BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy w...BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy with tympanostomy tube.While both procedures aim to improve hearing outcomes,the efficacy of these approaches has been a subject of ongoing research and debate.AIM To compare the efficacy of myringotomy alone and myringotomy with tympa-nostomy tube.METHODS In this comparative study,66 patients diagnosed as OME meeting the inclusion criteria were selected via ear,nose and throat department.They were divided into two groups randomly,each of 33 patients.In the first group(Group A)myrin-gotomy alone was performed while in the second group(Group B)myringotomy with tympanostomy tube placement was performed.We observed hearing outcome by pure tone audiogram(PTA)pre operatively.Patients were followed up and re-assessed in outdoor patient department at 4th week postoperatively again by PTA.RESULTS The mean age of the patients in Group A was 10.96±2.76 SD but the mean age of the patients in Group B was 10.22±2.73 SD(P=0.1056).In Group A,males were 63.6%and females were 36.3%.Also in Group B,males were 63.6%and females were 36.3%(P=1.0).In group A,post operative hearing gain using pure tone audiometry at one month was 20.45±3.78 SD while in group B,post operative hearing gain using pure tone audiometry at one month was 23.84±3.69 SD(P=0.00005).However,ear discharge was noted in 3.03%cases in group A and 15.15%cases in group B(P=0.035).By applying independent t-test,the P<0.05 indicated that there is a significant association between Group B and hearing improvement at 4th week.CONCLUSION Our study concluded that myringotomy with tympanostomy tube seems to have better hearing results than myringotomy alone in treatment of OME.展开更多
Otitis media is an infection of the middle ear mainly caused by bacteria,and current treatments rely heavily on antibiotics.However,the emergence of antibiotic-resistant bacterial strains seriously affects their effic...Otitis media is an infection of the middle ear mainly caused by bacteria,and current treatments rely heavily on antibiotics.However,the emergence of antibiotic-resistant bacterial strains seriously affects their efficacy.In our study,we found that extracellular vesicles(EVs)derived from human natural killer cells(NKs)inhibit the proliferation of both standard and levofloxacin(LVX)-resistant strains of Staphylococcus aureus in a dose-dependent manner.Moreover,compared to LVX,EVs were more effective at reducing effusion and rescuing hearing thresholds in animal models.For LVX-sensitive strains,EVs were significantly more effective in terms of curative time but not curative rate.For LVX-resistant strains,EVs were significantly more effective in terms of both curative rate and curative time when applied alone or applied jointly with LVX.In summary,we found that NK EVs are highly effective in treating otitis media,providing an alternative approach for treating this common disease.展开更多
Objectives: Necrotizing external otitis(NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread...Objectives: Necrotizing external otitis(NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.Methods: Retrospective chart review from 2010 to 2019 with NEO patients, who were divided into two cohorts: single spreading patterns(group A) or complex spreading patterns(group B) as diagnosed by CT.Clinical symptoms, diagnostic and treatment delay, course of disease, complications, and duration of antibiotic exposure were retrospectively collected from patient records.Results: 41 NEO patients were included, of which 27 patients belonged to group A(66%). The diseaserelated mortality rate was 12.2% among the entire cohort, no differences were found between group A and B. Higher rates of N.VII(42.9% vs 14.8% P = 0.047) and N. IX palsies were found in group B compared to group A(28.6% vs 3.7%, P = 0.039). The median duration of antibiotic use was significantly different for a complex spreading pattern, clinical recovery and hospitalizations. Complications were associated with higher diagnostic delay and with a complex spread pattern. The median duration of follow-up was 12.0(IQR 6.0-19.5) months.Conclusion: NEO is a severe disease, with significant mortality and morbidity(cranial nerve palsies). The radiological spread pattern may assist in predicting clinical outcome. Furthermore, complex spread patterns are associated with higher rates of clinical nerve palsies(N. VII and N.IX), complications, surgery rates and longer duration of antibiotic use. Diagnostic delay was associated with mortality, complications and facial palsies.展开更多
Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogen...Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogenesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic administration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre-and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 cases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P > 0.05). The rate of normal hearing following treatment in G3 was 70% or 7 / 10, higher than in G1(41.7% or 5 / 12) and G2 (54.5% or 6 / 11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8 / 10 in G2 and G3, respectively, higher than that in G1(50.0% or 6 / 12)(P < 0.05). Conclusions Therapeutic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In addition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.展开更多
Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behaviour...Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.展开更多
Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods:...Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods: Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results: The mean ETS score was 2.34 ± 0.97 preoperatively, and 6.17 ± 1.54, 7.23 ± 1.62, 8.24 ± 1.97, and 7.63 ± 1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ± 1.07 preoperatively, and 2.20 ± 0.54, 2.32 ± 0.68, 2.53 ± 0.79, and 2.67 ± 0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion: Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.展开更多
