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At least 19 recordsLinked to original sources
PubMed1979

Lysozyme activity and immunoglobulins in middle ear effusion fluid in acute purulent otitis media and in otitis media with effusion.

147 samples of punctured middle ear effusion fluid from cases of otitis media with effusion and 150 samples from patients with acute purulent otitis media were tested for lysozyme activity. In otitis media with effusion the concentration was 182.0 U/ml, in acute otitis 433.8 U/ml. The lysozyme concentration in otitis media with effusion depended upon the nature of the effusion. Serous fluid showed an activity of 124.8 U/ml and mucoid 311.6 U/ml, respectively. In culture-positive cases of acute otitis media the lysozyme level was 423.4 U/ml. Culture-negative cases showed about the same concentration, 438.3 U/ml. The possible role of lysozyme in defence systems of the middle ear is discussed.

Adolescent↗
PubMedDate not supplied

Serous otitis media.

Serous otitis media, as seen in children, may be an insidious disease which provides few signs and symptoms. Its effects may cause significant problems in the preschool and school-age child with respect to acquisition of necessary developmental skills. The nurse practitioner can effectively diagnose, treat, and manage children with serous otitis media. An algorithm is presented to aid in effective differential diagnosis of the disease.

Child↗
PubMed1975

Symposium. ENT for nonspecialists. Serous otitis media.

Serous otitis media is a capricious entity that can cause conductive deafness. The condition is most common in children, who often cannot describe the attending symptoms of deafness, fullness, and pressure. The basic contributing factor is inadequate function of the eustachian tube. Function improves as the child approaches 12 years of age. Underlying factors such as infections, adenoidal hypertrophy, and allergic states also must be managed. The otitis media may be treated medically or surgically.

Acute Disease↗
PubMed1979

Gram-negative bacteremia. Two cases in adults with chronic otitis media.

Chronic otitis media was the cause of septicemia in two hospitalized men. The organisms involved, K pneumoniae and B fragilis, are not usually associated with primary infections of the middle ear and would not have been traced to this site had proper cultures not been performed. In adults, the true incidence of bacteremia arising from the middle ear may be higher than suspected.

Aged↗
PubMed1978

Tuberculous otitis media.

Tuberculous otitis media is a variable and puzzling infectious disease which may remain undiagnosed or confused with other acute or chronic middle ear conditions if appropriate diagnostic studies are not performed. Among the common clinical findings are insiduous onset of painless watery drainage, severe hearing loss, multiple perforations of the tympanic membrane and subsequent appearance of profuse granulation tissue. As the disease progresses destruction of the middle ear conductive apparatus, facial paralysis, cochlear involvement with labyrinthitis and further hearing loss, and finally intracranial dissemination of infection may occur. The case histories of two patients recently treated at Mount Sinai Hospital illustrate some of the clinical problems encountered with this disease.

Adult↗
PubMedDate not supplied

Acute otitis media. A clinical bacteriological and serological study of children with frequent episodes of acute otitis media.

A series of episodes of acute otitis media was studied with reference to bacterial findings and specific serological responses in 48 children with histories of frequent episodes before. D. pneumoniae and H. influenzae were the most frequently isolated pathogens. Re-isolations after therapy were often made in episodes with slow healing or therapeutic failure. Most children harboured pathogens in nasopharynx even when they had no signs of respiratory tract infections. Homologous relapses were seen only in few cases and never with pneumococcus type 3 and only once with H. influenzae type b. Specific serological responses were demonstrable generally in children over 2 years of age. D. pneumococcus type 3 and H. influenzae type b generally provoked antibody response. No levels indicating immunoglobulin deficiencies could be found in the children.

Acute Disease↗
PubMedDate not supplied

Pathology of chronic otitis media.

A review of 800 pathological temporal bones collected from autopsy cases revealed 333 ((41.6%) to have some type of otitis media; purulent otitis media (52.5%), serous otitis media (6%), mucoid otitis media (4.5%), and chronic otitis media (36.9%). The 123 temporal bones with chronic otitis media were further studied and found to have granulation tissue, cholesteatoma, cholesterin granuloma, bone changes, and fibrosis. Other findings included tympanic membrane perforation, tympanosclerosis, metaplasia of the epithelium with subepithelial glandular formation, suppuration, labyrinthitis, and evidence of complications of chronic otitis media (meningitis, subdural abscess, brain abscess, petrositis, and endolymphatic hydrops). From this study it was concluded: 1) chronic otitis media occurred quite frequently, from a histological standpoint, in the absence of tympanic membrane perforation; 2) granulation tissue in temporal bones was found much more frequently in chronic otitis media than was cholesteatoma; and 3) complications and sequelae of otitis media tended to occur more commonly secondary to granulation tissue than to cholesteatoma.

Adult↗
PubMed1978

Tuberculous otitis media with complications.

