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1.
Artigo em Chinês | MEDLINE | ID: mdl-38973037

RESUMO

Objective:To analyze the surgical efficacy and safety of tympanoplasty with and without mastoidectomy for the treatment of active simple chronic suppurative otitis media(CSOM), and to investigate whether mastoidectomy can be avoided in tympanoplasty for active CSOM. Methods:The clinical data of 55 patients(55 ears) with active CSOM were retrospectively analyzed. Based on the development of the mastoid process and the upper tympanic chamber, patients who met the criteria for wall-up mastoidectomy were classified as group A (30 patients), and underwent tympanoplasty combined with wall-up mastoidectomy. Patients who did not meet the criteria for wall-up mastoidectomy were classified as group B(25 cases), and underwent tympanoplasty with the opening of the middle and upper tympanic chambers and sinus drainage after partial removal of the shield plate bone. The survival rate of tympanic membrane grafts, hearing before and after surgery, and complications such as reperforation were compared between the two groups at 3 months postoperatively. Results:The overall postoperative tympanic membrane survival rate of patients with active CSOM was 96.4%(53/55), including 96.7% in group A; 96.0% in group B. There was no significant difference in the tympanic membrane survival rate between the two groups(P>0.05). The postoperative mean air-bone gap(ABG) was significantly reduced in both groups compared with the preoperative period, but there was no significant difference in ABG gain between the two groups(P>0.05). No patients experienced serious adverse conditions such as peripheral facial paralysis, cerebrospinal fluid leakage, or sensorineural deafness after surgery. Conclusion:Microscopic tympanoplasty with patency of the middle and upper tympanic chambers and tympanic sinus drainage can be used to treat active simple chronic otitis media with satisfactory tympanic membrane viability and hearing improvement efficacy. This approach reduces patient trauma, prevents complications such as skin depressions in the mastoid area due to abrasion of the mastoid bone, and shortens the waiting time before surgery.


Assuntos
Mastoidectomia , Otite Média Supurativa , Timpanoplastia , Humanos , Otite Média Supurativa/cirurgia , Timpanoplastia/métodos , Estudos Retrospectivos , Mastoidectomia/métodos , Masculino , Feminino , Resultado do Tratamento , Doença Crônica , Pessoa de Meia-Idade , Adulto , Membrana Timpânica/cirurgia , Processo Mastoide/cirurgia
2.
Front Endocrinol (Lausanne) ; 15: 1407503, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38836234

RESUMO

Background: Type 2 diabetes mellitus (T2DM) and hearing loss (HL) constitute significant public health challenges worldwide. Recently, the association between T2DM and HL has aroused attention. However, possible residual confounding factors and other biases inherent to observational study designs make this association undetermined. In this study, we performed univariate and multivariable Mendelian Randomization (MR) analysis to elucidate the causal association between T2DM and common hearing disorders that lead to HL. Methods: Our study employed univariate and multivariable MR analyses, with the Inverse Variance Weighted method as the primary approach to assessing the potential causal association between T2DM and hearing disorders. We selected 164 and 9 genetic variants representing T2DM from the NHGRI-EBI and DIAGRAM consortium, respectively. Summary-level data for 10 hearing disorders were obtained from over 500,000 participants in the FinnGen consortium and MRC-IEU. Sensitivity analysis revealed no significant heterogeneity of instrumental variables or pleiotropy was detected. Results: In univariate MR analysis, genetically predicted T2DM from both sources was associated with an increased risk of acute suppurative otitis media (ASOM) (In NHGRI-EBI: OR = 1.07, 95% CI: 1.02-1.13, P = 0.012; In DIAGRAM: OR = 1.14, 95% CI: 1.02-1.26, P = 0.016). Multivariable MR analysis, adjusting for genetically predicted sleep duration, alcohol consumption, body mass index, and smoking, either individually or collectively, maintained these associations. Sensitivity analyses confirmed the robustness of the results. Conclusion: T2DM was associated with an increased risk of ASOM. Strict glycemic control is essential for the minimization of the effects of T2DM on ASOM.


