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Leichtle A, Lupatsii M, Graspeuntner S, Jeschke S, Penxová Z, Kurabi A, Ryan AF, Rupp J, Pries R, Bruchhage KL. Anti-inflammatory response to 1,8-Cineol and associated microbial communities in Otitis media patients. Sci Rep 2024; 14:16362. [PMID: 39014066 PMCID: PMC11252366 DOI: 10.1038/s41598-024-67498-5] [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] [Received: 03/18/2024] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
Chronic Otitis Media (COM) is defined as long term inflammation and colonization with pathogenic bacteria due to a defect or retraction of the tympanic membrane. Surgical interventions are often augmented by antibiotic resistance development and therefore, off-label treatment using the natural drug 1,8-Cineol was carried out. All COM patients underwent antibiotic therapy and middle ear surgery and developed antibiotic resistances. Microbiological investigations from the auditory canal and stool samples were performed in correlation with the clinical course. Therapy of COM patients with 1,8-Cineol revealed a clear reduction of inflammatory microbes P. aeruginosa and Proteus mirabilis in ear samples as well as intestinal Prevotella copri, which was associated with an improved clinical outcome in certain individuals. The present off-label study revealed manifold anti-inflammatory effects of the natural monoterpene 1,8-Cineol in Otitis media patients. A better understanding of the underlying mechanisms will improve the current treatment options and possible forms of application of this natural drug.
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Affiliation(s)
- Anke Leichtle
- Department of Otorhinolaryngology, University of Luebeck, 23538, Lübeck, Germany
| | - Mariia Lupatsii
- Department of Infectious Diseases and Microbiology, University of Luebeck, Lübeck, Germany
| | - Simon Graspeuntner
- Department of Infectious Diseases and Microbiology, University of Luebeck, Lübeck, Germany
| | - Stephanie Jeschke
- Department of Otorhinolaryngology, University of Luebeck, 23538, Lübeck, Germany
| | - Zuzana Penxová
- Department of Otorhinolaryngology, University of Luebeck, 23538, Lübeck, Germany
| | - Arwa Kurabi
- Department of Surgery/ Otolaryngology, University of California San Diego, La Jolla, USA
| | - Allen Frederic Ryan
- Department of Surgery/ Otolaryngology, University of California San Diego, La Jolla, USA
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Luebeck, Lübeck, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University of Luebeck, 23538, Lübeck, Germany
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Albrecht T, Fehre N, Ramackers W, Nikendei C, Offergeld C. "Seeing inside out": revealing the effectiveness of otoscopy training in virtual reality enhanced practical exams - a randomized controlled trial. BMC MEDICAL EDUCATION 2024; 24:439. [PMID: 38649953 PMCID: PMC11036670 DOI: 10.1186/s12909-024-05385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The study aimed to assess the impact of different training modalities on otoscopy performance during a practical exam using a high-fidelity simulator and to determine if objective evaluation of otoscopy is feasible using a simulator that records insertion depth and tympanic membrane coverage. METHODS Participants were assigned to one of four groups: control and three intervention groups with varying training approaches. Participants received otoscopy training and then were assessed through a practical exam on a high-fidelity simulator that uses virtual reality to visualize the ear canal and middle ear. Performance was evaluated using a modified Objective Structured Assessment of Technical Skills checklist and Integrated Procedural Performance Instrument checklist. Insertion depth, tympanic membrane coverage, and correct diagnosis were recorded. Data were tested for normal distribution using the Shapiro-Wilk test. One-way ANOVA and, for non-normally distributed data, Kruskal-Wallis test combined with Dunn's test for multiple comparisons were used. Interrater reliability was assessed using Cohen's κ and Intraclass correlation coefficient. RESULTS All groups rated their training sessions positively. Performance on the OSATS checklist was similar among groups. IPPI scores indicated comparable patient handling skills. The feedback group examined larger tympanic membrane areas and had higher rates of correct diagnosis. The correct insertion depth was rarely achieved by all participants. Interrater reliability for OSATS was strong. IPPI reliability showed good correlation. CONCLUSION Regardless of training modality, participants perceived learning improvement and skill acquisition. Feedback improved examination performance, indicating simulator-guided training enhances skills. High-fidelity simulator usage in exams provides an objective assessment of performance.
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Affiliation(s)
- Tobias Albrecht
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center - University of Tuebingen, Tuebingen, Germany.
| | - Nathalie Fehre
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center - University of Freiburg, Freiburg, Germany
| | - Wolf Ramackers
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, Medical Center - University of Heidelberg, Heidelberg, Germany
| | - Christian Offergeld
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center - University of Freiburg, Freiburg, Germany
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Luo Z, Wang R, Deng X, Chen T, Ma X, Zhang Y, Gao C, Wu A. Janus mesoporous organosilica/platinum nanomotors for active treatment of suppurative otitis media. NANOSCALE 2024; 16:3006-3010. [PMID: 38226693 DOI: 10.1039/d3nr05666j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
We report a Janus mesoporous organosilica/platinum (MOS/Pt) nanomotor for active targeted treatment of suppurative otitis media, as a new type of multi-functional ear drop. The efficient propulsion of MOS/Pt nanomotors in hydrogen peroxide ear-cleaning drops significantly improves their binding efficiency with Staphylococcus aureus and enhances their antibacterial efficacy.
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Affiliation(s)
- Zhizhou Luo
- Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, China.
| | - Ruonan Wang
- Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, China.
| | - Xiaoxia Deng
- Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, China.
| | - Tianxiang Chen
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Zhejiang Engineering Research Center for Biomedical Materials at Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China.
- University of Chinese Academy of Science, Beijing, 100049, China
| | - Xuehua Ma
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Zhejiang Engineering Research Center for Biomedical Materials at Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China.
- University of Chinese Academy of Science, Beijing, 100049, China
| | - Yujie Zhang
- Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, China.
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Zhejiang Engineering Research Center for Biomedical Materials at Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China.
- University of Chinese Academy of Science, Beijing, 100049, China
| | - Changyong Gao
- Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, China.
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Zhejiang Engineering Research Center for Biomedical Materials at Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China.
- University of Chinese Academy of Science, Beijing, 100049, China
| | - Aiguo Wu
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Zhejiang Engineering Research Center for Biomedical Materials at Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China.
- University of Chinese Academy of Science, Beijing, 100049, China
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Assiri K, Hudise J, Obeid A. Risk Factors for Chronic and Recurrent Otitis Media in Children: A Review Article. Indian J Otolaryngol Head Neck Surg 2024; 76:1464-1469. [PMID: 38440639 PMCID: PMC10908946 DOI: 10.1007/s12070-023-04256-5] [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: 07/24/2023] [Accepted: 09/28/2023] [Indexed: 03/06/2024] Open
Abstract
Otitis media is an inflammation of the mucous membrane of the middle ear, which includes mastoid air cells, the middle ear cavity, the Eustachian tube, and the mastoid antrum. Otitis media can be either acute, less than six weeks, or chronic, which lasts for more than six weeks. Recurrent otitis media refers to three episodes of the disease occurring within six months or four episodes within one year. There are many risk factors for otitis media among children; however, some of such factors may vary based on the type of otitis media. To highlight the risk factors of chronic and recurrent otitis media in pediatrics. Scientific databases were used to search for articles related to our objective. Various terms were used for the search process. The types of articles included in our review were original articles, review articles, meta-analyses, and systematic reviews written in the English language and concerned with our subject. The topic was discussed under four main titles; the first overviewed the prevalence and risk factors of otitis media, the second title discussed chronic otitis media and its risk factors, the third title discussed recurrent otitis media and its risk factors, and the last title discussed the risk factors of both chronic and recurrent otitis media. There are various risk factors for chronic and recurrent otitis media, and they include allergy, passive smoking, male gender, and snoring. Also, genetics may have a common role, but this needs further investigation.
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Affiliation(s)
- Kholood Assiri
- Otorhinolaryngology - Rhinology and Skull Base Surgery consultant, King Faisal Medical City for Southern Regions, Abha, Saudi Arabia
| | - Jibril Hudise
- Otorhinolaryngology - Facial Plastic and Reconstructive Surgery Consultant, King Faisal Medical City for Southern Regions, Abha, Saudi Arabia
| | - Ali Obeid
- Otorhinolaryngology Senior Registrar, Ministry of Health , Abha, Saudi Arabia
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Folino F, Caruso M, Bosi P, Aldè M, Torretta S, Marchisio P. Acute otitis media diagnosis in childhood: still a problem in 2023? Ital J Pediatr 2024; 50:19. [PMID: 38273404 PMCID: PMC10809769 DOI: 10.1186/s13052-024-01588-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/07/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Diagnosis of acute otitis media (AOM) in children can be challenging, given that symptoms are often non-specific or absent, and that the direct observation of the tympanic membrane in its entirety through otoscopy can sometimes be difficult. The aim of this study is to assess the diagnostic concordance in detection of AOM episodes between primary care paediatricians and physicians especially trained in paediatric otoscopy, and to characterize the most misleading elements in diagnostic failure. METHODS Consecutive clinical charts of children regularly followed for recurrent AOM (RAOM, i.e.: >3 episodes in 6 months or > 4 episodes in 1 year) at our Otitis Media paediatric outpatient clinic were retrospectively screened, in order to collect any diagnosis of AOM episode (and the related clinical findings/middle ear complaints) performed by primary care paediatricians/emergency room paediatricians. Diagnosis of AOM episode was validated by the same experienced physician (FF) in case of otoscopic relief of a bulging eardrum with at least one of the following: hyperaemia or yellow-like colour. The diagnostic concordance in detection of AOM episodes between primary care/emergency room paediatricians and our internal validator was expressed as the percentage of matching diagnosis. RESULTS One hundred and thirty-four single AOM episodes occurring in 87 children (mean age: 26.9 +/- 18.9 months) were included in the analysis. Diagnostic concordance in detection of AOM episodes between primary care/emergency room paediatricians and our internal validator was reported in 72.4% of cases. The most common pitfall found in our study was the misleading diagnosis of AOM in case of hyperaemic tympanic membrane without bulging (32/37 out of non-validated diagnoses). CONCLUSIONS AOM diagnosis still represents a relevant issue among paediatricians in our country, and the presence of tympanic membrane hyperaemia without concomitant bulging can be confusing.
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Affiliation(s)
- Francesco Folino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy
| | - Marco Caruso
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy
| | - Pietro Bosi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy
| | - Mirko Aldè
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy
| | - Sara Torretta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Paola Marchisio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Ozbek L, Kyriakides J, Asokan A. A case of otogenic septic arthritis of the knee. J Surg Case Rep 2023; 2023:rjad682. [PMID: 38115949 PMCID: PMC10728415 DOI: 10.1093/jscr/rjad682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023] Open
Abstract
Septic arthritis is a serious condition resulting in rapid destruction of articular cartilage and potential sepsis. Bacterial invasion of a joint occurs most commonly as a result of haematogenous spread from a distant infection. However, an otogenic source of this transient bacteraemia and resultant septic arthritis has not yet been reported in the literature. We report a case of acute septic arthritis of the knee with Streptococcus pyogenes, secondary to acute otitis media of the ear.
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Affiliation(s)
- Leyla Ozbek
- Otolaryngology Department, University College Hospital, 235 Euston Road, London NW1 2BU, United Kingdom
| | - Jonathon Kyriakides
- Trauma and Orthopaedics Department, Barnet Hospital, Wellhouse Lane, London EN5 3DJ, United Kingdom
| | - Ajay Asokan
- Trauma and Orthopaedics Department, Barnet Hospital, Wellhouse Lane, London EN5 3DJ, United Kingdom
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Damien M, Wiener-Vacher SR, Reynard P, Thai-Van H. Bone Conduction Cervical Vestibular Evoked Myogenic Potentials as an Alternative in Children with Middle Ear Effusion. J Clin Med 2023; 12:6348. [PMID: 37834992 PMCID: PMC10573357 DOI: 10.3390/jcm12196348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE To compare the amplitude ratio and P-wave latency of cervical vestibular evoked myogenic potentials (c-VEMPs) for bone conduction (BC) and air conduction (AC) stimulation in children with otitis media with effusion (OME). MATERIAL AND METHODS This is an observational study of a cohort of 27 children and 46 ears with OME. The c-VEMP amplitude ratio and P-wave latency were compared between BC and AC in children with OME and healthy age-matched children. RESULTS The c-VEMP response rate in children with OME was 100% when using BC stimulation and 11% when using AC stimulation. The amplitude ratio for BC was significantly higher in the OME group than the age-matched healthy control group (p = 0.004). When focusing on ears with an AC c-VEMP response (n = 5), there was a significant difference in the amplitude ratio between the AC and BC stimulation modes, but there was no significant difference in the AC results between the OME group and the age-matched control group. CONCLUSIONS BC stimulation allows for reliable vestibular otolith testing in children with middle ear effusion. Given the high prevalence of OME in children, clinicians should be aware that recording c-VEMPs with AC stimulation may lead to misinterpretation of otolith dysfunction in pediatric settings.