Objective: Clinical symptoms of otitis media with effusion are rarely brought forward to the guardians of young children who the disease is most prevalent in. This often leads to poor scholastic performances and diffi...Objective: Clinical symptoms of otitis media with effusion are rarely brought forward to the guardians of young children who the disease is most prevalent in. This often leads to poor scholastic performances and difficult social interactions. The objective of this study was to identify asymptomatic cases of otitis media with effusion present in individuals with adenoid hypertrophy. Material and Methods: In a cross sectional study advocated in Justice K.S.Hegde Hospital, Karnataka India we evaluated one hundred patients above the age of three from August 2016 to December 2017. Candidates who presented with an adenoid nasopharyngeal ratio of more than 0.5 were selected for the study. Individuals who complained of otological symptoms were not considered for the study. Patients cleared of other pathological otological conditions were underwent audiological evaluation with pure tone audiometry and tympanometry for evaluating the middle ear status and hearing loss. Results: The study showed a total of 36% of patients evaluated presented with asymptomatic otitis media with effusion. In candidates who presented with a bilateral B tympanogram, 40% had significant conductive hearing loss of more than 25dB. Conclusion: An objective test such as impedance audiometry in all patients with adenoid hypertrophy would aid in the diagnosis of fluid in the middle ear, so that timely intervention can be done and possible complications be averted.展开更多
Background:Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base.It can be a difficult entity to treat as clinical presentation varies and respo...Background:Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base.It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients.We reviewed cases of malignant otitis externa in our setup to document the epidemiology and outcome of management.Methods:This is a retrospective case review observational study from January 2013eDecember 2017.Fourteen patients diagnosed with malignant otitis externa in our tertiary referral centre were included in the study.Based on hospital protocol,empiric treatment was started.After discharge,the patients follow up visits to the hospital were also documented.Results:Otalgia was the most common symptom.Edema and congestion of the external auditory canal were observed in most cases.Diabetes was present in all patients.Three cases had associated facial palsy,and one patient had involvement of 7th,9th,10th,11th and 12th cranial nerve.Two patients with facial palsy recovered.Pseudomonas aeuroginosa was the most common organism isolated(50%).Conclusions:In our series,malignant otitis externa invariably presented with severe otalgia.Lower cranial palsies were also seen.Methods to evaluate complete eradication of disease should be centered on clinical symptoms and signs,but the measurement of erythrocyte sedimentation rate or radiological imaging may be used as a useful adjunct when there is uncertainty.展开更多
Otitis media （OM） is a middle ear infection associated with inflammation and pain. This disease frequently afflicts humans and is the major cause of hearing loss worldwide. OM continues to be one of the most challen...Otitis media （OM） is a middle ear infection associated with inflammation and pain. This disease frequently afflicts humans and is the major cause of hearing loss worldwide. OM continues to be one of the most challenging diseases in the medical field due to its diverse host targets and wide range of clinical manifestations. Substantial morbidity associated with OM is further exacerbated by high frequency of recurrent infections leading to chronic suppurative otitis media （CSOM）. Children have greater susceptibility to, and thus, suffer most frequently from OM, which can cause significant deterioration in quality of life. Genetic factors have been demonstrated, in large part by twin and family studies, to be key determinants of OM susceptibility. In this review, we summarize the current knowledge on immunity genes and selected variants that have been associated with predisposition to OM. In particular, polymorphisms in innate immunity and cytokine genes have been strongly linked with the risk of developing OM. Future studies employing state-of-the-art technologies, including next-generation sequencing （NGS）, will aid in the identification of novel genes associated with susceptibility to OM. This, in turn, will open up avenues for identifying high-risk individuals and designing novel therapeutic strategies based on precise targeting of these genes.展开更多
