Congenital Middle Ear Cholesteatoma: A Report of 3 Cases and a Literature Review.

Background: Congenital cholesteatoma is defined as a white mass behind an intact eardrum without a history of otitis media or previous otologic procedures. Congenital cholesteatoma is a relatively rare disease that accounts for about 2% to 5% of all cholesteatomas. However, the actual incidence rate of congenital cholesteatoma may be underestimated. Conductive hearing loss is the most common presenting symptom. The current study aims to describe the clinical characteristics and management of patients with congenital cholesteatoma and promote awareness of the disease in unilateral or asymmetric conductive hearing loss patients. Methods: In this study, we report a case series of 3 patients including 1 child, 1 adolescent, and 1 young adult, managed in our department between June and August 2023, and present a summary of the literature. Results: Congenital cholesteatoma is primarily a pediatric disease, but it has also been reported in adults. Two cases presented with unilateral secretory otitis media, and 1 case presented with asymmetric unilateral conductive hearing loss. Two patients of Potsic stage III congenital middle ear cholesteatomas underwent transcanal endoscopic ear surgery, and 1 patient of Potsic stage IV underwent conventional microscopic approach canal wall-up mastoidectomy combined with endoscopy. Conclusions: In children or young adults with persistent unilateral or asymmetric conductive hearing loss, congenital middle ear cholesteatoma should be considered. Congenital cholesteatoma cannot be ruled out in children with unilateral secretory otitis media.

Investigating the epidemiological relevance of secretory otitis media and neighboring organ diseases through an Internet search.

Background: This study examined the epidemiological correlations between secretory otitis media (SOM) and diseases of neighboring organs. We measured changes in disease incidences during the 2020 COVID-19 pandemic using Internet big data spanning from 2011 to 2021. Methods: This study used the Baidu Index (BI) to determine the search volume for the terms "secretory otitis media (SOM)", "tonsillitis", "pharyngolaryngitis", "adenoid hypertrophy (AH)", "nasopharyngeal carcinoma (NPC)", "nasal septum deviation (NSD)", "rhinosinusitis", "allergic rhinitis (AR)", and "gastroesophageal reflux disease (GERD)" in Mandarin from January 2011 to December 2021. The correlations between these terms were analyzed using Spearman's correlation coefficients. The results were compared search data from 2019 and 2021 to assess the effects of isolation on SOM in 2020. Results: The seasonal variations trends of SOM and other diseases coincided well (P < 0.05), except for AR. During the 11-year timeframe, the monthly searches for rhinosinusitis, NSD, tonsillitis, pharyngolaryngitis, and NPC were statistically correlated with SOM (R = 0.825, 0.594, 0.650, 0.636, 0.664, respectively; P < 0.05). No correlation was found between SOM and AR, SOM and AH, or SOM and GERD (R =  - 0.028, R = 0.259, R = 0.014, respectively, P > 0.05). The total search volumes for SOM, rhinosinusitis, NPC, and AH decreased in 2020 compared to 2019. Discussion: SOM exhibited a discernible epidemiological connection with rhinosinusitis, nasal septal deviation (NSD), tonsillitis, pharyngolaryngitis, and nasopharyngeal carcinoma (NPC). A decrease in public gatherings was observed to effectively reduce the incidences of SOM. This underscores the pivotal role of social measures in influencing the prevalence of SOM and emphasizes the intricate interplay between SOM and various associated health factors, with implications for public health strategies.

Harnessing astaxanthin-loaded diselenium cross-linked apotransferrin nanoparticles for the treatment of secretory otitis media.

Secretory otitis media (SOM) is a clinical condition characterized by the accumulation of fluids and oxidative stress in the middle ear, leading to hearing impairment and infection complications. One potential solution for mitigating oxidative stress associated with SOM is the use of antioxidants such as astaxanthin. However, its effectiveness is limited due to its poor bioavailability and rapid oxidation. Herein, we developed a novel diselenium-crosslinked apotransferrin enriched with astaxanthin (AST@dSe-AFT) nanoparticles to augment the transport of astaxanthin across biological membranes, resulting in increased bioavailability and reduced oxidative stress in SOM. Our research demonstrated that AST@dSe-AFT efficiently accumulated in the middle ear, allowing for controlled delivery of astaxanthin in response to reactive oxygen species and reducing oxidative stress. Additionally, AST@dSe-AFT stimulated macrophages to polarize towards M2 phenotype and neutrophils to polarize towards N2 phenotype, thereby facilitating an anti-inflammatory response and tissue restoration. Importantly, AST@dSe-AFT exhibited no toxicity or adverse effects, suggesting its potential for safety and future clinical translation. Our findings suggested that AST@dSe-AFT represents a promising approach for the treatment of secretory otitis media and other oxidative stress-related disorders.

