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Otorrhea is one of the most common ear complaints and is usually responsive to office treatment. The various causes of this condition are discussed and appropriate treatment options are detailed in this article. Topics include otorrhea from typanostomy tubes, chronic otitis media, external otitis and otorrhea, otorrhea after trauma, congenital anomalies and otorrhea, and neoplastic otorrhea.
Office pediatric otology requires the management of some of the most common acute and chronic conditions of childhood. Some of these conditions include eustachian tube dysfunction, otorrhea, granulation polyps, extruded tubes, otitis media, trauma, otalgia, and sudden hearing loss. An approach that recognizes the concerns of the child and parent facilitates the examination and treatment with minimal discomfort.
Ipomoea muricata (L.) Jacq, locally known as 'Tonkin', has been used for generations by the Dominicans in the Philippines for medicinal purposes. The seeds, stems and leaves are said to be effective in treating several types of skin ailments such as chronic and gangrenous wounds, cuts and blisters due to burns. Scientific investigations to rationalize the reported medicinal uses of the plant were carried out at University of Santo Tomas. Botanists at the University did the identification and studied the cultivation and propagation of the plant. Pharmacists and chemists worked closely together on the 'Tonkin' seeds. The seeds were found to have both analgesic and antiseptic properties. Chemists identified indolizidine alkaloids in the seeds, to which the analgesic properties have been attributed. Antimicrobial and antifungal compounds were also identified. Different formulations of the crude drug have been made, namely, an ointment for the treatment of skin ailments, glycerol preparation for the treatment of pharyngitis and an otic preparation for the treatment of otitis externa. Limited clinical trials of these formulations were carried out in collaboration with the medical doctors. The clinical trial studies were supported by in vitro studies carried out by microbiologists. Basic research on this plant material is still continuing. Efforts are now underway for the commercial production of the Tonkin ointment.
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Ceruminous adenoma (ceruminoma) of the external auditory meatus is a rare neoplasm with benign clinical behavior. This tumor is mainly composed of the ceruminous gland cells (modified apocrine sweat glands). These glands are localized deep in the skin mostly in the cartilaginous part of the external auditory meatus. The most often symptom of the ceruminous adenoma of external auditory meatus is the unilateral conductive hearing loss. Occasionally symptoms of this tumor (pain, otorrhoea) can result from an otitis externa secondary to meatus obstruction. Ceruminous adenoma should be radical excised with adequate margins of the normal tissues. The prognosis of these tumors is good. The difficulties of nomenclature, histological structure of the auditory external meatus ceruminoma, as well as symptomatology, treatment and clinical behavior are discussed on the basis of the literature. A case of histologically confirmed ceruminoma (ceruminous adenoma) of the external auditory meatus in a surgically treated 53 years old men is presented.
The article presents current views on etiopathogenesis of the diseases associated with contamination with microorganisms; reviews inflammatory ENT diseases in terms of current literature on clinical microbiology of these diseases; characterizes microorganisms more or less specific for each relevant nosological entity; analyses basic groups of antibacterial drugs with formulation of bacteriologically grounded principles of initial antibacterial therapy of ENT inflammation.
A group of 34 patients with nasopharyngeal cancer was studied to observe the influence of the radiation effect on the bacterial flora of the external ear canal. The effects were observed before and after radiation therapy. The Gram-positive aerobes, especially the Staphylococcus epidermidis, were found to have decreased (57.1% to 37.7%). Though there was a slight increase of the Gram-negative aerobes (44.6% to 50.8%), it was not statistically significant. We concluded that the higher incidence of otitis externa induced by irradiation is due to the local radiation reaction, but not the shifted colonization of the potentially pathologic flora.
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The authors present results of retrospective clinical analysis of usefulness the cefuroxime therapy of acute ENT diseases in children. The study group consist of 886 patients, aged 4 m. to 17 year, hospitalized at the Department of Paediatric Otolaryngology between 1997-2002. The efficacy of therapy was estimated on the ground of 4 degree scale. Particular attention was paid on measuring an average time of intravenous and oral administration of drug and on side effects of treatment. The results of the study shown that cefuroxime therapy is safe and effective. Beneficial therapeutic effect was obtained in 98.9% of patients.
Granular myringitis is the result of a localized chronic inflammation of the lateral surface of the tympanic membrane which is characterized by the development and persistence of granulation tissue over the involved area. The onset of the disease is insidious, and the symptoms, which are minor, are usually confined to chronic otorrhea and mild discomfort in the involved ear. Granular myringitis is a disease which is poorly understood and has received relatively little attention in the literature. The clinical features of this disease are outlined, the pathologic changes in the tympanic membrane illustrated, the literature reviewed and a strategy for treatment presented.
The external auditory canal is an uncommon location for the nevi that are common benign tumors of the skin. A papillomatous lesion was detected in the external auditory canal of the patient who was on follow-up for acute otitis externa. The lesion which resembled a nevus was excised and was diagnosed as an intradermal nevus in pathological examination. The clinical and pathological picture of the intradermal nevus of the external auditory canal was discussed.
Otorrhea is a symptom and not a diagnosis. It can be caused by many disease processes. There are several reasons to consider topical treatment of otorrhea. Two are that greater concentrations can be reached locally of pharmacologically active agents and there is less risk of systemic complications and side effects. One factor that might prevent their efficacy is the formation of biofilms by pathogenic organisms. Topical treatments usually include antimicrobial agents. There is evidence that aminoglycoside-containing drops can cause ototoxicity, particularly insidious vestibular ototoxicity. Nonaminoglycosides are recommended if there is access to the middle ear. There is some evidence that the addition of steroids hastens resolution. There is little evidence on which to estimate the risk reduction of serious complications of otitis media from treatment with topical therapy. In some causes of otorrhea, nonmicrobial treatments might be just as effective. Individualized therapy is recommended.
In recent years there has been increasing interest in the role of biofilms in perpetuating the chronicity and severity of bacterial infections. Enter the word biofilm as a search criterion with PubMed (National Library of Medicine) and you will doubtless be surprised to recover over 4000 citations, with nearly 3000 registered since 2000. So why has there been such an explosion of interest in this phenomenon? This article seeks to provide a brief overview of the subject, with particular reference to the role that biofilms may have to play in otologic disease.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.