Tympanoplasty can be Concurrent with Adenoidectomy. Tube Factor Assessment.

To assess changes in middle ear pressures following adenotonsillectomies in children, and to evaluate the possibility of performing tympanoplasty at the same surgical time. Prospective study in which tube function was assessed using tympanometry on the first postoperative day and on the seventh postoperative day after adenotonsillectomies. A total of 39 children aged 6.8 ± 2.6 years were evaluated. On the first postoperative day, 79.5% presented with changes in middle ear pressure. On the seventh postoperative day, only 12.8% maintained this change. Tube dysfunction following adenotonsillectomy is transient and would not preclude an associated tympanoplasty from being performed, thereby reducing costs and risks related to the surgical procedure.

Audiological Profile in Adenoid Hypertrophy.

Aim: The study aims to investigate the correlation between grade of adenoid hypertrophy and severity of hearing loss and to profile tympanometric findings in children with Adenoid Hypertrophy. Materials and methods: A within group comparison study was carried out in Father Muller College, Department of Speech and Hearing, Mangalore where 123 patients diagnosed with Adenoid Hypertrophy (86 males and 37 females; mean age 7.146; range 2 to 12 years) were analyzed using detailed case history, Pure tone audiometry (PTA) and Tympanometry. Results: The most prevalent presenting problems with adenoid hypertrophy were snoring (68.29%), mouth breathing (57.72%) and reduced hearing (35.77%). PTA results showed majority had bilateral hearing loss (60.27%). In the 230 ears that were tested, 50.85% had hearing loss. Majority of these ears had a minimal loss (23.91%), followed by mild loss (18.69%), moderate loss (7.82%), and moderately severe loss (0.43%). No correlation was found between the grade of Adenoid hypertrophy and the severity of hearing loss noted (p > 0.05). According to tympanometric findings, the most common tympanogram pattern was 'B' type (39.15%), 'A' type (31.60%), and 'C' type (18.39%). A small proportion of the population had 'As' (4.71%), 'Cs' (5.66%), and 'Ad' (0.47%). No correlation was found between the grade of adenoid hypertrophy and the type of tympanogram obtained (p > 0.05). Conclusion: In a significant percentage of cases, Adenoid hypertrophy affects the middle ear leading to conductive hearing loss. If left untreated it can lead to delayed speech and language development, auditory processing disorders, mental retardation, and physical and social complications. These are avoidable through primary health care education, accurate diagnosis, and effective treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04714-8.

Long-Term Preclinical Evaluation of a Permanent Stent Developed for the Human Eustachian Tube.

The Eustachian tube (ET) is a bottleneck when it comes to middle ear (ME) health. If its function is impaired, this can lead to serious consequences for the patient, such as hearing problems or deafness. Therefore, this study investigated a tapered nitinol stent (3-5 mm × 14 mm) for the human ET as a potential new permanent treatment for chronic Eustachian tube dysfunction (ETD) and thus ME ventilation disorders. The self-expanding stent was inserted unilaterally into the ET of 24 sheep with observation periods of 3, 6, and 12 months. Local tissue effects and the safety of the stent insertion were analyzed based on regular endoscopic checks, weekly tympanometry measurements, final imaging, and histological examinations. The animals showed no stent-related health restrictions. However, the individual anatomy and stenting procedure had an influence on the results. The tissue reaction in the endoscopic examinations was mild even though no concomitant antibiotics were administered. After all three monitoring periods, stented ETs had a significantly larger ET lumen than the non-stented contralateral ETs. However, tissue growth was detected in the stent. Overall, the first long-term study on an ET stent showed that the tapered ET stent could be a promising treatment option for ETD.

Correlation of the Size of Adenoids With Impedance Audiometry Findings.

