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At least 235 records · Page 13Linked to original sources
PubMed1998

Anomalous vessel in the middle ear: the role of CT and MR angiography.

An 8-year-old child was examined because of conductive hearing loss with a retrotympanic mass on otoscopy. CT and MR angiography showed a large inferior tympanic artery traversing the hypotympanum and joining a thin, irregular internal carotid artery with a normal middle meningeal artery. These investigations, coupled with knowledge of the embryological development allowed a diagnosis of a complex vascular anomaly in the middle ear and avoided potential surgical complications.

Carotid Artery, Internal↗
PubMed2003

Visualization of the temporal bone of the Chinese Visible Human.

Temporal bone anatomy is very difficult to understand. After dataset acquisition of the first Chinese Visible Human, we processed the two-dimensional images to build a digitized visible model of the temporal bone and explore the role of virtual endoscopy in the inner ear. On a SGI workstation three-dimensional computer reconstructions of the ear were generated from the Chinese visible human dataset, viewing the middle and inner ear imitating the traditional otoscopy. The three-dimensional data of the temporal bone were then converted to STL format, and the temporal bone replica were fabricated with rapid prototyping by laminated object manufacturing. The virtual model of the ear was successfully completed, and the virtual endoscopy improved three-dimensional visualization of the middle and inner ear. Physical replica of the temporal bone were built with paper; the accuracy was +/-0.2 mm. The reconstructed model and the replica of the temporal bone can be used to make preoperative plans in the complicated otoneurosurgical operations, allowing various surgical exercises to be carried out on the three-dimensional stereophysical model. The virtual endoscopy stands as a promising new visualization technique for elucidation of the middle and inner ear and reveals a tremendous potential in both clinical and educational settings, providing morphological data for the image diagnosis and otoneurosurgery.

Anatomy, Cross-Sectional↗
PubMed1999

The diagnostic and prognostic value of eardrum mobility in otitis media with effusion.

Diagnostic and prognostic values of eardrum mobility were determined by pneumatic otoscopy in 37 patients (56 ears) having otitis media with effusion (OME). Eardrum mobility was impaired or lost in less than half of the ears (46.4%), while a tympanogram detected 77.8% of OME. In 27 of the 37 patients (42 of the 56 ears), aeration of the middle ear space was examined by CT and demonstrated that the presence or absence of aeration was significantly correlated with the presence or absence of eardrum mobility. In another 38 children (62 ears with OME), effect of antibiotics was correlated with eardrum mobility before treatment, and the improvement rate was found to be significantly higher in ears with positive mobility of eardrum (34.3%) than in ears without eardrum mobility (10.0%). These results indicate that eardrum mobility is a good prognostic indicator of OME rather than its diagnostic indicator alone.

Acoustic Impedance Tests↗
PubMed2006

Effect of pneumococcal vaccination on otitis media with effusion in children older than 1 year.

Pneumococcal vaccines may be effective in preventing or decreasing the burden of disease related to otitis media. In study reported here, we investigated the effectiveness of pneumococcal vaccination on otitis media with effusion (OME) in children (n = 383 children aged 1-7 years) with a history of recurrent otitis media within the framework of a randomized double blind placebo controlled trial. Children were randomized to be immunized with either a 7-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine, or by hepatitis A or B vaccines. The proportion of children diagnosed with OME at the scheduled follow-up visits--7, 14, 20 and 26 months after randomization--was then calculated. OME was diagnosed according to an algorithm combining tympanometry and otoscopy. The percentage of children diagnosed with OME was similar in the pneumococcal vaccination group and control group at both baseline and the follow-up visits at 7, 14, 20 and 26 months--52.9 versus 52.7, 44.9 versus 44.2, 34.9 versus 31.5, 40.8 versus 32.2 and 31.4 versus 26.1, respectively (corresponding to p-values of 0.96, 0.89, 0.51, 0.13 and 0.36, respectively). We conclude that the combined pneumococcal conjugate and the polysaccharide vaccination have no beneficial effect on OME in children aged 1 year or older with a history of recurrent otitis media. Therefore, these vaccinations are not indicated in the prevention of OME in these children.

Child↗
PubMed1997

Intramuscular ceftriaxone compared with oral amoxicillin-clavulanate for treatment of acute otitis media in children.