Single Sequence Magnetic Resonance Imaging in Serous Otitis Media.

INTRODUCTION: We evaluated the usability of short-term (approximately 3 minutes) T2 sequence temporal bone magnetic resonance imaging (MRI) in the diagnosis of serous otitis media (SOM) in our study. METHODS: A prospective study. Otoscopic examination and audiometry-tympanometry were performed on all 73 patients included in the study. All patients underwent short-term T2 sequence temporal bone MRI before the paracentesis procedure. RESULTS: The mean age of 73 patients (30 female and 43 male) was 7.78 ± 3.01 (3 to 17 years). A total of 134 ear paracentesis operations were performed. As a result of the intraoperative paracentesis procedure, 107 Type B tympanogram and 13 Type C tympanogram were found out of 120 ears that had fluid in the middle ear. Out of 14 ears without fluid flow in the middle ear, five were found to be Type B tympanogram and nine to be Type C tympanogram. The sensitivity of the type B tympanogram in the diagnosis of SOM was 89.1%, the specificity was 64.2%, the positive predictive value was 95.5%, and the negative predictive value was 40.9%. The sensitivity and specificity of short-term T2 sequence MRI in diagnosing SOM were found to be 100% and 100%. CONCLUSION:  Among the available methods, the short-term T2 sequence temporal MRI is the most effective method for evaluating fluid in mastoid cells.

COVID-19-related secretory otitis media in the omicron era: a case series.

OBJECTIVES: Increased numbers of patients with secretory otitis media appeared in outpatient clinics after the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron pandemic; however, the relationship between SARS-CoV-2 Omicron variant infection and secretory otitis media is uncertain. METHODS: We performed tympanocentesis and used reverse transcription-polymerase chain reaction (RT-PCR) testing to examine middle ear effusion (MEE) and nasopharyngeal secretions from 30 patients with secretory otitis media associated with SARS-CoV-2 infection. RT-PCR was performed using the open reading frame 1ab and nucleocapsid protein gene kit from Shanghai Berger Medical Technology Co., Ltd., as the sole assay method, in accordance with the manufacturer's instructions. RESULTS: MEEs from 5 of the 30 patients tested positive for SARS-CoV-2, including one patient with positive results for both the nasopharyngeal secretion and MEE. We report and discuss the medical records of six patients, including these five MEE-positive patients and a MEE-negative patient. CONCLUSION: SARS-CoV-2 RNA can be detected in MEE caused by coronavirus disease 2019-related secretory otitis media even when a patient's nasopharyngeal secretion tests PCR-negative for SARS-CoV-2. The virus can remain in the MEE for a long time after SARS-CoV-2 infection.

Case report: A novel mutation in the EYA1 gene in a child with branchiootic syndrome with secretory otitis media and bilateral vestibular hypofunction.

Branchiootic syndrome (BOS) is a rare, autosomal dominant syndrome characterized by malformations of the ear associated with hearing loss, second branchial arch anomalies, and the absence of renal anomalies. Herein, we report the case of an 8-year-old male patient with BOS. The proband also experiences mixed conductive and sensorineural hearing loss in the right ear, and severe-to-profound sensorineural hearing loss in the left ear. Preauricular pits, branchial fistulae, and cochlear hypoplasia were present bilaterally. Type III cup-shaped ear, and external auditory canal stenosis were detected in the right ear. Lateral semicircular canal-vestibule dysplasia was detected in the left ear. Moreover, the patient had unilateral secretory otitis media (SOM) in the right ear and bilateral vestibular hypofunction (VH), which has not been reported in previous studies. The patient's hearing on the right side was restored to nearly normal after myringotomy. Whole exome sequencing identified a novel frameshift mutation in EYA1 (NM_000503.6): c.1697_1698delinT [p.(Lys566IlefsTer73)] in the proband, which was defined a "pathogenic" mutation according to American College of Medical Genetics and Genomics guidelines. This is the first report of a child presenting with BOS, SOM and VH, which expands the known clinical manifestations of this syndrome. We also observed a novel EYA1 gene mutation in this patient with BOS, which enriches the mutation map and provides a reference for genetic diagnosis of this syndrome.

Association between secretory otitis media and laryngopharygeal reflux in adults.