Introduction Adenoid tissue is part of the first line of immunity of the upper aero-digestive tract. It is located in the postero-superior wall of the nasopharynx behind the choana. Adenoid hypertrophy, a common childhood disorder, significantly contributes to the pathogenesis of otitis media with effusion (OME), which is the leading cause of hearing impairment in young children. This condition can result in delayed speech, poor academic performance, and language development issues. Assessing the size of the adenoids and their correlation with OME is crucial, as undiagnosed cases can lead to complications such as atelectasis of the tympanic membrane and cholesteatoma. Clinical examination of the nose alone is often insufficient, and children do not cooperate for nasal endoscopy. Therefore, a lateral radiograph of the skull is considered the most reliable method for assessing the adenoid size. The size of the adenoids can affect Eustachian tube patency, which is reflected in the results of impedance audiometry. This study aimed to correlate the size of adenoids with impedance audiometry findings. Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology of a tertiary care hospital from October 1, 2022, to March 31, 2024. A sample size of 50 patients was taken for the study. The inclusion criterion of selection of the patients included patients aged 3 to 15 years, who suffered from recurrent attacks of upper respiratory tract infections, particularly those with adenoid facies confirmed by X-ray with a non-perforated tympanic membrane. Exclusion criteria encompassed patients below 3 or above 15 years, and those with acute or chronic suppurative otitis media, craniofacial anomalies, or nasal pathologies like polyps. Adenoids were graded using X-ray imaging of the nasopharynx, and correlations between the adenoid size and impedance audiometry findings, such as middle ear pressure and compliance, were analyzed.  Results The study assessed the relationship between the adenoid size and impedance audiometry findings, focusing on middle ear pressure and compliance, as well as the occurrence of OME. The results indicated a significant decline in middle ear pressure with increasing adenoid grades. Specifically, adenoid grade 1 had an average pressure of -3.50 daPa, while grade 4 had the lowest average pressure at -119.72 daPa. This trend was statistically significant with a p-value of 0.00042. Similarly, compliance values also decreased with higher adenoid grades. Grade 1 had an average compliance of 0.64 ml, whereas grade 4 had the lowest average compliance at 0.28 ml. This relationship was statistically significant, as indicated by a p-value of 0.0048. Additionally, the analysis showed that a significant majority of patients with enlarged adenoids also presented with OME, highlighting a strong association between adenoid hypertrophy and this condition. Conclusion The study concluded that larger adenoids were associated with lower middle ear pressure and reduced compliance. Additionally, a significant majority of patients with enlarged adenoids also had OME. This underscores the importance of evaluating adenoid hypertrophy in the context of OME due to its potential impact on childhood hearing and development.

Contribution of Treatment with Ear Popper for Hearing in Children with Middle Ear Effusion.

OBJECTIVES: we aim to assess the contribution of the EarPopper device to hearing in children with middle ear effusion (MEE). METHODS: The study has three parts, including 1. tympanometry and audiometry before and six weeks after using the EarPopper to evaluate the treatment's effect over time compared to a control group; 2. tympanometry before and immediately after using the EarPopper to evaluate immediate changes in middle ear pressure (MEP); 3. length of effect 90 min after use to assess pressure fluctuations over time. RESULTS: Part 1 was a follow-up six weeks after using the device, and the patients in the study group that completed the study showed a significant improvement in hearing threshold. The average gain in hearing threshold ranged from 9.1 dB to 14 dB compared to the control group's max improvement of 1.1 dB. In addition, MEP was significantly improved in the study group, as most Type Bs improved to Type A and C. Part 2 was the tympanometry immediately after using EarPopper and showed the majority of Type Cs turned into Type As. The majority of Type Bs remained unchanged. Part 3 was a follow-up 90 min after use; Type Cs that had improved to Type A demonstrated a decrease in pressure and return to negative pressure. CONCLUSIONS: use of the EarPopper device for six weeks is associated with an improved hearing threshold and middle ear status.

Disrupted harmony of the skull skeleton: Middle ear resonance in acromegaly.