UNLABELLED: Two hundred and fifteen children aged 4 months 6 years with acute otitis media (AOM) were randomized to be treated either by a single i.m. injection of ceftriaxone, 50 mg/kg, with a second dose in the event of unsatisfactory response after 48 h or a history of recurrent AOM (109 patients) or amoxicillin clavulanate 12.5 mg tid (106 patients). The failure rate was similar in children treated by ceftriaxone and amoxicillin clavulanate, 4.6% and 4.7%, respectively (standard error for intergroup difference -2.87%, 95% confidence interval -5.62% to 5.87%). No significant differences between the groups were found in the dynamics of the resolution of the acute symptomatology, otoscopy findings, relapse rate at 30 days or tympanographic evidence of middle ear effusion at the scheduled visits on days 30, 60 and 90. Recurrence of AOM between days 31 and 90 was observed significantly in more children treated with amoxicillin clavulanate than with ceftriaxone--25 out of 84 (29.4%) versus 11 out of 81 (13.6%) (P = 0.012). CONCLUSION: Ceftriaxone injection(s) is as efficient at least as 10-day oral amoxicillin clavulanate for treatment of acute otitis media in children. Although not recommended as routine, ceftriaxone can be considered in the management of acute otitis media under special circumstances, particularly in cases when the ability to tolerate or absorb oral drugs is compromised, in children refusing or unable to take oral therapy or when the compliance is questionable.

Acute Disease↗
PubMed1998

Middle ear effusion among children diagnosed and treated actively for acute otitis media.

UNLABELLED: We assessed the point prevalence of middle ear effusion among day care children in an area where acute otitis media is diagnosed, treated and followed actively. Minitympanometry was used to screen 850 day care centre attendants aged 0.6 to 6.9 years (mean 3.7 years). Tympanometry was performed by two trained nurses at the day care centres and pneumatic otoscopy was done by a paediatrician when effusion was suspected. We found 60 (7.1%) children to have middle ear effusion, which was bilateral in 23 (2.7%) cases. Of the children with bilateral effusion 13 had respiratory symptoms fulfilling the criteria of acute otitis media, 8 of them had experienced acute otitis media during the past 3 weeks and were diagnosed to have otitis media with effusion, and only 2 (0.2%) were asymptomatic children not identified earlier. Of the 37 (4.4%) children with unilateral effusion, 14 had acute otitis media and 23 otitis media with effusion, of whom 12 children (1.4%) had not been identified earlier. The point prevalence of acute otitis media was 3.2% and that of otitis media with effusion 3.9%. CONCLUSION: We conclude that active diagnosis and treatment of acute otitis media practically eliminates such middle ear effusion that could cause significant hearing impairment.

Acoustic Impedance Tests↗
PubMed1986

The effect on the ear of late closure of the cleft hard palate.

Thirty-three patients with cleft palate are reviewed. The late effects on the ear of delayed closure of the hard palate after early soft palate repair are compared with the results of simultaneous early closure of both hard and soft palate clefts. Delayed closure of the hard palate does not affect the incidence of otitis media, the number of insertions of ventilation tubes or the findings on otoscopy. The prevalence of sensorineural hearing loss is significantly raised by late closure of the hard palate. The reason for this is unknown.

Adolescent↗
PubMed1979

Effect of middle-ear dysfunction and disease on hearing and language in high-risks infants.

The effect of middle-ear dysfunction and disease on hearing and language development at one year of age was evaluated for 143 high-risk infants. These infants were categorized as normal or abnormal based on otologic history, otoscopic examinations, and on tympanometric examinations. Language was significantly related to gestational age, being delayed by approximately the amount of prematurity. Language scores were therefore adjusted for gestational age. Speech-detection threshold was not related to gestational age, and was used as the measure of hearing. Hearing levels were negatively correlated with adjusted language quotients. Infants with abnormal otologic histories reported were not different from infants with normal histories in either hearing or language development. Infants with bilateral otoscopic abnormalities had significantly higher speech-detection thresholds, but did not differ in language development from those with bilaterally normal otoscopy. Infants who were abnormal bilaterally by tympanometric examination had significantly higher speech-detection thresholds as well as significantly delayed language development. A significant effect on both hearing and language was found among those infants bilaterally abnormal by tympanometry for whom evidence of middle-ear disease was not visualized by otoscopic examination. Implications of these findings are discussed.

Hearing Disorders↗
PubMed1993

Reflectometric screening for otitis media: inconsistencies in a sample of Australian aboriginal children.