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Affiliation(s)
- Maxime Damien
- Service d’Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 69003 Lyon, France; (M.D.)
- Centre de Recherche et d’Innovation en Audiologie Humaine, Institut Pasteur, Institut de l’Audition, rue du Docteur Roux, 75015 Paris, France
- Faculté de Médecine, Université Claude Bernard Lyon 1, 69003 Lyon, France
| | - Sylvette R. Wiener-Vacher
- Centre de Recherche et d’Innovation en Audiologie Humaine, Institut Pasteur, Institut de l’Audition, rue du Docteur Roux, 75015 Paris, France
- Service ORL, Centre d’Exploration Fonctionnelle de l’Équilibre chez l’Enfant (EFEE), Hôpital Robert-Debré AP-HP, 75019 Paris, France
| | - Pierre Reynard
- Service d’Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 69003 Lyon, France; (M.D.)
- Centre de Recherche et d’Innovation en Audiologie Humaine, Institut Pasteur, Institut de l’Audition, rue du Docteur Roux, 75015 Paris, France
- Faculté de Médecine, Université Claude Bernard Lyon 1, 69003 Lyon, France
| | - Hung Thai-Van
- Service d’Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 69003 Lyon, France; (M.D.)
- Centre de Recherche et d’Innovation en Audiologie Humaine, Institut Pasteur, Institut de l’Audition, rue du Docteur Roux, 75015 Paris, France
- Faculté de Médecine, Université Claude Bernard Lyon 1, 69003 Lyon, France
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Marino R, Eager K, Kuthubutheen J, Kadhim L, Távora-Vieira D. Results of a Novel, Nonsurgical Bone-Conduction Hearing Aid for the Treatment of Conductive Hearing Loss in Australian Children. Otol Neurotol 2023; 44:853-859. [PMID: 37621119 DOI: 10.1097/mao.0000000000003995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To determine and compare the benefits a novel adhesive bone-conduction system and a conventional bone-conduction hearing aid (BCHA) on a softband for children with conductive hearing loss. STUDY DESIGN Prospective, single-subject randomized, crossover trial. SETTING Tertiary referral center in Australia. PARTICIPANTS Eight children aged from 4 to 17 years with conductive hearing loss. INTERVENTION Rehabilitative with participants using the novel adhesive bone-conduction aid and a BCHA. MAIN OUTCOME MEASURES Aided thresholds, as well as speech perception in quiet, unaided and aided with the novel adhesive bone-conduction aid and BCHA on a softband. For the six older children, speech in noise testing was also conducted. RESULTS The mean unaided four frequency average hearing levels was 48 dB HL for air conduction, 10.5 dB HL for bone conduction, with a mean air-bone gap in the aided ear of 37.5 dB HL.Four-frequency average hearing level aided thresholds were 20.2 dB for the novel device and 19.8 dB for the BCHA, with no significant difference between the devices. Aided monosyllabic word scores improved from an average of 45% in the unaided condition to 81.6 and 85% for the novel adhesive and BCHA devices, respectively. Aided speech in noise performance improved, on average, by 1.6 dB SNR when wearing the BCHA and the novel adhesive device, with no significant difference in performance between the two devices. CONCLUSIONS The novel device provided equivalent performance to the BCHA on all measures and can be considered as an alternative device for pediatric patients with conductive hearing loss.
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Affiliation(s)
| | | | | | - Latif Kadhim
- Department of Otolaryngology Head and Neck Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Henok EA, Manilal A, Oumer Y, Keyta G, Birru M, Desta Araya B, Aklilu A, Alahmadi RM, Raman G, Idhayadhulla A. Factors Associated with Otitis Media Among Pediatrics in Two Government Hospitals in Arba Minch, Southern Ethiopia. Infect Drug Resist 2023; 16:6405-6426. [PMID: 37789841 PMCID: PMC10544254 DOI: 10.2147/idr.s424927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023] Open
Abstract
Background Bacterial otitis media (OM) is a common infection among the pediatric community worldwide and is the first reason for prescribing antibiotics in pediatric practices. However, if not promptly diagnosed and appropriately treated, it may persist and cause severe intra- and extra-cranial hard-to-cure complications. Hence, knowing the magnitude, etiology, and antibiotic susceptibility profile is very important for the proper management. Methods A cross-sectional study was carried out in 312 pediatrics (1 to 18 years) attending the Ear Nose Throat outpatient departments of the two title hospitals from 25 February to 30th August 2022. Patients were chosen through a systematic random sampling method. Data were obtained by means of a semi-structured questionnaire. Samples were collected to identify the causative bacteria as per microbiological guidelines. The antibiotic susceptibility test was done according to the Kirby-Bauer disc diffusion; SPSS version 25 was used for the analysis. Results The overall prevalence of otitis media was 67.3% (n=210); CSOM showed a slight preponderance (n=107) Gram-negative bacteria and Gram-positive bacteria were present in 59.8% (n=137) and 40.1% (n=92), respectively. Otitis media was predominantly caused by S. aureus (n=52, 56.5%), followed by Proteus spp. (n=33, 24%). Gram-negative bacteria were highly resistant to co-trimoxazole, amoxicillin-clavulanic acid, piperacillin, and tetracycline, whereas their positive counterparts were considerably penicillin and co-trimoxazole resistant. Overall, 61.5 and 19.2% of the isolates were MDR and XDR, respectively. MRSA, MR-CoNs, and VRE were 38.4% (n=20), 17.1% (n=5), and 58.3% (n=12), respectively; 19.7% (n=25) of Gram-negative bacteria produced ESBL, and 7% (n=9) were carbapenem-resistant. History of exposure to loud noise [AOR=3.4; CI=1.14-10.23; P-value=0.028] and family history of smoking at home [AOR=2.9; CI=1.18-7.25; P-value=0.020] have the greatest odds of otitis media. Conclusion Overall, the prevalence of otitis media is showing an upward trend, and MDR among bacterial isolates is increasing alarmingly.
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Affiliation(s)
- Ephrem Araya Henok
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yisiak Oumer
- Department of Medical Laboratory Science, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Gebre Keyta
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Melkam Birru
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Birhane Desta Araya
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Reham Mosleh Alahmadi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Gurusamy Raman
- Department of Life Sciences, Yeungnam University, Gyeongsan, Gyeongbuk-Do, South Korea
| | - Akbar Idhayadhulla
- Research Department of Chemistry, Nehru Memorial College (Affiliated to Bharathidasan University), Tiruchirappalli, Tamil Nadu, 621007, India
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Altamimi AAH, Robinson M, McKinnon EJ, Alenezi EMA, Veselinović T, Choi RSM, Brennan-Jones CG. The association between otitis media in early childhood with later behaviour and attention problems: A longitudinal pregnancy cohort. Int J Pediatr Otorhinolaryngol 2023; 168:111545. [PMID: 37043962 DOI: 10.1016/j.ijporl.2023.111545] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/09/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The present study aims to investigate the association between an early history of recurrent otitis media (OM) with or without ventilation tube insertion (VTI) and later behavioural problems in childhood and adolescence. METHODS Parental reports in a longitudinal pregnancy cohort were used to classify children into three groups; recurrent OM without VTI (rOM group; n = 276), recurrent OM with VTI (VTI group; n = 62), and no history of early-life recurrent OM as a reference group (n = 1485). The Child Behaviour Checklist (CBCL) was administered at ages 5, 8, 10, and 13 years and data were analysed for psychological wellbeing. Mixed-effects regression modelling was used to investigate the associations between a history of rOM and CBCL T-scores across all ages for rOM and VTI groups compared to the reference group. All analyses were controlled for a wide range of confounding variables. RESULTS The analyses revealed a significant association between recurrent OM and behavioural problems. While there was a general decline in scores (i.e. improvement) observed over the duration of the follow-up period, children in the rOM group displayed significantly higher scores for internalising and externalising behaviours at ages five, eight and 10 years. Attention scores were significantly higher across all ages in the rOM group. A transient increase in internalising behaviour was observed in the VTI group at ages eight and 10 years. Logistic regression models showed an increased overall likelihood for the rOM group only to fall within the abnormal clinical range for internalising and externalising behaviours. CONCLUSION Early-life recurrent OM with and without VTI was associated with increased behavioural and attention problems in early and late childhood. This suggests that recurrent OM can have a significant impact on children's behaviour and attention that can persist into early adolescence.
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Affiliation(s)
- Ali A H Altamimi
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Faculty of Life Sciences, Kuwait University, Kuwait.
| | - Monique Robinson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth J McKinnon
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Eman M A Alenezi
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | - Tamara Veselinović
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia
| | - Robyn S M Choi
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia
| | - Christopher G Brennan-Jones
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Kaya E, Bozan G, Kılıç Ö, Pınarbaşlı MÖ, Gürbüz MK, Kaya F. Acute Otitis Media with Intracranial and Intratemporal Complications: A Case Study. Indian J Otolaryngol Head Neck Surg 2023; 75:79-82. [PMID: 37206845 PMCID: PMC10188808 DOI: 10.1007/s12070-022-03254-3] [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: 06/21/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
Abstract
Acute otitis media continues to be one of the most common infections today and a major cause of the prescription of antibiotics in the pediatric age group. Complications of this condition are rare, especially when antibiotic therapy is started early; however, complications related to acute otitis media cause dramatic morbidity. This report provides a review related to a case of acute otitis media with bilateral intracranial and intratemporal complications.
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Affiliation(s)
- Ercan Kaya
- Department of Otorhinolaryngology, Eskişehir Osmangazi University, Meşelik Campus Prof. Dr. Nabi AVCI Road No:4 Eskisehir, 26040 Eskişehir, Turkey
| | - Gürkan Bozan
- Department of Pediatrics, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ömer Kılıç
- Department of Pediatrics, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Mehmet Özgür Pınarbaşlı
- Department of Otorhinolaryngology, Eskişehir Osmangazi University, Meşelik Campus Prof. Dr. Nabi AVCI Road No:4 Eskisehir, 26040 Eskişehir, Turkey
| | - Melek Kezban Gürbüz
- Department of Otorhinolaryngology, Eskişehir Osmangazi University, Meşelik Campus Prof. Dr. Nabi AVCI Road No:4 Eskisehir, 26040 Eskişehir, Turkey
| | - Furkan Kaya
- Department of Otorhinolaryngology, Eskişehir Osmangazi University, Meşelik Campus Prof. Dr. Nabi AVCI Road No:4 Eskisehir, 26040 Eskişehir, Turkey
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12
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Middle ear effusion and newborn hearing screening. Eur Arch Otorhinolaryngol 2023; 280:643-649. [PMID: 35838783 DOI: 10.1007/s00405-022-07524-2] [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: 02/28/2022] [Accepted: 06/20/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Middle ear effusion (MEE) is one of the reasons for screening failure and may require prolonged follow-up due to conductive hearing loss. We aimed to examine at 1-year follow-up, the fate of MEE. METHODS From medical charts, computerized data were collected retrospectively of newborns born in the years 2012-2013 in Rambam Health Care Campus, Haifa city, Israel, who failed the Universal Newborn Hearing Screening (UNHS), and follow-up hearing evaluation data were extracted. RESULTS Of 9527 newborns born in 2012-2013 in our institution, 144 [1.5%] failed the UNHS, and 46 were eventually diagnosed with conductive hearing loss caused by MEE. Spontaneous MEE clearance was recorded in 12 [26%], while 26 [57%] patients had persistent effusion that required further follow-up (10 [22%] required insertion of ventilation tubes and 16 [35%] were referred for further follow-up); 8 [17%] were lost to follow-up. CONCLUSION Congenital MEE causing conductive hearing loss and UNHS failure is persistent and resolves at lower rates than non-congenital MEE.