OBJECTIVES: This study aims to investigate whether the middle ear resonance frequency (RF) is affected in acromegaly, which causes growth in the skull bone. METHODS: Thirty acromegaly patients and 38 volunteers were included in the study. Pure tone average scores and middle ear RF values of the groups that underwent pure tone audiometry, tympanometry, and multifrequency tympanometry tests were compared. RESULTS: The pure tone mean was 14.95 ± 12.13 in acromegaly patients and 5.70 ± 8.52 in the control group (p:0.18). Sensorineural hearing loss(SNHL) was observed in 16.6% of the patients. The average middle ear RF was calculated as 815 ± 179.05 Hz in patients with acromegaly and 773 ± 127.15 in the control group. (p = 0.0001). CONCLUSION: This study is the first to evaluate middle-ear RF in acromegaly patients. Acromegaly-induced changes in soft tissues and bone structures impact middle ear functions. In this patient group, we found an increase in middle ear RF without conductive-type hearing loss and a 16.6% rate of SNHL.

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis.

Eustachian tube dysfunction (ETD) affects a significant portion of the population, manifesting symptoms that impact the quality of life. Despite the prevalence of ETD, there remains a notable gap in comprehensive studies exploring the condition's dynamics within specific demographic contexts, particularly within Saudi Arabia. This study aimed to assess the prevalence and severity of ETD across different demographic groups, to evaluate the efficacy of various treatment modalities, and to identify key predictors of treatment response in a Saudi Arabian cohort. A cross-sectional study was conducted from June 2022 to May 2023 in tertiary care hospitals in the Aseer region, Saudi Arabia. Participants included adults diagnosed with ETD, assessed through clinical symptoms, otoscopic examinations, audiometric evaluations, tympanometry, and the ETDQ-7 questionnaire. The study incorporated advanced diagnostics such as nasopharyngoscopy and pressure equalization tube function tests and involved 154 participants, revealing significant variations in ETD severity, with the 46-60 age group exhibiting the highest mean ETDQ-7 score of 4.85, and urban residents displaying lower severity scores compared to rural counterparts. Pharmacological interventions were most effective, achieving the highest symptom relief and audiological improvement rates of 87.78%. Multivariate regression highlighted age, geographic location, and treatment modality as key predictors of treatment efficacy, with notable interaction effects between climate conditions and treatment types influencing outcomes. The findings underscore the heterogeneity in ETD presentation and the differential efficacy of treatment modalities.

Effect of prosthetic management and its timing on otological and audiological outcomes in infants with cleft lip and palate: A clinical trial.

PURPOSE: To evaluate how prosthetic management affects the otological and audiological state of infants with cleft lip and palate by preventing or treating otitis media (OM). MATERIALS AND METHODS: Thirty infants with cleft lip and palate (L/P) were assigned to three equal groups according to the age of prosthetic intervention; Group I: immediately after birth, Group II: 2 months old, Group III: 5 months old. Assessment of middle ear function by tympanometry and hearing quality by auditory brainstem response (ABR) under natural sleep was conducted before and after prosthetic treatment every month till 10 months of age. Data from the study groups were compared. RESULTS: No statistically significant differences were found between Gp I and Gp II in the 2nd, 3rd, and 4th months for right and left ears (p > 0.05). In the 5th month, statistically significant differences between the three groups were found in tympanometry for right (p = 0.011) and left (p = 0.024) ears also, in ABR for right (p = 0.007) and left (p = 0.011) ears. Tympanometric readings starting from the 6th till the 10th month showed no statistically significant differences between the three groups (p >0.05). The final ABR outcomes of the 10th month indicated statistically significant differences between the three groups for both ears (p = 0.027). CONCLUSIONS: Early prosthetic care could delay the development of OM, so it could potentially improve the otological and audiological state in infants with cleft L/P. However, prosthetic treatment may not be able to completely prevent or eliminate middle ear disorders.

Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere's Disease? A Systematic Review and Meta-Analysis.