Assuntos
Diabetes Mellitus Tipo 2 , Análise da Randomização Mendeliana , Otite Média Supurativa , Humanos , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Otite Média Supurativa/genética , Otite Média Supurativa/complicações , Otite Média Supurativa/epidemiologia , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Doença Aguda , Perda Auditiva/genética , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Feminino , Masculino , Predisposição Genética para Doença
3.
Vestn Otorinolaringol ; 89(2): 88-94, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38805469

RESUMO

According to the literature, acute otitis media is complicated by mastoiditis in 0.15-1% of cases. In turn, mastoiditis can be complicated by meningitis, encephalitis, abscess of temporal lobe of brain and cerebellum, epidural and subdural abscesses, facial nerve paresis, labyrinthitis, phlegmon of soft tissues of neck, as well as subperiosteal abscess, which makes 7% in the structure of mastoiditis complications. Nowadays, when doctors have a wide range of antibacterial preparations at their disposal, a complicated course of acute otitis media and further mastoiditis is caused both by an aggressive atypical infectious agent and immunocompromised status of a patient. The article deals with a clinical case of a prolonged course of acute otitis media complicated by mastoiditis and subperiosteal abscess against the background of outpatient courses of antibacterial therapy. The examination revealed an atypical pathogen of otitis media Pseudomonas aeruginosa and HIV-positive status of the patient, previously unknown. Timely surgical intervention and the right combination of antibacterial drugs, meropenem and ciprofloxacin, prevented the development of intracranial and septic complications, despite the presence of multiple foci of bone destruction of the mastoid process and temporal bone pyramid, bordering the middle fossa and sigmoid sinus, according to multispiral head computed tomography. As a part of additional examination in the Center for AIDS and Infectious Diseases Prevention and Control, the patient was diagnosed with HIV infection, clinical stage 4C, progressing phase on the background of absence of antiretroviral therapy, and the necessary amount of treatment was prescribed.


Assuntos
Antibacterianos , Mastoidite , Otite Média Supurativa , Adulto , Humanos , Masculino , Doença Aguda , Antibacterianos/uso terapêutico , Infecções por HIV/complicações , Mastoidite/etiologia , Mastoidite/diagnóstico , Meropeném/administração & dosagem , Meropeném/uso terapêutico , Otite Média Supurativa/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Infecções por Pseudomonas/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
4.
BMJ Open ; 14(5): e087062, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38806427

RESUMO

INTRODUCTION: Radical mastoidectomy is a common procedure for chronic suppurative otitis media, typically performed under a microscope. The smooth operation is closely related to the clarity of the operative field. Our trial is designed to investigate whether the intravenous administration of tranexamic acid (TXA) can improve the clarity of the operative field, reduce the operative time, and increase surgeon satisfaction. METHODS AND ANALYSIS: This study is a prospective, randomised, double-blinded, controlled trial that aims to investigate the effects of TXA on patients with otitis media. The trial will include patients between the ages of 18 and 65 who will be randomly assigned to either the TXA group or the control group. In the TXA group, patients will receive 1 g of TXA diluted to 20 mL of normal saline before anaesthesia induction while the control group will receive 20 mL of normal saline. The primary outcome measure will be the Modena Bleeding Score, which will assess the clarity of the surgical field. Secondary outcomes will include the surgeon's satisfaction with surgical conditions, operation time, laboratory measurements (prothrombin time, activated partial thromboplastin time, fibrin degradation products, D-dimer) and levels of inflammatory factors (such as IL-6) at 24 hours postoperatively. In addition, the incidence of general adverse reactions such as postoperative nausea, vomiting and dizziness; serious adverse events such as arterial and venous thromboembolism, myocardial infarction and epilepsy within 90 days will be compared between the two groups. ETHICS AND DISSEMINATION: The protocol was approved by the Ethics Committee of Peking University People's Hospital (2021PHB173-001), on 19 July 2021. The trial results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ChiCTR2100049183.


