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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
Chronic Otitis Media
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Chronic otitis media may manifest in a variety of clinical phenotypes, including middle ear effusion (glue ear), cholesteatoma, tympanic membrane retraction, or tympanic membrane perforation (which may be associated with infection). Tympanosclerosis and myringitis are also discussed here, although their relation to chronic otitis media is less clear.
The Child with Fever or a Rash
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Bhanu Williams, Anna Battersby
Children in refugee settings may present with ear and urinary infections; these common diagnoses must not be forgotten. Otitis media presents with pain and fever and a red, bulging, dull, perforated or discharging tympanic membrane. Most children with acute otitis media will recover without antibiotics, but oral amoxicillin for 5–7 days is the preferred antibiotic in patients who have purulent discharge or those younger than 2 years with bilateral infection.
Cholesteatoma in chronic otitis media secondary to pars tensa perforation
Published in Acta Oto-Laryngologica, 2023
Caili Ji, Xiaowen Zhang, Xudong Yan, Songli Cao, Tao Fu
Secondary acquired cholesteatoma in patients with pars tensa perforation was rare in clinical situation. The pathogenesis was quite different with the retraction pocket related cholesteatoma. The tympanic membrane is basically composed of keratinized squamous epithelium in the outer layer, a fibrous layer in the middle, and cuboidal epithelium in the inner layer. Squamous epithelium migration was found in animal models with marginal perforation [13]. In recent years, migration of keratinized squamous epithelium into the middle ear from the perforation edge was also acknowledged in patients with tympanic membrane perforation [5–6]. That means that migration of squamous epithelium from the outer layer of tympanic membrane into the middle ear may be the first step of acquired cholesteatoma. There were some rules in terms of epithelium migration. Yamamoto et al. [10] found the epithelium invasion of the superior perforation edge around the malleus handle extended via the tendon of the tensor tympani muscle. In Jackler’s research among rat models, the mucosal migration on the pars tensa followed the pattern from the umbo to the posterior superior quadrant of the pars tensa, and for mucosa in the anterior part of the pars tensa or area inferior to the umbo, it migrated toward the tympanic annulus [14]. That kind of mucosa migration facilitated the epithelium migration from the perforation edge of the tympanic membrane. It was important for ENT surgeons to recognize the epithelium migration towards the tympanic cavity especially in marginal perforations.
Endoscopic transtympanic cartilage push-through myringoplasty without tympanomeatal flap elevation for tympanic membrane perforation
Published in Acta Oto-Laryngologica, 2021
A total of 75 patients who underwent endoscopic push-through myringoplasty (EPM) without tympanomeatal flap elevation for tympanic membrane perforation in Eye and ENT Hospital of Fudan University between January 2019 and March 2021 were included in this clinical retrospective study. The patient inclusion criteria were tympanic membrane perforation in chronic otitis media. The exclusion criteria included cholesteatoma, destruction of the ossicular chain, and the presence of purulent secretions, which were examined by preoperative endoscopy, computed tomography (CT) and/or magnetic resonance imaging (MRI) of the temporal bone. Perforation size was divided into small perforation (less than 1/3 of the eardrum area), middle perforation (between 1/3 and 2/3 of the eardrum area) and lagre perforation (more than 2/3 of the eardrum area). Approval was obtained from the Institutional Internal Review Board. All surgeries were performed by the first author.
Variability in Neuropsychological Phenotypes in Patients with 22Q11.2 Deletion Syndrome: Case Series
Published in Developmental Neuropsychology, 2021
Andrea Wierzchowski, Savanna Sablich-Duley, Veronica Bordes Edgar
Medical and Developmental History. Isabell (pseudonym) was an 8-year-old White/Hispanic/Latina female. Pregnancy was complicated by gestational hypertension and delivery by respiratory difficulties. Isabell was transferred to the NICU for further evaluation and management for a prominent cardiac murmur and respiration where she remained for 19 days. In addition to 22q11.2DS, medical history was complicated by Tetralogy of Fallot (TOF), proximal left pulmonary artery stenosis, single right coronary artery, right aortic arch post TOF repair, ventricular septal defect closure, left pulmonary artery patch, partial atrial septal defect closure. She had severe conduit stenosis by echocardiogram (age 2) with subsequent catheterization (age 2) with right ventricle-to-pulmonary artery (RV-PA) conduit stent placement. Conduit was subsequently replaced at age 7. Isabell had other medical complexities including autoimmune thrombocytopenia (related to 22q11.2DS), Bernard Soulier (platelet dysfunction), asthma, and dysphagia complicated by significant periodontal disease requiring dental rehab. A hearing exam revealed bilateral tympanic membrane perforations. Isabell wore prescription glasses. She had a history of strabismus and amblyopia. Isabell was prescribed sertraline and guanfacine.