(1) Background: Ménière's disease (MD) is a disease of the inner ear, presenting with episodes of vertigo, hearing loss, and tinnitus.The aim of this study is to examine the role of multifrequency tympanometry (MFT) in the diagnosis of MD. (2) Methods: A systematic review of MEDLINE (via PubMed), Scopus, Google Scholar, and the Cochrane Library was performed, aligned with the PRISMA guidelines. Only studies that directly compare ears affected by Ménière's disease with unaffected or control ears were included. Random-effects model meta-analyses were performed. (3) Results: Seven prospective case-control studies reported a total of 899 ears, 282 of which were affected by Ménière's disease (affected ears-AE), 197 unaffected ears in patients with MD (UE), and 420 control ears (CE) in healthy controls. No statistically significant differences between the groups were observed regarding resonant frequency (RF). The pure tone audiometry average of the lower frequencies (PTA basic) was significantly greater in affected ears when compared with unaffected ears. The conductance tympanogram at 2 kHz revealed a statistically significantly greater G width of 2 kHz in the affected ears when compared to both unaffected and control ears, while control ears had a statistically significant lesser G width of 2 kHz compared to both the other two groups. (4) Conclusions: MFT, and specifically G width at 2 kHz, could be an important tool in the diagnosis of MD.

Comparison of Video Nasopharyngoscopy and Tympanometry in Suspected Eustachian Tube Dysfunction - A Prospective Study.

Objective Tympanometry is widely used for diagnosing Eustachian tube dysfunction (ETD). However, in clinical practice, it is not uncommon to come across patients with symptoms of ETD with a normal tympanogram. Dynamic slow motion video endoscopy (DSMVE) of Eustachian tube (ET) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) are other tools to diagnose ETD. Primary aim of the study was to compare DSMVE and tympanometry in diagnosing ETD. Secondary objective was to find an association between DSMVE and ETDQ-7. It was a prospective diagnostic validity study in the department of Otorhinolaryngology at a tertiary care centre. Patients with symptoms suggestive of ETD with intact tympanic membrane (TM) and aged above 12 years were evaluated. The study duration was 17 months. The parameters assessed were tympanic membrane(TM) retraction by otoscopy, DSMVE, tympanometry and ETDQ-7 questionnaire. To test the significance of association and difference between tympanogram and nasopharyngoscopy, Chi-Square t test and McNemar's tests were applied. Out of 107 ears, DSMVE, tympanometry, ETDQ- 7 and otoscopy detected ETD in 51, 31,70 and 57 ears respectively. DSMVE and tympanometry together detected ETD in 29 ears and did not detect in 54 ears. Both these diagnostic methods were not comparable statistically (moderate agreement- Kappa value- 0.542). Comparison of DSMVE with ETDQ-7 was statistically significant (p-value- 0.004). Video nasopharyngoscopy cannot be a stand- alone diagnostic aid for ETD. ETDQ-7 questionnaire showed higher concordance with nasopharyngoscopy than tympanometry. Diagnostic accuracy was more when all four parameters were assessed together.

Eustachian tube dysfunction after using different types of masks during the coronavirus disease 2019 pandemic.

OBJECTIVE: This study aimed to investigate the relationship between the use of different types of masks (N95/filtering facepiece type 2, surgical) and Eustachian tube dysfunction in healthcare workers. METHODS: The study included 37 healthcare workers using N95/filtering facepiece type 2 masks and 35 using surgical masks for at least 6 hours per day, and 42 volunteers who are not healthcare workers using surgical masks for less than 6 hours per day. Participants' demographic features, clinical data and Eustachian Tube Dysfunction Questionnaire scores were compared. RESULTS: The frequencies of autophony and aural fullness were significantly higher in the healthcare workers using N95/filtering facepiece type 2 masks. Autophony and aural fullness were significantly greater in the post-mask period than the pre-mask period. Middle-ear peak pressures and Eustachian Tube Dysfunction Questionnaire scores were higher in healthcare workers who used N95/filtering facepiece type 2 masks. CONCLUSION: Healthcare workers who used N95/filtering facepiece type 2 masks had worsened middle-ear pressures and Eustachian Tube Dysfunction Questionnaire scores. Use of N95/filtering facepiece type 2 masks was associated with higher rates of autophony, aural fullness and higher Eustachian Tube Dysfunction Questionnaire scores in the post-mask period.