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Mohanty S, Podmore B, Cuñado Moral A, Weiss T, Matthews I, Sarpong E, Méndez I, Qizilbash N. Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England. BMC Public Health 2023; 23:201. [PMID: 36717794 PMCID: PMC9885604 DOI: 10.1186/s12889-023-14982-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children. The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs). METHODS AOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007-2009), early post-PCV13 (2011-2014) and late post-PCV13 (2015-2019) periods compared to the pre-PCV7 period (2003-2005) using generalized linear models. RESULTS From 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2-4 years: 7951.8 (95% CI 7902.5-8001.4); 5-17 years: 2184.4 (95% CI 2172.1-2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85-0.89), early post-PCV13 0.88 (95% CI 0.86-0.91), and late post-PCV13 0.75 (95% CI 0.73-0.78). CONCLUSIONS The AOM IRs declined during the 2003-2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.
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Affiliation(s)
- Salini Mohanty
- Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, NJ, USA.
| | - Bélène Podmore
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | | | - Thomas Weiss
- grid.417993.10000 0001 2260 0793Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, NJ USA
| | - Ian Matthews
- grid.419737.f0000 0004 6047 9949MSD (UK) Ltd, Value, Access and Devolved nations (VAD), London, UK
| | - Eric Sarpong
- grid.417993.10000 0001 2260 0793Merck & Co., Inc., Real-world Data Analytics and Innovation (RDAI), Rahway, NJ USA
| | - Ignacio Méndez
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | - Nawab Qizilbash
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
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Yu H, Gu D, Yu F, Li Q. Social distancing cut down the prevalence of acute otitis media in children. Front Public Health 2023; 11:1079263. [PMID: 36778556 PMCID: PMC9911446 DOI: 10.3389/fpubh.2023.1079263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives To evaluate the additional, unintended benefits of social distancing in cutting down the prevalence of acute otitis media (AOM) in children, especially during coronavirus disease 2019 (COVID-19) periods. Methods The daily outpatient attendance of AOM for childhood (from 6 months to 12 years) was compared in the tertiary hospital in Shanghai during pre-COVID-19 and COVID-19 year. Results A total of 24,543 AOM cases were included from 2015 to 2020. When age was taken into account, children in kindergarten (aged 4-6) constitute 66.2% (16,236/24,543) of all case, followed by primary school students (6,441/24,543, 26.2%) and preschoolers <3 years old (1,866/24,543, 7.6%). There was an estimated 63.6% (54.32-70.36%) reduction in the daily outpatient attendance of AOM associated with the introduction of social distancing in 2020 (COVID-19 year). The epidemic trend of AOM in 2015-2019 was characterized by seasonal fluctuations, with highest incidence in December (18.8 ± 0.5%) and lower in February (4.5 ± 0.2%), June (3.7 ± 0.7%) and August (3.5 ± 0.5%). And distribution characteristics of different ages in COVID-19 period broadly in line with that in non-pandemic period. Conclusion Seasonal fluctuation in the prevalence of AOM was observed in pre-COVID-19 period (2015-2019), with a peak in winter and a nadir in summer. The >50% drop of outpatient attendance of AOM in 2020 (COVID-19 year) suggest that social distancing, mask effects and good hand hygiene can significantly reduce the incidence of AOM, which provides a preventive and therapeutic point of view for AOM.
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Santos-Cortez RLP, Ong KMC, Carlos-Hiceta A, Tantoco MLC, Yarza TKL, San Agustin ML, Pedro M, Cruz TLG, Cutiongco-de la Paz EM, Abes GT, Llanes EGD, Chan AL, Chiong CM, Reyes-Quintos MRT. Audiologic Measures in an Indigenous Community with A2ML1- and FUT2-Related Otitis Media. Genet Test Mol Biomarkers 2023; 27:12-17. [PMID: 36719978 PMCID: PMC9902046 DOI: 10.1089/gtmb.2022.0171] [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: 02/02/2023] Open
Abstract
Background: Many indigenous peoples are at elevated risk for otitis media, however there is limited information on hearing loss due to OM in these communities. An Indigenous Filipino community that has previously been described with an elevated prevalence of OM that is due to rare A2ML1 variants and a common FUT2 variant underwent additional phenological testing. In this study, we describe the audiologic profiles in A2ML1- and FUT2-related otitis media and the validity of otoscopy and genotyping for A2ML1 and FUT2 variants in screening for otitis media and hearing loss. Method: We analyzed A2ML1 and FUT2 genotypes together with demographic, otologic and audiologic data from tympanometry and hearing level assessments of 109 indigenous individuals. Results: We confirmed previous findings of a spectrum of nonsyndromic otitis media as associated with A2ML1 variants. A2ML1 and FUT2 variants were associated with high-frequency hearing loss at 4000 Hz. As expected, young age was associated with flat tympanograms, and eardrum perforations due to chronic otitis media were associated with severe-to-profound hearing loss across frequencies. Adding A2ML1 or FUT2 genotypes improved the validity of otoscopy as a screening test to rule out moderate-to-profound hearing loss. Conclusion: Continued multi-disciplinary management and audiologic follow-up using tympanometry and screening audiometry are needed to document and treat otitis media and prevent permanent hearing loss in the indigenous community.
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Affiliation(s)
- Regie Lyn P. Santos-Cortez
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Center for Children's Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Kimberly Mae C. Ong
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Angeli Carlos-Hiceta
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Ma. Leah C. Tantoco
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Talitha Karisse L. Yarza
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Ma. Luz San Agustin
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Melquiadesa Pedro
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Teresa Luisa G. Cruz
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Eva Maria Cutiongco-de la Paz
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Philippine Genome Center, University of the Philippines Diliman, Quezon City, Philippines
| | - Generoso T. Abes
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Erasmo Gonzalo d.V. Llanes
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Abner L. Chan
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Charlotte M. Chiong
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
| | - Maria Rina T. Reyes-Quintos
- Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Newborn Hearing Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Otorhinolaryngology, University of the Philippines College of Medicine–Philippine General Hospital, Manila, Philippines
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16
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Thorsen J, Pedersen TM, Mora-Jensen ARC, Bjarnadóttir E, Bager SC, Bisgaard H, Stokholm J. Middle ear effusion, ventilation tubes and neurological development in childhood. PLoS One 2023; 18:e0280199. [PMID: 36638109 PMCID: PMC9838841 DOI: 10.1371/journal.pone.0280199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/22/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Otitis media with middle ear effusion (MEE) can be treated with ventilation tubes (VT) insertion, and it has been speculated that prolonged MEE in childhood can affect neurological development, which in turn may be important for later academic achievements. OBJECTIVE To investigate the association between middle ear effusion (MEE), treatment with ventilation tubes (VT) and childhood neurological development. STUDY DESIGN We examined 663 children from the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) unselected mother-child cohort study. Children were followed by study pediatricians with regular visits from pregnancy until 3 years of age. MEE was diagnosed using tympanometry at age 1, 2 and 3 years. Information regarding VT from age 0-3 years was obtained from national registries. We assessed age at achievement of gross motor milestones from birth, language scores at 1 and 2 years, cognitive score at 2.5 years and general development score at age 3 years using standardized quantitative tests. RESULTS Children with MEE had a lower 1-year word production vs. children with no disease: (median 2, IQR [0-6] vs. 4, IQR [1-7]; p = 0.017), and a lower 1-year word comprehension (median 36; IQR [21-63] vs. 47, IQR [27-84]; p = 0.03). Children with VT had a lower 2-5-year cognitive score vs. children with no disease; estimate -2.34; 95% CI [-4.56;-0.12]; p = 0.039. No differences were found between children with vs. without middle ear disease regarding age at achievement of gross motor milestones, word production at 2 years or the general developmental score at 3 years. CONCLUSION Our study supports the previous findings of an association between MEE and concurrent early language development, but not later neurological endpoints up to the age of 3. As VT can be a treatment of those with symptoms of delayed development, we cannot conclude whether treatment with VT had positive or negative effects on neurodevelopment.
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Affiliation(s)
- Jonathan Thorsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tine Marie Pedersen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Anna-Rosa Cecilie Mora-Jensen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Elín Bjarnadóttir
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Søren Christensen Bager
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatrics, Naestved Hospital, Naestved, Denmark
- * E-mail:
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Bernkopf E, Cristalli G, de Vincentiis GC, Bernkopf G, Capriotti V. Temporomandibular Joint and Otitis Media: A Narrative Review of Implications in Etiopathogenesis and Treatment. Medicina (B Aires) 2022; 58:medicina58121806. [PMID: 36557008 PMCID: PMC9786198 DOI: 10.3390/medicina58121806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided.
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Affiliation(s)
| | - Giovanni Cristalli
- Otolaryngology Unit, Bambino Gesù Children’s Hospital, IRCCS, Via della Torre di Palidoro, 00050 Rome, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
| | | | | | - Vincenzo Capriotti
- Otorhinolaryngology and Head and Neck Surgery Unit, ASST Bergamo Ovest, Treviglio-Caravaggio Hospital, Piazzale Ospedale Luigi Meneguzzo 1, 20047 Treviglio, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
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18
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McLaren H, Kim R, MacFater W, Neeff M, Jelicic T, Douglas R. Factors affecting clinic attendance for children referred with middle ear conditions. ANZ J Surg 2022; 92:3264-3267. [PMID: 36424855 PMCID: PMC10100060 DOI: 10.1111/ans.18140] [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: 04/28/2022] [Revised: 08/30/2022] [Accepted: 10/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Middle ear disease is common in children and, if untreated, can lead to long term complications. This study investigated whether ethnic or socioeconomic inequities existed among children referred to a tertiary regional paediatric ORL service. METHODS All middle ear pathology related referrals to Starship Children's Hospital ORL service during 2018 and 2019 were reviewed. Online clinical records were accessed to collect demographic data and appointment outcomes. The relationships between ethnicity, socioeconomic status, age at referral and clinic attendance were analysed. RESULTS A total of 1530 children were referred and 214 (14.0%) of these did not attend their scheduled appointments. Compared with the age of referral for European children, Māori children were referred on average 1.1 years older while Pasifika children were referred 2.4 years older. Compared to European children, Māori children were 4.3 times more likely to miss an appointment while Pasifika were 7.2 times more likely. Socioeconomic status had no significant effect on either age of referral or clinic attendance. CONCLUSIONS Māori and Pasifika children with middle ear disease are referred later and are more likely to miss outpatient clinic appointments. Pasifika children are affected more than Māori.
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Affiliation(s)
- Holly McLaren
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Raymond Kim
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Wiremu MacFater
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Michel Neeff
- Department of Paediatric Otolaryngology, Starship Children's Hospital, Auckland, New Zealand
| | - Tanja Jelicic
- Department of Paediatric Otolaryngology, Starship Children's Hospital, Auckland, New Zealand
| | - Richard Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand
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Markandan K, Tiong YW, Sankaran R, Subramanian S, Markandan UD, Chaudhary V, Numan A, Khalid M, Walvekar R. Emergence of infectious diseases and role of advanced nanomaterials in point-of-care diagnostics: a review. Biotechnol Genet Eng Rev 2022:1-89. [PMID: 36243900 DOI: 10.1080/02648725.2022.2127070] [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: 06/08/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.