Assuntos
Administração Intravenosa , Antifibrinolíticos , Mastoidectomia , Ácido Tranexâmico , Humanos , Ácido Tranexâmico/administração & dosagem , Ácido Tranexâmico/uso terapêutico , Ácido Tranexâmico/efeitos adversos , Método Duplo-Cego , Antifibrinolíticos/administração & dosagem , Antifibrinolíticos/uso terapêutico , Estudos Prospectivos , Adulto , Mastoidectomia/métodos , Pessoa de Meia-Idade , Feminino , Masculino , Adolescente , Otite Média Supurativa/cirurgia , Otite Média Supurativa/tratamento farmacológico , Adulto Jovem , Ensaios Clínicos Controlados Aleatórios como Assunto , Duração da Cirurgia , Idoso
6.
Lancet ; 403(10441): 2339-2348, 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38621397

RESUMO

Chronic suppurative otitis media (CSOM) is a leading global cause of potentially preventable hearing loss in children and adults, associated with socioeconomic deprivation. There is an absence of consensus on the definition of CSOM, which complicates efforts for prevention, treatment, and monitoring. CSOM occurs when perforation of the tympanic membrane is associated with severe or persistent inflammation in the middle ear, leading to hearing loss and recurrent or persistent ear discharge (otorrhoea). Cholesteatoma, caused by the inward growth of the squamous epithelium of the tympanic membrane into the middle ear, can also occur. The optimal treatment of discharge in CSOM is topical antibiotics. In resource-limited settings where topical antibiotics might not be available, topical antiseptics are an alternative. For persistent disease, surgery to repair the tympanic membrane or remove cholesteatoma might offer long-term resolution of otorrhoea and potential improvement to hearing. Recent developments in self-fitted air-conduction and bone-conduction hearing aids offer promise as new options for rehabilitation.


Assuntos
Antibacterianos , Otite Média Supurativa , Humanos , Otite Média Supurativa/terapia , Otite Média Supurativa/complicações , Doença Crônica , Antibacterianos/uso terapêutico , Criança , Perda Auditiva/etiologia , Perfuração da Membrana Timpânica/terapia , Perfuração da Membrana Timpânica/etiologia , Adulto , Colesteatoma da Orelha Média
7.
Otolaryngol Head Neck Surg ; 171(1): 90-97, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38482959

RESUMO

OBJECTIVE: This study aims to identify dominant causative pathogens of chronic suppurative otitis media (CSOM) and their antimicrobial susceptibility patterns. The secondary objective is to assess the cholesteatoma concurrence among this population. STUDY DESIGN: A prospective descriptive study. SETTING: Port Elizabeth Provincial Hospital, Eastern Cape, South Africa. METHODS: Aural swabs of purulent otorrhoea were collected from patients with CSOM attending the otorhinolaryngology outpatient department between April 2022 and June 2023. Samples were analyzed to determine the microbiological spectrum and evaluate antimicrobial sensitivities. Patient files were reviewed to identify cases with cholesteatoma. The study population size of 169 enabled representative results for a confidence interval of 90%. RESULTS: Patients were divided into 2 age categories: children (0-12 years) and adults (>12 years). Adults represented the majority of cases (76.9%) and females (58.6%) were affected more than males. Fungal isolates, Candida species and Aspergillus species, were the most common (20.8%). This was followed by Pseudomonas aeruginosa (12.4%) and Staphylococcus aureus (11.8%). 3.6% of cases cultured Mycobacterial tuberculosis which was high compared to global estimates. Susceptibility patterns showed 94.3% sensitivity of fungal cultures to fluconazole. Pseudomonas aeruginosa was 100% susceptible to piperacillin-tazobactam and cefepime, but only 76.2% sensitive to ciprofloxacin. Cholesteatoma concurrence was identified in 17.8%. CONCLUSION: CSOM remains a public health challenge. This study highlights the need to consider fungal etiology in instances where standard antibiotic treatments prove ineffective. Given the variety of cultured organisms and their susceptibility patterns, incorporating culture-directed therapy should be considered standard practice for chronic otorrhoea patients.