Different techniques of adenoidectomy and its impact on middle ear pressure: a randomized controlled study.

OBJECTIVES: The aim of this work is to compare between different techniques of adenoidectomy: endoscopic microdebrider-assisted, coblation and conventional adenoidectomy and its effect on middle ear pressure. BACKGROUND: Adenoidectomy, either alone or with tonsillectomy, is considered among the most performed procedures in pediatric otorhinolaryngology. This procedure usually related to the Eustachian tube function and middle ear status. Eustachian tube dysfunction is mainly caused by mechanical obstruction of the tubal orifice, insufficient swallowing and inflammation in the nasopharyngeal mucosa. METHODS: This prospective randomized study was conducted on 90 patients with symptomatic adenoid hypertrophy confirmed by nasopharyngeal X-ray and endoscopic grading preoperatively. Patients were admitted at Otorhinolaryngology department of our institute during the period from January 2022 to January 2023. They were divided into three groups that were operated either by conventional (Group I), endoscopic microdebrider (Group II), or coblation technique (Group III). Each group was assessed through the audiometric parameters plus postoperative bleeding, and VAS results for pain score and postoperative endoscopic grading for adenoid recurrence. RESULTS: Mean age in group A was 9.03 years and in group B was 8.99 years and was 8.99 years in group C with insignificant differences between three groups. There is significant improvement of tympanographic results comparing all groups of the patients at 6 months postoperatively. There is significant relation between the mean VAS comparing preoperative and postoperative results. CONCLUSION: There are better results in tympanographic data at conventional adenoidectomy versus other techniques. However, there are also better postoperative results after either coblation or endoscopic microdebrider adenoidectomy over the conventional technique.

Is Topical Nasal Steroid Useful for Treatment of Otitis Media with Effusion in Children?

BACKGROUND: Otitis media with effusion is a common and important pediatric clinical problem; it is the leading cause of hearing impairment in children. Medical treatment remains controversial. AIM: To evaluate the usefulness of using topical nasal steroids in the treatment of otitis media with effusion. PATIENTS AND METHODS: Between November 2019 and October 2022, a prospective controlled clinical study was carried out in the department of otolaryngology at Al-Jerrahat Teaching Hospital in Medical City, Baghdad, Iraq. This study comprised 40 patients with bilateral otitis media with effusion (23 males, 17 females). Two groups were created for the patients. Patients in group A (20 patients) were treated with mometasone furoate nasal spray; 1 puff (50 µg) in each nostril daily for 2 weeks, while the 20 patients in group B were treated with saline nasal spray; 1 puff in each nostril daily for 2 weeks. At the end of the first and second weeks of treatment, otoscopic examination was used to monitor the patients. At the end of the second post-treatment week, pure tone audiometry and tympanometry were performed again. Normal otoscopic results, a type A tympanogram, and enhanced pure tone hearing threshold average to be ≤20 dB HL within 0, 5, 1, and 4 KHz were used to characterize resolution of OME. The association between two means was determined using an independent sample t-test, while the association between categorical variables was determined using an X2-test. RESULTS: At the end of 2nd post-treatment week, there was no significant difference regarding improvement of otitis media with effusion regarding otoscopic, audiometric, and tympanometric results in both groups (P-value >0.05). CONCLUSION: Topical nasal steroid is unuseful for the treatment of otitis media with effusion in the short-term.

The Impact of Inferior Turbinate Reduction on Middle Ear Function in Adults With Nasal Obstruction.