Background:Patients with bilateral chronic otitis media-mucosal type have been conventionally treated with sequential tympanoplasty.Bilateral simultaneous tympanoplasty is usually not preferred because of the theoreti...Background:Patients with bilateral chronic otitis media-mucosal type have been conventionally treated with sequential tympanoplasty.Bilateral simultaneous tympanoplasty is usually not preferred because of the theoretical risk of iatrogenic sensorineural hearing loss.With the advent of modern surgical instruments and surgical techniques,the risk is expected to be lower.This study compares the clinical outcomes in typeⅠtympanoplasty performed simultaneously and sequentially.Materials&methods:This randomized prospective study was carried out in a tertiary care hospital between August 2015 and July 2017.A total of 30 patients were divided into two groups of 15 each.This study analyzed the graft uptake,pure tone audiogram findings pre-and post-operatively,duration of surgery and number of hospital visit for each patient and the outco mes were co mpared between both the groups.Result:Patients undergoing bilateral simultaneous tympanoplasty had significantly lesser mean duration of surgery and number of hospital visits than the patients undergoing sequential tympanoplasty.Graft uptake and postoperative wound infections were similar in both the groups.Postoperative hearing improvement was significantly better in the bilateral simultaneous tympanoplasty group.However,further studies are needed to authenticate this observation.None of the patients had a postoperative deterioration of hearing or sensorineural hearing loss.Conclusion:Bilateral simultaneous tympanoplasty is not only feasible but also better than sequential tympanoplasty,especially in terms of operating time,follow-up and overall financial implications on the patient.展开更多
Background:Tuberculosis(TB)of the middle ear cleft(MEC)is a rare extra-pulmonary manifestation.Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making earl...Background:Tuberculosis(TB)of the middle ear cleft(MEC)is a rare extra-pulmonary manifestation.Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult.Objectives:To study the clinical presentations,complications and effective diagnostic modalities in tuberculosis of middle ear cleft.Methods:We retrospectively studied 10 patients diagnosed with chronic otitis media,unresponsive to 2 months conventional treatment.Pure tone audiogram,High resolution computed tomography(HRCT)of temporal bone,and AFB staining of ear discharge were done.All patients underwent mastoid surgery.AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done.Results:Clinical findings were mastoid swelling,facial palsy and post-aural fistula 3,4&2 patients respectively.All patients had persistent ear discharge and three had vertigo.Hearing loss was of moderate conductive type in five,sensorineural type in three and mixed type in two.HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases.Diagnosis of TB was confirmed either by(a)demonstration of AFB in ear discharge(4 patients)/tissue removed during surgery(4 patients)or(b)by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC(8 patients).Conclusion:Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas.Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.展开更多
Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and meth...Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and methods:This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected. Results: All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t ? ?25.95 and ?14.09, respectively for CAP and SIR, p<0.05). Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI. Copyright ? 2015, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight developmen...Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM.Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming learn.With thorough preparation and complete knowledge about characters of specific issues,implantation would be performed successfully,and patients with ossified cochlear could benefit from cochlear implantation.展开更多
BACKGROUND Acute otitis media(AOM)is a common disease that is more prevalent in children.Most studies concerning AOM-associated sudden sensorineural hearing loss are case reports and retrospective in nature,hence the ...BACKGROUND Acute otitis media(AOM)is a common disease that is more prevalent in children.Most studies concerning AOM-associated sudden sensorineural hearing loss are case reports and retrospective in nature,hence the etiology of AOM-associated sudden hearing loss has not been fully established.AIM To analyze audiological characteristics of AOM-associated sudden hearing loss and evaluate efficacy of combined tympanostomy tube placement(TTP)and intratympanic methylprednisolone.METHODS Eight adult patients who were diagnosed with AOM-associated sudden hearing loss and ineffectively treated by conventional medical therapy were enrolled in this study.Basic data were collected,and pure tone audiometry was performed to assess the audiological characteristics.Combination therapy with TTP and intratympanic methylprednisolone injection was given to the patients.RESULTS Mixed or sensorineural hearing loss was observed at high frequencies(2–4 kHz).All the cases in this study were cured after TTP and intratympanic methylprednisolone.After treatment,the average hearing threshold at affected frequencies was significantly lower than those in the pretreatment group(P<0.05)and was similar to that in the healthy ears(P>0.05).CONCLUSION AOM rarely induces sudden sensorineural hearing loss.Combination therapy with TTP and intratympanic methylprednisolone injection may be effective after failure of conventional medical treatment.展开更多
