Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Otitis”

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 343 records · Page 19Linked to original sources
PubMed2005

The reliability of self-reported childhood otitis media by adults.

OBJECTIVE: To estimate reliability of retrospective questionnaire data on childhood recurrent otitis media, and to identify factors influencing inconsistency in self-report. METHODS: Retrospective questionnaire data from a population-based sample of 4430 Norwegian twins who participated in two questionnaire surveys, 6 years apart, containing identical questions on otitis media. Main outcome measure was individual consistency in reporting of otitis media. The tetrachoric correlation and Cohen's Kappa were used to measure reliability. Inconsistent and consistent responders were compared on medical history and mental distress. The use of twin data made it possible to test whether inconsistent responders represent a group with intermediate levels of otitis media severity. RESULTS: The test-retest tetrachoric correlation was 0.82 and Kappa was 0.53. Inconsistency in response was not associated with mental distress, but related to reported number of otitis media episodes per year, use of medical services and history of ear surgery. CONCLUSION: Retrospective self-reported otitis media is a relatively reliable measure. The study suggests that reporting inconsistency is likely to be associated with less severe disease. The finding that reporting pattern is related to disease severity is in accordance with the proposed need for a uniform agreement on the definition of the term "recurrent otitis media" for research purposes.

Adult↗
PubMed2006

Recurrent otitis media and tonsillitis: common disease predisposition.

OBJECTIVE: To estimate the relative contribution of genetic and environmental effects to the association between recurrent otitis media and recurrent tonsillitis. METHODS: Self-report questionnaire data from a population-based cohort of 9479 Norwegian twins born from 1967 to 1979. Recurrent otitis media and recurrent tonsillitis were main outcome measures. Structural equation modelling was used to fit alternative biometric models to the twin data and to estimate the relative contribution of genetic and environmental effects to the association between otitis media and tonsillitis. RESULTS: The lifetime prevalence was 11.7% (95% CI: 11.0-12.3) for recurrent tonsillitis and 11.2% (95% CI 10.5-11.9) for recurrent otitis media. Tetrachoric correlations were greater in monozygotic than in dizygotic twins in both males and females. A model specifying additive genetic effects and individual environmental effects for otitis media and tonsillitis and non-additive genetic effects for tonsillitis yielded the best fit. There was no evidence for sex differences in the genetic source or magnitude of the genetic effects. There was a substantial overlap in genetic factors influencing variation in liability to otitis media and tonsillitis. CONCLUSION: Common genetic factors contribute substantially to comorbidity between recurrent otitis media and recurrent tonsillitis.

Environment↗
PubMedDate not supplied

Pediatricians' opinions about otitis media and speech-language-hearing development.

UNLABELLED: Twenty-five pediatricians responded to a confidential survey about their opinions on the relationship between otitis media and children's speech-language-hearing status. Results found that pediatricians did not necessarily agree that otitis media has an impact on speech-language-hearing development. Pediatricians reported that an early otitis media onset (birth to age 2) affects speech-language development, but they also reported that parents and daycare environments could mitigate any otitis media effect. Pediatricians reported a possible otitis media impact on hearing status, but they did not necessarily agree that an otitis media history required referral for audiological testing. Clinical implications are discussed for collaboration among pediatricians, speech-language pathologists, and audiologists. LEARNING OUTCOMES: (1) The reader will become familiar with pediatricians' opinions about the impact of otitis media on speech-language development. (2) The reader will become familiar with strategies to support interdisciplinary collaboration between pediatricians, speech-language pathologists, and audiologists.

Attitude to Health↗
PubMed2006

Implementing guidelines for the treatment of acute otitis media.

