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1.
BMJ Case Rep ; 17(3)2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38490712

RESUMO

An obliterated Eustachian tube (ET) is a rare occurrence that can lead to chronic otitis media (OM) and aural fullness even with treatment. Our study presents a review of the literature on methods of stenting the ET. We additionally present a case of a man with mucoepidermoid carcinoma of the ET who underwent a radical nasal pharyngectomy with reconstruction and adjuvant radiation, and who had symptoms of intolerable otorrhea after tympanostomy tube placement to treat aural fullness and mucoid OM. We used a novel method of stenting the ET using a transnasal lighted guidewire catheter and steroid eluting stents placed along the entire medial ET. Previously described methods in the literature were unable to be used due to the complex middle ear anatomy filled with granulation tissue and the lack of a visible nasopharyngeal ET ostium available for straightforward placement of the stent. The procedure was successful, and postoperatively, the patient experienced decreased otorrhea.


Assuntos
Otopatias , Tuba Auditiva , Otite Média , Masculino , Humanos , Tuba Auditiva/cirurgia , Tuba Auditiva/patologia , Orelha Média , Otopatias/patologia , Stents , Cateteres , Ventilação da Orelha Média
2.
Int Tinnitus J ; 27(2): 238-241, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38507640

RESUMO

External Auditory Canal Cholesteatomas (EACC), is an exceptionally rare condition with a prevalence of only 0.1-0.5% among new patients1. EACC are known to possess bone eroding properties, causing a variety of complications, similar to the better-known attic cholesteatomas. We describe here the novel surgical management of a case of EACC. She is 38-year-old female who presented with otorrhea for 6 months. Clinical examination and radiological investigations suggested the diagnosis of an external auditory canal cholesteatoma. The patient underwent modified radical mastoidectomy with type 1 tympanoplasty with meatoplasty. Post-operatively, the patient showed marked clinical improvement.


Assuntos
Colesteatoma , Otopatias , Feminino , Humanos , Adulto , Meato Acústico Externo/cirurgia , Estudos Retrospectivos , Colesteatoma/diagnóstico , Colesteatoma/cirurgia , Miringoplastia
3.
Otol Neurotol ; 45(4): 447-453, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38437801

RESUMO

OBJECTIVE: To make recommendations for evaluation, approach to counseling and treatment for patients who present with ear fullness without abnormalities on otomicroscopic examination, standard audiometric studies, or imaging results. METHODS: Retrospective chart review of adult patients in a tertiary referral center presenting with ear fullness and/or otalgia without external, middle, and/or inner ear pathologies. Data collected include demographics (age and gender), laterality and duration of symptoms, co-morbid conditions and final diagnoses of temporomandibular joint (TMJ) dysfunction, intermittent Eustachian tube dysfunction (iETD), migraine disorder, and anxiety. RESULTS: In the span of 8 years of a single neurotologist's practice, 964 patients presented with ear fullness. After excluding all instances where external, middle, and inner ear disorders were identified and where audiometric and radiologic findings were abnormal, 263 patients had ear fullness and no objective causes. Women were more likely than men to complain of ear fullness and/or otalgia and were also more likely to present with no objective abnormalities ( p < 0.05). Patients who reported isolated ear fullness were more likely to be diagnosed with iETD, whereas patients who reported pain were more likely to be diagnosed with TMJ dysfunction (TMJD). Fourteen patients (5.3%) had completely unexplained sensation of ear fullness. CONCLUSIONS: There were 94.7% of the patients presenting with unexplained ear fullness were diagnosed as having a possible contribution of TMJ dysfunction, IETD, migraine disorder, anxiety, or a combination of these conditions to their symptomatology. Directing treatments toward these diagnoses may alleviate symptoms of ear fullness or, if unsuccessful, provide an avenue for counseling in the framework of functional neurologic disorders.