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Affiliation(s)
- Kalaimani Markandan
- Temasek Laboratories, Nanyang Technological University, Nanyang Drive, Singapore
- Faculty of Engineering, Technology and Built Environment, UCSI University, Kuala Lumpur, Malaysia
| | - Yong Wei Tiong
- NUS Environmental Research Institute, National University of Singapore, Engineering Drive, Singapore
| | - Revathy Sankaran
- Graduate School, University of Nottingham Malaysia Campus, Semenyih, Selangor, Malaysia
| | - Sakthinathan Subramanian
- Department of Materials & Mineral Resources Engineering, National Taipei University of Technology (NTUT), Taipei, Taiwan
| | | | - Vishal Chaudhary
- Research Cell & Department of Physics, Bhagini Nivedita College, University of Delhi, New Delhi, India
| | - Arshid Numan
- Graphene & Advanced 2D Materials Research Group (GAMRG), School of Engineering and Technology, Sunway University, Petaling Jaya, Selangor, Malaysia
- Sunway Materials Smart Science & Engineering (SMS2E) Research Cluster School of Engineering and Technology, Sunway University, Selangor, Malaysia
| | - Mohammad Khalid
- Graphene & Advanced 2D Materials Research Group (GAMRG), School of Engineering and Technology, Sunway University, Petaling Jaya, Selangor, Malaysia
- Sunway Materials Smart Science & Engineering (SMS2E) Research Cluster School of Engineering and Technology, Sunway University, Selangor, Malaysia
| | - Rashmi Walvekar
- Department of Chemical Engineering, School of Energy and Chemical Engineering, Xiamen University Malaysia, Sepang, Selangor, Malaysia
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20
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Zloczower E, Bartov N, Allon R, Sokolov M, Lahav Y, Shoffel-Havakuk H. The impact of birth weight and gestational age on acute mastoiditis in children. Eur Arch Otorhinolaryngol 2022; 280:2133-2139. [PMID: 36153783 DOI: 10.1007/s00405-022-07672-5] [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] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Previous data correlate preterm and low birth weight (LBW) with acute otitis media, but there is a gap concerning the relations with acute mastoiditis (AM). This study investigates the effect of LBW and preterm birth on AM disease severity, neuro-otological complications, and recurrence. STUDY DESIGN Retrospective cohort. SETTING Tertiary medical center. METHODS The cohort is retrospective in nature consisting of 294 children with AM admitted between 1999 and 2020. Data collection included: patient gestational age and birth weight, signs and symptoms, physical examination, laboratory tests, imaging findings, and long-term outcomes. RESULTS 294 cases of AM were included, 41/281 (15%) had LBW (< 2500 g), and 46/294 (15.7%) were preterm (gestational age < 37 weeks). We found no significant differences in laboratory tests, imaging studies (CT), rate of mastoidectomy performed, or late complications between LBW and normal birth weight (NBW) and between preterm and normal gestational age children. LBW children tended to develop AM at an older age compared with NBW children, 2.28 + 1.64 Vs. 1.84 + 1.4 years, respectively (p-value = 0.016). Additionally, preterm children were more prone to develop a second event of AM, with a shorter interval between these episodes. CONCLUSIONS LBW and preterm birth are not independent risk factors for disease severity, need for intervention, or future complications in AM. Yet, LBW children present with AM at an older age, and preterm children are more prone for recurrent episodes of AM with a shorter interval between episodes suggesting a distinct disease course in these populations.
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Affiliation(s)
- Elchanan Zloczower
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Hadassah Medical School, The Hebrew University of Jerusalem, Rehovot, Israel.
| | - Noam Bartov
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Hadassah Medical School, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Raviv Allon
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Hadassah Medical School, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Meirav Sokolov
- Pediatric Ear-Nose-Throat Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonatan Lahav
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Hadassah Medical School, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Hagit Shoffel-Havakuk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
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21
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Aithal S, Kei J, Aithal V. High frequency (1000 Hz) tympanometry in six-month-old infants. Int J Pediatr Otorhinolaryngol 2022; 160:111223. [PMID: 35802992 DOI: 10.1016/j.ijporl.2022.111223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/14/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES High frequency tympanometry (HFT) using a 1000 Hz probe tone is recommended for infants from birth to six months of age. However, there is limited normative HFT data outside the newborn period. The objective of this study was to describe HFT data in healthy six-month-old infants. METHODS HFT and distortion product otoacoustic emission (DPOAE) tests were performed on 168 six-month-old full-term healthy infants. Ears that passed DPOAEs and had a single-peaked tympanogram were included for analysis. The tympanometric measures included in the normative HFT data were tympanometric peak pressure (TPP), peak compensated static admittance (Ytm) and tympanometric width (TW). RESULTS A total of 118 ears from 118 infants who passed DPOAE and had single-peaked tympanograms were included in the analysis. Normative data were presented for TPP, Ytm and TW. A comparison of the present study with studies on neonates and younger infants revealed significantly higher mean Ytm and lower mean TPP for six-month-old-infants. CONCLUSION Significant differences in HFT findings between neonates and six-month-old infants suggest a developmental trend and confirm the need for separate age-appropriate norms for the tympanometric measures. Normative HFT data described in the present study may provide useful information for optimizing the diagnosis of conductive conditions in six-month-old infants.
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Affiliation(s)
- Sreedevi Aithal
- Department of Audiology, Townsville University Hospital, Queensland, Australia; Hearing Research Unit for Children, School of Health & Rehabilitation Sciences, University of Queensland, Australia; Department of Speech Pathology, School of Rehabilitation Sciences, James Cook University, Australia.
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health & Rehabilitation Sciences, University of Queensland, Australia
| | - Venkatesh Aithal
- Department of Audiology, Townsville University Hospital, Queensland, Australia; Hearing Research Unit for Children, School of Health & Rehabilitation Sciences, University of Queensland, Australia
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22
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Díez R, Verd S, Ponce-Taylor J, Gutiérrez A, Llull M, Martin-Delgado MI, Cadevall O, Ramakers J. A Preliminary Study on Acute Otitis Media in Spanish Children with Late Dinner Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10721. [PMID: 36078436 PMCID: PMC9518556 DOI: 10.3390/ijerph191710721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The timing of caloric intake plays an important role in the long-term process that leads to communicable diseases. The primary objective of this study was to analyse whether children who ate dinner early were at lower risks of acute respiratory infections than children who ate dinner late during the COVID-19 pandemic. METHODS This cross-sectional study was conducted from July to December 2020 on children attending Majorcan emergency services. Our survey on dinner time habits was carried out by using self-administered questionnaires. RESULTS A total of 669 children were included in this study. The median dinner time was 8:30 pm. Late dinner eaters accounted for a higher proportion of acute otitis media (7% vs. 3%; p = 0.028) than early dinner eaters. Other infectious diseases were not associated with dinner time habits. CONCLUSIONS We make a preliminary estimate of the link between late dinner habits and acute otitis media in children. However, no conclusions about causality can be established due to the observational design of the study, and further research is needed in order to confirm the different issues raised by our initial exploration of an emerging research area.
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Affiliation(s)
- Ruth Díez
- Department of Pediatrics, Son Espases University Hospital, 07120 Palma de Mallorca, Spain
- Department of Pediatrics, Quiron Rotger Hospital, 07012 Palma de Mallorca, Spain
| | - Sergio Verd
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, 07013 Palma de Mallorca, Spain
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma de Mallorca, Spain
| | | | - Antonio Gutiérrez
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain
- Baleares Medical Council, 07012 Palma de Mallorca, Spain
| | - María Llull
- Pediatric Unit, Esporles Surgery, Department of Primary Care, 07190 Mallorca, Spain
| | - María-Isabel Martin-Delgado
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma de Mallorca, Spain
- Pediatric Unit, Santa Ponsa Surgery, Department of Primary Care, 07180 Mallorca, Spain
| | - Olga Cadevall
- Department of Pediatrics, Quiron Rotger Hospital, 07012 Palma de Mallorca, Spain
| | - Jan Ramakers
- Department of Pediatrics, Son Espases University Hospital, 07120 Palma de Mallorca, Spain
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma de Mallorca, Spain
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23
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Jamal A, Alsabea A, Tarakmeh M, Safar A. Etiology, Diagnosis, Complications, and Management of Acute Otitis Media in Children. Cureus 2022; 14:e28019. [PMID: 36134092 PMCID: PMC9471510 DOI: 10.7759/cureus.28019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 11/30/2022] Open
Abstract
Acute otitis media (AOM) is the most common infectious disease encountered by children under the age of two years and the most common cause of antibiotic use in children in the United States. AOM causes irritability, sleeplessness, decreased appetite, imbalance, and dizziness in patients, especially young children. This assessment was conducted to measure the effectiveness of surgical interventions in treating AOM. We reviewed the present findings regarding the etiology, clinical presentations, diagnosis, treatment, and surgical treatment of complications of AOM. Pain associated with AOM (otalgia) can be severe enough to cause parents to seek treatment for their infants or children. Various suggested measures have been used to treat AOM; antibiotic treatment with amoxicillin is still the treatment of choice for AOM, yet other antibiotics may be used in cases of allergy to penicillin or recent use of amoxicillin. Surgical intervention has been introduced and studied as a diagnostic, therapeutic, and preventive measure for AOM; nevertheless, a few studies have shown that surgical interventions are beneficial in treating and preventing AOM compared to the common practice of using antibiotics. Overdiagnosis of AOM is widespread, leading to injudicious antibiotic use, which contributes to antibiotic resistance. Further management should be determined together with the parent, particularly if observation is the primary intervention.
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Affiliation(s)
- Abdullah Jamal
- Department of Otolaryngology, Zain Hospital, Kuwait, KWT
| | - Abdulla Alsabea
- Department of Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | | | - Ali Safar
- Department of Otolaryngology, Zain Hospital, Kuwait, KWT
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24
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Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights 2022; 15:11786361221104446. [PMID: 35734305 PMCID: PMC9208041 DOI: 10.1177/11786361221104446] [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: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Otitis media (OM), also known as middle ear infection, is a clinically significant childhood disease. In sub-Saharan Africa, there is a paucity of contemporary reports on it is bacterial aetiologies and antimicrobial resistance among them. Aim: To investigate the OM bacterial aetiologies and their antimicrobial resistance patterns among children visiting the Ear, Nose, and Throat clinics of 3 healthcare facilities in Accra, Ghana – Princess Marie Louise Children’s Hospital, 37 Military Hospital, and Mamprobi Hospital. Methods: This cross-sectional study involved 100 children below 13 years old with suppurative otitis media. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharges from the study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic and clinical characteristics. Results: The major OM bacterial aetiologies were Pseudomonas aeruginosa (38.5%), Klebsiella pneumoniae (19.8%), Proteus mirabilis (11.5%), and Staphylococcus aureus (10.4%). The majority of the bacteria demonstrated low to moderate resistance (0%-33.3%) to most of the antibiotics. Eight of the bacteria (4 each of Klebsiella pneumoniae and Escherichia coli) were extended-spectrum beta-lactamase (ESBL) producers; 6 ampicillinase (Amp C)-producing organisms (4 Citrobacter spp. and one each of Morganella morganii and Serratia marcescens) were also identified, and they showed high antibiotic resistance. Conclusions: The predominant OM aetiologies were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus, and they were generally susceptible to most of the antibiotics tested. Amikacin, cefepime, ciprofloxacin, and meropenem could be valuable in the empirical management of childhood OM.