The recently published Clinical Practice Guideline for the Diagnosis and Management of Acute Otitis Media represents a sincere effort by the AAP andthe AAFP to provide management guidelines for the practitioner based upon the best scientific evidence available. Despite many years of research and hundreds of clinical studies addressing various aspects of the epidemiology, clinical presentation, and treatment of acute otitis media, important questions remain unaddressed or have been addressed in a less than optimal fashion. These gaps in knowledge and deficiencies in several of the studies that formed the scientific basis for the proposed guidelines are the major reasons behind continued disagreement over certain recommendations. Until more comprehensive and careful analyses can be performed, disagreements are likely to persist. Even so, there is general agreement about most of the recommendations made in these guidelines, and these recommendations will provide a very valuable framework for the practicing physician as he or she cares for children with acute otitis media. To briefly review the major points, first is the critical importance of accurately diagnosing acute otitis media using a combination of clinical findings and observable abnormalities of the tympanic membrane and middle ear space. Particularly important is the differentiation of acute otitis media from otitis media with effusion. Second is the value of treating the pain associated with acute otitis media as a regular component of care, irrespective of any decision concerning antimicrobial treatment. Third is the option, for a select group of older patients with nonsevere disease, of withholding antimicrobial therapy for the first 48 to 72 hours, if close follow-up and active parental involvement can be guaranteed. Fourth is the recommendation that if an antimicrobial agent is used, high-dose amoxicillin (80 to 90 mg/kg/d) is the treatment of choice for most children at the time of initial presentation unless disease is particularly severe or the child has recently failed a previous course of the antibiotic. Finally highlighted is the importance of ongoing education efforts on the part of physicians in advising parents about the things they can do in their households to lessen the risk of future disease.

Acute Disease↗
PubMedDate not supplied

[Otitis medias with effusion: association with the Eustachian tube dysfunction and adenoiditis. The case of the Central Hospital of Maputo].

INTRODUCTION: Although the aetiology of otitis media is known to be multifactorial, adenoids infections and Eustachian tube dysfunction, have been frequently associated with the incidence of middle-ear effusion. Middle-ear effusion cases are frequent in Maputo, Mozambique, and very often insertion of tympanostomy tubes and adenoidectomy alone or with amigdalectomy have been used to treat these cases and to prevent further episodes. The objective of this study is to describe the association of these factors with otitis medias with effusion in patients that visit the Otorrinolaringology department (ENT) at the Central Hospital of Maputo (HCM), as well as to describe the clinical and epidemiological profile of these patients. PATIENTS AND METHODS: A cross sectional study was conducted. 4157 clinical files of all patients who made their first visit to the ENT department at the HCM, with otitis media during a period of 4 years (1995 to 1998). RESULTS: 23.3% of patients who visited the ORL service of Maputo with otitis media, are children under 3 years; the major proportion of otitis media with effusion was observed in children aged from 3 to 7 years old (49.2%). In boys under, otitis media with effusion is strongly associated with the history of adenoiditis and/or Eustachian tube dysfunction (OR=9.53) and in older patients (OR=12.26). CONCLUSION: The proportion of otitis media with effusion increases more evidently in patients with disfuntion tube syndrome. Other factor that can be important in patients under seven, is the presence of adenoiditis.

Adenoids↗
PubMed2006

Antibiotics for acute otitis media: a meta-analysis with individual patient data.

BACKGROUND: Individual trials to test effectiveness of antibiotics in children with acute otitis media have been too small for valid subgroup analyses. We aimed to identify subgroups of children who would and would not benefit more than others from treatment with antibiotics. METHODS: We did a meta-analysis of data from six randomised trials of the effects of antibiotics in children with acute otitis media. Individual patient data from 1643 children aged from 6 months to 12 years were validated and re-analysed. We defined the primary outcome as an extended course of acute otitis media, consisting of pain, fever, or both at 3-7 days. FINDINGS: Significant effect modifications were noted for otorrhoea, and for age and bilateral acute otitis media. In children younger than 2 years of age with bilateral acute otitis media, 55% of controls and 30% on antibiotics still had pain, fever, or both at 3-7 days, with a rate difference between these groups of -25% (95% CI -36% to -14%), resulting in a number-needed-to-treat (NNT) of four children. We identified no significant differences for age alone. In children with otorrhoea the rate difference and NNT, respectively, were -36% (-53% to -19%) and three, whereas in children without otorrhoea the equivalent values were -14% (-23% to -5%) and eight. INTERPRETATION: Antibiotics seem to be most beneficial in children younger than 2 years of age with bilateral acute otitis media, and in children with both acute otitis media and otorrhoea. For most other children with mild disease an observational policy seems justified.