Objective This study aims to evaluate the effect of inferior turbinate reduction on middle ear compliance and pressure. Methods A prospective observational study was conducted on 100 patients between 20 and 60 years of age with bilateral nasal obstruction due to inferior turbinate hypertrophy and a normal-looking external and middle ear. The Wilcoxon signed-rank test with a 95% confidence interval was used to compare the middle ear peak compliance and pressure on tympanometry before and one month after the inferior turbinate reduction surgery. Results The mean age was 28.44 ± 8.23 years, with a male/female ratio of 7:3. After surgery, patients with normal compliance increased by 8%, high compliance decreased by 12%, and low compliance increased by 4% in the right ear. High compliance decreased by 2%, normal compliance decreased by 10%, and low compliance increased by 12% in the left ear. Positive tympanometric peak pressure (TPP) increased by 37% and 43% in the right and left ears, respectively. Conclusion After turbinate reduction surgery, the overall tympanometric peak pressure and compliance improved. However, we did not see an obvious improvement in low middle ear compliance. Thus, turbinate reduction surgery might benefit patients with inferior turbinate hypertrophy and associated poor middle ear ventilation.

High Frequency Tympanometry in Early Infancy and Its Effect on Oto Acoustic Emissions.

The present study was conducted to study the benefit of high frequency tympanometry (HFT) in detecting middle ear pathologies in infants. This study also aims to find the effect of middle ear diseases on absent otoacoustic emissions (OAE). Our study was a prospective study which included 123 healthy neonates below 1 month of age. The babies were referred for the new born hearing screening programme. They were subjected to DPOAE followed by tympanometry with a 1000z probe tone (HFT). The study was approved by the institutions ethical committee. "Present" OAE result was obtained for 202 ears, while "absent" OAE result was obtained for 44 ears. High frequency tympanometry was also performed on all the participants, where a normal tympanogram was obtained in 170 ears and 76 ears showed an abnormal tympanogram. The following parameters were studied: peak pressure, ear canal volume and compliance. Descriptive statistics were obtained for the same. Association of OAE with HFT was studied. Out of the 44 ears with refer OAE, 34 ears had an abnormal tympanogram and among 202 ears with a present OAE, 160 ears had a normal tympanometric peak indicating a sensitivity and specificity of 77.3% and 79.2% respectively. High frequency tympanometry not only helps in early detection of middle ear pathologies but also to find the effect of middle ear diseases on absent otoacoustic emissions.

[Clinical protocol: audiological assessment of infants in Russian Federation. Part I]. / Protokol audiologicheskogo obsledovaniya detei pervogo goda zhizni v Rossiiskoi Federatsii. Chast' I.

The clinical protocol of audiological assessment in infants was prepared by the workgroup of Russian pediatric audiologists from different regions. The goal of the protocol is unification approaches to audiological diagnosis of the infants. The protocol has been developed according the evidence based medicine principles, by reviewing current scientific publications on the topic and taking into account the order of providing medical services and other clinical practice guidelines. When direct evidence was not available, both indirect evidence and consensus practice were considered in making recommendations. This guideline is not intended to serve as a standard to dictate precisely how the child should be diagnosed. This guideline is meant to provide the evidence base from which the clinician can make individualized decisions for each patient. The first part of the protocol covers following sections: equipment, staff requirements, timing of the diagnostics, case history and risk factors, preparing the child for the appointment, sedation and general anesthesia, otoscopy, tympanometry and acoustic reflex, otoacoustic emissions, skin preparing, electrode montage, choosing the stimulators, auditory brainstem responses on broadband and narrow-band stimuli, on bone conducted stimuli, auditory steady-state responses, masking, combined correction factors.

Correlation of Conductive Hearing Impairment With Sizes of Adenoids in the Pediatric Age Group: An Observational Case-Control Study.

INTRODUCTION: When adenoids enlarge and elicit symptoms it is referred to as symptomatic adenoids, which is a preventable cause of hearing loss and nasal obstruction in the pediatric age group. This study was done to correlate conductive hearing loss with the size of adenoids and to emphasize the importance of screening in the pediatric age group. METHODS: An observational case-control study was conducted to analyze the degree of hearing impairment in children with adenoid hypertrophy. In total, 98 patients with at least one symptom of adenoid hypertrophy aged between 5 and <15 years were recruited. Those with conductive hearing loss were in the case group and those with normal hearing were in the control group. Audiometry, tympanogram, X-ray, and fibreoptic nasal endoscopy were conducted and compared. RESULTS: The mean age of presentation of conductive hearing loss with adenoids was 7.67 years. The mean conductive hearing loss on audiometry was 31.69 dB. Tympanogram showed a type B curve in 40.81% of ears and type C in 26.53%. On X-ray nasopharynx, the majority of cases had grade III hypertrophy followed by grade II and grade IV. In nasal endoscopy, most cases had second-degree adenoid hypertrophy followed by third degree, first degree, and then fourth degree. The highest degree of hearing loss of 32-48 dB was present with fourth-degree adenoids. Conductive hearing loss was five times more in patients with third- and fourth-degree adenoids. CONCLUSIONS: In our study, adenoid hypertrophy has a positive correlation with conductive hearing loss in pediatric patients. So proper screening and early management should be done to prevent hearing loss in children.