BACKGROUND: The relationship between Secretory Otitis Media (SOM) and Laryngopharygeal Reflux (LPR) hasn't been well investigated in adult. PURPOSE: To study the involvement of LPR- in adult SOM. METHODS: We analyzed 60 adult SOM patients who were admitted to Department of Otolaryngology and Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, China from January 2022 to October 2022. First, we instructed the patients to fill Reflux Symptom Index (RSI) form and Reflux Finding Score (RFS). Second, Dx-ph monitor was used to monitor patients' oropharyngeal PH for 24 h. Finally, we obtained Ryan index based on the characteristics of reflux events in different body postures. In addition, all patients were evaluated by the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7). RESULTS: The positive rate of RSI and/or RFS scale was 73.33% (44/60) in 60 SOM patients. The positive rate of Ryan index was 76.67% (46/60), and the index was the highest in upright position in 60 SOM patients. The positive rate of ETDQ-7 was 100% (46/46) in 46 SOM patients with LPR. CONCLUSION: LPR may be involved in SOM in adults by impairing the function of the eustachian tube.

Efficacy and safety of ambroxol hydrochloride in the treatment of secretory otitis media: a systematic review and meta-analysis.

Background: Secretory otitis media is a very common nonsuppurative inflammatory disease in otorhinolaryngology. Ambroxol hydrochloride helps to improve ciliary movement in the ear canal and promote the dissolution and discharge of secretions. However, its effect still lacks systematic evaluation. We conducted a meta-analysis of clinical studies to systematically evaluate the application effect of ambroxol hydrochloride. Methods: A computer-based search of the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), PubMed, and Web of Science databases was conducted using the keywords "Ambroxol hydrochloride" & "secretory otitis media". Randomized controlled trials published after 2015 were selected and then screened and analyzed using RevMan 5.4 software. Results: Ten studies involving a total of 998 patients were included. Meta-analysis showed that adding ambroxol hydrochloride to the original glucocorticoid treatment improved therapeutic efficacy [odds ratio (OR) =4.95, 95% confidence interval (CI): 3.27, 7.50, P<0.00001], reduced tympanic pressure after treatment [mean difference (MD) =-19.04, 95% CI: -22.72, -15.36, P<0.00001], and increased the pure tone threshold (MD =6.37, 95% CI: 5.36, 7.37, P<0.00001), without increasing adverse reactions (OR =0.51, 95% CI: 0.14, 1.85, P=0.30). Discussion: On the basis of the original treatment of secretory otitis media, adding ambroxol hydrochloride treatment improved the therapeutic effect, reduced tympanic pressure after treatment, and improved the pure tone threshold (hearing), without increasing adverse reactions.

[Eigenvalue analysis of wideband acoustic immittance in secretory otitis media in children of different ages].

Objective:The characteristic values of broadband acoustic immittance of children of different ages during secretory otitis media were collected resonance frequency and absorption rate of middle ear in children of different ages were compared. Methods:Eighty-two children with secretory otitis media were selected for the broadband acoustic immittance test, including 62 cases （83 ears） in the young effusion group（[3.5±0.7]months）, and 20 cases （40 ears） in the older effusion group（[4.0±0.6]years old）. 82 normal children were selected for broadband acoustic immittance test in the same environment, including 62 cases （124 ears） in the younger normal group and 20 cases （40 ears） in the older normal group. The resonance frequency and absorptivity of different age groups under broadband peak pressure were compared, and the frequency absorptivity curve was drawn for analysis. Results:The resonance frequencies of older normal group and younger normal group, older effusion group and older normal group, younger effusion group and younger normal group, older effusion group and younger effusion group were statistically significant（P<0.001）. Analysis of sound energy absorption rate at different ages. There was significant difference in sound energy absorption rate between older normal group and younger normal group at 226-1155 / 4757-8000 Hz（P<0.001）. The difference of full frequency sound energy absorption rate between the older effusion group and the older normal group was statistically significant（P<0.001）, among which the difference of 866-1542 / 2520-4362 Hz absorption rate was the largest. The difference of full frequency sound energy absorption rate between young effusion group and young normal group was statistically significant（P<0.001）, and the difference of 1091-2245 / 3776-5494 Hz absorption rate was the largest. Conclusion:Middle ear effusion in children of different ages has different performance under broadband acoustic immittance peak pressure, and has its own characteristic acoustic energy absorption frequency band. This study provides a reference basis for the analysis of the characteristics of middle ear sound transmission in children with secretory otitis media in the future.