This paper evaluates reflectometry, or acoustic otoscopy, as an objective test for the mobility of intact tympanic membranes in Australian Aboriginal children, who are a population at high risk for otitis media. Reflectometry, pneumotoscopy and tympanometry were compared in 395 ears in 198 Aboriginal children living in remote communities in Northern Australia. A strong interaction was found between pneumotoscopy and tympanometry (P < 0.001), there was some interaction between pneumotoscopy and reflectometry (breakpoint 5.0) (P < 0.05) and there was no significant interaction between reflectometry and tympanometry. Results showed that intra-observer and inter-observer agreement for measures of reflectivity were 0.87 and 0.83, respectively. Unexpected differences between reflectivity measures for right (mean 5.4 units) and left (mean 4.9 units) ears and for different test locations were attributed to procedural artifact or training effects. It was concluded that, despite its practical advantages, reflectometry cannot be recommended as a screening tool for tympanic membrane (TM) immobility in this population.

Acoustic Impedance Tests↗
PubMed1994

An experimental study of cefixime in the treatment of Streptococcus pneumoniae otitis media.

Previous studies using the chinchilla animal model demonstrated that the third generation cephalosporin cefixime (Suprax) with split dosing was as effective as ampicillin in sterilizing the middle ear cleft when infected with S. pneumoniae. In this investigator-blinded, randomized trial, a single daily dose of cefixime (8 mg/kg per day) performed as well as split dosing of cefixime (8 mg/kg every 8 h) and ampicillin (150 mg/kg every 8 h) in the time to sterilization of the middle ear cleft. No statistically significant differences were noted between groups in otoscopy or tympanometry. All antibiotic regimens performed better than saline control (P < 0.0001) with regard to time to sterilization of the middle ear cleft. The results of this study support the daily administration of cefixime as an effective agent for the treatment of otitis media due to its extended half-life and broad antibiotic spectrum.

Acoustic Impedance Tests↗
PubMed1994

A study on the otoscopical and audiological findings in patients with Down's syndrome in Greece.

One hundred and twenty patients (children) with Down's Syndrome were examined by the Audiological Dept. at 'Aghia Sophia' Children's Hospital during the period 1988-1990. Of these 73 (60.8%) were boys and 47 (37.2%) were girls. Their ages varied from 7-18 years of age with an average age of 14.8 years. Physical examination included otoscopy, tympanometry, and in some cases auditory brainstem audiometry. It is worth noting that a high percentage of these patients were unable to cooperate in this study, therefore making it obligatory to utilize objective measures for hearing evaluation.

Acoustic Impedance Tests↗
PubMed1995

A prevalence study of ear problems in school children in Kiambu district, Kenya, May 1992.

Information on the prevalence of hearing impairment and related ear pathologies in children in sub-Saharan Africa is scarce. A pilot study for a clinical trial of simple treatments for chronic suppurative otitis media (CSOM) in school children in Kiambu district, Kenya, provided information on the prevalence of hearing impairment and ear pathologies. Five-thousand-three-hundred-sixty-eight children from 57 randomly chosen primary schools in Kiambu district were examined. Simple otoscopy was performed by clinical officers with specialty training in ENT, and hering testing was performed by trained nurses, using a hand held field audiometer. Microbiological specimens were obtained from those children with CSOM. Five-point-six percent of the children had a hearing impairment of > 30 dB HL in one or both ears, with 2.2% having bilateral hearing impairment. Two-point-four percent had at least one perforated tympanic membrane, and 1.1% had CSOM. Eight-point-six percent of the children had wax obstructing the tympanic membrane. There is evidence of a relationship between hearing impairment and both CSOM and wax obstructing the tympanic membrane. The most common organisms found were Pseudomonas spp. (34%), Proteus spp. (34%) and Eschericia coli (19%). These results are comparable with other studies in Africa and indicate a considerable burden of ear disease in Kiambu district, Kenya.

Adolescent↗
PubMed1996

Hearing levels of young patients 10 years after mastoidectomy.

In several reports, the functional results of mastoid surgery in children have been stated to be disappointing. In this study, a series of 49 child patients who underwent mastoid surgery for chronic suppurative otitis media were examined 10 years postoperatively. At surgery, a cholesteatoma was detected in 49% of the patients. During the observation period, 33% of the patients were subjected to a second operation. At the last follow-up examination, 57% of the operated ears showed hearing levels of 20 dB or better, but in 16% hearing levels were worse than 40 dB. In 16% of the patients, contralateral disease had required surgical treatment and in only 39% of the patients, contralateral ear was found to be normal in otoscopy. Still, at the last follow-up examination, 90% of the better hearing ears had hearing levels of 20 dB or better and only one patient had hearing levels worse than 30 dB in both ears. Compared with an age-and sex-matched control group, hearing levels of the patients were significantly worse but the difference in the mean hearing levels of the better hearing ears was as little as 5 dB. Thus, 10 years after mastoidectomy, hearing levels of child patients were found to be better than expected.