Assuntos
Otopatias , Orelha Interna , Transtornos de Enxaqueca , Adulto , Masculino , Humanos , Feminino , Dor de Orelha/etiologia , Estudos Retrospectivos , Otopatias/diagnóstico , Transtornos de Enxaqueca/complicações
4.
Otol Neurotol ; 45(4): 415-418, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38437819

RESUMO

OBJECTIVES: Barochallenge-induced Eustachian tube dysfunction (ETD) is difficult to diagnose because the examination is often normal during clinical assessment. In adults, functional tympanometry testing, performed by asking the patient to Valsalva and Toynbee while measuring the pressure shift, can aid in the diagnosis of ETD. However, standardized values do not exist in children. We aim to determine the age at which children can perform these maneuvers and the normative values in this population. METHODS: Patients with a normal basic ear examination 4 years and older, presenting to the pediatric Otolaryngology clinic, were recruited. Otoscopy, baseline tympanometry, followed by Valsalva and Toynbee maneuvers were performed. Because there are no pediatric norms, we hypothesized that children would achieve the same minimum normal pressure shift as cited in the adult literature (+20 daPa or higher for Valsalva and -20 daPa or lower for Toynbee). The data were analyzed using receiver operating characteristic curves and logistic regression. RESULTS: One hundred sixty-eight children (276 ears) were assessed. Participants as young as 4 years old were able to perform a Valsalva and Toynbee. Age cut-offs at which children achieved adult norms were 12.5 years ( p = 0.016) and 8.5 years ( p = 0.071) for Valsalva and Toynbee maneuvers, respectively. Mean pressure shift ranged from +29 to -36 daPa, and males were 2.5 times more likely to achieve Toynbee compared with females ( p = 0.006). CONCLUSIONS: Functional tympanometry testing may be used to help diagnose barochallenge-induced ETD in older children.


Assuntos
Otopatias , Tuba Auditiva , Masculino , Adulto , Feminino , Humanos , Criança , Pré-Escolar , Testes de Impedância Acústica , Otoscopia , Manobra de Valsalva
5.
Head Neck Pathol ; 18(1): 5, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334859

RESUMO

A 48-year-old man presented with a chief complaint of intermittent right ear otorrhea of several-month duration, occasional otalgia and progressive unilateral hearing impairment. He also reported frequent episodes of headache and pressure in the sinuses and maxilla. Previous systemic treatment with antibiotics failed to alleviate the symptoms. A head/neck CT showed completely normal mastoid, middle ear and external auditory canal regions without any evidence of opacification or bone erosion. Otoscopic examination of the right ear disclosed aggregates of dried, brown, fibrillar material and debris occluding the external auditory canal and obstructing the otherwise intact tympanic membrane. Dilation of the external auditory canal or thickening of the tympanic membrane were not appreciated. The canal was debrided and the fibrillar material was placed in formalin. Histopathologic examination revealed numerous branching, septated fungal hyphae organized in densely-packed clusters. In other areas, the fungal hyphae abutted or were attached to lamellated collections of orthokeratin. As highlighted by GMS staining, the fungi were morphologically compatible with Aspergillus species. The clinicopathologic findings supported a diagnosis of fungal otitis externa, while the numerous anucleate squamous cells were compatible with colonization of an underlying, probably developing, cholesteatoma. Culture of material isolated from the external auditory canal confirmed the presence of Aspergillus flavus. In this illustrative case, we present the main clinical and microscopic characteristics of Aspergillus-related otomycosis developing in the setting of a tautochronous cholesteatoma.


Assuntos
Colesteatoma , Otopatias , Otite Externa , Otomicose , Masculino , Humanos , Pessoa de Meia-Idade , Otomicose/microbiologia , Aspergillus flavus , Otite Externa/microbiologia , Meato Acústico Externo , Colesteatoma/diagnóstico
6.
Eur Arch Otorhinolaryngol ; 281(4): 2031-2035, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38367073