Objective： To observe the clinical efficacy of Qingqiao Capsule （清窍胶囊, QQC） in treating patients with secretory otitis media （SOM）. Methods： A total of 90 patients were randomly assigned into the treated gro...Objective： To observe the clinical efficacy of Qingqiao Capsule （清窍胶囊, QQC） in treating patients with secretory otitis media （SOM）. Methods： A total of 90 patients were randomly assigned into the treated group （n：45） and the control group （n=45）. Patients in the treated group were administrated with QQC, 5 capsules each time, 3 times a day for totally 10-14 days, and those in the control group were given per os cefaclor capsules 0.5g each time for adult, 3 times a day, or 20mg/（kg·d） for children, for 10-14 days. The therapeutic efficacy of treatment on the patients was observed and compared after treatment and followed up for 3-6 months. Results： （1） The clinical efficacy in the treated group was superior to that in the control group with significant statistical difference （P〈0.01）; （2） Comparison of the efficacies in patients of three different TCM syndrome types （the external pathogenic wind invasion caused auditory orifice stuffiness type, the Gan-Dan damp-heat steaming up auditory orifice type and the Pi-deficiency dysfunction induced dirty dampness blocking ear type） showed no statistically significant difference（P〉0.05）; （3） The vanishing rate and time needed of the main symptoms and signs in the treated group were superior to those in the control group on ear muffle, tinnitus, hearing impairment, hydrotypanum, pure tone threshold and abnormal tongue figure, and the difference was statistically significant （P〈0.05 or P〈0.01）, only those of earache, otopiesis and abnornal pulse figure were insignificantly different between the two groups （P〉0.05）. Conclusion： QQC is an effective Chinese composite medicine on patients with SOM, and shows no obvious adverse reaction.展开更多
Background Chronic otitis media(COM) is a significant clinical problem.Understanding the mechanisms of COM is critical for its control and treatment.However,little is known of the processes leading to COM as a result ...Background Chronic otitis media(COM) is a significant clinical problem.Understanding the mechanisms of COM is critical for its control and treatment.However,little is known of the processes leading to COM as a result of lack of animal models of N-ethyl-N-nitrosourea(ENU) induced mutations in otitis media with effusion(OME).Methods Otoscopy and auditory brain response(ABR) evaluation were carried out under sedation in Nmf391nmf/nmf mice of 2,4,6 and 8 months of age.The mice were killed for study of middle and inner ear pathology.Results Tympanic membrane visualization and ABR thresholds in 1-to 8-month-old Nmf391nmf/nmf mice showed spontaneous OME and inner ear diseases in approximately 100% of the animals.The significant elevation of ABR thresholds suggested a sensorineural component in hearing loss in addition to the conductive loss.Middle and inner ear histology showed various degrees of outer hair cells loss and middle ear inflammation in all the mice,but no inflammation cells in the inner ear.The ABR threshold at 32 kHz was significantly elevated.Conclusions This study shows histopathologic changes in the Nmf391nmf/nmf mouse model of COM with effusion that have not been reported in human COM.This ENU induced mutation model of COM will be valuable for the characterization of middle ear inflammation and inner ear disease processes that are induced by middle ear infections.We propose that COM with effusion in this ENU induced mutation model is the cause of the cochlea hair cells damage.展开更多
Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dog...Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.展开更多
Tuberculous otitis media is a rare disease,hence not often considered in the differential diagnosis of otorrhea.This results in late diagnosis with resulting complications such as irreversible hearing loss.A case repo...Tuberculous otitis media is a rare disease,hence not often considered in the differential diagnosis of otorrhea.This results in late diagnosis with resulting complications such as irreversible hearing loss.A case report with review of the literature is presented,emphasizing that tuberculosis should be considered in the differential diagnosis of otorrhea not responding to commonly prescribed antibiotics.We also emphasize the importance of awareness creation in the management of such a disease,involving family members to oversee treatment and also research on ways of shortening duration of treatment to avoid default in treatment.展开更多
Objective To explore the diversity of stagnant effusions and the pathologic processes leading to granulation tissue formation in otitis media with effusion(OME). Methods Temporal bone slides from 306 ears with OME w...Objective To explore the diversity of stagnant effusions and the pathologic processes leading to granulation tissue formation in otitis media with effusion(OME). Methods Temporal bone slides from 306 ears with OME were studied histopathologically under the light microscope. Results Results of this study revealed a pathologic process in witch the type and the condition of stagnant effusion in the middle ear cleft was a variable in the dynamics of OME progression from an early stage to an advanced stage. The location of granulation tissue and retentive effusion were found to be closely related. Conclusion Early stage granulation tissue formation exhibited a pathologic process in which granulation tissue formation occurred only in areas where effusion had stagnated or was absorbed. The incidence of the retentive effusion and formation of granulation tissue was much higher and the pathologic changes most extensive in the area around the ossicular chain.展开更多
Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose...Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department.We also tried to identify the particularities of the fungal infection.Patients and methods:It is an observational cohort that included all the patients hospitalised for the management of NOE.The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.Results:A total of 40 patients were included.The mean age was 65±12.9 years and the sex ratio was 0.9.Ninety percent of the patients included were diabetics.The most common signs found were oedema of the external canal(97.5%)and auricular discharge(92.5%).The main pathogen isolated was Pseudomonas aeruginosa(61.7%).Fungi were isolated in 9 cases(26.47%).Computed tomography was performed for 32 patients(80%).Bone erosion was seen in 26 cases(81.3%).The main complications were cerebral venous thrombosis,retropharyngeal abscess and cerebral empyema.Thirty one patients received only antibiotics,2 received only antifungal treatment,and 7 received both antibiotics and antifungal treatment.All patients had a favorable outcome.Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections.No other differences were noted.Conclusion:Our management protocol seems to be efficient since all patients had initial favorable outcome.A higher median erythrocyte sedimentation rate was associated with fungal infections.展开更多
