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González-Eslait FJ, Blanco-Sarmiento PA, Bejarano-Domínguez K, Barreto JM, Ruiz-Tejada E. Tracing of Helicobacter pylori in the middle ear and mastoid mucosa of patients under 18 years of age with chronic otitis media (with and without cholesteatomas). J Laryngol Otol 2024; 138:503-506. [PMID: 37781780 DOI: 10.1017/s002221512300169x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE It has been estimated that about 5 million people of those affected with otitis media have cholesteatoma, however, its pathophysiology is unclear. In this study we aimed to detect Helicobacter pylori via polymerase chain reaction and real-time polymerase chain reaction in young patients with chronic otitis media. METHODS Patients included in our prospective cross-sectional study had middle-ear/mastoid inflammation and underwent surgical procedures. Middle-ear mucosa samples were collected, and genomic DNA was extracted for H pylori detection by polymerase chain reaction and real-time polymerase chain reaction analyses. Sociodemographic data and gastroesophageal reflux symptoms were analysed. RESULTS We included 49 patients with mean age of 12.7 ± 3.8 years. Twenty per cent of the patients were diagnosed with cholesteatoma. No increase in H pylori-amplified fluorescence was observed, indicating absence of H pylori. CONCLUSION Due to the absence of amplification for H pylori and the fact that albumin was amplified in all samples, we conclude that H pylori does not appear to be a causal factor.
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Affiliation(s)
- Francisco Javier González-Eslait
- Department of General Surgery, Section of Otorhinolaryngology, Universidad del Valle, Cali, Colombia
- Department of General Surgery, Section of Otorhinolaryngology, Clínica Imbanaco, Cali, Colombia
- Department of General Surgery, Section of Otorhinolaryngology, Hospital Universitario del Valle "Evaristo García," Cali, Colombia
| | | | | | - José María Barreto
- Department of General Surgery, Section of Otorhinolaryngology, Universidad del Valle, Cali, Colombia
- Department of General Surgery, Section of Otorhinolaryngology, Clínica de Otorrinolaringología y Cirugía Plástica, Cali, Colombia
| | - Emelina Ruiz-Tejada
- Department of General Surgery, Section of Otorhinolaryngology, Universidad del Valle, Cali, Colombia
- Department of General Surgery, Section of Otorhinolaryngology, Clínica de Otorrinolaringología y Cirugía Plástica, Cali, Colombia
- Department of General Surgery, Section of Otorhinolaryngology, Fundación Valle del Lili, Cali, Colombia
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Sokolovs-Karijs O, Brīvība M, Saksis R, Rozenberga M, Girotto F, Osīte J, Reinis A, Sumeraga G, Krūmiņa A. Identifying the Microbiome of the Adenoid Surface of Children Suffering from Otitis Media with Effusion and Children without Middle Ear Effusion Using 16S rRNA Genetic Sequencing. Microorganisms 2023; 11:1955. [PMID: 37630514 PMCID: PMC10459895 DOI: 10.3390/microorganisms11081955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The upper respiratory tract harbors diverse communities of commensal, symbiotic, and pathogenic organisms, originating from both the oral and nasopharyngeal microbiota. Among the primary sites of microbial colonization in the upper airways are the adenoids. Alterations in the adenoid microbiota have been implicated in the development of various conditions, including secretory otitis media. AIM This study aims to employ 16S rRNA genetic sequencing to identify the most common bacteria present on the surface of adenoids in children with otitis media with effusion and compare them with children without pathologies in the tympanic cavity. Additionally, we seek to determine and compare the bacterial diversity in these two study groups. MATERIALS AND METHODS A total of nineteen samples from the adenoid surfaces were collected, comprising two groups: thirteen samples from children without middle ear effusion and six samples from children with secretory otitis media. The libraries of the V3-V4 hypervariable region of the bacterial 16S rRNA gene was made and sequenced using MiSeq platform. RESULTS The most prevalent phyla observed in both groups were Proteobacteria, Firmicutes, and Bacteroidetes. The most common bacterial genera identified in both groups were Haemophilus, Streptococcus, Moraxella, Fusobacterium, and Bordetella, with Fusobacterium and Moraxella being more prevalent in the groups that had no middle ear effusion, while Haemophulus and Streptococcus were more prevalent in the otitis media with effusion group, although not in a statistically significant way. Statistical analysis shows a trend towards bacterial composition and beta diversity being similar between the study groups; however, due to the limited sample size and unevenness between groups, we should approach this data with caution. CONCLUSION The lack of prolific difference in bacterial composition between the study groups suggests that the role of the adenoid microbiome in the development of otitis media with effusion may be less significant.