RESUMO

PURPOSE: Achromobacter xylosoxidans is an emerging pathogen mainly associated with resistant nosocomial infections. This bacteria had been isolated in the ear together with other pathogens in cultures from patients with chronic otitis media, but it had never been reported as a cause of osteomyelitis of the external auditory canal. CASE PRESENTATION: We present a unique case of a healthy 81-year-old woman who presented with left chronic otorrhea refractory to topical and oral antibiotic treatment. Otomicroscopy revealed an erythematous and exudative external auditory canal (EAC) with scant otorrhea. The tympanic membrane was intact, but an area of bone remodeling with a small cavity anterior and inferior to the bony tympanic frame was observed. Otic culture isolated multi-drug-resistant A. xylosoxidans, only sensitive to meropenem and cotrimoxazole. Temporal bone computed tomography showed an excavation of the floor of the EAC compatible with osteomyelitis. Targeted antibiotherapy for 12 weeks was conducted, with subsequent resolution of symptoms and no progression of the bone erosion. CONCLUSIONS: Atypical pathogens such as A. xylosoxidans can be the cause of chronic otitis externa. Early diagnosis and specific antibiotherapy can prevent the development of further complications, such as osteomyelitis. In these cases, otic cultures play an essential role to identify the causal germ. This is the first case of EAC osteomyelitis due to A. xylosoxidans reported to date.


Assuntos
Achromobacter denitrificans , Otopatias , Osteomielite , Otite Externa , Feminino , Humanos , Idoso de 80 Anos ou mais , Meato Acústico Externo/diagnóstico por imagem , Otite Externa/diagnóstico , Otite Externa/tratamento farmacológico , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Osteomielite/complicações
7.
Int J Pediatr Otorhinolaryngol ; 177: 111871, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38266378

RESUMO

OBJECTIVE: Telemedicine, particularly real time video-otoscopy in rural and remote Australia holds great potential in assessing and managing otology conditions. There is good evidence of store and forward images for assessment, however limited evidence exists for the use of real-time video-otoscopy. The objective of this study was to assess the validity of using real time video-otoscopy, compared to standard store and forward still image otoscopy, in a paediatric population. METHOD: Fifty-two paediatric tympanic membranes in 27 patients were examined and photographed by a telehealth facilitator with prior otoscope training. This occurred at two rural Western Australian health centre sites. These images were stored and forwarded to a tertiary paediatric hospital for otolaryngology department assessment on the day of real-time video-otoscopy consultation. During this consultation the same twenty-seven patients underwent real-time video-otoscopy assessment, which was recorded. Across six domains including, image quality, focus, light, cerumen amount, field of view and tympanic membrane landmarks, real-time video-otoscopy was compared against still image capture. The recording of each real-time video-otoscopy and still image tympanic membrane was assessed by two otology specialists for the ability to diagnose each as either normal or abnormal. An inter-rater reliability agreement was then calculated. RESULTS: There was greater image adequacy across five of the six domains for real time video-otoscopy compared to standard store and forward otoscopy images. Substantial agreement in diagnosing each tympanic membrane as either normal or abnormal between each rater was evident. CONCLUSION: This study supports the use of real time video-otoscopy during telemedicine consultation. With greater image quality, focus, light, field of view and identification of tympanic membrane landmarks video-otoscopy compared to still images has broad clinical applications. This includes primary assessment of the tympanic membrane and post operative follow-up clinical settings. Video-otoscopy offers a promising new way to over-come barriers in delivering ear health care in rural populations.


Assuntos
Otopatias , Telemedicina , Criança , Humanos , Otoscopia/métodos , Reprodutibilidade dos Testes , Austrália , Membrana Timpânica/diagnóstico por imagem , Telemedicina/métodos , Otopatias/diagnóstico
8.
Int J Pediatr Otorhinolaryngol ; 177: 111832, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38215661