Tuberculous otitis media, although uncommon today, is still a differential diagnosis of suppurative otitis media. Our patient's otitis progressed from a draining ear with hearing loss to include facial nerve paralysis and meningitis. Several surgical procedures including radical mastoidectomy were insufficient to halt progression of the disease. After culture of acid-fast bacilli from the aural drainage and the cerebrospinal fluid, antituberculous chemotherapy was started and the patient responded well to treatment.

Adult↗
PubMed1976

Otitis media of guinea pigs.

Otitis media occurred in 177 of 1373 guinea pigs necropsied during a six-year period. Streptococcus pneumoniae (20%), Streptococcus zooepidemicus (15%), Bordetella bronchiseptica (12%), and Pseudomonas aeruginosa (11%) were the most common bacteria isolated from affected tympanic bullae. Radiology and otoscopy were tested as means of antemortem screening for affected guinea pigs. Radiology gave 96% accuracy in diagnosing otitis media and proved to be a more satisfactory technique than otoscopy.

Animals↗
PubMedDate not supplied

Otitis media and developmental disability. Epidemiologic considerations.

Review of the literature indicates that: a) otitis media is a common disorder with risk being highest in the pre- and early school years, b) no marked differences in sex distribution of incidence exist, c) frequent recurrences are the hallmark of this disease, and d) mild hearing deficit lasting for months is not uncommon. A retrospective study in a defined population is suggested as an initial effort to investigate the proposed associations between developmental disability and hearing loss, developmental disability and history of otitis media, and finally, hearing loss and history of otitis media. Such an approach, however, a) could not determine the absolute risk of developmental disability in children with otitis media, and b) would underestimate the frequency of otitis media, since occult otitis media would not be thus identified. The determination of an accurate incidence of otitis media and of the absolute risk of developmental disability in children with otitis media calls for a prospective study. Such an investigation is likely to be justified only as a part of a collaborative study designed to measure multiple outcomes from a limited number of antecedents.

Adolescent↗
PubMed1978

Developmental and psychoeducational sequelae of chronic otitis media.

The developmental, psychological, and educational sequelae of chronic otitis media occurring during the first three years of life were investigated in a selected group of children with educational difficulties. One group of children had a history of chronic and severe otitis media, requiring myringotomy after 3 years of age. The control group had infrequent and relatively mild episodes of otitis media and no surgical intervention. Children with chronic and severe otitis media manifested substantial delays in speech and language, auditory processing deficits, disturbances in auditory-visual integration, reading disorders, and poor spelling skills. Early medical and educational intervention for children with a high-risk profile of language delay and severe chronic otitis media is suggested as a possible strategy for preventing the development of a specific learning disability.

Auditory Perception↗
PubMed1978

Acute otitis media in children: diagnostic and therapeutic dilemmas.

Otitis media is still a condition with a level of diagnostic confidence lower than physicians fresh from hospital training are accustomed to. Even with improved diagnostic criteria, there will still be other influences which will affect the physician's prescribing habits, especially in the treatment of early signs of otitis media. This study shows that the determinants of prescribing behavior by ambulatory care physicians are more complex than traditional teaching of students implies. The appropriate use of antibiotics is discussed, and the importance of limiting additional medication is stressed. It is the author's contention that the outcome of care is frequently being measured without attempting to examine closely the dilemmas facing ambulatory care physicians in their day-to-day decisions. Otitis media has been used as the model in this report, but the complexities of clinical judgment are equally applicable to other common infections presenting to the primary care physician.

Acute Disease↗
PubMedDate not supplied

Adenoids and otitis media with effusion.

At adenoidectomy specimens for bacteriological, virological, and histological investigation were obtained from the adenoids of 144 children, 53 of whom suffered from otitis media with effusion, or frequently recurring otitis media. Comparison of findings in children with ear diseases with those obtained in the rest of the material showed that Hemophilus influenza was cultured from 50% of the specimens from the children with ear diseases, while only 14% of the cultures from the other children yielded H. influenza. Virus isolates were made from 17 adenoids. In children with ear diseases a virus was isolated from 28% of the specimens, whereas positive isolates were obtained in only 3% of the rest of the speciemens. Both findings are statistically significant and support the view that the adenoid tissue may play an important role in the etiology of otitis media with effusion. The infected adenoid may be the direct source of the primary infections, or continuous microbial irritation in the nasopharynx may indirectly be the cause of otitis media with effusion, as persistent infection and edema maintain chronic dysfunction of the eustachian tube. Thus adenoidectomy may be beneficial in the treatment of frequently recurring otitis media, preventing otitis media with effusion from developing.

Adenoids↗
PubMed1979

Endolymphatic hydrops and otitis media.

Clinical observation of patients with fluctuant sensorineural hearing loss following or occurring with chronic otitis media led to the hypothesis that endolymphatic hydrops can result from chronic otitis media. Illustrative case reports are described. This hypothesis resulted in a temporal bone study of 560 cases in which 109 temporal bones demonstrated the presence of hydrops and 194 evidenced otitis media. Seventy-five cases demonstrated both otitis media and hydrops, of which 20 cases were selected for more detailed histopathological study. An interesting finding was the presence of apical hydrops in every case of the latter group. Statistical interpretation of this data helped rule out a coincidental or chance occurrence. A discussion of this clinical relationship included the significance of subclinical (silent) otitis media as a possible cause of endolymphatic hydrops.