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Affiliation(s)
- Oļegs Sokolovs-Karijs
- Department of Otolaryngology, Riga Stradiņš University, 16 Dzirciema Str., LV-1007 Riga, Latvia
- AIWA Clinic, 241 Maskavas Str., LV-1019 Riga, Latvia
| | - Monta Brīvība
- Latvian Biomedicine Research and Study Center, 1 Ratsupites Str., LV-1067 Riga, Latvia
| | - Rihards Saksis
- Latvian Biomedicine Research and Study Center, 1 Ratsupites Str., LV-1067 Riga, Latvia
| | - Maija Rozenberga
- Latvian Biomedicine Research and Study Center, 1 Ratsupites Str., LV-1067 Riga, Latvia
| | - Francesca Girotto
- Faculty of Medicine, Riga Stradiņš University, 16 Dzirciema Str., LV-1007 Riga, Latvia
| | - Jana Osīte
- Centrālā Laboratorrija, 1b. Šarlotes Str., LV-1011 Riga, Latvia
| | - Aigars Reinis
- Department of Biology and Microbiology, Riga Stradiņš University, 16 Dzirciema Str., LV-1007 Riga, Latvia
| | - Gunta Sumeraga
- Department of Otolaryngology, Riga Stradiņš University, 16 Dzirciema Str., LV-1007 Riga, Latvia
| | - Angelika Krūmiņa
- Department of Infectology, Riga Stradiņš University, 16 Dzirciema Str., LV-1007 Riga, Latvia
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Taha A, Pitaro J, Lazarovitch T, Muallem-Kalmovich L, Garti Y, Gavriel H. The association between Helicobacter pylori and chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2023; 280:891-896. [PMID: 36178529 DOI: 10.1007/s00405-022-07677-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Chronic otitis media with effusion (COME) is a common condition in children and a leading cause for hearing loss and ventilation tubes (VT) insertion. Among other risk factors, it is suggested that Helicobacter pylori (H. pylori) infection may have a role in the pathogenesis of COME. Previous studies have reached different results, and therefore, there is a need for further data on the relationship between H. pylori infection and COME development in children. Our objective is to investigate the presence of H. pylori in the middle-ear fluid (MEF) from children with COME. METHODS A Comparative cross-sectional study. Children ≤ 18 years were included. The study group included children diagnosed with COME and required VT insertion. The control group included children with acute otitis media (AOM) who required myringotomy in the emergency room. Middle-ear fluid samples were sent for both culture and bacterial identification using polymerase chain reaction (PCR) testing. RESULTS A total of 43 children were included. Eighteen with COME (median age 4 years, IQR 3-6), and 25 with AOM (median age 1 year, IQR 1-2). All samples were cultured for H. pylori. Twenty-two samples underwent H. pylori PCR testing of them, 12 samples from children with COME, and 10 from children with AOM. All cultures and PCR tests results were negative for H. pylori. CONCLUSIONS Our results suggest that H. pylori does not have a role in the pathogenesis of COME. Future larger studies are needed to investigate whether H. pylori has a role in the pathogenesis of COME.
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Affiliation(s)
- Ahmed Taha
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel.
| | - Jacob Pitaro
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel
| | - Tsilia Lazarovitch
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel
| | - Limor Muallem-Kalmovich
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel
| | - Yael Garti
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel
| | - Haim Gavriel
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300, Zerifin, Israel
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The Relationship Between Otitis Media With Effusion and Gastroesophageal Reflux Disease: A Meta-analysis. Otol Neurotol 2021; 42:e245-e253. [PMID: 33555743 DOI: 10.1097/mao.0000000000002945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Recent studies have investigated the mechanism by which refluxed gastric materials reach the middle ear, to establish otitis media with effusion (OME) causal relation between them in both children and adults. Therefore, the relationship between OME and gastro-esophageal reflux disease (GERD) should be further studied extensively. METHODS To identify eligible original articles, we searched a range of computerized databases, including Medline via PubMed, EMBASE, CNKI, and Web of Science with a systematic searching strategy. Subgroup analysis was performed to analyze heterogeneity and Egger and Begg funnel plot to assess the publication bias of the included articles. RESULTS The meta-analysis had an overall sample size of 1961. We identified a significant relationship between OME and GERD, with a pooled odds ratio (OR) of 4.52 (95% confidence interval [CI]: 2.42-8.44; p < 0.001). The pooled data were calculated with the random-effects model as a high significant heterogeneity was found among the studies and there was no significant publication bias observed. CONCLUSIONS The meta-analysis suggested that there was a significant association between otitis media with effusion and gastroesophageal reflux disease.
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Khasawneh L, Khassawneh AH, Kheirallah KA, Neri G, Filograna Pignatelli G, Al-Balas HI, Martinotti S, Al-Mistarehi AH. Otitis media with effusion: The role of Helicobacter Pylori in its pathogenesis. Ann Med Surg (Lond) 2021; 62:278-282. [PMID: 33537143 PMCID: PMC7841229 DOI: 10.1016/j.amsu.2021.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Otitis Media with Effusion (OME) is the most common disease of the middle ear. Different factors play a role in its pathogenesis, such as viral and bacterial infections, allergy, morphological and functional changes of nasal passage, Eustachian Tube (ET), and cleft palate. This study aims to investigate the Helicobacter Pylori presence in middle ear effusions from patients with OME through RT-PCR and compare our results with results from other published articles. METHODS The study was carried out from October 2007 to February 2009, in the Department of Otorhinolaryngology of SS. Annunziata Hospital, Chieti, Italy. 132 consecutive patients with OME were included in the study. Fluid in the middle ear was assessed for the presence of Helicobacter Pylori through RT-PCR. RESULTS 132 consecutive patients with OME were included in the study. The patients were between ages 8 and 78 (median 50); 62 were males (47%), 70 were females (53%), and 53 patients had bilateral OME (40%). 185 samples were collected from 132 patients. Of the 185 samples taken from the ear, 21 (11.35%) were not adequate for the correct execution of the DNA extraction procedure. The remaining 167 samples, subjected to RT-PCR, did not show in any case an increase in fluorescence linked to the FAM fluorophore, thus demonstrating the complete absence of Helicobacter Pylori. CONCLUSION Based on the results obtained, we can affirm that although a third of the cases of OME is correlated to the presence of reflux, Helicobacter Pylori does not seem to play any role in the pathophysiology of OME as it cannot be found in endo-tympanic exudate.