RESUMO

BACKGROUND: One third of children require repeat ventilation tube insertion (VTI) for otitis media. Disease recurrence is associated with persistent middle ear bacterial biofilms. With demonstration that Dornase alfa (a DNase) disrupts middle ear effusion biofilms ex vivo, we identified potential for this as an anti-biofilm therapy to prevent repeat VTI. First, safety and tolerability needed to be measured. METHODS: This was a phase 1B double-blinded randomized control trial conducted in Western Australia. Children between 6 months and 5 years undergoing VTI for bilateral middle ear effusion were recruited between 2012 and 2014 and followed for two years. Children's ears were randomized to receive either Dornase alfa (1 mg/mL) or 0.9 % sodium chloride (placebo) at time of surgery. Children were followed up at 2 weeks post-VTI and at 3-monthly intervals for 2 years. Outcomes assessed were: 1) safety and tolerability, 2) otorrhoea frequency, 3) blocked or extruded ventilation tube (VT) frequency, 4) time to blockage or extrusion, 5) time to infection recurrence and/or need for repeat VTI. RESULTS: Sixty children (mean age 2.3 years) were enrolled with 87 % reaching study endpoint. Treatment did not change otorrhoea frequency. Hearing improved in all children following VTI, with no indication of ototoxicity. Dornase alfa had some effect on increasing time until VT extrusion (p = 0.099); and blockage and/or extrusion (p = 0.122). Frequency of recurrence and time until recurrence were similar. Fourteen children required repeat VTI within the follow-up period. CONCLUSION: A single application of Dornase alfa into the middle ear at time of VTI was safe, non-ototoxic, and well-tolerated. TRIAL REGISTRATION: ACTRN12623000504617.


Assuntos
Otopatias , Otite Média com Derrame , Otite Média , Criança , Humanos , Pré-Escolar , Otite Média com Derrame/cirurgia , Otite Média/tratamento farmacológico , Otite Média/cirurgia , Desoxirribonuclease I , Orelha Média , Otopatias/cirurgia , Ventilação da Orelha Média/efeitos adversos , Cloreto de Sódio , Proteínas Recombinantes
9.
Ann Otol Rhinol Laryngol ; 133(4): 369-374, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38197378

RESUMO

OBJECTIVE: Eustachian Tube Balloon Dilation (ETBD) represents an innovative therapeutic approach for chronic Eustachian tube dysfunction (CETD), a common disease in children. Some evidence of a benefit of ETBD in the adults exist in contrast to sparse reports in children. The objective was to analyze short- and long-term outcome of ETBD in children with CETD. METHODS: A retrospective chart-review was performed in a cohort of 19 children (mean age 13 years, 7-17) who underwent ETBD. The following parameters were analyzed: tubomanometry (R-value), tympanogram, hearing (CPT-AMA, Air-bone gap [ABG]), Eustachian Tube Score (ETS and ETS-7), and Eustachian Tube Disease questionnaire (ETDQ). RESULTS: Twenty-four ears were dilated (in 5 patients subsequently after successful first intervention) and grouped as A (17) without and B (7) with additional T-tube insertion. Most children suffered from either chronic otitis media with effusion or chronic perforation (12, 63%), the remainder comprising recurrent otitis media, adhesive otitis media and CETD with barotrauma. Mean duration of symptoms were 7/8.2 years and mean follow-up 13.7/11.1 months. Eighty percent of patients reported a subjective benefit. Accordingly, the R-value, ETS, and ETS-7 were significantly (P < .05) improved. Tympanometry, CPT-AMA and ABG showed a positive trend, but the result was not significant. Tympanic retraction remained largely the same; a spontaneous closure of a chronic tympanic perforation was seen in 1 of 3 cases. CONCLUSIONS: The high subjective benefit and some significant objective improvement warrants further analysis of ETBD as part of the therapeutic management in pediatric CETD.