Acute Disease↗
PubMedDate not supplied

The relative community burden of otitis media and varicella.

Otitis media is a common and costly condition of childhood, with a great potential for cost savings from an effective vaccine. We present a population-based survey of the family burden of otitis media and compare it with another common childhood illness, varicella, for which vaccine prevention is available and cost-effective. We report yearly rates of affected children, complications, medication use, hospitalizations, parental work absences, and use of special sick-child day care in a population of 4557 households containing 9047 children younger than 13 years of age. Of the 9047 children in the sample, 26.1% were affected by otitis media in the year of the study; 68% of children in the second year of life had at least one episode. About one third of families lost workdays due to otitis media in their children, with an overall average loss of about 3 hours per affected child. Compared with the community burden of varicella, otitis media involves a greater total burden in terms of the number of affected children, the number of episodes, physician visits, prescription drugs, hospitalizations, and surgical procedures. Work loss was 3.4 times greater per family with a varicella case, but the number of families affected by otitis media was 3.3 times greater than for varicella, so that the total amount of family work loss was about the same for both illnesses for the year. The community burden of otitis media should be studied in a population-based longitudinal manner that includes parental work loss as well as health care costs to accurately determine the potential cost-benefit of prevention programs.

Absenteeism↗
PubMed2002

Predicting the development and outcome of otitis media by tympanometry.

OBJECTIVE: Identification of children with high risk of development or prolongation of otitis media would be highly useful in clinical practice. In this study, tympanometry was assessed for its capability in predicting development and resolution of acute otitis media (AOM). METHODS: Visits of 329 children followed in the Finnish Otitis Media Cohort Study from 2 to 24 months of age were evaluated for this report. Tympanometry was routinely performed on all children during their visits to a special study clinic. Adjacent consecutive visits were used for analysis of development and resolution of middle ear fluid (MEF) between the visits. Descriptive analysis utilized all data obtained during the longitudinal follow-up; confirmatory statistical analysis was performed on data of one randomly selected visit per subject to ensure independence of observations. Presence of MEF at the second visit was used as the outcome. RESULTS: Negative tympanometric peak pressure (<-100 daPa) was found to predict the development of otitis media when observed during respiratory infection with no concomitant ear disease. Otitis media developed within 20 days to 40% of children with negative pressure compared with 20% of children without negative pressure. The observed association was confirmed statistically (odds ratio 4.8, 95% confidence interval 2.4-9.6). Poor outcome of AOM at the subsequent follow-up visit 3-5 weeks later was found in 9% of ears with negative pressure tympanogram compared with 24% with initial type B or normal pressure tympanogram during AOM. However, we could not confirm the finding in statistical analysis (odds ratio 0.6, 95% confidence interval 0.2-2.0). CONCLUSIONS: Profound negative tympanometric peak pressure is a significant marker of increased risk for development of otitis media. Children with negative pressure have to be thoroughly followed for subsequent progress of the respiratory disease and development of otitis media. For the prediction of resolution of AOM, the findings remained inconclusive.

Acoustic Impedance Tests↗
PubMed1998

A nation-wide, population-based survey of otitis media and school achievement.

The purpose of the study was to evaluate whether there is an association between early recurrent otitis media and later school achievement. A nation-wide, population-based random cluster sampling of 1708 children in 119 school classes was performed throughout Finland. Data were collected with questionnaires sent to the parents and teachers of the children. Teachers evaluated each child's performance at school, and the association between the number of episodes of early otitis media and school achievement was determined. Recurrent otitis media episodes before the age of 3 years associated significantly with lower performance in mathematical skills (risk ratios [RR] 1.2-1.4, 95% confidence intervals [95% CI] 1.0-1.7, P-values 0.04-0.02) and classroom concentration (RR 1.4, 95% CI 1.1-1.8, P-value 0.02) among the girls. The boys with recurrent otitis episodes performed more poorly in reading (RR 1.3, 95%, CI 1.0-1.6, P-value 0.05) and oral performance (RR 1.2, 95% CI 1.1-1.4, P-value 0.01). No association between otitis episodes after the age of 3 years and school achievement was found. Our findings suggest that recurrent otitis media episodes before the age of 3 years have adverse long-term consequences even when treated actively. Even though the risk ratios were low our finding is important because recurrent otitis media is a common problem during infancy and school achievement has many practical influences on a child's future.