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Affiliation(s)
- Laith Khasawneh
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Adi H. Khassawneh
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A. Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Giampiero Neri
- Department of Neuroscience, Imaging e Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Italy
| | | | | | - Stefano Martinotti
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio of Chieti-Pescara, Italy
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Du P, Zong S, Wen Y, Liu T, Qu Y, Li H, Yu W, Wang E, Zhong Y, Xiao H. Association between Helicobacter pylori and otitis media with effusion in children: A systematic review. Int J Pediatr Otorhinolaryngol 2020; 135:110091. [PMID: 32422370 DOI: 10.1016/j.ijporl.2020.110091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Studies have shown that Helicobacter pylori (H. pylori) infection may be associated with the occurrence of otitis media with effusion (OME) in children. OBJECTIVE This is a systematic review of the relevant published literature to explore the relationship between H. pylori infection and OME in children. METHOD Articles published before October 30, 2019 in the PubMed, Web of Science, Ovid, the China National Knowledge Infrastructure (CNKI) database, and Wanfang databases were retrieved. Articles were screened based on prespecified inclusion and exclusion criteria. Quality assessment was applied to the included studies. Data in the included studies were extracted and classified for qualitative analysis. RESULTS Ten studies, which enrolled a total of 397 cases and 334 controls, were included; all were case-control studies of varying quality. We summarized and compared H. pylori infections in different specimens from pediatric patients with OME. Due to the apparent heterogeneity between the included studies, meta-analysis was not appropriate, hence we carried out only a qualitative analysis. CONCLUSION The detection rate of H. pylori in the middle ear, tonsil and gastric juice in children with OME was higher than that in children without OME. There is no clear and reliable conclusion as to whether there is a difference in the detection rate of H. pylori in adenoid specimens of children with or without OME. Eradication of H. pylori may improve symptoms of drug-resistant OME. Nevertheless, more studies of higher quality are needed to improve the conclusions.
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Affiliation(s)
- Peiyu Du
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shimin Zong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yingying Wen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tianyi Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yanji Qu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Hao Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wenting Yu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Enhao Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yi Zhong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Hongjun Xiao
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Kim SE, Memon A, Kim BY, Jeon H, Lee WK, Kang SC. Gastroprotective effect of phytoncide extract from Pinus koraiensis pinecone in Helicobacter pylori infection. Sci Rep 2020; 10:9547. [PMID: 32533032 PMCID: PMC7293342 DOI: 10.1038/s41598-020-66603-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 05/23/2020] [Indexed: 12/11/2022] Open
Abstract
For centuries, herbs have been used by traditional therapists around the world to treat gastrointestinal tract disorders, such as gastritis. We hypothesized that the anti-Helicobacter pylori properties of phytoncide, which is extracted from pinecone waste, would facilitate use as a natural gastroprotective product to treat gastrointestinal tract disorders. Thus, we investigated in vitro antibacterial efficacy against H. pylori by agar diffusion assay. To determine the gastroprotective properties of phytoncide, we conducted hematoxylin and eosin staining, performed assays for the detection of the cytotoxin gene, and evaluated pro-inflammatory cytokine expression in H. pylori-infected C57BL/6 mice. Phytoncide significantly inhibited the survival of H. pylori in the gastrointestinal system of C57BL/6 mice. Reduction of gastric severity in H. pylori-infected mice was associated with reductions in the expression levels of pro-inflammatory cytokines in the gastric mucosa, and of the cytotoxin CagA gene in phytoncide treated groups (P < 0.05 and P < 0.01). In conclusion, phytoncide significantly inhibited the growth of H. pylori in gastro tissue, possibly due to the abundant α-pinene present in the phytoncide as detected by HPLC analysis. Further studies are needed to validate our findings, but we suggest that phytoncide has the potential to be used as a natural ingredient in anti-H. pylori products.
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Affiliation(s)
- Se-Eun Kim
- Research Institute, Phyrus Co., LTD., Danyang-gun, 27000, Chungcheongbuk-do, South Korea.,Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, 17104, Gyeonggi-do, Korea
| | - Azra Memon
- Department of Biomedical Sciences, School of Medicine, Inha University, Incheon, 22212, South Korea
| | - Bae Yong Kim
- Research Institute, Phyrus Co., LTD., Danyang-gun, 27000, Chungcheongbuk-do, South Korea.,Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, 17104, Gyeonggi-do, Korea
| | - Hyelin Jeon
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, 17104, Gyeonggi-do, Korea
| | - Woon Kyu Lee
- Department of Biomedical Sciences, School of Medicine, Inha University, Incheon, 22212, South Korea.
| | - Se Chan Kang
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, 17104, Gyeonggi-do, Korea.
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Wu X, Zheng Y, Gao X, Li G, Cao Q. Association Between Helicobacter pylori Infection and Otitis Media With Effusion Risk in Children: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2020; 163:654-661. [PMID: 32482139 DOI: 10.1177/0194599820921861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the potential correlation between Helicobacter pylori infection and otitis media with effusion (OME) risk in children. DATA SOURCES Electronic databases were searched, including Cochrane Library, PubMed, Embase, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang Database, and China National Knowledge Infrastructure Database. REVIEW METHODS A systematic review and meta-analysis were conducted with Revman 5.3 software. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate infection-disease association. RESULTS In total, 11 studies from 9 articles regarding H pylori infection and OME risk were enrolled in this meta-analysis. A significant association between H pylori infection and OME was detected for both adenoid samples from the case group (OR, 2.75; 95% CI, 1.43-5.30; P = .002) and middle ear fluid samples from the case group (OR, 4.45; 95% CI, 2.52-7.88; P < .00001). Subgroup analyses suggested a stronger correlation in African and Asian populations. CONCLUSION This study indicated the correlation between H pylori infection and increased risk of OME in children, especially in African and Asian populations. Further well-designed studies regarding the white population are strongly recommended in the future.
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Affiliation(s)
- Xiaohui Wu
- Department of Otolaryngology-Head and Neck Surgery, Xiamen Children's Hospital, Xiamen, China
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yun Zheng
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Xingqiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Xiamen Children's Hospital, Xiamen, China
| | - Gang Li
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Qiuxue Cao
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
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Ivoylov AY, Garov EV, Bodrova IV, Yanovsky VV, Sudarev PA, Morozova ZN, Martirosyan TG, Ibragimova ZS. [Auditory tube dysfunction in children (literature review, part 1)]. Vestn Otorinolaringol 2020; 85:83-87. [PMID: 32241996 DOI: 10.17116/otorino20208501183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present the review of the literature on the anatomical and physiological features of the structure of the auditory tube in children, epidemiology, etiology, and the pathogenesis of the formation of auditory tube dysfunction is presented. The first part of the article presents in more detail the structural and functional differences in the Eustachian tube in children, the classification and mechanism of the occurrence of the auditory tube dysfunction in pediatric practice.