[Evaluation of Eustachian tube function in children with adenoid hypertrophy by nasopharyngeal digital photography and ETDQ-7 scores].

Objective:To evaluate the Eustachian tube function of children with simple adenoid hypertrophy and adenoid hypertrophy with secretory otitis media（OME） by using the A/N value of lateral radiograph of nasopharyngeal X-ray and EDQ-7 scale scores. Methods:Sixty cases of children with adenoid hypertrophy admitted from February 2019 to August 2021 were all underwent nasopharyngeal X-ray lateral radiographs to determine the adenoid/nasopharyngeal cavity ratio（A/N ratio） and then determine the size of adenoids. The Eustachian tube function ETDQ-7 survey was used to evaluate the patient's self-evaluation of the severity of the disease and ear symptoms, and the degree of influence were scored. Subsequently, the correlation between adenoid hypertrophy with OME and ETDQ-7 scores was statistically analyzed by using the Spearman rank correlation statistical method. Results:In adenoid hypertrophy with OME group, the ETDQ-7 scores of A/N≤0.60, A/N 0.61-0.70 and A/N≥0.71 were 4.15±1.75, 14.55±6.67 and 23.95±6.63, respectively. The higher the grade of adenoid hypertrophy, the higher the ETDQ-7 scores. In adenoid hypertrophy with OME group, the degree of adenoid hypertrophy was positively correlated with the ETDQ-7 scores（P<0.05）. Conclusion:Adenoid hypertrophy is also one of the potential factors causing OME in children.

Perfil clínico e audiológico de pacientes submetidos a timpanostomia e inserção de tubo de ventilação / Clinical and audiological features in patients undergoing tympanostomy tube placement

Introdução: A presença de líquido na orelha médiapode causar perdas auditivas de condução e atrasos no desenvolvimento da criança. A timpanotomia e colocação do tubo de ventilação é o tratamento para casos em que o acúmulo de secreção é persistente. Objetivo: Avaliar o perfil epidemiológico e audiológico dos pacientes submetidos a timpanotomia e colocação do tubo de ventilação. Métodos: Estudo observacional, retrospectivo e transversal baseado em revisão de prontuários. Resultados: Foram incluídos 69 pacientes que realizaram o procedimento. O sexo masculino correspondeu a 64% e a média de idade foi de 8 anos. Otite média secretora foi o diagnóstico predominante. Pelo menos uma comorbidade foi encontrada em 63 pacientes, com predomínio de rinite alérgica. A maioria realizou apenas 1 operação. A bilateralidade da colocação do tubo ocorreu em 57%. Amigdalectomia e/ou adenoidectomia foram frequentemente adicionadas. Hipoacusia, roncopatia, prurido nasal, obstrução nasal e respiração oral noturna foram as queixas predominantes. Em relação à audiometria, 68% evoluíram para limiares normais; já na timpanometria 62% mostraram melhora no timpanograma. Conclusão: No tratamento com colocação de tubo de ventilação bilateral houve melhora pós-operatória na audiometria e timpanometria na maioria dos casos.

Introduction: The presence of fluid in the middle ear can cause conductive hearing loss and developmental delays in children. Tympanotomy and ventilation tube placement is the treatment for cases where secretion accumulation is persistent. Objective: To evaluate the epidemiological and audiological profile of patients submitted to tympanotomy and ventilation tube placement. Methods: Observational, retrospective and cross-sectional study based on medical records. Results: 69 patients who underwent the procedure were included. Males accounted for 64% and the mean age was 8 years. Secretory otitis media was the predominant diagnosis. At least one comorbidity was found in 63 patients, with a predominance of allergic rhinitis. Most performed only 1 operation. Bilateral tube placement occurred in 57%. Tonsillectomy and/or adenoidectomy were frequently added. Hypoacusis, snoring, nasal itching, nasal obstruction and nocturnal oral breathing were the predominant complaints. Regarding audiometry, 68% evolved to normal thresholds; in the tympanometry 62% showed improvement in the tympanogram. Conclusion: In the treatment with placement of a bilateral ventilation tube, there was postoperative improvement in audiometry and tympanometry in most cases.

[Clinical observation of chronic recurrent secretory otitis media in adults treated by balloon dilatation of Eustachian tube combined with myringotomy and catheterization].