Adolescent↗
PubMed1996

Prevalence of otitis media, hearing impairment and cerumen impaction among school children in rural and urban Dar es Salaam, Tanzania.

Eight hundred and two (802) primary school children in rural and urban Dar es Salaam, Tanzania, were examined to determine the prevalence of otitis media, hearing impairment and cerumen impaction by otoscopy and pure tone audiometry. Ear disease was found in 222 (27.7%) of the children. One hundred and twenty six (15.7%) had cerumen impaction, 70 (8.7%) had sensorineural hearing loss and 21 (2.6%) had chronic suppurative otitis media. Cerumen impaction was found in 20.45% of the rural school children and in 14.8% of the urban school children. This difference in prevalence between the two groups was not statistically significant. The prevalence of chronic suppurative otitis media (COM) was 9.44% among the rural school children and 1.3% among the urban school children, the difference being statistically significant (P < 0.001). Sensorineural hearing impairment was found in 14.1% of the rural school children and in 7.7% of the urban children, this also being statistically significant (P < 0.05). The low prevalence of chronic suppurative otitis media among the urban school children is ascribed to better medical services which facilitate early diagnosis and treatment of acute otitis media. This emphasizes the need to improve the health services in the rural areas so that acute otitis media is diagnosed and treated at the primary level of health care. This will in turn prevent hearing impairment due to chronic suppurative otitis media.

Adolescent↗
PubMed1996

Correlation of clinical sinusitis signs and symptoms to imaging findings in pediatric patients.

The purpose of this study was to determine the correlation between signs and symptoms of upper respiratory tract disease and sinus images in a convenience sample of sixty pediatric patients scheduled for computed tomography or magnetic resonance imaging of the head for non-sinus diagnoses over a 2-year period. The study was carried out in a tertiary pediatric referral center. Each patient underwent rhinoscopy and otoscopy just prior to imaging, and each patient's parent was asked to fill out a questionnaire regarding recent symptoms of upper respiratory tract infection; a blinded comparison was then made between respiratory signs and symptoms and images of the paranasal sinuses. Forty-seven percent of patients had abnormalities of their sinus images, and a significant (P < 0.05) correlation was found between the presence of absence of respiratory signs and symptoms and the presence or absence of abnormalities of sinus images, especially in younger patients. In conclusion, a large percentage of pediatric patients undergoing imaging procedures of the head for non-sinus diagnoses have sinus image abnormalities. In the population studied these imaging abnormalities appear to reflect ongoing or resolving upper respiratory tract viral or allergic inflammation.

Adolescent↗
PubMedDate not supplied

Impact of operator technique and device on infrared emission detection tympanic thermometry.

Preliminary data on the use of infrared emission detection (IRED) tympanic thermometers suggest that operator technique may be important in IRED readings. No systematic investigation of specific technique and available IRED devices has previously been performed. In a prospective, blinded trial, 40 healthy adult subjects using six IRED thermometers with two techniques were examined in random sequence. Differences between IRED tympanic, oral, and rectal temperatures were compared using ANOVA. Significant differences were observed between all temperatures, the IRED devices, and the method of probe insertion. Differences between oral or rectal temperatures and IRED tympanic readings were reduced by an ear tug (as for routine otoscopy) for all but one device. An "ear tug" results in increased IRED readings that may improve accuracy of tympanic thermometers using IRED.

Adult↗
PubMedDate not supplied

Diagnosis and management of aggressive, acquired cholesteatoma with skull base and calvarial involvement: a report of 3 cases.

A prospective case review of 3 patients treated at a tertiary referral center from 1997 to 2002 are presented. Three men, age 30 to 68 (mean, 45) years, were treated for acquired cholesteatoma with skull base invasion. Two patients had no prior otological surgery, and 1 was detected after 4 prior mastoid procedures. One presented with progressive unilateral facial palsy, 1 with otorrhea, and 1 with temporal mass above a modified radical mastoidectomy cavity. All 3 patients were treated with single-staged canal wall-down mastoidectomy. Patients were followed up with otoscopy and neuroimaging from 40 to 61 months. Two patients had no recurrence of cholesteatoma, and 1 had squamous debris in the mastoid cavity removed in the outpatient clinic. One had complete ipsilateral facial nerve paralysis preoperatively and recovered to House-Brackmann grade III within 1 year of surgery. Patient 1 had labyrinthine involvement before surgery and had ipsilateral anacusis after resection and repair. No other complications occurred. Initial presentation, workup, surgical challenges, disease follow-up, facial nerve function, hearing results, and complications are reported.

Adult↗