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Affiliation(s)
- A Yu Ivoylov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152; Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Department of Otolaryngology of Pediatric Faculty, Moscow, Russia, 117997; Speransky Pediatric Municipal Clinical Hospital No. 9 of the Moscow Healthcare Department, Moscow, Russia, 123317
| | - E V Garov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152
| | - I V Bodrova
- Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Department of Radiation Diagnostics and Radiation Therapy of Cure Faculty, Moscow, Russia, 119991
| | - V V Yanovsky
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152
| | - P A Sudarev
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152
| | - Z N Morozova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152
| | - T G Martirosyan
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152
| | - Z S Ibragimova
- E.P. Glinka Republican Pediatric Clinical Hospital, Ministry of Health of the Chechen Republic, Grozny, Russia, 364028
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Damghani MA, Dehghan E. Is there any association between Helicobacter pylori and otitis media with effusion? Braz J Otorhinolaryngol 2018; 86:217-221. [PMID: 30595350 PMCID: PMC9422722 DOI: 10.1016/j.bjorl.2018.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/18/2018] [Accepted: 11/10/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction It is proposed that Helicobacter pylori can be responsible for the development of otitis media with effusion. Objective The aim of this study is to investigate the prevalence of H. pylori in the adenoid tissue and fluid of the middle ear in patients who suffer from adenoid hyperplasia and otitis media with effusion in comparison with those who suffer from adenoid hyperplasia without otitis media with effusion. Methods This is a case–control study that was carried out in 50 children of age 2–7 years old who were admitted with adenoid hyperplasia. Patients were divided into case and control groups. The study group included 25 patients with adenoid hyperplasia and otitis media with effusion and the control group included 25 patients with adenoid hyperplasia without otitis media with effusion. The patients in both groups underwent surgical adenoidectomy. For the case group we carried out myringotomy and placement of tympanostomy tube, and fluid samples were collected under sterile conditions. The samples were sent to the laboratory for polymerase chain reactions. Results In the case group H. pylori was found to be positive in 18 samples of the middle ear fluid (70%) and in 1 polymerase chain reaction adenoid tissue sample (4%). In the control group H. pylori was positive in 3 samples of adenoid tissues (12%). There was no gender difference. Conclusion H. pylori is one of the important bacteria that plays a role in the pathogenesis of otitis media with effusion. Whether adenoid tissue may be a reservoir for H. Pylori is unclear.
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Affiliation(s)
| | - Elham Dehghan
- Kerman University, Faculty of Medicine, Department of Otolaryngology, Kerman, Iran.
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11
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Jeyakumar A, Bégué RE. Otitis Media with Effusion and Helicobacter pylori. OTO Open 2018; 2:2473974X18792489. [PMID: 31535067 PMCID: PMC6737865 DOI: 10.1177/2473974x18792489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/09/2019] [Accepted: 07/13/2018] [Indexed: 11/24/2022] Open
Abstract
Previous studies reported the presence of Helicobacter pylori in middle ear fluid and raised a possible causal role of this bacterium in otitis media with effusion (OME). We investigated 48 children with OME (age, 7 months to 12 years) seen in New Orleans, Louisiana, and found no evidence of H pylori presence in any middle ear fluid specimen by amplification of the 16S rRNA gene. One child had H pylori detected in a stool specimen, in accordance with the low prevalence in our population. While H pylori may be significant in other countries, these findings do not support a role for H pylori in OME in our pediatric population in the United States.
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Affiliation(s)
- Anita Jeyakumar
- Pediatric Otolaryngology, Akron Children's Hospital, Akron, Ohio, USA
| | - Rodolfo E Bégué
- Pediatric Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Saki N, Jahani M, Samarbaf A, Kaydani GA, Nikakhlagh S, Kenani M, Mogehi S. Correlation Between Tympanosclerosis and Helicobacter pylori. Jundishapur J Microbiol 2015; 8:e16069. [PMID: 26568799 PMCID: PMC4640059 DOI: 10.5812/jjm.16069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/12/2015] [Accepted: 06/20/2015] [Indexed: 01/27/2023] Open
Abstract
Background: Tympanosclerosis is a condition caused by calcification of tissues in the middle ear mucosa that sometimes results hearing loss. Helicobacter pylori is one of the pathological and etiologic factors in the development of tympanosclerosis. Objectives: The purpose of this study was to show the role of H. pylori in the different aspects of chronic suppurative otitis media using the polymerase chain reaction (PCR) technique. Patients and Methods: This case-control and cross-sectional study was performed on all patients with chronic otitis media, candidates for surgical operations, in 2013. They were allocated into the case group with tympanosclerosis and the control group without tympanosclerosis. During the surgical operation, biopsy was done from middle ear and the samples were studied to see if they contained H. pylori using the PCR method. Results: From a total of 19 patients with tympanosclerosis , 16 cases (84.2%) were H. pylori positive, while in the control group 15 (45.4%) cases out of the 37 cases were H. pylori positive, which showed a significant difference (P = 0.002). Age and gender of the patients, ear dryness and perforation size were not correlated with the presence or absence of H. pylori. Conclusions: There is a significant correlation between tympanosclerosis and H. pylori (P = 0.002). This correlation can single out H. pylori as a pathological factor in the development of tympanosclerosis; however, further studies are needed to prove this correlation.