Assuntos
Testes de Sensibilidade Microbiana , Otite Média Supurativa , Humanos , Otite Média Supurativa/microbiologia , Otite Média Supurativa/tratamento farmacológico , Masculino , Estudos Prospectivos , Feminino , Criança , Pré-Escolar , Lactente , Doença Crônica , Adulto , África do Sul , Adolescente , Recém-Nascido , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Adulto Jovem , Pessoa de Meia-Idade
9.
Int Tinnitus J ; 27(2): 135-140, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38507626

RESUMO

BACKGROUND: Tympanic membrane perforation due to inactive mucosal chronic suppurative otitis media is a common problem in otolaryngology, with consequent conductive hearing loss. Still, there is controversy about the relationship between the location of the tympanic membrane perforation and the degree of hearing impairment. AIM OF THE STUDY: To assess the correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss in adult patients with inactive mucosal chronic suppurative otitis media. PATIENTS AND METHODS: A prospective cross-sectional study enrolled 74 adult patients with small tympanic membrane perforations (perforation involves less than one quadrant of the tympanic membrane) and conductive hearing loss (airbone gap ≥ 20 dB HL) due to inactive mucosal chronic suppurative otitis media for at least 3 months. The locations of the tympanic membrane perforations were classified as anterosuperior, anteroinferior, posterosuperior, and poster inferior perforations. Audiometric analysis and a CT scan of the temporal bone were done for all patients. The means of the air and bone conduction pure tone hearing threshold averages at frequencies 500, 1000, 2000, and 4000 Hz were calculated, and consequently, the air-bone gaps were calculated and presented as means. The ANOVA test was used to compare the means of the air-bone gaps, and the Scheffe test was used to determine if there were statistically significant differences regarding the degree of conductive hearing loss in relation to different locations of the tympanic membrane perforation. RESULTS: The ages of the patients ranged from 20 to 43 years (mean = 31.9 ± 6.5 years), of whom 43 (58%) were females and 31 (42%) were males. The means of the air-bone gaps were 32.29 ± 5.41 dB HL, 31.34 ± 4.12 dB HL, 29.87 ± 3.48 dB HL, and 29.30 ± 4.60 dB HL in the posteroinferior, posterosuperior, anteroinferior, and anterosuperior perforations, respectively. Although the air-bone gap's mean was greater in the posteroinferior perforation, statistical analysis showed that it was insignificant (P-value=0.168). CONCLUSION: In adult patients with inactive chronic suppurative otitis media, the anteroinferior quadrant is the most common location of the tympanic membrane perforation, and there was an insignificant correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss.


Assuntos
Surdez , Perda Auditiva , Otite Média Supurativa , Perfuração da Membrana Timpânica , Adulto , Masculino , Feminino , Humanos , Otite Média Supurativa/complicações , Perfuração da Membrana Timpânica/diagnóstico , Perfuração da Membrana Timpânica/etiologia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Estudos Prospectivos , Estudos Transversais , Membrana Timpânica
10.
Acta Otolaryngol ; 144(2): 112-117, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38436696

RESUMO

BACKGROUND: Numerous studies have been conducted on the effect of the stapes superstructure after ossicular chain reconstruction, but the findings are not uniform. OBJECTIVE: To compare the hearing outcomes of ossicular chain reconstruction with partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) under otoendoscopy. MATERIALS AND METHODS: The records of 111 patients diagnosed with chronic suppurative otitis media were retrospectively analyzed. These patients were divided into PORP group (n = 57) and TORP group (n = 54). They were further subdivided into subgroups PORP-a (with a malleus handle) and PORP-b (without a malleus handle), subgroups TORP-a and TORP-b. Pre- and postoperative audiometric results were analyzed. RESULTS: The mean postoperative air conduction hearing thresholds improvement, mean air-bone gap improvement, and the success rate of reconstruction were significantly higher in the PORP group than in the TORP group (p < .05). The mean postoperative air conduction hearing thresholds improvement and the success rate of reconstruction were significantly higher in the PORP-a group than in the TORP-a group (p < .05); and similar results were concluded in comparison of the PORP-b group and the TORP-b group. CONCLUSIONS AND SIGNIFICANCE: The stapes superstructure has an important positive effect on the postoperative outcome of endoscopic ossicular chain reconstruction.