文摘BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy with tympanostomy tube.While both procedures aim to improve hearing outcomes,the efficacy of these approaches has been a subject of ongoing research and debate.AIM To compare the efficacy of myringotomy alone and myringotomy with tympa-nostomy tube.METHODS In this comparative study,66 patients diagnosed as OME meeting the inclusion criteria were selected via ear,nose and throat department.They were divided into two groups randomly,each of 33 patients.In the first group(Group A)myrin-gotomy alone was performed while in the second group(Group B)myringotomy with tympanostomy tube placement was performed.We observed hearing outcome by pure tone audiogram(PTA)pre operatively.Patients were followed up and re-assessed in outdoor patient department at 4th week postoperatively again by PTA.RESULTS The mean age of the patients in Group A was 10.96±2.76 SD but the mean age of the patients in Group B was 10.22±2.73 SD(P=0.1056).In Group A,males were 63.6%and females were 36.3%.Also in Group B,males were 63.6%and females were 36.3%(P=1.0).In group A,post operative hearing gain using pure tone audiometry at one month was 20.45±3.78 SD while in group B,post operative hearing gain using pure tone audiometry at one month was 23.84±3.69 SD(P=0.00005).However,ear discharge was noted in 3.03%cases in group A and 15.15%cases in group B(P=0.035).By applying independent t-test,the P<0.05 indicated that there is a significant association between Group B and hearing improvement at 4th week.CONCLUSION Our study concluded that myringotomy with tympanostomy tube seems to have better hearing results than myringotomy alone in treatment of OME.
基金supported by grants from the Ministry of Science and Technology of China(2021YFA1101302)the National Natural Science Foundation of China(82171141 and 82192862)the Science and Technology Commission of Shanghai Municipality(21 JC401000).
文摘Otitis media is an infection of the middle ear mainly caused by bacteria,and current treatments rely heavily on antibiotics.However,the emergence of antibiotic-resistant bacterial strains seriously affects their efficacy.In our study,we found that extracellular vesicles(EVs)derived from human natural killer cells(NKs)inhibit the proliferation of both standard and levofloxacin(LVX)-resistant strains of Staphylococcus aureus in a dose-dependent manner.Moreover,compared to LVX,EVs were more effective at reducing effusion and rescuing hearing thresholds in animal models.For LVX-sensitive strains,EVs were significantly more effective in terms of curative time but not curative rate.For LVX-resistant strains,EVs were significantly more effective in terms of both curative rate and curative time when applied alone or applied jointly with LVX.In summary,we found that NK EVs are highly effective in treating otitis media,providing an alternative approach for treating this common disease.
文摘Objectives: Necrotizing external otitis(NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.Methods: Retrospective chart review from 2010 to 2019 with NEO patients, who were divided into two cohorts: single spreading patterns(group A) or complex spreading patterns(group B) as diagnosed by CT.Clinical symptoms, diagnostic and treatment delay, course of disease, complications, and duration of antibiotic exposure were retrospectively collected from patient records.Results: 41 NEO patients were included, of which 27 patients belonged to group A(66%). The diseaserelated mortality rate was 12.2% among the entire cohort, no differences were found between group A and B. Higher rates of N.VII(42.9% vs 14.8% P = 0.047) and N. IX palsies were found in group B compared to group A(28.6% vs 3.7%, P = 0.039). The median duration of antibiotic use was significantly different for a complex spreading pattern, clinical recovery and hospitalizations. Complications were associated with higher diagnostic delay and with a complex spread pattern. The median duration of follow-up was 12.0(IQR 6.0-19.5) months.Conclusion: NEO is a severe disease, with significant mortality and morbidity(cranial nerve palsies). The radiological spread pattern may assist in predicting clinical outcome. Furthermore, complex spread patterns are associated with higher rates of clinical nerve palsies(N. VII and N.IX), complications, surgery rates and longer duration of antibiotic use. Diagnostic delay was associated with mortality, complications and facial palsies.
文摘Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogenesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic administration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre-and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 cases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P > 0.05). The rate of normal hearing following treatment in G3 was 70% or 7 / 10, higher than in G1(41.7% or 5 / 12) and G2 (54.5% or 6 / 11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8 / 10 in G2 and G3, respectively, higher than that in G1(50.0% or 6 / 12)(P < 0.05). Conclusions Therapeutic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In addition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.
文摘Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.