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Affiliation(s)
- Nicholas Tkd Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Vida Bannah
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Felicia P Dwomoh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,Department of Medical Laboratory, University of Ghana Medical Centre, Legon, Accra, Ghana
| | - Fleischer Cn Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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25
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Ngo CC, Massa HM, McMonagle BA, Perry CF, Nissen MD, Sloots TP, Thornton RB, Cripps AW. Predominant Bacterial and Viral Otopathogens Identified Within the Respiratory Tract and Middle Ear of Urban Australian Children Experiencing Otitis Media Are Diversely Distributed. Front Cell Infect Microbiol 2022; 12:775535. [PMID: 35360096 PMCID: PMC8963760 DOI: 10.3389/fcimb.2022.775535] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Otitis media (OM) is one of the most common infections in young children, arising from bacterial and/or viral infection of the middle ear. Globally, Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the predominant bacterial otopathogens. Importantly, common upper respiratory viruses are increasingly recognized contributors to the polymicrobial pathogenesis of OM. This study aimed to identify predominant bacteria and viruses in the nasopharynx, adenoids and middle ears of peri-urban/urban South-East Queensland Australian children, with and without clinical history of chronic otitis media with effusion (COME) and/or recurrent acute otitis media (RAOM). Methods Sixty children, 43 diagnosed with OM and 17 controls with no clinical history of OM from peri-urban/urban South-East Queensland community were recruited to the study. Respiratory tract bacterial and viral presence were examined within nasopharyngeal swabs (NPS), middle ear effusions (MEE) and adenoids, using real-time polymerase chain reaction (RT-PCR) and bacterial culture. Results At least one otopathogen present was observed in all adenoid samples, 86.1% and 82.4% of NPS for children with and without OM, respectively, and 47.1% of the MEE from the children with OM. NTHi was the most commonly detected bacteria in both the OM and control cohorts within the adenoids (90.0% vs 93.8%), nasopharynx (67.4% vs 58.8%) respectively, and in the MEE (OM cohort 25.9%). Viruses were detected in all adenoid samples, 67.4% vs 47.1% of the NPS from the OM and control cohorts, respectively, and 37% of the MEE. Rhinovirus was the predominant virus identified in the adenoids (85.0% vs 68.8%) and nasopharynx (37.2% vs 41.2%) from the OM and control cohorts, respectively, and the MEE (19.8%). Conclusions NTHi and rhinovirus are predominant otopathogens within the upper respiratory tract of children with and without OM from peri-urban and urban South-East Queensland, Australia. The presence of bacterial otopathogens within the middle ear is more predictive of concurrent URT infection than was observed for viruses, and the high otopathogen carriage within adenoid tissues confirms the complex polymicrobial environment in children, regardless of OM history.
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Affiliation(s)
- Chinh C. Ngo
- John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Helen M. Massa
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
- *Correspondence: Helen M. Massa,
| | - Brent A. McMonagle
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Pindara Private Hospital, Ramsay Health Care, Gold Coast, QLD, Australia
| | - Christopher F. Perry
- School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Otolaryngology, Head and Neck Surgery Department, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Michael D. Nissen
- Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Theo P. Sloots
- Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Ruth B. Thornton
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Disease, Telethon Kids Institute, Perth, WA, Australia
| | - Allan W. Cripps
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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26
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Mun SK, Chang M. Development of prediction models for the incidence of pediatric acute otitis media using Poisson regression analysis and XGBoost. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:18629-18640. [PMID: 34694557 DOI: 10.1007/s11356-021-17135-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
Otitis media has profound health and economic impact, and its occurrence is known to be influenced by air pollution and climate. The purpose of this study was to develop prediction models using climate and air pollution indicators for the occurrence of acute otitis media (AOM). The study was conducted from January 1, 2014, to December 31, 2019, and included pediatric patients (age < 12 years) diagnosed on their emergency room visit in our tertiary medical institution. We obtained data on the weekly number of AOM patients and the weekly average values of air pollution and climate indicators. Poisson regression analysis and eXtreme Gradient Boosting (XGBoost) were used to develop prediction models for the overall pediatric patients and for the patients classified according to sex (male and female) and age (< 2 years and ≥ 2 years). For the overall population, the correlation coefficients between the original and estimated data in the testing set were 0.441 (p < 0.001) and 0.844 (p < 0.001) for the models developed using Poisson regression analysis and XGBoost, respectively. The root-mean-square errors in the testing set were 3.094 and 1.856, respectively. For patients classified according to sex and age, the prediction models developed using XGBoost showed better performance than the models developed using Poisson regression analysis. In conclusion, this study successfully developed prediction models with air pollution and climate indicators for the incidence of pediatric AOM, using XGBoost. This model can be further developed to prevent pediatric AOM.
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Affiliation(s)
- Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea.
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27
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Perdrizet J, Farkouh RA, Horn EK, Hayford K, Sings HL, Wasserman MD. The broader impacts of otitis media and sequelae for informing economic evaluations of pneumococcal conjugate vaccines. Expert Rev Vaccines 2022; 21:499-511. [PMID: 35191368 DOI: 10.1080/14760584.2022.2040989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Otitis media (OM) is a common childhood infection. Pneumococcal conjugate vaccines (PCVs) prevent OM episodes, thereby reducing short- and long-term clinical, economic, humanistic, and societal consequences. Most economic evaluations of PCVs focus on direct health gains and cost savings from prevented acute episodes but do not fully account for the broader societal impacts of OM prevention. AREAS COVERED This review explores the broader burden of OM on children, caregivers, and society to better inform future economic evaluations of PCVs. EXPERT OPINION OM causes a substantial burden to society through long-term sequelae, productivity losses, reduced quality of life for children and caregivers, and contribution to antimicrobial resistance from inappropriate antibiotic use. The effect of PCVs on acute OM has been recognized globally, yet the broader impact has not been consistently quantified, studied, or communicated. Economic evaluations of PCVs must evolve to include broader effects for patients, caregivers, and society from OM prevention. Future PCVs with broader coverage may further reduce OM incidence and antimicrobial resistance, but optimal uptake will depend on increasing the recognition and use of novel frameworks that include broader benefits. Communicating the full value of PCVs to decision makers may result in wider access and positive societal returns.
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Affiliation(s)
- Johnna Perdrizet
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Raymond A Farkouh
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Emily K Horn
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Kyla Hayford
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Toronto, Canada
| | - Heather L Sings
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Collegeville, PA, USA
| | - Matt D Wasserman
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
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28
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You MW, Kim D, Lee EH, Park DC, Lee JM, Kang DW, Kim SH, Yeo SG. The Roles of NOD-like Receptors in Innate Immunity in Otitis Media. Int J Mol Sci 2022; 23:ijms23042350. [PMID: 35216465 PMCID: PMC8879371 DOI: 10.3390/ijms23042350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 02/04/2023] Open
Abstract
Acute otitis media (AOM) can persist or lead to various complications in individuals in which the innate immune system is impaired. In this context, impaired expression of nucleotide-binding oligomerization domain (NOD)-like receptor (NLR), an intracellular pathogen-recognition receptor (PRR), is involved in the etiology of OM in humans and animals, affecting its development, severity, chronicity, recurrence, and associated complications. To assess this relationship, we reviewed literature reports relating NLR expression patterns with the pathophysiology and clinical features of OM in the larger context of impaired innate immunity. We summarized the results of published studies on the expression of NLRs in animals and humans in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. NLRs were expressed mainly in association with bacterial infection in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. In addition, expression of NLRs was affected by the presence or absence of bacteria, fluid characteristics, disease recurrence, tissue type, and repeated surgery. Various factors of the innate immune system are involved in the pathogenesis of OM in the middle ear. NLRs are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. Impaired NLR expression induced the development, chronicity and recurrence of OM and exacerbated associated complications, indicating that NLRs have important roles in the pathogenesis of OM.
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Affiliation(s)
- Myung-Won You
- Department of Radiology, College of Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Dokyoung Kim
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Eun-Hye Lee
- Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Dong-Choon Park
- St. Vincent’s Hospital, The Catholic University of Korea, Suwon 16247, Korea;
| | - Jae-Min Lee
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.-M.L.); (D.-W.K.); (S.-H.K.)
| | - Dae-Woong Kang
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.-M.L.); (D.-W.K.); (S.-H.K.)
| | - Sang-Hoon Kim
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.-M.L.); (D.-W.K.); (S.-H.K.)
| | - Seung-Geun Yeo
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.-M.L.); (D.-W.K.); (S.-H.K.)
- Correspondence: ; Tel.: +82-2-958-8474; Fax: +82-2-958-8470
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Zhang N, Qian T, Sun S, Cao W, Wang Z, Liu D, Li P, Wu J, Li H, Yang J. IL-17 is a Potential Therapeutic Target in a Rodent Model of Otitis Media with Effusion. J Inflamm Res 2022; 15:635-648. [PMID: 35140496 PMCID: PMC8818970 DOI: 10.2147/jir.s338598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Otitis media with effusion (OME) is a non-suppurative inflammation of the middle ear that is characterized by middle ear effusion and hearing loss. However, the mechanisms of OME are not fully understood. The aim of this study was to determine the function and the mechanism of the IL-17 cytokine in the pathogenesis of OME and to investigate IL-17 as a potential strategy for the treatment of OME. Methods In this study, the OME rat model was induced by ovalbumin (OVA) as previously described. The severity of OME was determined with an oto-endoscope, by histochemical analysis, and by acoustic immittance. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of RNA-sequencing (RNA-seq) data was carried out to analyze the signaling pathways related to the pathogenesis of OME, which indicated that IL-17 is involved in OME. The anti-IL-17A monoclonal antibody was administrated by nasal drip to block IL-17 to treat OME in the rat model. The rats were finally injected intraperitoneally with the inhibitor of Notch signaling pathway to study the mechanisms of IL-17-induced inflammation. Serum and lavage fluid were collected for the detection of related cytokines, and middle ear tissue was collected for Western blot, quantitative real-time PCR (qRT-PCR), and immunohistochemical and immunofluorescence analysis. Results KEGG analysis of RNA-seq data suggested that the IL-17 signaling pathway might be involved in the onset of OME. IL-17 expression was confirmed to be increased in both the serum and the middle ear of the rat model. The monoclonal antibody against IL-17 neutralized IL-17, inhibited the inflammation in the middle ear, and reduced the overall severity of OME in vivo. Furthermore, the Notch signaling pathway was activated upon IL-17 upregulation in OME and was suppressed by IL-17 blockage. However, there was no change in IL-17 expression after Notch inhibitor treatment, which reduced the severity of OME in the rat middle ear. Conclusion IL-17 plays a key role in the pathogenesis of the OVA-induced OME rat model. IL-17 induced inflammatory responses via the Notch signaling pathway and targeting IL-17 might be an effective approach for OME therapy.
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Affiliation(s)
- Nanfeng Zhang
- Department of ENT, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, People’s Republic of China
| | - Tingting Qian
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Shan Sun
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Wei Cao
- Department of ENT, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, People’s Republic of China
| | - Zhixian Wang
- Department of ENT, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, People’s Republic of China
| | - Danling Liu
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Peifan Li
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Jingfang Wu
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Huawei Li
- Department of ENT, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, People’s Republic of China
- Department of ENT Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Jianming Yang
- Department of ENT, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, People’s Republic of China
- Correspondence: Jianming Yang; Huawei Li, Email ;
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Xie D, Zhao T, Zhang X, Kui L, Wang Q, Wu Y, Zheng T, Ma P, Zhang Y, Molteni H, Geng R, Yang Y, Li B, Zheng QY. Autophagy Contributes to the Rapamycin-Induced Improvement of Otitis Media. Front Cell Neurosci 2022; 15:753369. [PMID: 35153674 PMCID: PMC8832103 DOI: 10.3389/fncel.2021.753369] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/31/2021] [Indexed: 12/02/2022] Open
Abstract
Otitis media (OM) is a pervasive disease that involves hearing loss and severe complications. In our previous study, we successfully established a mouse model of human OM using Tlr2tm1Kir (TLR2-/-) mice with middle ear (ME) inoculation of streptococcal peptidoglycan-polysaccharide (PGPS). In this study, we found that hearing loss and OM infections in OM mice were significantly alleviated after treatment with rapamycin (RPM), a widely used mechanistic target of RPM complex 1 (mTORC1) inhibitor and autophagy inducer. First of all, we tested the activity of mTORC1 by evaluating p-S6, Raptor, and mTOR protein expression. The data suggested that the protein expression level of p-S6, Raptor and mTOR are decreased in TLR2-/- mice after the injection of PGPS. Furthermore, our data showed that both the autophagosome protein LC3-II, Beclin-1, ATG7, and autophagy substrate protein p62 accumulated at higher levels in mice with OM than in OM-negative mice. The expression of lysosomal-associated proteins LAMP1, Cathepsin B, and Cathepsin D increased in the OM mice compared with OM-negative mice. Rab7 and Syntaxin 17, which is necessary for the fusion of autophagosomes with lysosomes, are reduced in the OM mice. In addition, data also described that the protein expression level of p-S6, mTOR and Raptor are lower than PGPS group after RPM treatment. The accumulation of LC3-II, Beclin-1, and ATG7 are decreased, and the expression of Rab7 and Syntaxin 17 are increased significantly after RPM treatment. Our results suggest that autophagy impairment is involved in PGPS-induced OM and that RPM improves OM at least partly by relieving autophagy impairment. Modulating autophagic activity by RPM may be a possible effective treatment strategy for OM.