Assuntos
Otopatias , Tuba Auditiva , Otite Média , Adulto , Humanos , Criança , Adolescente , Tuba Auditiva/cirurgia , Estudos Retrospectivos , Dilatação , Otite Média/terapia , Testes de Impedância Acústica , Otopatias/diagnóstico , Resultado do Tratamento
10.
HNO ; 72(3): 192-198, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38289500

RESUMO

BACKGROUND: In 1873, Hermann Schwartze and Adolf Eysell described a new surgical technique for treating mastoid disease using a mallet, chisels, and gouges of various sizes instead of trephines or drill instruments also called "modern mastoidectomy." On the 150th jubilee of this landmark article, we pay tribute by studying the reception and implementation of mastoidectomy in the 2 years following its publication. METHODS: The commentaries published in the otological and medical literature between the second part of 1873 to the end of 1875 were studied with an emphasis on the three specialized otological journals and the otological textbooks that existed during this period. RESULTS AND CONCLUSION: The princeps paper Ueber die künstliche Eröffnung des Warzenfortsatzes ("On the artificial opening of the mastoid process") by Hermann Schwartze and Adolf Eysell published in 1873 was rapidly disseminated in the medical literature for nearly 1 year, and then entered a phase of evaluation followed by a phase of extension and implementation, before finding its definitive place in the history of mastoid process surgery.


Assuntos
Otopatias , Mastoidectomia , Humanos , Processo Mastoide/cirurgia , Instrumentos Cirúrgicos
11.
N Z Med J ; 137(1588): 57-66, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38261775

RESUMO

AIM: The study aimed to explore the impact of middle ear disease on the lives of New Zealand Maori. Ear disease is common, yet there is a paucity of research into the effect it has on people's lives, particularly indigenous populations. METHOD: The study used Kaupapa Maori-based qualitative methodology and involved a series of seven semi-structured interviews with Maori adults living with middle ear disease. RESULTS: All participants felt there were delays in recognition and treatment of their ear condition and that there were barriers to accessing healthcare. The ear condition prevented participation in cultural and recreational activities, particularly those involving water. The associated hearing loss affected education and employment opportunities, and together with ear discharge, resulted in social isolation and disconnection from Te Ao Maori (the Maori world). Overall, the condition impacted negatively on mental and spiritual wellbeing. Participants felt that funding for hearing aids, earlier recognition and treatment of the condition and healthcare staff with a better understanding of Te Ao Maori could reduce the morbidity associated with middle ear disease. CONCLUSION: The study demonstrates that living with middle ear disease presents many challenges and disadvantages for Maori and the importance of early detection and referral to specialist care.


Assuntos
Otopatias , Povo Maori , Adulto , Humanos , Otopatias/epidemiologia , Povos Indígenas , Nova Zelândia
12.
HNO ; 72(1): 57-68, 2024 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-38047932

RESUMO

Congenital malformations of the pinna and aural atresia can result in major aesthetic and functional deficits. Knowledge about embryologic developments and established classification systems is an essential requirement when dealing with affected patients. Early detection of deficiencies and introduction of appropriate diagnostic measures is vital to initiate adequate therapies and prevent long-term disabilities. Treatment for malformations of the pinna-if requested-is mostly surgical, infrequently an epithesis is applied. As in other surgical fields, tissue engineering will likely play a crucial role in the future. Treatment of aural stenosis and atresia aims at improvement of hearing levels and prevention of secondary complications like cholesteatoma and chronic otorrhea. Auditory rehabilitation comprises a spectrum from conventional hearing aids to invasive hearing implants, the latter being favored in recent years.


Assuntos
Anormalidades Congênitas , Microtia Congênita , Otopatias , Humanos , Anormalidades Congênitas/terapia , Anormalidades Congênitas/cirurgia , Microtia Congênita/diagnóstico , Microtia Congênita/terapia , Microtia Congênita/complicações , Otopatias/diagnóstico , Otopatias/terapia , Orelha Externa , Audição , Testes Auditivos
13.
J Craniofac Surg ; 35(1): e88-e90, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37948616

RESUMO

The question mark ear is a rare abnormality characterized by a cleft between the helix and the earlobe, resulting in a protrusion of the upper part of the ear. The severity of this ear malformation can range from a minor notch in the helix to a complete separation of the helix and the earlobe. In this study, we present a case of a patient with a moderately severe right-sided unilateral question mark deformity. To address this issue, we utilized a novel technique that involves a combination of a Y-V flap with double opposing Z-plasty. Our clinical study demonstrates that using this technique for reconstructing the deformity yields excellent results in terms of the helical rim and fold contour, utilizing solely the local tissues.


