Audiometric evaluation in different clinical presentations of otitis media.

OBJECTIVES: To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. METHODS: Cross sectional, controlled study. We performed conventional audiometry (500-8000Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. RESULTS: Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n=31; suppurative COM, n=18; cholesteatomatous COM, n=23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). CONCLUSION: All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p<0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.

Audiometric evaluation in different clinical presentations of otitis media

Abstract Objectives To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. Methods Cross sectional, controlled study. We performed conventional audiometry (500-8000 Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. Results Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n = 31; suppurative COM, n = 18; cholesteatomatous COM, n = 23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000 Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). Conclusion All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p < 0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.

Extended high-frequency hearing loss following the first episode of otitis media.

OBJECTIVES/HYPOTHESIS: Otitis media has been associated with several auditory and developmental sequelae. Here, the results of auditory tests were evaluated in patients who had a first episode of unilateral otitis media and compared with the contralateral healthy ear. STUDY DESIGN: Cohort study. METHODS: This study was undertaken from 2015 to 2016, with a follow-up period of 6 months. RESULTS: A total of 41 patients who had been diagnosed with unilateral acute otitis media were selected. Standard (250 Hz-8 kHz) and extended high-frequency (8 kHz-16 kHz) audiometry was performed within 5 days of the beginning of the clinical symptoms, and then in defined time frames for a period of 6 months. The results of the contralateral healthy ears were used as individual controls. After closure of the initial air-bone gap, the results of the standard audiometry did not demonstrate significant differences in the thresholds of diseased ears compared with controls. A significant elevation of the mean extended high-frequency thresholds in the ears affected by otitis media was observed at the first and subsequent appointments within the 6-month follow-up period. Diseased ears from patients who experienced tinnitus during the 6-month follow-up period had significantly higher thresholds in the extended high frequencies than diseased ears from patients without residual tinnitus. CONCLUSIONS: These results suggest that the first episode of otitis media may lead to persistent elevation of the mean thresholds of extended high-frequencies, whereas persistent tinnitus after 6 months of the acute infection is associated with more severe hearing loss. LEVEL OF EVIDENCE: 2b Laryngoscope, 128:2879-2884, 2018.

Perfil da situação sistêmica do paciente pré-exodontia em postos de saúde de Curitiba / Systemic health profile of the patient before tooth extraction in primary care units in Curitiba

Introdução: Os avanços tecnológicos na área da saúde resultaram em aumento na longevidade da populaçãoocasionando um incremento de pacientes com doenças crônicas no consultório odontológico.Doenças que mal eram contempladas na ficha clínica odontológica, hoje passam a representar importantepapel na tomada de decisões quanto ao diagnóstico, prognóstico e tratamento odontológico. Muitas dessasdoenças sistêmicas crônicas podem comprometer o sucesso do tratamento e devem ser descobertasdurante a anamnese. Objetivo: Traçar um perfil epidemiológico clínico quantitativo e qualitativo das doençassistêmicas em pacientes submetidos a exodontias. Material e Métodos: 722 pacientes que realizaramexodontias eletivas em unidades básicas de saúde no Distrito Sanitário do Portão em Curitiba foraminvestigados quanto ao estado de saúde sistêmico, por meio de questionário confirmado pela pesquisa emprontuários médicos e, se necessário, nova entrevista. Resultados: Na população de 722 pacientes observou-se que a idade média foi de 36 anos, com predominância do sexo feminino, etnia branca, estado civilcasado e com primeiro grau. Quanto às profissões, os trabalhadores de serviços diversos e do lar foram os predominantes. A maioria negou tabagismo ou etilismo. Por fim, 32,7 % dos pacientes que se submeterama exodontias apresentavam uma ou mais doenças sistêmicas crônicas, sendo a hipertensão arterial sistêmicaa mais comum, seguida por alergias, diabete melito e outras cardiopatias. Conclusão: Considerandoque, aproximadamente, um terço dos pacientes avaliados tinham alguma comorbidade, observou-se quea avaliação sistêmica pré-operatória não afasta a possibilidade da ocorrência de complicações, mas, semdúvida, atua preventivamente, principalmente no que se refere à possibilidade de emergências.

Introduction: The technological improvement of the health care has led to an increase of population longevity,causing a rise in the number of patients with chronic diseases in the dental clinics. Illnesses that were barely contemplatedon the dental records in the past are now fundamental to the decision making about diagnosis, prognosis andtreatment. Many of these chronic systemic diseases may compromise the dental treatment and must be identifiedduring the clinical interview. Objective: To make a quantitative and qualitative clinical epidemiological profile ofthe systemic diseases of patients submitted to teeth extraction. Materials and methods: 722 patients submittedto routine teeth extraction in primary care units at the Portão Sanitary District in Curitiba were interviewed abouttheir health situation and the data were confirmed through research in the medical files and a new interview whenneeded. Results: In the population of 722 patients it was found that the average age was 36 years, gender predominantlyfemale, white ethnicity, marital status married with elementary school level. As for occupations, serviceworkers and domestic workers were predominant. Most denied smoking or drinking. Finally, 32.7% of patients whounderwent dental extractions, had one or more chronic systemic diseases, hypertension being the most common, followed by allergies, diabetes and other heart diseases. Conclusion: Considering that approximately one-third of thepatients had some comorbidity, we found that preoperative systemic evaluation does not rule out the possibility ofthe occurrence of complications, but it certainly prevent them, mainly with regard to emergencies.