基金supported by the Guangzhou Science and Technology Project (Industrial, Academic and Research Collaborative Innovation Project):201803010093the major development projects of sun yat-sen university: 201812281965
文摘Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods: Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results: The mean ETS score was 2.34 ± 0.97 preoperatively, and 6.17 ± 1.54, 7.23 ± 1.62, 8.24 ± 1.97, and 7.63 ± 1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ± 1.07 preoperatively, and 2.20 ± 0.54, 2.32 ± 0.68, 2.53 ± 0.79, and 2.67 ± 0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion: Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.
文摘Objective: Clinical symptoms of otitis media with effusion are rarely brought forward to the guardians of young children who the disease is most prevalent in. This often leads to poor scholastic performances and difficult social interactions. The objective of this study was to identify asymptomatic cases of otitis media with effusion present in individuals with adenoid hypertrophy. Material and Methods: In a cross sectional study advocated in Justice K.S.Hegde Hospital, Karnataka India we evaluated one hundred patients above the age of three from August 2016 to December 2017. Candidates who presented with an adenoid nasopharyngeal ratio of more than 0.5 were selected for the study. Individuals who complained of otological symptoms were not considered for the study. Patients cleared of other pathological otological conditions were underwent audiological evaluation with pure tone audiometry and tympanometry for evaluating the middle ear status and hearing loss. Results: The study showed a total of 36% of patients evaluated presented with asymptomatic otitis media with effusion. In candidates who presented with a bilateral B tympanogram, 40% had significant conductive hearing loss of more than 25dB. Conclusion: An objective test such as impedance audiometry in all patients with adenoid hypertrophy would aid in the diagnosis of fluid in the middle ear, so that timely intervention can be done and possible complications be averted.
文摘Background:Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base.It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients.We reviewed cases of malignant otitis externa in our setup to document the epidemiology and outcome of management.Methods:This is a retrospective case review observational study from January 2013eDecember 2017.Fourteen patients diagnosed with malignant otitis externa in our tertiary referral centre were included in the study.Based on hospital protocol,empiric treatment was started.After discharge,the patients follow up visits to the hospital were also documented.Results:Otalgia was the most common symptom.Edema and congestion of the external auditory canal were observed in most cases.Diabetes was present in all patients.Three cases had associated facial palsy,and one patient had involvement of 7th,9th,10th,11th and 12th cranial nerve.Two patients with facial palsy recovered.Pseudomonas aeuroginosa was the most common organism isolated(50%).Conclusions:In our series,malignant otitis externa invariably presented with severe otalgia.Lower cranial palsies were also seen.Methods to evaluate complete eradication of disease should be centered on clinical symptoms and signs,but the measurement of erythrocyte sedimentation rate or radiological imaging may be used as a useful adjunct when there is uncertainty.
基金supported by grants from the National Institutes of Health/National Institute on Deafness and Other Communication Disorders(Nos.R01 DC05575,R01 DC01246 and R01 DC012115)
文摘Otitis media （OM） is a middle ear infection associated with inflammation and pain. This disease frequently afflicts humans and is the major cause of hearing loss worldwide. OM continues to be one of the most challenging diseases in the medical field due to its diverse host targets and wide range of clinical manifestations. Substantial morbidity associated with OM is further exacerbated by high frequency of recurrent infections leading to chronic suppurative otitis media （CSOM）. Children have greater susceptibility to, and thus, suffer most frequently from OM, which can cause significant deterioration in quality of life. Genetic factors have been demonstrated, in large part by twin and family studies, to be key determinants of OM susceptibility. In this review, we summarize the current knowledge on immunity genes and selected variants that have been associated with predisposition to OM. In particular, polymorphisms in innate immunity and cytokine genes have been strongly linked with the risk of developing OM. Future studies employing state-of-the-art technologies, including next-generation sequencing （NGS）, will aid in the identification of novel genes associated with susceptibility to OM. This, in turn, will open up avenues for identifying high-risk individuals and designing novel therapeutic strategies based on precise targeting of these genes.
