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Otitis Media
Published in Charles Theisler, Adjuvant Medical Care, 2023
Acute otitis media is a type of ear infection in the middle ear space behind the eardrum, or tympanic membrane. Pain is the major symptom of acute otitis media. It primarily occurs in children 6-36 months old, but adults can also be affected. About three out of four children have at least one episode of otitis media by the time they are three years old. Otitis media, whether acute, with effusion, chronic suppurative, or adhesive, is the most common cause of earaches.” Earaches can be debilitating, but do not always warrant antibiotics. Otitis media with fluid (effusion) does not respond to antibiotics.1 When antibiotics are prescribed, high-dose amoxicillin is most often recommended, but antibiotics do not decrease ear pain.2
Ear, nose and throat
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Normally follows an URTI (either viral or bacterial), frequently bilateral and most common in children. Clinical features: ear pain/tenderness, conductive deafness, fever and an ab nor mal ear drum on otoscopy (e.g. bulging, redness, perforation with otorrhoea). Management: many will resolve spontaneously but if not, antibiotic therapy should be started.
Noise, hearing and vibration
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
Middle ear: Ossicles – small bones behind eardrum (malleus, incus and stapes).Eardrum – transmits vibrations via ossicles through middle ear to inner ear.Eustachian tube – connects middle ear to posterior oropharynx for pressure equalization.
Evaluation of switching or simultaneous use of biologic treatment in patients with severe chronic rhinosinusitis with nasal polyps and severe asthma. Considerations in clinical decision making
Published in Expert Review of Clinical Immunology, 2023
Josje Otten, Rik van der Lans, Eugenio de Corso, kanstantsin Dziadziulia, Bart Hilvering, Els Weersink, Matteo Bonini, Jan Hagemann, Wanrawee Thaitrakool, Claudio Montuori, Ludger Klimek, Sietze Reitsma, Wytske Fokkens
After 6 months of treatment, his asthma control remained excellent without any work impairment and without exacerbations. In addition, he was able to exercise vigorously. Also, his upper airway symptoms strongly improved with improved sense of smell, but infrequent mild pressure on AD persisted. Nasal endoscopy showed minimal polyps on the right side (NPS grade 1) and none on the left (NPS grade 0). Sniffin’s Sticks-12 (olfactory) identification test (SSIT-12: 0–12; 0–6 anosmia, 7–10 hyposmia, 11–12 normosmia) was 6, indicating borderline anosmia. Spirometry results showed FVC = 5,11 L(137,71%); FEV1 = 3,59 L(123,10%); FEV1%M = 70%. Otoscopy showed an unaltered retracted tympanic membrane AD and no abnormalities in AS. We decided to reduce the dose of dupilumab to 300 mg/4 wks. At a recent visit one year after the start of treatment with dupilumab and now 6 months on a dose of 300 mg/4 weeks, he has excellent control of both upper and lower airways. His only remaining complaint is infrequent aural pressure in AD, without conductive hearing loss. Nasal endoscopy showed grade 0 NPS on both sides, and SSIT remained 6. Otoscopy showed a retracted eardrum on the right side, AS normal. The patient indicated that he could perceive all odors during the olfaction identification test, which he was unable to do previously, but he continued to have trouble identifying them. We advised him on smell training. In the end, we decided to further lengthen the dupilumab dosing interval to 300 mg/6 weeks. The patient is continuing on this dose and has well-controlled CRSwNP and asthma.
Sensory profiles, behavioral problems, and auditory findings in children with autism spectrum disorder
Published in International Journal of Developmental Disabilities, 2023
Ummugulsum Gundogdu, Ahmet Aksoy, Mehtap Eroglu
In the tympanometry test, which measures the pressure of the middle ear, air pressure is applied to the outer ear canal to measure the mobility of the middle ear and eardrum. By measuring the mobility in the middle ear and eardrum, information about the function of these structures can be obtained. During the tympanometry test, the eardrum should not be perforated (Demopoulos and Lewine 2016, Helenius et al.2012, Shanks and Shohet 2009). Five types of tympanogram can be seen Type A – Normal middle ear pressure, Type B – Little or no mobility, suggestive of fluid behind the tympanic membrane or perforation, Type C – Negative pressure in the middle ear, suggestive of a retracted tympanic membrane, Type As – A very stiff middle ear system that can be caused by myringosclerosis or otosclerosis, Type Ad – The highly compliant tympanic membrane seen in ossicular chain discontinuity
The broader impacts of otitis media and sequelae for informing economic evaluations of pneumococcal conjugate vaccines
Published in Expert Review of Vaccines, 2022
Johnna Perdrizet, Raymond A. Farkouh, Emily K. Horn, Kyla Hayford, Heather L. Sings, Matt D. Wasserman
Otitis media (OM), or inflammation of the middle ear, is one of the most common diseases in young children worldwide [1,2]. OM is caused by viral or bacterial infection, most notably by four major bacterial pathogens, Streptococcus pneumoniae, non-typeable Haemophilus influenzae (NTHi), Moraxella catarrhalis, and Streptococcus pyogenes, which are part of the normal flora of the upper respiratory tract. OM is classified into several clinical subtypes, including acute otitis media (AOM), an acute inflammation of the middle ear with effusion and signs and symptoms of acute infection; otitis media with effusion (OME), a chronic yet asymptomatic inflammation of the middle ear with effusion; and chronic suppurative otitis media (CSOM), a chronic infection of the middle ear and mastoid cells with chronic perforation of the eardrum and otorrhea [1]. OM is a leading cause of physician visits and antibiotic use in young children and places considerable strain on health systems globally [3,4]. Compared with other clinical subtypes, AOM is most frequently observed by healthcare professionals, with an estimated 709 million cases per year globally (global incidence rate, 10.9% or 10.9 new episodes per hundred people per year) [5], half of which occur among children under 5 years of age. Incidence varies by region, ranging from 3.6 to 43.3 episodes per 100 population per year in Central Europe to Sub-Saharan Africa, respectively [5].