Age Distribution↗
PubMed1998

Otitis media in children with vertically-acquired HIV infection: the Great Ormond Street Hospital experience.

Human immunodeficiency virus (HIV) infection continues to be a vexing problem in the pediatric population. Otitis media, a common entity in immunocompetent as well as immunocompromised children, is prevalent in pediatric patients with HIV infection. Recurrent infections and complications secondary to otitis media are also common in this population. The purpose of this review was to evaluate the records of a large group of children with HIV infection undergoing treatment for otitis media at a tertiary care center. Incidence of infections, severity of infections, and pathogens responsible were the key points of data collection in relation to each patient's HIV clinical and immunologic classification. We reviewed 72 patients with vertically-acquired HIV infection undergoing treatment at the Hospital for Sick Children, Great Ormond Street, London. All patients were born to HIV infected mothers of sub-Saharan African origin. A total of 32 (44.4%) of these children presented to our institution with one or more episodes of otitis media, six of whom suffered systemic complications secondary to middle ear pathology. Middle ear culture data, when available from actively draining ears, was similar to those of immunocompetent children in the general population. The most common complications were systemic bacteremia and recalcitrant infections requiring intravenous antibiotic therapy. Severity of immunosuppression was associated with higher incidence and severity of otitis media. Otitis media in an HIV infected child must be treated aggressively at its outset in an attempt to minimize possible complications. Administration of prophylactic antibiotics to these children may reduce the frequency of acute and chronic infections. Improvement in immunologic status using antiretrovirals or protease inhibitors is a primary goal in diminishing the severity of otitis media as well as other infections in these children.

AIDS-Related Opportunistic Infections↗
PubMed1976

The natural history of chronic otitis media.

A retrospective study was made of 200 chronic otitis media patients. Simple chronic otitis media was observed in 76 per cent of cases; the rest were associated with cholesteatoma. In about one third of the patients, the contralateral ear showed some inflammatory middle ear disease as well. The average time lapse between initial symptoms and hospitalization was about 10 years. The events leading to the tympanic perforation were difficult to ascertain, but included probably acute otitis media, possibly external otitis, trauma, and a rather large group (35-40 per cent) of insidious 'essential perforations'. The aetiology of the 'essential perforations' is so far not known, but might be non-inflammatory in nature but related to insufficient middle ear aeration and hypo-pneumatization as well as to what is termed atelectatic ears. The bacteria isolated from chronic otitis media ears (usually gram negative bacteria and staphylococcus aureus) are usually not the types of micro-organisms found in association with any primary or acute otitis media. It is proposed that the bacterial infection encountered in what is termed 'chronic otitis media' is often a secondary infection of a primary perforated tympanic membrane, the perforation originating or persisting in underventilated ears, and having arisen from various causes--some of them as yet unknown.

Adolescent↗
PubMed1988

Otitis media and language development at 1 year of age.

The effect of otitis media on emerging language was examined in a group of 1-year-olds. Based on pneumatic otoscopy, 15 babies were considered to be free of otitis media in both ears at 80% or more of their first year medical visits (otitis free) and 12 infants had bilaterally positive otoscopy results at 30% or more of their visits (otitis positive). Outcome measures at 1 year included the Bayley Scales of Infant Development (Bayley, 1969) and the Sequenced Inventory of Communication Development (SICD; Hedrick, Prather, & Tobin, 1984) Receptive and Expressive scales. No significant differences were detected on either the Bayley or the SICD Receptive scale. However, the otitis positive group exhibited significantly lower expressive language scores than the otitis free group, suggesting that impairments in language expression may be evident as early as 1 year of age in children with otitis media.