Assuntos
Prótese Ossicular , Substituição Ossicular , Humanos , Feminino , Estudos Retrospectivos , Masculino , Pessoa de Meia-Idade , Adulto , Substituição Ossicular/métodos , Idoso , Endoscopia/métodos , Otite Média Supurativa/cirurgia , Adulto Jovem , Ossículos da Orelha/cirurgia , Adolescente , Estribo
11.
J Laryngol Otol ; 138(6): 634-637, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38305030

RESUMO

OBJECTIVE: The outcome of cartilage interposition ossiculoplasty was assessed in cases of incus necrosis after posterior malleus repositioning in the plane of the stapes, in terms of hearing gain after ossicular reconstruction. METHODS: A retrospective observational study was conducted of 30 patients admitted to an Ain Shams University hospital from March 2021 to September 2021. All patients with ossicular disruption due to chronic suppurative otitis media and hearing loss of more than 40 dB were included in the study. Pure tone audiometry was conducted for each patient after three months, six months and one year post operation. RESULTS: The audiogram showed a post-operative air-bone gap of 20 dB or less in 83.33 per cent of patients (n = 25) at three months post-operatively and in 80 per cent of patients after six months; after one year, the results remained the same. CONCLUSION: The use of cartilage interposition after malleus posterior mobilisation represents an excellent partial ossicular replacement technique.


Assuntos
Bigorna , Martelo , Necrose , Substituição Ossicular , Humanos , Martelo/cirurgia , Estudos Retrospectivos , Bigorna/cirurgia , Bigorna/patologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Substituição Ossicular/métodos , Audiometria de Tons Puros , Resultado do Tratamento , Otite Média Supurativa/cirurgia , Otite Média Supurativa/complicações , Estribo/patologia , Adulto Jovem , Perda Auditiva/etiologia , Perda Auditiva/cirurgia , Cirurgia do Estribo/métodos , Cirurgia do Estribo/efeitos adversos , Adolescente , Cartilagem/transplante
12.
Int J Pediatr Otorhinolaryngol ; 178: 111888, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38354594

RESUMO

INTRODUCTION: The Greenlandic population has one of the world's highest prevalence of otitis media (OM). Approximately 9-14% of all children suffer from OM during childhood. Due to the climate, lack of infrastructure, and minimal access to specialist services, the Greenlandic healthcare system operates under significant challenges. To support treatment implementation, we explored parental experiences of having a child with recurrent acute otitis media (rAOM) and chronic suppurative otitis media in Greenland (CSOM). METHODS: We applied a qualitative methodology with semi-structured interviews, to investigate parents' individual experiences. We included parents from six selected towns and settlements in Greenland, who were primary caregivers to minimum one child who had suffered from rAOM or CSOM. The interviews followed a semi-structured interview guide. RESULTS: Eight interviews were conducted with ten parents (nine mothers, one father) to 13 children (nine girls, four boys) aged two to 20 years (median age five years). We carried out a hermeneutic-phenomenological, Ricoeur-inspired text analysis of data. The first episode of OM was associated with uncertainty about the condition, including pain relief and treatment. However, recurrence led to symptom recognition and a changed disease perception among the parents: from being a simple case of childhood OM to a recognition of a chronic condition that might lead to delayed linguistic development and hearing impairment. CONCLUSION: Under difficult healthcare situations, parents represented a unique resource in care and treatment implementation. Parents often feel alone with the responsibility of care and had concerns for their child's hearing and language development, and they wished for their experiences and observations to be actively included in consultations.