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Affiliation(s)
- Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Mojtaba Jahani
- Department of Otolaryngology, Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Alireza Samarbaf
- Department of Virology, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Gholam Abbas Kaydani
- Department of Otolaryngology, Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Soheila Nikakhlagh
- Department of Infectious Diseases, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Soheila Nikakhlagh, Department of Infectious Diseases, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6133738283, Fax: +98-6132921838, E-mail:
| | - Malek Kenani
- Department of Pathology, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Sasan Mogehi
- Department of Infectious Diseases, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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Bayindir T, Toplu Y, Otlu B, Yakupogullari Y, Yildirim O, Kalcioglu MT. Prevalence of the Helicobacter pylori in the tonsils and adenoids. Braz J Otorhinolaryngol 2015; 81:307-11. [PMID: 25900719 PMCID: PMC9452227 DOI: 10.1016/j.bjorl.2014.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 08/24/2014] [Indexed: 01/29/2023] Open
Abstract
Introduction There is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue. Objective A clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis. Methods Phosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients’ serum by using polymerase chain reaction. Results Hp IgG was detected in 57 (89%) patients’ serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism. Conclusion This study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas.
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Saki N, Samarbaf Zadeh AR, Sheikhpour Jonaky R, Noori SM, Kayedani GA, Nikakhlagh S. The Prevalence Rate of Helicobacter pylori Infection in, Chronic Otitis Media With Effusion Patients. Jundishapur J Microbiol 2014; 7:e15694. [PMID: 25147680 PMCID: PMC4138655 DOI: 10.5812/jjm.15694] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/02/2014] [Accepted: 01/20/2014] [Indexed: 12/21/2022] Open
Abstract
Background: Otitis media with effusion (OME) is a common disease in children. Viral or bacterial infections, allergy, adenoids, functional abnormalities of the Eustachian tube, and gastroesophageal reflux might have a possible role in the pathogenesis of OME. However, the exact pathogenesis of OME is still unsettled. Objectives: The purpose of this study was to compare Helicobacter pylori prevalence rates in the nasopharynx of pediatric patients with and without OME. Patients and Methods: Eighty-four patients (50 males and 34 females) who were subjected to adenoidectomy and myringotomy were included in the study group. Ninety-one patients (48 males and 43 females) who had only adenoidectomy were selected as the control group. Detection of H. pylori was done by polymerase chain reaction (PCR). Results: Adenoid samples were positive for H. pylori in 21 (25%) patients in study group and 18 (19.8%) patients in control group. In the study group, 36 (42.8%) effusion samples (otitis media) of the patients were positive for H. pylori. In an analysis that compared H. pylori–negative and –positive children, the odds ratio (OR) for the occurrence of H. pylori was 1.35 (95% CI, 0.66 - 2.71). The association of age with H. pylori positivity decreased for 1-5 years age group, (1.09; 95% CI, 0.39 – 3.05) but increased for the 6-10 years group (OR, 1.48; 95% CI, 0.61–3.58). Furthermore, the association of sex with H. pylori positivity decreased for the male group (OR, 1.21; 95% CI, 0.50 – 2.91), but increased in the female group (OR, 1.44; 95% CI, 0.51–0.4.05). Conclusions: Heavy colonization of H. pylori in adenoid tissue and middle ear might have a role in pathogenesis of this infection. For OME cases resistant to medical treatment, it might be meaningful to evaluate the patient for H. pylori.
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Affiliation(s)
- Nader Saki
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Reza Samarbaf Zadeh
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Reza Sheikhpour Jonaky
- Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Seyed Mahdi Noori
- Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Gholam Abbas Kayedani
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Soheila Nikakhlagh
- Hearing and Speech Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Soheila Nikakhlagh, Imam Khomeini hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel/Fax: +98-6112921838, E-mail: ,
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Güçlü O, Akçalı A, Sahin EM, Tekin K, Barutçu O, Otkun MT, Dereköy FS. Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children. Balkan Med J 2013; 30:301-4. [PMID: 25207124 DOI: 10.5152/balkanmedj.2013.8585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 04/12/2013] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. AIMS To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. STUDY DESIGN Prospective clinical trial. METHODS PATIENTS SCHEDULED FOR ADENOIDECTOMY OR TONSILLECTOMY WERE CLASSIFIED INTO THREE GROUPS BASED ON INDICATIONS: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. RESULTS Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. CONCLUSION In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.
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Affiliation(s)
- Oğuz Güçlü
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Alper Akçalı
- Department of Medical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Erkan Melih Sahin
- Department of Family Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Kazım Tekin
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Ozan Barutçu
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Müşerref Tatman Otkun
- Department of Medical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Fevzi Sefa Dereköy
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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16
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The Role of Helicobacter pylori in Upper Respiratory System Infections: Is it More Than Colonization? Curr Infect Dis Rep 2012; 14:128-36. [PMID: 22311663 DOI: 10.1007/s11908-012-0237-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Helicobacter pylori (HP) is recognized as a common chronic human bacterial infection and is the most common cause of gastritis. Recent studies suggest an increased HP prevalence in patients with various extra-digestive inflammatory diseases. Since many respiratory diseases are characterized by chronic inflammation as well as increased immune response, and HP may enter the nasopharyngeal cavity by gastroesophageal reflux, an association between respiratory disorders and HP infection has been suggested. Several studies discover HP in clinical samples from the patients with upper respiratory system infections. Even some of them revealed a relief after the treatment directed to HP eradication. However some studies do not support this theory and whether this association means a definite proof of a causal relationship between HP and respiratory diseases needs to be clarified. In this study, we aimed to review the reports about the role of HP in upper respiratory system infections.
