Sweat Gland↗