Objective:To explore the clinical effect of balloon dilatation of the Eustachian tube combined with myringotomy and catheterization in treating chronic recurrent secretory otitis media in adults. Methods:100 cases（135 ears） of chronic recurrent secretory otitis media in our hospital from January 2018 to May 2020 were selected as the research objects, and were divided into two groups according to the random number table method, 50 cases（68 ears） in the control group and 50 cases（67ears） in the observation group. The control group received tympanostomy and catheterization, while the observation group received tympanostomy with catheterization and balloon dilatation of the Eustachian tube. The total effective rates, Eustachian tube dysfunction scores, Eustachian tube pressure R scores, pure tone thresholds, complication rates, scores of life quality and recurrence rates 1 year after operation were compared between the two groups. Results:The total effective rate was higher in the observation group than the control group（P<0.05）. Compared with pre-operation, the score of Eustachian tube dysfunction, the pure tone listening threshold of each frequency were lower and the Eustachian tube pressure R scores were higher in the two groups at 3 months, 6 months and 12 months after operation（P<0.05）; 3 months, 6 months and 12 months after operation, the scores of Eustachian tube dysfunction, the pure tone listening threshold of each frequency in the observation group were lower than those in the control group（P<0.05）, and Eustachian tube pressure R scores were higher than those in the control group（P<0.05）. Compared with the control group, the incidence of complications and recurrence rate 1 year after operation were lower in the observation group（P<0.05）. Compared with before operation, the scores of life quality in the two groups were higher at 3 months, 6 months and 12 months after operation（P<0.05）; 3 months, 6 months and 12 months after operation, the scores of life quality were higher in the observation group than the control group（P<0.05）. Conclusion:Tympanotomy combined with balloon dilatation of Eustachian tube can effectively improve the Eustachian tube function of adult patients with chronic recurrent secretory otitis media, it has impressiveclinical effects. On the one hand,it can be better to promote the recovery of patients' hearing and improve the clinical cure rate of patients; On the other hand, it reduce the occurrence of complications and disease recurrence greatly, so the quality of the patients' life were improved significantly.

[The bacteriological characteristics and drug resistance of the nasopharyngeal region in 311 cases of adenoid hypertrophy with secretory otitis media].

Objective:To analyze the bacteriological distribution and drug resistance of nasopharynx in patients with adenoid hypertrophy complicated with secretory otitis media, and to clarify the distribution of pathogenic bacteria, so as to provide guidance and basis for antibiotic use in clinical treatment. Methods:A retrospective analysis was performed on 311 patients with adenoid hypertrophy and secretory otitis media who underwent surgical treatment in the department of otolaryngology head and neck surgery, Affiliated Hospital of Qingdao University from February 2013 to January 2020. They were divided into 3 groups by age: Group A（0-5 years old）, Group B（6-10 years old）, and Group C（11-16 years old）. The secretions from deep adenoid near the eustachian tube of the affected ear were collected during the surgery for bacterial culture and drug resistance analysis. Results:One hundred and forty-two strains of pathogenic bacteria were isolated and cultured, with a detection rate of 45.66%. Staphylococcus aureus （63 strains）, streptococcus pneumoniae （15 strains） ,streptococcus pyogenes （13 strains） and moraxella cachinella（28 strains）was the main strain.Staphylococcus aureus had high drug resistance rate to penicillin, erythromycin and clindamycin.Streptococcus pneumoniae and Streptococcus pyogenic had high resistance rates to erythromycin,clindamycin and tetracycline. The resistance rate of Moraxella catarrhalis to ampicillin and co-trimoxazole was higher. Conclusion:The main pathogens detected in patients with adenoid hypertrophy complicated with secretory otitis media are staphylococcus aureus, streptococcus pneumoniae, streptococcus pyogenes and moraxella catarrhalis. Drug resistance of different pathogens is quite different. So it is recommended to carry out extensive bacteriological detection, and select antibiotics according to the principle of rational drug use and the results of drug resistance test, so as to achieve good therapeutic effect.

[Animal model analysis of secretory otitis media based on characteristics of clinical symptoms of traditional Chinese and Western medicine].

Based on the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,by reference to clinical diagnostic criteria,efforts were made to analyze and establish the Western medical diagnostic criteria and traditional Chinese medicine( TCM) syndrome differentiation criteria for secretory otitis media,and summarize the modeling methods and model characteristics of secretory otitis media animal models. According to the clinical diagnostic criteria and symptom characteristics,the coincidence degree between the existing animal models and clinical symptoms was evaluated,and its advantages and disadvantages were defined. On the basis of the statistical results,there were fewer methods for modeling secretory otitis media animal models,and only a specific relevant pathogenic mechanism could be revealed. Among them,the model with a higher coincidence degree was genetic engineering technology modeling and injection into the middle ear vesicles. The two modeling methods of bacterial factors highly coincided with the clinical symptoms of Western medicine,but both failed to reflect the TCM syndrome type. Therefore,establishing an animal model that simultaneously reflects the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,and improving the evaluation criteria of secretory otitis media based on animal models are the main tasks of future studies on secretory otitis media.