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Aycicek A, Çetinkaya Z, Kıyıcı H, Bukulmez A, Yucedag F. Can Helicobacter pylori cause inflammation in the middle ear? Int J Pediatr Otorhinolaryngol 2012; 76:1087-90. [PMID: 22552023 DOI: 10.1016/j.ijporl.2012.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 04/04/2012] [Accepted: 04/07/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate whether Helicobacter pylori causes inflammation in the normal middle ear and in the middle ear with effusion. METHODS Sixteen adult New Zealand white rabbits were divided into two gropus equally. Group I was representing histamine-induced middle ear inflammation and Group II was representing normal middle ear. While H. pylori was inoculated in the right ears, physiologic saline was inoculated in the left ears of the rabbits in both groups. Results were evaluated clinically, histopathologically and microbiologically. Fisher's exact test was used for statistical analysis. RESULTS In Group I, clinical scores of the inflammation in the right ears were higher than the left ears scores at the 7th day. Histopathological scores of the inflammation in the right ears were higher than the left ears scores at the 7th day. Also, H. pylori was isolated in 6 of the 8 right ears of the rabbits. In Group II, while clinical scores of the inflammation in the right ears scores were higher than the left ears scores at the 7th day, histopathological scores were not significantly different between both ears. Also, no H. pylori was isolated in right ears of the rabbits. CONCLUSIONS Effusion in the middle ear induced by histamine is an appropriate medium for H. pylori reproduction and it also aggravates the inflammation process. In contrary, H. pylori did not cause inflammation in the normal middle ear. We suggest that H. pylori does not play a role in the etiology of otitis media with effusion alone, but it contributes to the inflammation process in the presence of an effusion.
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Affiliation(s)
- Abdullah Aycicek
- Department of Otolaryngology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
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18
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Melake NA, Shaker GH, Salama MA. Incidence of Helicobacter pylori infection and their clarithromycin-resistant strains in otitis media with effusion regarding phenotypic and genotypic studies. Saudi Pharm J 2012; 20:345-53. [PMID: 23960809 DOI: 10.1016/j.jsps.2012.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 02/19/2012] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) are pathogenic bacteria that infect a half of the human population, colonize gastric mucosa and can be found in gastric juice. Reflux of gastric juice has been suggested to be associated with glue ear in children. It has been suggested that tonsil and adenoid tissues are potential reservoirs of H. pylori infection. These observations raise the question as to whether H. pylori infection might have a role in otitis media with effusion (OME) in children. The objectives of this research were to evaluate the incidence and possible role of H. pylori in the pathogenesis of OME in children and to evaluate the clarithromycin-resistant strains. Molecular assessment was done to evaluate the culture results vs. molecular study. A total of 60 children, who were prone to ventilation tube insertion, adenoidectomy and/or tonsillectomy were included in the study. The control group consisted of 40 children who underwent adenoidectomy and/or tonsillectomy without the history of OME. Samples of the middle ear fluid and mucosa, adenoid tissue, tonsillar tissue and gastric lavage were cultured and underwent polymerase chain reaction (PCR) analysis then were assembled by using QIAxcel System as capillary electrophoresis for H. pylori detection. There was significant difference between the results of cultures and PCR (P < 0.05). Middle ear fluid culture was positive for H. pylori in 40% of the patients vs. 56.7% PCR results while middle ear mucosa culture was positive in 20% vs. 26.7% PCR results. Gastric lavage culture was positive in 46.6% of the patients and PCR was positive in 63.3% of the patients. Adenoid culture and PCR were positive in 56.3% for each, while tonsil culture was positive in 70% and PCR was positive in 90%. H. pylori presence in the gastric lavage, the tonsillar and adenoid tissues by culture and PCR was significantly more frequent in the study group compared to the control group. The minimum inhibitory concentration (MIC) values of clarithromycin-resistant isolates ranged from 1.5 to 8 μg/ml. This study showed the presence of H. pylori in around 50% of the patients with OME. PCR revealed its sensitivity than culture techniques. The incidence of clarithromycin resistance was found to be high among the isolates (39.6%).
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Affiliation(s)
- Nahla A Melake
- Department of Pharmaceutics-Microbiology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Treatment options in otitis media with effusion. Indian J Otolaryngol Head Neck Surg 2011; 66:191-7. [PMID: 24533382 DOI: 10.1007/s12070-011-0423-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 11/24/2011] [Indexed: 10/14/2022] Open
Abstract
Secretary Otitis media with effusion (OME) is the accumulation of mucus in the middle ear and sometimes in the mastoid air cell system. The main etiological factor is alteration in mucociliary system of middle ear secondary to ET malfunction which may be primary or secondary. OME is the cause of concern due to its occurance in paediatric age group, highest at 2 years of age, presenting as impairment of hearing leading to delayed speech and language development, poor academic performance and behavioral problems. In spite of this there are no confirmed guidelines of treatment to overcome. Many treatment options are available medical as well as surgical. Prospective study conducted to evaluate various treatment options revealed that auto inflation of ET is the main stay of treatment. If the ET malfunction is due to any reasons like adenoids, deviated nasal septum, hypertrophied turbinates or any other cause surgical intervention of the same gives 100% results. Medical management gives good results but recurrence is equally common.