文摘Background:Patients with bilateral chronic otitis media-mucosal type have been conventionally treated with sequential tympanoplasty.Bilateral simultaneous tympanoplasty is usually not preferred because of the theoretical risk of iatrogenic sensorineural hearing loss.With the advent of modern surgical instruments and surgical techniques,the risk is expected to be lower.This study compares the clinical outcomes in typeⅠtympanoplasty performed simultaneously and sequentially.Materials&methods:This randomized prospective study was carried out in a tertiary care hospital between August 2015 and July 2017.A total of 30 patients were divided into two groups of 15 each.This study analyzed the graft uptake,pure tone audiogram findings pre-and post-operatively,duration of surgery and number of hospital visit for each patient and the outco mes were co mpared between both the groups.Result:Patients undergoing bilateral simultaneous tympanoplasty had significantly lesser mean duration of surgery and number of hospital visits than the patients undergoing sequential tympanoplasty.Graft uptake and postoperative wound infections were similar in both the groups.Postoperative hearing improvement was significantly better in the bilateral simultaneous tympanoplasty group.However,further studies are needed to authenticate this observation.None of the patients had a postoperative deterioration of hearing or sensorineural hearing loss.Conclusion:Bilateral simultaneous tympanoplasty is not only feasible but also better than sequential tympanoplasty,especially in terms of operating time,follow-up and overall financial implications on the patient.
文摘Background:Tuberculosis(TB)of the middle ear cleft(MEC)is a rare extra-pulmonary manifestation.Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult.Objectives:To study the clinical presentations,complications and effective diagnostic modalities in tuberculosis of middle ear cleft.Methods:We retrospectively studied 10 patients diagnosed with chronic otitis media,unresponsive to 2 months conventional treatment.Pure tone audiogram,High resolution computed tomography(HRCT)of temporal bone,and AFB staining of ear discharge were done.All patients underwent mastoid surgery.AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done.Results:Clinical findings were mastoid swelling,facial palsy and post-aural fistula 3,4&2 patients respectively.All patients had persistent ear discharge and three had vertigo.Hearing loss was of moderate conductive type in five,sensorineural type in three and mixed type in two.HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases.Diagnosis of TB was confirmed either by(a)demonstration of AFB in ear discharge(4 patients)/tissue removed during surgery(4 patients)or(b)by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC(8 patients).Conclusion:Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas.Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.
基金supported by grants from the National Basic Research Program of China(973 Program)(#2012CB9679002011CBA01000)+1 种基金the National Natural Science Foundation of China(NSFC #81271082)the grants of the National Key Basic Research Program of China(973 Program),No.2014CB943003
文摘Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and methods:This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected. Results: All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t ? ?25.95 and ?14.09, respectively for CAP and SIR, p<0.05). Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI. Copyright ? 2015, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
基金funded by Chinese National Scientifie Research Special-Purpose Project for Public Health Profession(No.200802070)National Program on Key Basic Research(2011CB504503)
文摘Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM.Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming learn.With thorough preparation and complete knowledge about characters of specific issues,implantation would be performed successfully,and patients with ossified cochlear could benefit from cochlear implantation.
文摘BACKGROUND Acute otitis media(AOM)is a common disease that is more prevalent in children.Most studies concerning AOM-associated sudden sensorineural hearing loss are case reports and retrospective in nature,hence the etiology of AOM-associated sudden hearing loss has not been fully established.AIM To analyze audiological characteristics of AOM-associated sudden hearing loss and evaluate efficacy of combined tympanostomy tube placement(TTP)and intratympanic methylprednisolone.METHODS Eight adult patients who were diagnosed with AOM-associated sudden hearing loss and ineffectively treated by conventional medical therapy were enrolled in this study.Basic data were collected,and pure tone audiometry was performed to assess the audiological characteristics.Combination therapy with TTP and intratympanic methylprednisolone injection was given to the patients.RESULTS Mixed or sensorineural hearing loss was observed at high frequencies(2–4 kHz).All the cases in this study were cured after TTP and intratympanic methylprednisolone.After treatment,the average hearing threshold at affected frequencies was significantly lower than those in the pretreatment group(P<0.05)and was similar to that in the healthy ears(P>0.05).CONCLUSION AOM rarely induces sudden sensorineural hearing loss.Combination therapy with TTP and intratympanic methylprednisolone injection may be effective after failure of conventional medical treatment.
文摘Objective： To observe the clinical efficacy of Qingqiao Capsule （清窍胶囊, QQC） in treating patients with secretory otitis media （SOM）. Methods： A total of 90 patients were randomly assigned into the treated group （n：45） and the control group （n=45）. Patients in the treated group were administrated with QQC, 5 capsules each time, 3 times a day for totally 10-14 days, and those in the control group were given per os cefaclor capsules 0.5g each time for adult, 3 times a day, or 20mg/（kg·d） for children, for 10-14 days. The therapeutic efficacy of treatment on the patients was observed and compared after treatment and followed up for 3-6 months. Results： （1） The clinical efficacy in the treated group was superior to that in the control group with significant statistical difference （P〈0.01）; （2） Comparison of the efficacies in patients of three different TCM syndrome types （the external pathogenic wind invasion caused auditory orifice stuffiness type, the Gan-Dan damp-heat steaming up auditory orifice type and the Pi-deficiency dysfunction induced dirty dampness blocking ear type） showed no statistically significant difference（P〉0.05）; （3） The vanishing rate and time needed of the main symptoms and signs in the treated group were superior to those in the control group on ear muffle, tinnitus, hearing impairment, hydrotypanum, pure tone threshold and abnormal tongue figure, and the difference was statistically significant （P〈0.05 or P〈0.01）, only those of earache, otopiesis and abnornal pulse figure were insignificantly different between the two groups （P〉0.05）. Conclusion： QQC is an effective Chinese composite medicine on patients with SOM, and shows no obvious adverse reaction.