The Prevalence of Adenoid Hypertrophy among Children with Zika Related Microcephaly.

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.

Inflammatory Mediator Profiles in Secretory Otitis Media in Relationship to Viable Bacterial Pathogens and Bacterial and Viral Nucleic Acids.

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-ß (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-1ß, 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.

Effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors.

To explore the effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors, a total of 50 chronic secretory otitis media patients in the control group were subjected to caefaclor capsule, while the total of 50 cases in the observation group were treated with Qing Qiao Capsule. The traditional Chinese medicine (TCM) syndrome scores, therapeutic effects, and the levels of inflammatory factors were evaluated. After treatment, the scores of deafness, hearing loss, dizziness, soreness and weakness of the waist and knees, and fever is hens in palms and soles were significantly decreased in both groups (all P value <0.05). However, each score in the observation group was markedly less than that of the control group (all P value <0.05). Moreover, the C-reactive protein (CRP), procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) levels measured after treatment were significantly lowered than those before treatment (all P value <0.05). Also, the levels of CRP, PCT and TNF-α in the observation group were obviously less than that of the control group (all P value <0.05). And the total therapeutic efficacy of the observation group was significantly higher than that of the control group (P<0.05). But no significant difference was observed in the rates of adverse reactions between both groups (P>0.05). Application of Qing Qiao Capsule in the treatment of chronic secretory otitis media yields better results, lowers TCM syndrome scores, and alleviates the body's inflammatory response, which is a safe drug in clinical use.

Hydrogen-oxygen therapy can alleviate radiotherapy-induced hearing loss in patients with nasopharyngeal cancer.

Three patients with nasopharyngeal carcinoma developed binaural secretory otitis media 12, 2, and 0.5 years after radiotherapy, respectively. The secretions subsided after conventional drug and drainage treatments, but hearing continued to deteriorate until severe loss was documented in both ears. After examination of the eardrum and tympanum, patients were enrolled in a clinical trial in the first half of 2019 (ClinicalTrials.gov: NCT03818347). After 0.5, 1 and 2 months of continuous hydrogen-oxygen therapy, our first three patients reported different levels of improvement in binaural hearing. This is the first report to show that, after treatment for nasopharyngeal carcinoma, hearing loss can be alleviated using hydrogen-oxygen therapy.

Balloon dilation of Eustachian tube combined with tympanostomy tube insertion and middle ear pressure equalization therapy for recurrent secretory otitis media.

Objective to report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results The mean ETS score was 2.34 ±â€¯0.97 preoperatively, and 6.17 ±â€¯1.54, 7.23 ±â€¯1.62, 8.24 ±â€¯1.97, and 7.63 ±â€¯1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ±â€¯1.07 preoperatively, and 2.20 ±â€¯0.54, 2.32 ±â€¯0.68, 2.53 ±â€¯0.79, and 2.67 ±â€¯0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.

Effect of balloon dilation eustachian tuboplasty combined with tympanic tube insertion in the treatment of chronic recurrent secretory otitis media.

PURPOSE: To investigate the long-term clinical effect of balloon dilation eustachian tuboplasty (BET) combined with tympanic tube insertion (TTI) in the treatment of chronic recurrent secretory otitis media (CRSOM). MATERIALS AND METHODS: A retrospective study of 30 cases of CRSOM treated with BET combined with TTI under general anesthesia between August 2014 and September 2016. Thirty cases of CRSOM treated with TTI in the same period were taken as the control group. All cases were followed over 24 months. The scores of eustachian tube (ET) function preoperation, 1 month, 6 months, 12 months, and 24 months postoperation were collected and analyzed, respectively. A satisfaction questionnaire was used to evaluate the therapy at 24-months postoperation. RESULTS: The symptoms were significantly improved and the ET score was obviously increased postsurgery in most cases treated with BET plus TTI compared with those treated with TTI alone. The highest ET score was obtained at 6 months post BET. Five (14%) cases (6 ears) of CRSOM recurred. The 24-month postoperation follow-up questionnaire showed that 84.6% of the patients were satisfied with the treatment, while ten cases (25%) in the TTI group recurred. CONCLUSION: BET combined with TTI surgery is an effective therapy for patients with CRSOM.