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Abstract
BACKGROUND Acute otitis media (AOM) is a common and important source of morbidity in children, although the majority of cases resolve spontaneously. While frequently recommended, decongestant and antihistamine therapy is of unclear benefit. OBJECTIVES To determine the efficacy of decongestant and antihistamine therapy in children with AOM on outcomes of AOM resolution, symptom resolution, medication side effects, and complications of AOM. SEARCH STRATEGY In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE (January 2004 to May 2007); and EMBASE (July 2003 to May 2007). SELECTION CRITERIA Randomized controlled trials (RCTs) evaluating decongestant or antihistamine treatment for children with AOM were included. Patient-oriented outcomes were considered most relevant. DATA COLLECTION AND ANALYSIS The review authors independently evaluated studies for inclusion, performed validity assessments and completed data extraction. Dichotomous data were pooled to generate relative risks; homogeneity was assessed using approximate chi-square tests. MAIN RESULTS No new studies were included following this updated search. Fifteen trials involving 2695 people were included. Only the combined decongestant-antihistamine group demonstrated statistically lower rates of persistent AOM at the two week period (fixed relative risk (RR) 0.76; 95% confidence interval (CI) 0.60 to 0.96; number needed to treat (NNT) 10). No benefit was found for early cure rates, symptom resolution, prevention of surgery or other complications. There was a five to eight -fold increased risk of side effects for those receiving an intervention, which reached statistical significance for all decongestant groupings. Validity sub analyses demonstrated that lower quality studies found benefit, while analysis of those studies with higher validity scores found no benefit of treatment. AUTHORS' CONCLUSIONS Given lack of benefit and increased risk of side effects, these data do not support the use of decongestant treatment in children with AOM. There was a small statistical benefit from combination medication use but the clinical significance is minimal and study design may be biasing the results. Thus, the routine use of antihistamines for treating AOM in children cannot be recommended.
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Affiliation(s)
- Cassie Coleman
- Wycombe HospitalDepartment of PaediatricsThe Walled Garden, High StreetMaidenheadBerkshireUKSL6 5NB
| | - Michael Moore
- Aldermoor Health CentrePrimary Care Research Network South WestAldermoor CloseSouthamptonUKSO16 5ST
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Vilarinho S, Guimarães NM, Ferreira RM, Gomes B, Wen X, Vieira MJ, Carneiro F, Godinho T, Figueiredo C. Helicobacter pylori colonization of the adenotonsillar tissue: fact or fiction? Int J Pediatr Otorhinolaryngol 2010; 74:807-11. [PMID: 20452684 DOI: 10.1016/j.ijporl.2010.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The transmission of the gastric pathogen Helicobacter pylori involves the oral route. Molecular techniques have allowed the detection of H. pylori DNA in samples of the oral cavity, although culture of H. pylori from these type of samples has been sporadic. Studies have tried to demonstrate the presence of H. pylori in adenotonsillar tissue, with contradictory results. Our aim was to clarify whether the adenotonsillar tissue may constitute an extra gastric reservoir for H. pylori. METHODS Sixty-two children proposed for adenoidectomy or tonsillectomy were enrolled. A total of 101 surgical specimens, 55 adenoid and 46 tonsils, were obtained. Patients were characterized for the presence of anti-H. pylori antibodies by serology. On each surgical sample rapid urease test, immunohistochemistry, fluorescence in situ hybridization (FISH) with a peptide nucleic acid probe for H. pylori, and polymerase chain reaction-DNA hybridization assay (PCR-DEIA) directed to the vacA gene of H. pylori were performed. RESULTS Thirty-nine percent of the individuals had anti-H. pylori antibodies. Rapid urease test was positive in samples of three patients, all with positive serology. Immunohistochemistry was positive in samples of two patients, all with negative serology. All rapid urease test or immunohistochemistry positive cases were negative by FISH. All samples tested were negative when PCR-DEIA for H. pylori detection was used directly in adenotonsillar specimens. CONCLUSIONS The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.
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Affiliation(s)
- Sérgio Vilarinho
- Serviço de Otorrinolaringologia, Hospital de São Marcos, Braga, Portugal
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Eyigor M, Eyigor H, Gultekin B, Aydin N. Detection of Helicobacter pylori in adenotonsiller tissue specimens by rapid urease test and polymerase chain reaction. Eur Arch Otorhinolaryngol 2009; 266:1611-3. [PMID: 19130070 DOI: 10.1007/s00405-008-0903-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 12/17/2008] [Indexed: 12/13/2022]
Abstract
In recent studies, there have been many arguments concerning Helicobacter pylori being reservoir in adenotonsillar tissue. In this study, our objective was to detect whether adenoid and/or tonsillar tissue of patients diagnosed with chronic adenotonsillitis was a reservoir for H. pylori. This study was performed with 47 patients with the diagnosis of chronic tonsillitits and adenoid hypertrophy. Helicobacter pylori was searched by rapid urease test (RUT) and polymerase chain reaction (PCR). Presence of H. pylori glmM gene (formerly named as ureC gene) was tested using ureC and ureC2 primers. Fifty-five specimens used in the study were made up of 35 adenoid and 20 tonsil tissues. Rapid urease test was positive in three (5.5%) specimens. Helicobacter pylori was not detected in any of the patients by PCR. Further studies are needed to clarify the possible role of H. pylori in upper aerodigestive tract diseases such adenotonsillitis.
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Affiliation(s)
- Mete Eyigor
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey,
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23
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Role of Helicobacter Pylori in Pathogenesis of Upper Respiratory System Diseases. J Natl Med Assoc 2008; 100:1224-30. [DOI: 10.1016/s0027-9684(15)31471-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Kariya S, Okano M, Fukushima K, Nomiya S, Kataoka Y, Nomiya R, Akagi H, Nishizaki K. Expression of inflammatory mediators in the otitis media induced by Helicobacter pylori antigen in mice. Clin Exp Immunol 2008; 154:134-40. [PMID: 18727622 DOI: 10.1111/j.1365-2249.2008.03740.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Helicobacter pylori is a Gram-negative bacterium that is recognized as one of the key factors in gastric diseases such as gastritis, peptic ulcer and gastric cancer. Recent studies have shown relationships between H. pylori and extra-digestive diseases, and the presence of H. pylori in the middle ear and upper respiratory tract has been reported. However, the role of H. pylori in middle ear disease remains unclear. The present study demonstrated that H. pylori whole-cell protein directly induces macrophage migration inhibitory factor, macrophage inflammatory protein 2, interleukin 1 beta and tumor necrosis factor alpha in middle ear epithelium in mice, and severe proliferation of inflammatory cells was observed in middle ear cavity inoculated with H. pylori whole-cell protein. In addition, trans-tympanic injection of macrophage migration inhibitory factor up-regulated expression of macrophage inflammatory protein 2 in the middle ear. These findings indicate that H. pylori infection causes immunological inflammation in middle ear epithelium, and H. pylori may play a significant role in otitis media.