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Affiliation(s)
- Daoli Xie
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Tong Zhao
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Xiaolin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Lihong Kui
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Qin Wang
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Yuancheng Wu
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Tihua Zheng
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Peng Ma
- Department of Genetics, School of Pharmacy, Binzhou Medical University, Yantai, China
| | - Yan Zhang
- Department of Otolaryngology, Head and Neck Surgery, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Helen Molteni
- Department of Otolaryngology, Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, United States
| | - Ruishuang Geng
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Ying Yang
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Bo Li
- Hearing and Speech Rehabilitation Institute, College of Special Education, Binzhou Medical University, Yantai, China
| | - Qing Yin Zheng
- Department of Otolaryngology, Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, United States
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Muniz GB, Shope TR, Bhatnagar S, Shaikh N, Haralam MA, Liu H, Martin JM, Pogoda JM, Hoberman A. Intranasal Surfactant for Acute Otitis Media: A Randomized Trial. Pediatrics 2021; 148:183389. [PMID: 34851411 DOI: 10.1542/peds.2021-051703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acute otitis media (AOM) is the most frequent reason for children to be prescribed antimicrobial treatment. Surfactants are naturally occurring substances that may restore the eustachian tube's function and potentially enhance resolution of AOM. METHODS This was a phase 2a, single-center, double-blind, randomized, placebo-controlled, parallel group clinical trial to assess safety, tolerability, and efficacy of 20 mg per day intranasal OP0201 as an adjunct therapy to oral antimicrobial agents for treating AOM in young children. We randomly assigned 103 children aged 6 to 24 months with AOM to receive either OP0201 or placebo twice daily for 10 days. All children received amoxicillin-clavulanate 90/6.4 mg/kg per day in 2 divided doses for 10 days. Participants were managed for up to 1 month. Postrandomization visits occurred between days 4 and 6 (visit 2), days 12 and 14 (visit 3), and days 26 and 30 (visit 4). Primary efficacy endpoints were resolution of a bulging tympanic membrane at visit 2 and resolution of middle-ear effusion at visit 3. RESULTS No clinically meaningful differences between treatment groups were apparent for primary or secondary endpoints. There were no safety concerns identified. CONCLUSIONS In young children with AOM, intranasally administered surfactant (OP0201) did not improve clinical outcomes. Further research may be warranted among children with persistent middle-ear effusion.
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Affiliation(s)
- Gysella B Muniz
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Timothy R Shope
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sonika Bhatnagar
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Nader Shaikh
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary Ann Haralam
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hui Liu
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Judith M Martin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Alejandro Hoberman
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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Kılıç N, Yörük Ö, Kılıç SC. An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube. Angle Orthod 2021; 91:772-777. [PMID: 34254990 DOI: 10.2319/021421-127.1] [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] [Received: 02/01/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). MATERIALS AND METHODS The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. RESULTS In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P > .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P < .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). CONCLUSIONS The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.
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Karn RR, Acharya R, Rajbanshi AK, Singh SK, Thakur SK, Shah SK, Singh AK, Shah R, Upadhya Kafle S, Bhattachan M, Abrahamyan A, Shewade HD, Zachariah R. Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal. Public Health Action 2021; 11:1-5. [PMID: 34778008 PMCID: PMC8575382 DOI: 10.5588/pha.21.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
SETTING Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM). OBJECTIVE In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance. DESIGN A cohort study using hospital data, January 2018-January 2020. RESULTS Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery. CONCLUSION Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.
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Affiliation(s)
- R R Karn
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - R Acharya
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - A K Rajbanshi
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Singh
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Thakur
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Shah
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - A K Singh
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - R Shah
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S Upadhya Kafle
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - M Bhattachan
- World Health Organization, Country Office, Kathmandu, Nepal
| | - A Abrahamyan
- Tuberculosis Research and Prevention Center, Yerevan, Armenia
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
- The Union, South East Asia, New Delhi, India
| | - R Zachariah
- United Nations Children's Fund/United Nations Development Programme/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
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Harnessing the power of artificial intelligence to transform hearing healthcare and research. NAT MACH INTELL 2021. [DOI: 10.1038/s42256-021-00394-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Choi SW, Choi S, Kang EJ, Lee HM, Oh SJ, Lee IW, Lee HH, Kong SK. Effects of cigarette smoke on Haemophilus influenzae-induced otitis media in a rat model. Sci Rep 2021; 11:19729. [PMID: 34611260 PMCID: PMC8492685 DOI: 10.1038/s41598-021-99367-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Abstract
Exposure to cigarette smoke (CS) is a factor that could delay or worsen the recovery of otitis media (OM) by causing inflammatory swelling of the Eustachian tube (ET). However, despite the suggested relationship, little is known about the association between OM and CS. Therefore, we aimed to evaluate the effects of CS on the development, progression, and recovery of OM, as well as the histological and molecular changes caused by CS exposure, by using a rat model of OM infected with non-typeable Haemophilus influenzae (NTHi). Eighty Sprague-Dawley rats with normal middle ears (MEs) were divided into four groups (n = 20 rats/group): control, CS, OM, and CS + OM. The CS and CS + OM groups were exposed to CS for 2 weeks. The inflammatory reaction to NTHi was more intense and lasted longer in the CS + OM group than in the other groups. Goblet cell proliferation and mucus secretion in the ET were more significant in the CS and CS + OM groups than in the other groups. These findings suggested that because CS directly affects the ET and ME mucosa, bacterial OM can become more severe and may resolve more slowly in the presence of CS exposure rather than in its absence.
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Affiliation(s)
- Sung-Won Choi
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea
| | - Sunmi Choi
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea
| | - Eun-Jin Kang
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea
| | - Hyun Min Lee
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Se-Joon Oh
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hwan Ho Lee
- Department of Otolaryngology and Kosin University College of Medicine, Kosin University Hospital, Busan, Republic of Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology and Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea.
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Jinhage M, Hermansson A, Gisselsson-Solén M. Nasopharyngeal cultures in children with AOM - A retrospective study on bacteriological findings and impact on management. Int J Pediatr Otorhinolaryngol 2021; 149:110848. [PMID: 34304116 DOI: 10.1016/j.ijporl.2021.110848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/09/2021] [Accepted: 07/18/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite a far from perfect correlation with middle ear growth, nasopharyngeal cultures are sometimes used in children with acute otitis media (AOM) in order to have some idea of the causative pathogen. How these cultures are used in clinical practice and to what extent they influence clinical management has not previously been studied. The objective with this study was to investigate in what circumstances nasopharyngeal cultures are performed in children with AOM, what the bacteriological results are and to what extent cultures influence clinical management. METHODS All nasopharyngeal cultures taken in clinical practice from children with AOM in the county of Skåne, Sweden, during 2017-2018 were retrieved together with details from the medical charts two months prior to and one month after the culture. Information about the reason for culturing, the bacteriological result, and whether this result changed the management of the child, was retrieved from the charts. RESULTS During the 2 years, 978 nasopharyngeal cultures were taken in children with AOM. The most common reasons for obtaining a culture was a recurrence of AOM (40%) or treatment failure (22%). Many of the children had ongoing or recent antibiotic treatment. M. catarrhalis was the most commonly identified pathogen (53%), followed by H. influenzae (30%) and S. pneumoniae (14%). Resistance rates were low, and the most commonly identified resistant pathogen was betalactamase-negative ampicillin-resistant H. influenzae. One in five cultures led to a change in management, such as a change of antibiotics or an additional check-up. This was most commonly seen in association with H. influenzae, reflecting clinical practice in Sweden, where AOM is primarily treated with penicillin V. CONCLUSION Despite not having a perfect correlation with middle ear growth, nasopharyngeal cultures can provide clues about suitable alternative antibiotics in cases of treatment failure, and they can help monitoring nasopharyngeal carriage and resistance rates.
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Affiliation(s)
- Malin Jinhage
- Skåne University Hospital, Sweden; Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, 22185, Lund, Sweden.
| | - Ann Hermansson
- Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, 22185, Lund, Sweden
| | - Marie Gisselsson-Solén
- Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, 22185, Lund, Sweden
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Song CI, Kang BC, Shin CH, An YS, Kim TS, Lim HW, Shim HJ, Yoo MH, Ahn JH. Postoperative results of ventilation tube insertion: a retrospective multicenter study for suggestion of grading system of otitis media with effusion. BMC Pediatr 2021; 21:375. [PMID: 34465299 PMCID: PMC8406977 DOI: 10.1186/s12887-021-02855-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/20/2021] [Indexed: 11/15/2022] Open
Abstract
Background In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI). Methods We classified the collective 1,012 ears from 506 patients into six groups: grade 0 (no effusion), grade I (scant effusion, but abnormal), grade II (effusion less than half of the tympanic cavity), grade III (effusion over half of the tympanic cavity, with air bubbles), grade IV (complete effusion), and grade V (retracted tympanic membrane or hemotympanum without air bubbles). Results The mean age at VTI was 5.2 (±2.9) years and mean duration between diagnosis and operation was 4.1 (±1.8) months. Between the grades, the nature of the middle ear effusion was also significantly different (p < 0.001). The duration of ventilation tube retention after VTI was significantly different when compared between two groups: grade I-IV and grade V (p = 0.019). Our results showed that the recurrence rate, as well as rate of revision VTI, increased as the grade increased (p < 0.001). Conclusions The new grading system of OME using endoscopic otoscope evaluation had a significant correlation with the age at VTI, the nature of middle ear effusion, the recurrence rate of OME, and the rate of revision VTI.
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Affiliation(s)
- Chan Il Song
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Chul Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chol Ho Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea
| | - Yun Suk An
- Department of Otorhinolaryngology-Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Tae Su Kim
- Department of Otolaryngology, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Hyun Woo Lim
- Department of Otolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hyun Joon Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Myung Hoon Yoo
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Joong Ho Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea.
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Albrecht T, Nikendei C, Praetorius M. Face, Content, and Construct Validity of a Virtual Reality Otoscopy Simulator and Applicability to Medical Training. Otolaryngol Head Neck Surg 2021; 166:753-759. [PMID: 34313515 PMCID: PMC8978475 DOI: 10.1177/01945998211032897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective Otologic diseases are common in all age groups and can significantly impair
the function of this important sensory organ. To make a correct diagnosis,
the correct handling of the otoscope and a correctly performed examination
are essential. A virtual reality simulator could make it easier to teach
this difficult-to-teach skill. The aim of this study was to assess the face,
content, and construct validity of the novel virtual reality otoscopy
simulator and the applicability to otologic training. Study Design Face and content validity was assessed with a questionnaire. Construct
validity was assessed in a prospectively designed controlled trial. Setting Training for medical students at a tertiary referral center. Method The questionnaire used a 6-point Likert scale. The otoscopy was rated with a
modified Objective Structured Assessment of Technical Skills. Time to
complete the task and the percentage of the assessed eardrum surface were
recorded. Results The realism of the simulator and the applicability to medical training were
assessed across several items. The ratings suggested good face and content
validity as well as usefulness and functionality of the simulator. The
otolaryngologists significantly outperformed the student group in all
categories measured (P < .0001), suggesting construct validity of the
simulator. Conclusion In this study, we could demonstrate face, content, and construct validity for
a novel high-fidelity virtual reality otoscopy simulator. The results
encourage the use of the otoscopy simulator as a complementary tool to
traditional teaching methods in a curriculum for medical students.