Adult↗
PubMedDate not supplied

Design factors in the characterization and identification of otitis media and certain related conditions.

Because the state of our knowledge of many aspects of the etiology and pathogenesis of otitis media and related conditions is deficient, precise characterizations of certain aspects of the disease may not be possible. In fact although most studies in the past have failed to define the specific disease state to be investigated, the specific type of otitis media or related condition to be studied must be as clearly defined as is clinically possible in order for any prospective study of otitis media to be valid. The state of the art of the presently available methods to identify these conditions also poses certain limitations; at present, there are five methods to identify otitis media and related conditions: history, audiometry, tympanocentesis/myringotomy, otoscopy (including otomicroscopy), and impedance measurements (tympanometry and assessment of the middle earl muscle reflex), and they all have inherent elements of unreliability. Historical information obtained from parents or the child is usually unreliable; a positive history may aid in defining the problem, but a negative otologic history does not rule out the presence of otitis media since it is frequently asymptomatic. Audiometry has been shown to be a poor method of identifying otitis media. Although tympanocentesis or myringotomy is the most reliable way to identify otitis media with effusion (OME), it is invasive, frequently requires an anesthetic, and is usually a confounding variable. In an effort to establish the diagnostic value of otoscopy, tympanometry, and the presence or absence of the middle ear muscle reflex in identifying OME, the diagnostic findings by these three methods, were compared with the findings at myringotomy in 239 children (425 ears). The study showed that even experienced clinicians had some difficulty in identifying those ears with effusion (sensitivity) and had even greater difficulty in making a diagnosis of those ears without an effusion (specificity). Tympanometry employing patterns that have been validated with myringotomy findings was found to be as accurate as expert otoscopy. On the other hand, the presence or absence of the middle ear muscle reflex was found not to be a useful method of diagnosing the presence of OME due to its extremely low specificity. An algorithm derived from the combination of the three methods had highest sensitivity and specificity. From this study, the following recommendations regarding the identification of OME are suggested. All investigators who employ otoscopy should be validated by comparing their assessments either with the findings at myringotomy or with a previously validated otoscopist. Interobserver realiability of all otoscopists should be established prior to and maintained during clinical studies of OME. Only electroacoustic impedance instruments in which the tympanometric patterns have been validated should be used. Tympanometry employing validated tympanometric patterns has a high degree of sensitivity and specificity, and as such can provide an objective method to identify OME...

Acoustic Impedance Tests↗
PubMed1979

Infiltration of the tensor tympani and stapedius muscles in otitis media. An experimental study in the cat.

A longitudinal sequential study of otitis media was done in an experimental animal (cat) using eustachian tube obstruction. Fifty animals were used. Cellular infiltration of the tensor tympani and stapedius muscles was studied in a continuum from day 1 to 6 months after inducing otitis media. We observed that there is infiltration of the connective tissue of both muscles in otitis media, and that the cellular changes follow the same pattern as that seen in the mucoperiostium and the round window of the middle ear, although to a lesser degree. In this first report of sequential changes in middle ear muscles in otitis media, clinical implications of these findings are discussed.

Animals↗
PubMed1978

Lactate dehydrogenase as a measure of inflammation in experimental otitis media.

A reliable animal model for acute otitis media due to Streptococcus pneumoniae was used to study the accumulation of lactate dehydrogenase (LDH) in middle ear effusion during acute pneumococcal otitis media and after penicillin treatment. The findings indicate that LDH levels rise in the middle ear effusion during the early phase of acute infection and decrease as the infection resolves over time. Penicillin treatment affects the natural course of infection by resolving most visible signs of inflammation and by sterilizing the middle ear. However, once middle ear infection was established, penicillin treatment did not reduce the elevated levels of effusion LDH, suggesting that inflammation persists after sterilization of infected middle ears.

Animals↗
PubMed1977

Comparison otitis media due to types 3 and 23 Streptococcus pneumoniae in the Chinchilla model.

Only a few pneumococcal serotypes are responsible for the majority of cases of acute otitis media due to Streptococcus pneumoniae in children. The immunopathogenesis of otitis media cause by two serotypes, type 3 and 23, was studied in chinchillas. Chinchillas with type 23 pneumococcal otitis media were capable of clearing the infection over a six-week period without treatment, whereas the type 3 infection persisted throughout the six-week study. In addition, bacteremia or meningitis occurred more frequently and earlier with type 3 pneumococcal otitis media than with type 23. The resolution of the type 23 pneumococcal infection paralleled the development of type-specific antibody, as measured by radioimmunoassay, whereas type 3 infection was associated with a fall in serum antibody to low levels. Since the pathogenesis of pneumococcal otitis media in the chinchilla differs between pneumococcal serotypes, it may be important to correlate pneumococcal serotypes with sequealae and recurrence of otitis media in children.

Animals↗