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Affiliation(s)
- S Kariya
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Abstract
BACKGROUND Acute otitis media (AOM) is a common and important source of morbidity in children, although the majority of cases resolve spontaneously. While frequently recommended, decongestant and antihistamine therapy is of unclear benefit. OBJECTIVES To determine the efficacy of decongestant and antihistamine therapy in children with AOM on outcomes of AOM resolution, symptom resolution, medication side effects, and complications of AOM. SEARCH STRATEGY In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE (January 2004 to May 2007); and EMBASE (July 2003 to May 2007). SELECTION CRITERIA Randomized controlled trials (RCTs) evaluating decongestant or antihistamine treatment for children with AOM were included. Patient-oriented outcomes were considered most relevant. DATA COLLECTION AND ANALYSIS The review authors independently evaluated studies for inclusion, performed validity assessments and completed data extraction. Dichotomous data were pooled to generate relative risks; homogeneity was assessed using approximate chi-square tests. MAIN RESULTS No new studies were included following this updated search. Fifteen trials involving 2695 people were included. Only the combined decongestant-antihistamine group demonstrated statistically lower rates of persistent AOM at the two week period (fixed relative risk (RR) 0.76; 95% confidence interval (CI) 0.60 to 0.96; number needed to treat (NNT) 10). No benefit was found for early cure rates, symptom resolution, prevention of surgery or other complications. There was a five to eight -fold increased risk of side effects for those receiving an intervention, which reached statistical significance for all decongestant groupings. Validity sub analyses demonstrated that lower quality studies found benefit, while analysis of those studies with higher validity scores found no benefit of treatment. AUTHORS' CONCLUSIONS Given lack of benefit and increased risk of side effects, these data do not support the use of decongestant treatment in children with AOM. There was a small statistical benefit from combination medication use but the clinical significance is minimal and study design may be biasing the results. Thus, the routine use of antihistamines for treating AOM in children cannot be recommended.
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Affiliation(s)
- Cassie Coleman
- Department of Paediatrics, Wycombe Hospital, The Walled Garden, High Street, Maidenhead, Berkshire, UK, SL6 5NB.
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A critical evaluation of the evidence on a causal relationship betweenHelicobacter pyloriand otitis media with effusion. The Journal of Laryngology & Otology 2007; 122:905-11. [DOI: 10.1017/s0022215107000989] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AbstractObjective:There is growing interest in the presence ofHelicobacter pyloriin the upper aerodigestive tract, and in the middle ear in patients with otitis media with effusion. Some studies have reported detectingH pyloriin the middle ear, although reports to the contrary exist. In this study, we critically evaluate the evidence for the theory thatH pyloriin the middle ear plays a role in otitis media with effusion.Material:We undertook a systematic review of all available studies investigating the presence ofH pyloriin the middle ear of patients with otitis media with effusion. The current literature was critically analysed using the key words and phrases ‘Helicobacter pylori’ ‘otitis media with effusion’, ‘serous otitis media’, ‘glue ear’ and ‘middle ear’. Six original research papers were identified, studying a total of 203 patients and 27 controls; two of these papers were randomised, controlled studies and four were prospective, cohort studies.Results:At present, there is poor evidence for the existence ofH pylori-associated otitis media with effusion.Conclusions:Further research in the field is needed in order to delineate the presence ofH pyloriand its role in the pathogenesis of otitis media with effusion.
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Bohr URM, Annibale B, Franceschi F, Roccarina D, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection -- other Helicobacters. Helicobacter 2007; 12 Suppl 1:45-53. [PMID: 17727460 DOI: 10.1111/j.1523-5378.2007.00533.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Today there is evidence that Helicobacter pylori has a critical role in different extragastric diseases. The discovery of a number of other novel Helicobacter species has stimulated the research in different extragastric diseases, in which an infectious hypothesis is plausible. Enterohepatic Helicobacter species have been hypothesized to play a role in different disorders, including hepatocellular carcinoma, gallstones formation and cholangiocellular carcinoma, as well as enteric diseases and inflammatory bowel diseases. Concerning the extragastric manifestations of H. pylori infection, idiopathic thrombocytopenic purpura, and sideropenic anemia represent, based on the current data, the diseases in which the pathogenic link appears to be strongest. There is also an increasing evidence for a possible association of H. pylori with cardiovascular disease.
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Affiliation(s)
- Ulrich R M Bohr
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany
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Goodman KJ, Joyce SL, Ismond KP. Extragastric diseases associated with Helicobacter pylori infection. Curr Gastroenterol Rep 2007; 8:458-64. [PMID: 17105683 DOI: 10.1007/s11894-006-0035-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper critically reviews the current literature on extragastric diseases associated with Helicobacter pylori infection, with an emphasis on methodologic issues that complicate interpretation of study findings. This review reveals common study limitations and overall uncertainty that H. pylori infection plays a role in extragastric diseases, although such a role has not been clearly ruled out for specific diseases of relevance. Evidence suggests that anti-H. pylori therapy may lead to improvement of a few extragastric diseases, in particular, idiopathic thrombocytopenic purpura, iron deficiency anemia, and chronic idiopathic urticaria, but the data from randomized controlled trials are insufficient to confirm this beneficial effect; if the benefit of anti-H. pylori therapy for specific diseases is real, it is not clear if it results from removing H. pylori-specific injurious effects, eliminating some other infectious pathogen, or reducing the total infectious burden.
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Affiliation(s)
- Karen J Goodman
- Division of Gastroenterology, Zeidler Ledcor Centre, University Campus 130, University of Alberta, Edmonton, AB, Canada, T6G 2X8.
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