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Affiliation(s)
- Tobias Albrecht
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, Medical Center-University of Heidelberg, Heidelberg, Germany
| | - Mark Praetorius
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Hamburg, Hamburg, Germany
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Toll-Like Receptors: Expression and Roles in Otitis Media. Int J Mol Sci 2021; 22:ijms22157868. [PMID: 34360632 PMCID: PMC8346131 DOI: 10.3390/ijms22157868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022] Open
Abstract
Otitis media is mainly caused by upper respiratory tract infection and eustachian tube dysfunction. If external upper respiratory tract infection is not detected early in the middle ear, or an appropriate immune response does not occur, otitis media can become a chronic state or complications may occur. Therefore, given the important role of Toll-like receptors (TLRs) in the early response to external antigens, we surveyed the role of TLRs in otitis media. To summarize the role of TLR in otitis media, we reviewed articles on the expression of TLRs in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. Many studies showed that TLRs 1–10 are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. TLR expression in the normal middle ear mucosa is absent or weak, but is increased in inflammatory fluid of AOM, effusion of OME, and granulation tissue and cholesteatoma of COM. In addition, TLRs show increased or decreased expression depending on the presence or absence of bacteria, recurrence of disease, tissue type, and repeated surgery. In conclusion, expression of TLRs is associated with otitis media. Inappropriate TLR expression, or delayed or absent induction, are associated with the occurrence, recurrence, chronicization, and complications of otitis media. Therefore, TLRs are very important in otitis media and closely related to its etiology.
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Optical absorbance of the tympanic membrane in rat and human samples. PLoS One 2021; 16:e0254902. [PMID: 34293032 PMCID: PMC8297804 DOI: 10.1371/journal.pone.0254902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022] Open
Abstract
Chronic infections are often connected to biofilm formation. In presence of implants, this can lead to loss of the implant. Systemic or local application of drugs is relatively ineffective in case of biofilm formation. One technique to provide antibacterial properties on demand is the antibacterial photodynamic therapy (aPDT). Using this technique, these properties can be “switched on” by light illumination. In the middle ear with the semitransparent tympanic membrane, it might be possible in future to activate the antibacterial effect without opening the membrane. Therefore, we investigated the optical absorbance spectra of the tympanic membrane. Optical absorbance spectra were measured in ex vivo preparations from neonatal and adult rats with the membrane still being attached to the surrounding bony ring and four human samples. After performing area scans, the spot with the lowest absorbance being surrounded by a ring like structure with higher absorbance was chosen as region of interest for scanning wavelengths between 300 and 900 nm. Absorbance is generally higher at lower wavelengths with a local absorbance maximum at 420 nm and a weak second maximum with two neighbouring peaks at 540 / 580 nm and is significantly higher in adult rats compared to neonatal rats where about 10% of light was transmitted. The human samples show similar characteristics with a little higher absorbance. For activation of aPDT through the tympanic membrane, larger wavelengths are more promising. Whether the amount of light transmitted through the membrane would be sufficient to induce aPDT remains to be tested in further experiments.
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Sun PP, Won J, Choo-Kang G, Li S, Chen W, Monroy GL, Chaney EJ, Boppart SA, Eden JG, Nguyen TH. Inactivation and sensitization of Pseudomonas aeruginosa by microplasma jet array for treating otitis media. NPJ Biofilms Microbiomes 2021; 7:48. [PMID: 34078901 PMCID: PMC8172902 DOI: 10.1038/s41522-021-00219-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/28/2021] [Indexed: 02/04/2023] Open
Abstract
Otitis media (OM), known as a middle ear infection, is the leading cause of antibiotic prescriptions for children. With wide-spread use of antibiotics in OM, resistance to antibiotics continues to decrease the efficacy of the treatment. Furthermore, as the presence of a middle ear biofilm has contributed to this reduced susceptibility to antimicrobials, effective interventions are necessary. A miniaturized 3D-printed microplasma jet array has been developed to inactivate Pseudomonas aeruginosa, a common bacterial strain associated with OM. The experiments demonstrate the disruption of planktonic and biofilm P. aeruginosa by long-lived molecular species generated by microplasma, as well as the synergy of combining microplasma treatment with antibiotic therapy. In addition, a middle ear phantom model was developed with an excised rat eardrum to investigate the antimicrobial effects of microplasma on bacteria located behind the eardrum, as in a patient-relevant setup. These results suggest the potential for microplasma as a new treatment paradigm for OM.
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Affiliation(s)
- Peter P Sun
- Department of Civil and Environmental Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
- N. Holonyak, Jr. Micro and Nanotechnology Laboratory, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jungeun Won
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Gabrielle Choo-Kang
- Department of Civil and Environmental Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Shouyan Li
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Wenyuan Chen
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Guillermo L Monroy
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Stephen A Boppart
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL, USA.
| | - J Gary Eden
- N. Holonyak, Jr. Micro and Nanotechnology Laboratory, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL, USA.
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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Chai Y, He W, Yang W, Hetrick AP, Gonzalez JG, Sargsyan L, Wu H, Jung TTK, Li H. Intratympanic Lipopolysaccharide Elevates Systemic Fluorescent Gentamicin Uptake in the Cochlea. Laryngoscope 2021; 131:E2573-E2582. [PMID: 33956344 PMCID: PMC8453712 DOI: 10.1002/lary.29610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022]
Abstract
Objectives/Hypothesis Lipopolysaccharide (LPS), a key component of bacterial endotoxins, activates macrophages and triggers the release of inflammatory cytokines in mammalian tissues. Recent studies have shown that intratympanic injection of LPS simulates acute otitis media (AOM) and results in morphological and functional changes in the inner ear. Here we established an AOM mouse model with LPS to investigate the uptake of ototoxic gentamicin in the inner ear, and elucidated the underlying mechanism by focusing on cochlear inflammation as a result of AOM. Study Design Preclinical rodent animal model. Methods Fluorescently tagged gentamicin (GTTR) was systemically administered to mice with AOM. Iba1‐positive macrophage morphology and inner ear cytokine profile were evaluated by immunofluorescence technique and a mouse cytokine array kit, respectively. Results We observed characteristic symptoms of AOM in the LPS‐treated ears with elevated hearing thresholds indicating a conductive hearing loss. More importantly, the LPS‐induced AOM activated cochlear inflammatory responses, manifested by macrophage infiltration, particularly in the organ of Corti and the spiral ligament, in addition to the up‐regulation of proinflammatory cytokines. Meanwhile, GTTR uptake in the stria vascularis and sensory hair cells from all the LPS‐treated ears was significantly enhanced at 24, 48, and 72‐hour post‐treatment, as the most prominent enhancement was observed in the 48‐hour group. Conclusion In summary, this study suggests that the pathological cochlea is more susceptible to ototoxic drugs, including aminoglycosides, and justified the clinical concern of aminoglycoside ototoxicity in the AOM treatment. Laryngoscope, 131:E2573–E2582, 2021
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Affiliation(s)
- Yongchuan Chai
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Weiwei He
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Weiqiang Yang
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Alisa P Hetrick
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Jessica G Gonzalez
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Liana Sargsyan
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A
| | - Hao Wu
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Timothy T K Jung
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
| | - Hongzhe Li
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, U.S.A.,Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A
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Olivé-Busom J, López-Costas O, Quer-Agustí M, Márquez-Grant N, Kirchner H. Evidence of otitis media and mastoiditis in a Medieval Islamic skeleton from Spain and possible implications for ancient surgical treatment of the condition. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 32:17-22. [PMID: 33232880 DOI: 10.1016/j.ijpp.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate lesions on a cranium from the Iberian Peninsula and assess its medico-historical and paleopathological significance. MATERIALS The skeletal remains of a juvenile individual found in a Medieval Islamic grave (10th -16th century) in Eastern Spain. METHODS Macroscopic examination of the left and right temporal bones, binocular microscopy, X-ray, and Scanning Electron Microscopy - Energy Dispersive X-ray Spectroscopy (SEM-EDS) were performed. RESULTS A sub-oval perforation superior to the right mastoid process and pathological changes on the right temporal bone were identified. SEM-EDS confirmed the presence of copper in the surrounding area of the perforation. CONCLUSIONS The observed pathological changes are most likely compatible with otitis media and subsequent mastoiditis. The sub-oval perforation could be interpreted either as an abscess or as evidence of a surgical procedure (mastoidectomy) or a combination of both; and the Cu traces may be the result of an associated object or, possibly, the application of a plaster with copper acetate used as medical treatment. SIGNIFICANCE This case contributes to the paleopathological record and the interpretation of similar cases, and also helps in the understanding of medical care and treatment in Medieval Islam. LIMITATIONS The lack of similar pre-modern cases of surgical intervention limits comparability to clinical cases. Suggestion for further research: Exploration into indicators of health care in past populations.
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Affiliation(s)
- Júlia Olivé-Busom
- Departament de Ciències de l'Antiguitat I l'Edat Mitjana, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Spain.
| | - Olalla López-Costas
- Group EcoPast (GI-1553), Universidade de Santiago de Compostela, Santiago de Compostela, 15782, Spain; Archaeological Research Laboratory, Stockholm University, Wallenberglaboratoriet, SE-10691, Stockholm, Sweden; Laboratorio de Antropología Física, Facultad de Medicina, Universidad de Granada, Granada, 18012, Spain.
| | - Miquel Quer-Agustí
- Departament de Cirurgia Àrea d'Otorrinolaringologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Spain.
| | - Nicholas Márquez-Grant
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, SN6 8LA, United Kingdom.
| | - Helena Kirchner
- Departament de Ciències de l'Antiguitat I l'Edat Mitjana, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Spain.
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Seppälä EM, Oikarinen S, Lehtonen JP, Neupane S, Honkanen H, Tyni I, Siljander H, Ilonen J, Sillanpää S, Laranne J, Knip M, Hyöty H. Association of Picornavirus Infections With Acute Otitis Media in a Prospective Birth Cohort Study. J Infect Dis 2021; 222:324-332. [PMID: 32108877 DOI: 10.1093/infdis/jiaa087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/25/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Human rhinoviruses (HRVs), human enteroviruses (HEVs) and human parechoviruses (HPeVs) have been linked to acute otitis media (AOM). We evaluated this association in a prospective birth cohort setting. METHODS A total of 324 healthy infants were followed up from birth to age 3 years. Nasal swab samples were collected at age 3, 6, 12, 18, 24, and 36 months and screened for HRV and HEV using real-time reverse-transcription quantitative polymerase chain reaction. Stool samples were collected monthly and analyzed for HRV, HEV, and HPeV. AOM episodes diagnosed by physicians were reported by parents in a diary. The association of viruses with AOM was analyzed using generalized estimation equations, and their relative contributions using population-attributable risk percentages. RESULTS A clear association was found between AOM episodes and simultaneous detection of HEV (adjusted odds ratio for the detection of virus in stools, 2.04; 95% confidence interval, 1.06-3.91) and HRV (1.54; 1.04-2.30). HPeV showed a similar, yet nonsignificant trend (adjusted odds ratio, 1.44; 95% confidence interval, .81-2.56). HRV and HEV showed higher population-attributable risk percentages (25% and 20%) than HPeV (11%). CONCLUSIONS HEVs and HRVs may contribute to the development of AOM in a relatively large proportion of cases.
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Affiliation(s)
- Elina M Seppälä
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jussi P Lehtonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Hanna Honkanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Iiris Tyni
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heli Siljander
- Children's Hospital, University of Helsinki, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland.,Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Saara Sillanpää
- Department of Otorhinolaryngology, Tampere University Hospital, Tampere, Finland
| | - Jussi Laranne
- Department of Otorhinolaryngology, Central Ostrobothnia Central Hospital, Kokkola, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, University of Helsinki, Helsinki, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
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Jiang T, Zhao L, Yin Y, Yu H, Li Q. Evaluation of Middle Ear Function by Tympanometry and the Influence of Lower Barometric Pressure at High Altitude. High Alt Med Biol 2021; 22:70-76. [PMID: 33395350 DOI: 10.1089/ham.2020.0042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Jiang, Tao, Liping Zhao, Yanbo Yin, Huiqian Yu, and Qingzhong Li. Evaluation of middle ear function by tympanometry and the influence of lower barometric pressure at high altitude. High Alt Med Biol. 22:70-76, 2021. Objective: To evaluate middle ear function in residents of high-altitude areas in comparison to sea-level participants. Design: Prospective observational study. Setting: All experiments were performed by experienced audiologists with a calibrated tympanometry machine. Participants: Young adults between the age of 17 and 23 were recruited. Seventy-five participants from Shanghai (altitude 4 m) and 133 participants from the Shigatse area (altitude 4,040 m) were recruited. Any participant with any otological disorder was excluded. Main Outcome Measure: Four indexes of the tympanogram were evaluated in the two groups from different altitudes. Results: Our results showed that the peak of static compliance for the participants in Shigatse was smaller, but the absolute compliance of tympanic membrane remained the same. Similarly, the ear canal volume (ECV) from tympanometry was also affected by the elevated altitude in Tibet. In addition, the tympanometric peak pressure was decreased in high-altitude residents, which suggests a slightly declined function of the Eustachian tube at lower barometric pressure. However, no difference was found in the tympanometric width (TW). Conclusion: Our results indicate that tympanograms were affected by decreased atmospheric pressure at high altitude. Therefore, other than pressure-related indexes, TW is better for evaluating the function of the middle ear in high-altitude regions.