Assuntos
Pavilhão Auricular , Otopatias , Orelha/anormalidades , Procedimentos de Cirurgia Plástica , Humanos , Retalhos Cirúrgicos/cirurgia , Pavilhão Auricular/cirurgia
14.
J Ultrasound Med ; 43(2): 411-414, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37929614

RESUMO

Primrose syndrome is a very rare congenital malformation. Symptoms of this disorder may appear during childhood, but the diagnosis is identified in adulthood in the majority of cases. The prenatal diagnosis of Primrose syndrome is not developed in the literature. We present herein a case series of 3 cases with characteristic sonographic features. A dysmorphic metopic suture, downslanting palpebral fissures, a wide forehead, and agenesis of corpus callosum are the main signs. A missense mutation in ZBTB20 identified in whole exome sequencing can confirm the prenatal diagnosis of Primrose syndrome.


Assuntos
Anormalidades Múltiplas , Calcinose , Otopatias , Deficiência Intelectual , Atrofia Muscular , Gravidez , Feminino , Humanos , Anormalidades Múltiplas/diagnóstico por imagem , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/genética , Diagnóstico Pré-Natal , Agenesia do Corpo Caloso/diagnóstico por imagem , Agenesia do Corpo Caloso/genética
15.
J Laryngol Otol ; 138(3): 349-352, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37586785

RESUMO

OBJECTIVE: Auricular pseudocysts are rare, painless, benign intracartilaginous cysts of the auricle that are not lined by epithelium and have no known aetiology. METHOD: This was a prospective study conducted in an ENT department from January 2020 to June 2022. In 21 patients, complete aspiration of the pseudocyst with enhanced negative drainage was performed. They were followed for a minimum of six months. RESULTS: All patients completely responded to the negative drainage treatment. No cases of recurrence or obvious deformities were observed. CONCLUSION: Aspiration with intensified negative drainage was associated with a positive response in patients with auricular pseudocysts. Complete resolution of the swelling can be achieved without any serious complications. Thus, it appears to be a simple and effective method for managing the condition.


Assuntos
Cistos , Pavilhão Auricular , Otopatias , Humanos , Estudos Prospectivos , Otopatias/cirurgia , Drenagem , Pavilhão Auricular/cirurgia , Cistos/cirurgia
16.
Laryngoscope ; 134(3): 1426-1430, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37615366

RESUMO

We describe an unusual case of glomangiopericytoma presenting as a mass filling the middle ear, enveloping the ossicles, and extending into the mastoid antrum without bony destruction. Management involved three surgeries and stereotactic radiosurgery, which achieved short-term local control with no evidence of disease on MRI imaging 12 months after radiation. Facial nerve function and hearing were preserved. This is the first report to our knowledge of a glomangiopericytoma presenting as a primary temporal bone lesion. Treatment with surgery and stereotactic radiosurgery for residual or recurrent disease is a reasonable approach to achieve local control and functional preservation. Laryngoscope, 134:1426-1430, 2024.


Assuntos
Otopatias , Neoplasias de Cabeça e Pescoço , Radiocirurgia , Humanos , Audição , Radiocirurgia/métodos , Orelha Média/diagnóstico por imagem , Resultado do Tratamento
17.
Health Promot J Austr ; 35(1): 225-234, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36961054

RESUMO

ISSUE ADDRESSED: Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. METHODS: The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. RESULTS: A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. CONCLUSION: These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.


