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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
Respiratory system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
In acute otitis media fever and irritability are the main symptoms, though irritability is not always present. The landmarks of the ear drum are not clear and the light reflex is altered. Decongestive agents are of little use. Most infections are viral in origin. The drug of choice is amoxycillin or trimethoprim with sulphamethoxazole, since secondary bacterial infections are due to Haemophilus influenzae, Streptococcus pyogenes or Streptococcus pneumoniae.
Paediatric neck lumps
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Cervical masses in the neonatal period and early infancy are usually congenital (though these can present at a later age) [2]. Reactive lymphadenopathy usually occurs in children over 6 months of age. The age of the child may also provide information about a possible infectious source, for example acute otitis media in children under the age of 2 years. Reactive lymphadenopathy is common with 40%–55% of young children found to have palpable lymph nodes [2].
Pediatric cochlear implants and myringotomy tubes: a systematic review
Published in Cochlear Implants International, 2023
Shubham Patel, Alexa Robbins, Ching Siong Tey, Chao Zhang, Shenita Peterson, Nandini Govil
Four studies commented on incidence of acute otitis media (AOM) post-operatively. Of those patients with a MT, 6.8% had at least one episode of AOM post-operatively, compared to 4.0% in those without MT. Metanalysis test of heterogeneity for patients with current or history of MT undergoing CI surgery showed no significant relationship between MT and post-operative AOM (Googe and Carron, 2016; Luntz et al., 2001; Roberson et al., 2006; Sokolov et al., 2016). A fixed model was performed, which also demonstrated no significance between historical or current MT at CI surgery and post-operative AOM episode (p = 0.25). The risk ratio was 1.58 (0.73–3.44 with 95% confidence) (Fig 3). Luntz et al., 2001, which was the only study assessing CSF leak rates, found that 1 of 10 patients with history of MT had CSF leaks following cochlear implantation compared to 1 of 8 with no history of MT. Cevizci et al. also assessed complications following CIs in 100 patients without MT and 5 patients with MT who underwent CI. The study found no complications in either group of patients. Other less commonly reported complications such as device failure, wound infection, and meningitis were also noted in studies, but numbers were too low for aggregate statistical analysis (Baranano et al., 2010; Googe and Carron, 2016).
Leveraging real-world data to improve cochlear implant outcomes: Is the data available?
Published in Cochlear Implants International, 2023
Callum Findlay, Mathew Edwards, Kate Hough, Mary Grasmeder, Tracey A. Newman
Otitis media, an umbrella term for middle ear inflammation (MEI), is a spectrum of diseases with closely related pathological phenotypes and clinical definitions (Schilder et al., 2016). Amongst children, otitis media is a leading cause of antibiotic prescription and surgery. Approximately 60–83% of children will have ≥1 episode of acute otitis media (AOM) by the age of 3, and around 25% of three year olds will have had ≥3 episodes (Kaur et al., 2017; Teele et al., 1989). In addition to the transient conductive hearing loss due to the increased stiffness and mass of the tympanum caused by middle ear effusion (Cai et al., 2017), middle ear inflammation is associated with the development and worsening of sensorineural hearing loss (Costa and Rosito LPS, 2009). The evidence is strongest for chronic otitis media; however, there is evidence that even a single episode of acute otitis media can produce very high frequency hearing deficits. Chronic otitis media, which involves persistent middle ear inflammation, has been shown to cause damage to the cochlea (Bhutta et al., 2017; Costa and Rosito LPS, 2009; Cureoglu et al., 2004; Kaur et al., 2017; Paparella et al., 1984) that is maximal at the basal turn, reducing the thickness of the stria vascularis and the number of inner and outer hair cells (Cureoglu et al., 2004; Paparella and Goycoolea, 1980).
Into and out of the cochlea: A re-implantation saga
Published in Cochlear Implants International, 2021
N. Wendell Todd, Jolie C. Fainberg, Nadja Kadom
The patient is 15-year old as of this writing. He was born prematurely at 26 weeks gestation, birth mass less than 1 kg. From newborn auditory physiologic screening, he was identified to have hearing impairment with features consistent with auditory neuropathy. He had hearing aids beginning at age six months. Despite intensive speech therapy, he lagged severely in expressive verbal language development. He walked independently at age 14 months (Table 1). The father, a professional musician who himself had tympanostomy-tubes in childhood, and the mother were eager for the patient to have hearing and spoken language. Computed tomography of the temporal bones was normal bilaterally at age seven months (Figure 1). Recurrent acute otitis media was addressed with episodic antibiotics, then by tympanotomy-tube placement each ear at age 20 months. Parental concerns about his hearing crescendoed as he approached his 2nd birthday. Magnetic resonance imaging of the head and temporal bones was normal at age 25 months (Figure 2). His first CI done at age 27 months into his left ear, using a Cochlear Corporation model Nucleus CI24R(CA), was uneventful: trans-mastoid posterior tympanotomy, cochleostomy anterior-inferior adjacent, and incorporating the round window, full insertion of the electrode array using the advance-off-stylet technique. Right CI subsequently was uneventful, the same technique.