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Affiliation(s)
- Tao Jiang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, P.R. China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, P.R. China
| | - Liping Zhao
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, P.R. China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, P.R. China
| | - Yanbo Yin
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, P.R. China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, P.R. China
| | - Huiqian Yu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, P.R. China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, P.R. China
| | - Qingzhong Li
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, P.R. China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, P.R. China
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Effects of allergic rhinitis on the progression and recovery of acute otitis media in a mouse model. Int J Pediatr Otorhinolaryngol 2021; 140:110497. [PMID: 33218690 DOI: 10.1016/j.ijporl.2020.110497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the effects of allergic rhinitis (AR) on the development, progression, and recovery of acute otitis media (OM) in an animal model and investigate the secondary effects of bacterial infection. METHODS BALB/c mice were divided into four groups: AR + OM, AR, OM, and control groups. AR + OM and AR groups were sensitized with ovalbumin (OVA) and alum and then challenged intranasally with OVA. Phosphate-buffered saline (PBS) was administered to the OM and control groups the same number of times. After AR induction, OM was induced by surgical inoculation of non-typeable Haemophilus influenza (NTHi) into the middle ear (ME) cavity of the mice in the AR + OM and OM groups. PBS was injected into the bulla in the AR and control groups. Each group was subdivided into sets of six mice, one for each of the four time points (0, 2, 7, and 10 days post-bacterial inoculation), at which point the mice were euthanized and ME and nasal cavity mucosa were obtained and evaluated. The occurrence of OM and the ME mucosa thickness were evaluated and compared among the four groups. Tissue expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) in infected ME mucosa was assessed by immunohistochemical staining. We also investigated IgE, IL-4, and IL-5 in the nasal mucosa. RESULTS Most of the ears showed OM on post-inoculation day 2 in both AR + OM and OM groups. In the AR + OM group, 58.3% of ears still had OM on post-inoculation day 10, while only 16.7% of the OM group had OM. The ME mucosa of all groups increased, and the AR + OM group exhibited the thickest mucosa. The OM group showed peak thickness on post-inoculation day 2 and then decreased, whereas the ME mucosa thickness of the AR + OM group continued to increase to day 7. In the OM group, the expression of IL-1β, IL-6, and TNF-α in the ME also increased significantly, peaking on post-inoculation day 2, and then gradually decreased. In the AR + OM group, the expression of these proteins increased until day 7 and then decreased. The IgE and Th2 response (IL-4 and IL-5) cytokines were expressed at higher levels in the AR + OM and AR groups than in the OM and control groups. CONCLUSION The inflammatory reaction to NTHi was more intense and lasted longer in the allergic group, which indicates that AR affects the progression and subsequent recovery of acute bacterial OM.
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Skovbjerg S, Roos K, Andersson M, Rabe H, Nilsson S, Lindh M, Wold AE. Inflammatory Mediator Profiles in Secretory Otitis Media in Relationship to Viable Bacterial Pathogens and Bacterial and Viral Nucleic Acids. J Interferon Cytokine Res 2020; 40:555-569. [PMID: 33337936 DOI: 10.1089/jir.2020.0075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Secretory otitis media (SOM) is characterized by persistence of fluid in the middle ear, often following an episode of acute otitis media. Our hypothesis is that failure to eliminate bacterial or viral pathogens may result in persistent low-grade inflammation. In this study, we analyzed inflammatory mediators in middle ear fluids from 67 children with SOM. This was combined with determinations of viable bacteria by culture along with detection of bacterial and viral genetic material by real-time polymerase chain reaction (PCR). The inflammatory mediators found at the highest concentrations (>30 ng/mL) were stem cell growth factor-β (median 110 ng/mL), CXCL1, IL-16, IL-8, migration inhibitory factor, CXCL10, and CXCL9. Among bacterial pathogens, Moraxella catarrhalis and Haemophilus influenzae dominated, regardless of detection methods, while rhinovirus dominated among viral pathogens. Middle ear fluid levels of interleukin (IL)-1α, IL-17, IL-1β, fibroblast growth factor basic, and tumor necrosis factor correlated strongly with presence of bacteria detected either by culture or PCR, while IL-1RA, IL-3, IL-6, IL-8, CCL3, CCL4, and granulocyte-colony stimulating factor correlated significantly with real-time PCR values. CXCL10, CXCL9, CCL2, and TRAIL correlated significantly with viral nucleic acid levels. To conclude, persistence of viral and bacterial pathogens may fuel persistent inflammation in SOM. Bacteria caused a broad inflammatory response, while viruses chiefly elicited the interferon-induced chemokines CXCL9 and CXCL10.
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Affiliation(s)
- Susann Skovbjerg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristian Roos
- ENT Department, Capio Lundby Hospital, Gothenburg, Sweden
| | - Maria Andersson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hardis Rabe
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Staffan Nilsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Magnus Lindh
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Agnes E Wold
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Yim JJ, Singh SP, Xia A, Kashfi-Sadabad R, Tholen M, Huland DM, Zarabanda D, Cao Z, Solis-Pazmino P, Bogyo M, Valdez TA. Short-Wave Infrared Fluorescence Chemical Sensor for Detection of Otitis Media. ACS Sens 2020; 5:3411-3419. [PMID: 33175516 DOI: 10.1021/acssensors.0c01272] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Otitis media (OM) or middle ear infection is one of the most common diseases in young children around the world. The diagnosis of OM is currently performed using an otoscope to detect middle ear fluid and inflammatory changes manifested in the tympanic membrane. However, conventional otoscopy cannot visualize across the tympanic membrane or sample middle ear fluid. This can lead to low diagnostic certainty and overdiagnoses of OM. To improve the diagnosis of OM, we have developed a short-wave infrared (SWIR) otoscope in combination with a protease-cleavable biosensor, 6QC-ICG, which can facilitate the detection of inflammatory proteases in the middle ear with an increase in contrast. 6QC-ICG is a fluorescently quenched probe, which is activated in the presence of cysteine cathepsin proteases that are up-regulated in inflammatory immune cells. Using a preclinical model and custom-built SWIR otomicroscope in this proof-of-concept study, we successfully demonstrated the feasibility of robustly distinguishing inflamed ears from controls (p = 0.0006). The inflamed ears showed an overall signal-to-background ratio of 2.0 with a mean fluorescence of 81 ± 17 AU, while the control ear exhibited a mean fluorescence of 41 ± 11 AU. We envision that these fluorescently quenched probes in conjunction with SWIR imaging tools have the potential to be used as an alternate/adjunct tool for objective diagnosis of OM.
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Affiliation(s)
- Joshua J. Yim
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Surya Pratap Singh
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
- Department of Biosciences and Bioengineering, Indian Institute of Technology Dharwad, Dharwad, Karnataka 580011, India
| | - Anping Xia
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Raana Kashfi-Sadabad
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Martina Tholen
- Department of Pathology, Stanford University School of Medicine, Stanford, California 94305, United States
| | - David M. Huland
- Molecular Imaging Program at Stanford, Department of Radiology, Stanford University School of Medicine, Stanford, California 94305, United States
| | - David Zarabanda
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Zhixin Cao
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Paola Solis-Pazmino
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Matthew Bogyo
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, California 94305, United States
- Department of Pathology, Stanford University School of Medicine, Stanford, California 94305, United States
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Tulio A. Valdez
- Department of Otolaryngology−Head & Neck Surgery Divisions, Stanford University School of Medicine, Stanford, California 94305, United States
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Daneshi A, Daneshvar A, Asghari A, Farhadi M, Mohebbi S, Mohseni M, Yazdani N, Mohammadi S, Hosseinzadeh F. Endoscopic Versus Microscopic Cartilage Myringoplasty in Chronic Otitis Media. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2020; 32:263-269. [PMID: 33014902 PMCID: PMC7515622 DOI: 10.22038/ijorl.2020.44015.2453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction: Operations on the tympanic membrane of the middle ear, myringoplasty, and tympanoplasty are now widely accepted, and attempts are underway all over the world to standardize the surgical techniques. This study aimed to compare postoperative outcomes of endoscopic and microscopic cartilage myringoplasty in patients suffering from chronic otitis media (COM). Materials and Methods: This clinical trial study compared 130 patients with COM who underwent transcanal endoscopic myringoplasty by repairing perforation using auricular concha cartilage under general anesthesia (n=75) and conventional repairing method by postauricular incision and tympanomeatal flap elevation under microscopic surgery (n=55). Results: According to the results, there was no significant difference between the two groups in terms of hearing gain 1, 6, and 12 months after surgery (P=0.063); however, higher hearing gain scores were observed in the endoscopic group. Moreover, lower recovery time and post-operative pain were reported in patients who underwent the endoscopic approach, compared to those who treated with the conventional repairing method (P<0.001). Conclusion: Endoscopic myringoplasty technique is a safe and effective way to improve hearing loss as much as the conventional method. However, due to the lower recovery time and post-operative pain, it seems to be the method of choice in myringoplasty surgery.
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Affiliation(s)
- Ahmad Daneshi
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Ali Daneshvar
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Alimohamad Asghari
- Skull Base Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farhadi
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Saleh Mohebbi
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Nasrin Yazdani
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Amir Alam Hospital, Tehran, Iran
| | - Shabahang Mohammadi
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Hosseinzadeh
- ENT and Head & Neck Research Center , The Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran
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Brennan-Jones CG, Whitehouse AJO, Calder SD, Costa CD, Eikelboom RH, Swanepoel DW, Jamieson SE. Does Otitis Media Affect Later Language Ability? A Prospective Birth Cohort Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2441-2452. [PMID: 32539591 DOI: 10.1044/2020_jslhr-19-00005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aim of the study was to examine whether otitis media (OM) in early childhood has an impact on language development in later childhood. Methods We analyzed data from 1,344 second-generation (Generation 2) participants in the Raine Study, a longitudinal pregnancy cohort established in Perth, Western Australia, between 1989 and 1991. OM was assessed clinically at 6 years of age. Language development was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at 6 and 10 years of age and the Clinical Evaluation of Language Fundamentals-Third Edition at 10 years of age. Logistic regression analysis accounted for a wide range of social and environmental covariates. Results There was no significant relationship between bilateral OM and language ability at 6 years of age (β = -0.56 [-3.78, 2.66], p = .732). However, while scores were within the normal range for the outcome measures at both time points, there was a significant reduction in the rate of receptive vocabulary growth at 10 years of age (PPVT-R) for children with bilateral OM at 6 years of age (β = -3.17 [-6.04, -0.31], p = .030), but not for the combined unilateral or bilateral OM group (β = -1.83 [-4.04, 0.39], p = .106). Conclusions Children with OM detected at 6 years of age in this cohort had average language development scores within the normal range at 6 and 10 years of age. However, there was a small but statistically significant reduction in the rate of receptive vocabulary growth at 10 years of age (on the PPVT-R measure only) in children who had bilateral OM at 6 years of age after adjusting for a range of sociodemographic factors.
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Affiliation(s)
- Christopher G Brennan-Jones
- Telethon Kids Institute, The University of Western Australia, Perth
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth
- Department of Audiology, Perth Children's Hospital, Western Australia
| | | | - Samuel D Calder
- Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Cheryl Da Costa
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth
| | - Robert H Eikelboom
- Ear Science Institute Australia, Perth, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth
- Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Ear Science Institute Australia, Perth, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth
- Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Sarra E Jamieson
- Telethon Kids Institute, The University of Western Australia, Perth
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