基金supported by National Natural Science Foundation of China(grant no.39970785)International Collaborate Research Foundation of National Natural Science of China(grant no.322200462)National Institutes of Health (grant no.ROIDC007392)
文摘Background Chronic otitis media(COM) is a significant clinical problem.Understanding the mechanisms of COM is critical for its control and treatment.However,little is known of the processes leading to COM as a result of lack of animal models of N-ethyl-N-nitrosourea(ENU) induced mutations in otitis media with effusion(OME).Methods Otoscopy and auditory brain response(ABR) evaluation were carried out under sedation in Nmf391nmf/nmf mice of 2,4,6 and 8 months of age.The mice were killed for study of middle and inner ear pathology.Results Tympanic membrane visualization and ABR thresholds in 1-to 8-month-old Nmf391nmf/nmf mice showed spontaneous OME and inner ear diseases in approximately 100% of the animals.The significant elevation of ABR thresholds suggested a sensorineural component in hearing loss in addition to the conductive loss.Middle and inner ear histology showed various degrees of outer hair cells loss and middle ear inflammation in all the mice,but no inflammation cells in the inner ear.The ABR threshold at 32 kHz was significantly elevated.Conclusions This study shows histopathologic changes in the Nmf391nmf/nmf mouse model of COM with effusion that have not been reported in human COM.This ENU induced mutation model of COM will be valuable for the characterization of middle ear inflammation and inner ear disease processes that are induced by middle ear infections.We propose that COM with effusion in this ENU induced mutation model is the cause of the cochlea hair cells damage.
基金Supported in part by the Second University of Naples and University of Naples"Federico II",Fondi di Ateneo,by a fellowship from the University of Naples‘Federico II’(2012-4/STV-Project FORGIARE),and co-funded by"Compagnia San Paolo"of Turin,Italy
文摘Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.
文摘Tuberculous otitis media is a rare disease,hence not often considered in the differential diagnosis of otorrhea.This results in late diagnosis with resulting complications such as irreversible hearing loss.A case report with review of the literature is presented,emphasizing that tuberculosis should be considered in the differential diagnosis of otorrhea not responding to commonly prescribed antibiotics.We also emphasize the importance of awareness creation in the management of such a disease,involving family members to oversee treatment and also research on ways of shortening duration of treatment to avoid default in treatment.
文摘Objective To explore the diversity of stagnant effusions and the pathologic processes leading to granulation tissue formation in otitis media with effusion(OME). Methods Temporal bone slides from 306 ears with OME were studied histopathologically under the light microscope. Results Results of this study revealed a pathologic process in witch the type and the condition of stagnant effusion in the middle ear cleft was a variable in the dynamics of OME progression from an early stage to an advanced stage. The location of granulation tissue and retentive effusion were found to be closely related. Conclusion Early stage granulation tissue formation exhibited a pathologic process in which granulation tissue formation occurred only in areas where effusion had stagnated or was absorbed. The incidence of the retentive effusion and formation of granulation tissue was much higher and the pathologic changes most extensive in the area around the ossicular chain.
文摘Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department.We also tried to identify the particularities of the fungal infection.Patients and methods:It is an observational cohort that included all the patients hospitalised for the management of NOE.The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.Results:A total of 40 patients were included.The mean age was 65±12.9 years and the sex ratio was 0.9.Ninety percent of the patients included were diabetics.The most common signs found were oedema of the external canal(97.5%)and auricular discharge(92.5%).The main pathogen isolated was Pseudomonas aeruginosa(61.7%).Fungi were isolated in 9 cases(26.47%).Computed tomography was performed for 32 patients(80%).Bone erosion was seen in 26 cases(81.3%).The main complications were cerebral venous thrombosis,retropharyngeal abscess and cerebral empyema.Thirty one patients received only antibiotics,2 received only antifungal treatment,and 7 received both antibiotics and antifungal treatment.All patients had a favorable outcome.Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections.No other differences were noted.Conclusion:Our management protocol seems to be efficient since all patients had initial favorable outcome.A higher median erythrocyte sedimentation rate was associated with fungal infections.