Assuntos
Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Otopatias , Serviços de Saúde do Indígena , Criança , Humanos , Estudos de Coortes , Coleta de Dados , Estudos Longitudinais , Pais , Otopatias/epidemiologia
19.
Eur Arch Otorhinolaryngol ; 281(3): 1259-1265, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37725135

RESUMO

PURPOSE: Chronic obstructive Eustachian tube dysfunction (OETD) can lead to tympanic membrane (TM) retraction and middle ear effusion (MEE) which can cause conductive hearing impairment, which among other ear symptoms can lower the quality of life (QoL). In this prospective study we assess hearing results and subjective changes in QoL following balloon Eustachian tuboplasty (BET) in treatment of OETD. METHODS: Totally 25 ears with TM retraction and 18 ears with MEE due to chronic OETD underwent BET as the sole intervention. Outcomes including otoscopy, ability to perform the Valsalva maneuver, tympanometry, audiometry, Eustachian tube inflammation scale and the Glasgow Benefit Inventory questionnaire (GBI) were obtained on all patients preoperatively and 6 months postoperatively. RESULTS: Hearing thresholds improved statistically significantly (p < 0.05) with means of 3 dB in the TM retraction group and 9 dB in the MEE group. Total GBI results indicated a positive influence on patients' QoL. Valsalva success rate was 80% in patients with TM retraction and 67% in patients with MEE. Tympanometry results improved in 50% of TM retraction patients and in 33% of MEE patients. CONCLUSIONS: Here we demonstrated that the BET has a positive impact on patients' conductive hearing loss and QoL in patients with TM retraction or MEE. Results were better in TM retraction group than in MEE group.


Assuntos
Otopatias , Tuba Auditiva , Otite Média com Derrame , Humanos , Qualidade de Vida , Tuba Auditiva/cirurgia , Estudos Prospectivos , Dilatação/métodos , Otopatias/cirurgia , Otite Média com Derrame/complicações , Otite Média com Derrame/cirurgia , Otite Média com Derrame/diagnóstico , Testes de Impedância Acústica , Audição , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva/cirurgia , Resultado do Tratamento
20.
Otolaryngol Head Neck Surg ; 170(3): 944-951, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38037398

RESUMO

OBJECTIVES: To investigate how eustachian tube dysfunction symptoms change following surgical treatment of nonsinusitis-related nasal obstruction. STUDY DESIGN: Retrospective chart review. SETTING: Single academic center. METHODS: We assessed patients who underwent septoplasty, turbinate reduction, or both for nasal obstruction. Chronic sinusitis patients were excluded. Eustachian tube dysfunction (ETD) symptoms were studied using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7), collected preoperatively and postoperatively (1 week, 1 month, 3 months, 6 months postop). Patients with preoperative ETDQ-7 > 14.5 were considered to have clinically significant symptoms. Sinonasal outcomes test scores were also assessed. Pre- and postoperative ETDQ-7 scores were compared using t test. Multivariate linear regression analysis identified factors associated with ETDQ-7 change. RESULTS: We analyzed 259 patients. Preoperatively, 37.5% of patients with nasal obstruction had clinically significant ETD symptoms. These patients exhibited significant improvement in ETDQ-7 at all postoperative timepoints from 23.3 ± 7.6 at baseline to 19.1 ± 9.1 at 1 week, 16.5 ± 8.0 at 1 month, 16.2 ± 7.8 at 3 months, and 16.7 ± 10.4 at 6 months (all P < .01). In patients without baseline ETD symptoms, (baseline ETDQ-7: 9.1 ± 2.3) ETDQ-7 scores did not change significantly at postoperative timepoints, except for an acute worsening at 1 week postoperatively (10.7 ± 5.1, P < .001). Regression analysis showed that higher preoperative ETDQ-7 score (ß = -0.84, 95% confidence interval [CI]: -1.10 to -0.59) and postoperative antihistamine spray usage (ß = -8.70, 95% CI: -14.20 to -3.20) were associated with ETDQ-7 improvement, while comorbid GERD (ß = 7.50, 95% CI: 3.42-11.58) and asthma (ß = 5.62, 95% CI: 0.80-10.45) were negatively associated with improvement. CONCLUSION: Surgical correction of nasal obstruction may improve ETD symptoms.


Assuntos
Otopatias , Tuba Auditiva , Obstrução Nasal , Sinusite , Humanos , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Estudos Retrospectivos , Tuba Auditiva/cirurgia , Inquéritos e Questionários , Sinusite/complicações , Sinusite/cirurgia , Otopatias/diagnóstico
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