Acoustic Impedance Tests↗
PubMed2002

Allergic otitis externa.

Chronic otitis externa is a common condition, which is usually successfully treated by topical medications and aural toilet. In cases that persist despite conventional treatment, a diagnosis of allergic otitis externa should be considered. Sensitization to otic medications (secondary contact otitis) is not uncommon. Topical aminoglycosides are the most common sensitizers although many components of topical preparations can cause sensitization. Patients who may have developed allergic otitis externa should undergo patch testing. Otolaryngologists should consider using topical antibiotics with a low allergenic potential and avoiding neomycin when treating patients with otitis externa. Primary contact otitis may occur to metals used in earrings and also to hearing aid moulds. Treatment of both primary and secondary contact otitis consists of identifying the allergen, avoiding further contact and use of simple preparations avoiding common sensitizers.

Chronic Disease↗
PubMedDate not supplied

The association between iron-deficiency anemia and recurrent acute otitis media.

PURPOSE: This study was designed to examine the association between iron-deficiency anemia and the frequency of recurrent acute otitis media in children, and to evaluate the effect of restoring normal hemoglobin levels on the frequency of acute otitis media attacks. MATERIALS AND METHODS: A total of 680 children with frequent episodes of acute otitis media were enrolled in the study. The levels of the hemoglobin were measured in both these children and in 200 healthy children with no history of infections. The correlation between hemoglobin level and the frequency of middle ear infections was studied and analyzed. All children with hemoglobin levels lower than 9.5 g/dL received iron supplementation until they reached a level of at least 11 g/dL, and the subsequent frequency of middle ear infections was recorded. RESULTS: The 680 children had an average of 8.3 +/- 2.7 episodes of acute otitis media per year per child, and an average hemoglobin level of 11.4 +/- 2.7 g/dL, whereas the controls had an average hemoglobin level of 13.1 +/- 2.5 g/dL. Twenty percent had hemoglobin levels below 9.5 g/dL. These children had more episodes of acute otitis media when compared with children with average levels. By increasing the hemoglobin level in these children, the frequency of the episodes of acute otitis media decreased significantly. CONCLUSIONS: This study confirms that anemic children have higher prevalence of episodes of acute otitis media in comparison to healthy, nonanemic children, and shows that there is a direct relationship between the degree of the anemia and the number of the episodes.

Acute Disease↗
PubMed1998

Antibiotic treatment of acute otitis media. Criteria and performance in Danish general practice.

OBJECTIVE: To assess implicit criteria (i.e. what the general practitioner (GP) considers good clinical practice) for and performance (i.e. what the GP actually does) with regard to antibiotic treatment of acute otitis media in Danish general practice. DESIGN: a) Criteria assessed by survey among general practitioners. b) Performance assessed by prospective registration of consultations with general practitioners related to otitis media. SETTING: General practices in three Danish counties. SUBJECTS: a) All the GPs in the three countries (n = 790). b) 368 children with acute otitis media. MAIN OUTCOME MEASURES: a) Criteria for timing of treatment and first drug of choice for acute otitis media; b) prescribed antibiotics and multivariate analysis of factors predicting antibiotic prescription. RESULTS: a) The response rate was 72%. Only 51% (95% CI 47-55) of GPs would give antibiotics to all children with acute otitis media, and 79% (95% CI 76-82) of GPs would use penicillin-V as first drug of choice. b) Seventy-four per cent (95% CI 68-81) of children with acute otitis media were given antibiotics. Factors predicting the GPs' decision to prescribe antibiotics were the general condition of the child and the factors that are normally used in diagnosing the condition. CONCLUSION: Danish general practitioners' criteria for antibiotic treatment of acute otitis media are restrictive, with non-antibiotic treatment in cases of short duration and penicillin-V as first drug of choice. Performance suggests a less restrictive pattern.

Anti-Bacterial Agents↗
PubMedDate not supplied

Efficacy of pneumococcal polysaccharide vaccine in preventing acute otitis media in infants in Huntsville, Alabama.