Tympanometric findings among adult HIV patients undergoing a short-term treatment with high active antiretroviral therapy (HAART) in port harcourt.

Background: In our practice as ENT specialists, people living with Human immunodeficiency Virus/acquired immunodeficiency syndrome (HIV/AIDS) have presented at the clinics with symptoms suggestive of otitis media with effusion such as the sensation of fluid in the ear, aural fullness and hearing loss. Eustachian tube dysfunction which is often the beginning of middle ear pathology could be caused by nasal allergy, upper respiratory tract infection, or obstruction by a nasal pharyngeal lesion such as lymphoid hyperplasia which is a common feature in people living with HIV/AIDS. Tympanometric findings give a measure of the objective assessment of middle ear function. Aim and Objective: This study was designed to determine tympanometric findings among adult patients undergoing short-term treatment with HAART in Port Harcourt. Patients and Methods: A hospital-based study involving 150 HIV-positive patients that received the same HAART treatment over 6 months and a control group of 150 HIV-negative individuals in Port Harcourt. The data extracted includes; the patient's ear symptoms, otoscopic findings, and tympanogram. Data were analyzed using SPSS version 20 and statistical significance was set at P > 0.05. Results: There was a high proportion of type B-Typanogram at baseline (Rt ear 24[16.0%], left ear 23 [15.3%]) and at repeat (Rt ear 23 (15.3%), Lt ear 21 (14%) evaluations. Also, there was a relatively high proportion of type C- tympanogram at baseline {right ear 18 (12%), left ear 15 (10%)} and at repeat Rt ear 14 (9.3%), Lt ear 10 (6.7%)} evaluations. Conclusion: One out of every eight patients living with HIV infection may likely have Eustachian tube dysfunction while one out of every five may have developed otitis media with effusion already. There was no significant change in tympanometric findings after treatment with HAART.

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.

Prevalence Rate of Hearing Loss in Patients with Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is a common chronic inflammatory disorder that can be associated with some hearing impairments. Hence, we aimed to evaluate the prevalence rate of hearing loss (HL) in RA patients. Materials and Methods: This study included 130 participants from February 2019 to March 2020 including 100 RA patients (78 females and 22 males) as RA group and 30 healthy cases (16 females and 14 males) as control group. All patients underwent pure tone audiometry, speech audiometry, tympanometry, acoustic reflex, and tone decay test by single operator and device. The rate of HL and contributing factors were then determined. Results: The mean age of RA group was 53.95 ± 7.6 years, and the mean duration of disease was 12.74 years. Rheumatoid factor was positive in 54% of patients, and the frequency rates of diabetes, chronic kidney disease, hypertension, and dyslipidemia among RA patients were 14%, 1%, 26%, and 19%, respectively. These values among RA patients with HL were 18%, 1.7%, 34%, and 27.5%, respectively. HL in RA patients was related to dyslipidemia (P = 0.011) and age (P = 0.0001). Frequency rate of conductive HL in left and right ears was 2% and 5%, respectively, and these rates for sensorineural hearing loss (SNHL) were 55% and 61%, respectively. In addition, the percent of HL in low, mid, and high frequency ranges was 18%, 19%, and 57%, respectively. Conclusions: The findings of the present research demonstrate that HL especially with SNHL and high-frequency types is common among RA patients.