In a study of the efficacy of pneumococcal capsular polysaccharide vaccines in preventing otitis media due to Streptococcus pneumoniae, 179 infants were randomly assigned to receive either a "target" vaccine containing serotypes 1, 3, 6, 7, 14, 18, 19, and 23 (which account for most cases of pneumococcal otitis media) or a control vaccine containing serotypes 2, 4, 5, 8, 9, 12, and 25 (which account for few cases). Vaccine (0.5 ml) was administered subcutaneously; a dose contained 25 micrograms of each serotype. The incidence of otitis media due to "target" serotypes was determined in both groups. There were not significant differences between vaccines and controls in either the incidence or etiology of episodes of otitis media before immunization. During a two-year follow-up, no significant difference was observed regarding the incidence of episodes due to "target" serotypes in infants who were immunized after 12 months of age. However, of 66 control infants immunized before 12 months of age, 22 experienced 33 pneumococcal episodes due to a "target" serotype, whereas only 13 of 67 vaccines accounted for 22 such episodes. Among infants who had two or fewer episodes before immunization, four vaccines and 13 controls continued to have episodes of otitis media and became "otitis prone," i.e., six or more episodes (chi 2 = 4.84; P = 0.05). Low levels of serum antibody were not protective, and in one case a level of 609 ng of antibody nitrogen/ml of middle ear effusion was not protective. Thus, although the vaccine may be associated with a lower incidence of otitis media, the results of this study do not show a statistically significant efficacy of the vaccine.

Acute Disease↗
PubMed1998

Childhood imbalance and chronic otitis media with effusion: effect of tympanostomy tube insertion on standardized tests of balance and locomotion.

The goal of this study was to investigate the role of chronic otitis media with effusion as a cause of childhood imbalance. Nineteen 4- to 6-year-old children with chronic otitis media with effusion and 14 matched control children underwent a series of laboratory tests, including two standardized tests of balance and locomotion: the Peabody Developmental Motor Scales (PDMS) and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The children in the chronic otitis media with effusion group underwent tympanostomy tube insertion. Both groups underwent the same battery of tests within 6 to 8 weeks of initial testing. Analysis of variance for the PDMS and BOTMP demonstrated significantly lower performance in the balance subscales for the otitis group before (P < .01). Both otitis and control groups improved when retested. The improvement was greater and approaching significance in the otitis group on the PDMS and BOTMP (P = .056 and .097, respectively). It is concluded that chronic otitis media with effusion significantly affects balance and coordination skills in 4- to 6-year-old children. These skills improve after tympanostomy tube insertion at a rate greater than that of the control group.

Child↗
PubMed2002

Effect of bacterial endotoxin and middle ear effusion on ciliary activity: implications for otitis media.

OBJECTIVES/HYPOTHESIS: Otitis media with effusion (OME) is the most common cause of childhood deafness. The pathogenesis is not fully understood, especially the reasons for failure of mucociliary clearance of the middle ear. It is not clear whether the cilia function normally in the middle ear and eustachian tube in the chronic phase of otitis media with effusion. However, impaired ciliary function in primary ciliary dyskinesia is known to be frequently associated with the development of otitis media with effusion. We hypothesized that endotoxin or the bacterial products in middle ear fluid in otitis media with effusion would adversely affect ciliary activity, thereby contributing to the pathogenesis of the disease. STUDY DESIGN: Laboratory-based study of human ciliary activity with reference to otitis media with effusion. METHODS: We have studied the activity of human adenoidal cilia under various conditions. Ciliary activity in the presence of Haemophilus influenzae endotoxin additions (at varying concentrations) to cultured adenoidal explants has been measured. In addition, ciliary activity of these explants was also observed after addition of middle ear effusion aspirated from patients. RESULTS: We have shown that endotoxin in concentrations far in excess of those found in the middle ear with chronic otitis media with effusion had no effect on ciliary activity. Furthermore, ciliary activity was completely unaffected by the presence of middle ear effusion. CONCLUSION: There is no evidence that ciliary activity is reduced by the constituents of middle ear fluid in chronic otitis media with effusion.

Adenoids↗