Assuntos
Otite Média Supurativa , Otite Média , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Doença Crônica , Groenlândia/epidemiologia , Otite Média/terapia , Otite Média/epidemiologia , Otite Média Supurativa/epidemiologia , Pais , Pesquisa Qualitativa , Adolescente , Adulto Jovem
13.
Laryngoscope ; 134(7): 3335-3341, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38332523

RESUMO

OBJECT: Chronic otitis media (COM) is an inflammatory disease that commonly presents with otorrhea and hearing loss. Bacteria-induced inflammation can cause inner ear damage, leading to sensorineural hearing loss (SNHL). This study aimed to compare the prevalence and severity of SNHL in patients with gram-negative versus gram-positive cultures and examine associations between the concentrations of circulating monocytes and neutrophils with bacteria species and SNHL. METHODS: This was a retrospective study. Cholesteatoma or chronic suppurative otitis media patients with otorrhea were enrolled. Middle ear secretions were collected using sterile swabs under an otoscope, and sent for bacterial detection within 30 min. Pure tone audiometry and circulating leukocyte counts were recorded and analyzed in patients infected with different pathogens. Logistic regression analysis was used to identify the risk factors associated with SNHL. RESULTS: A total of 137 patients were enrolled, including 45 patients infected with gram-negative bacteria, 41 with gram-positive bacteria, 20 with polymicrobial infection, and 31 with no bacterial growth. Logistic regression analysis showed that bacterial culture positive infections (OR = 7.265, 95% CI 2.219-23.786, p = 0.001) were an independent risk factor for SNHL. Patients with gram-negative bacteria had higher risks of SNHL (p < 0.0001) and more severe hearing loss (p = 0.005) than those with gram-positive bacteria. COM patients infected with gram-negative bacteria showed an increase in circulating monocytes, which correlated with the occurrence of SNHL (p = 0.0343). CONCLUSION: Gram-negative bacteria are associated with elevated circulating monocyte counts and have a higher risk of severe SNHL. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3335-3341, 2024.


Assuntos
Bactérias Gram-Negativas , Perda Auditiva Neurossensorial , Humanos , Feminino , Masculino , Perda Auditiva Neurossensorial/microbiologia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/epidemiologia , Doença Crônica , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Bactérias Gram-Negativas/isolamento & purificação , Otite Média/microbiologia , Otite Média/complicações , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/microbiologia , Fatores de Risco , Otite Média Supurativa/microbiologia , Otite Média Supurativa/complicações , Idoso , Prevalência , Audiometria de Tons Puros , Adulto Jovem , Neutrófilos , Monócitos , Índice de Gravidade de Doença , Adolescente , Contagem de Leucócitos
14.
Acta Otolaryngol ; 144(1): 19-22, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38315117

RESUMO

BACKGROUND: Chronic suppurative otitis media (CSOM) is a prevalent chronic inflammatory disease globally. Current research suggests a possible association between anaemia and the development of CSOM. OBJECTIVES: The objective of this trial was to investigate the relationship between iron metabolism and chronic suppurative otitis media (CSOM) in adults aged 20-60 years. MATERIALS AND METHODS: A consecutive sampling case-control study was used. The study participants were divided into a case group (42 children diagnosed with CSOM) and a control group (42 children with normal ears). Haemoglobin (Hb), Hematocrit (Hct), mean corpuscular volume of erythrocytes (MCV), serum iron level (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin (TF), ferritin (Fer) were tested in all the participants, and the results were compared with the normal ranges of the World Health Organization (WHO). The comparative analysis of cases and controls was performed using the Fisher extract test, independence t-test, or Mann-Whitney U test. p-value <.05 was considered statistically significant for correlation. RESULTS: There were 61 patients with CSOM and 61 controls included in the study. In the case group, 16 out of 61 patients (26.2%) had low ferritin levels and in the control group, 1 out of 61 patients (1.6%) had low ferritin levels (p < .001). In the case group, 6 (9.8%) of 61 patients had IDA, and in the control group, there were no patients with IDA among 61 patients (p = .027). There were significant differences in SI, UIBC, and Fer parameters between the groups. CONCLUSIONS: In adult patients, the incidence of iron deficiency was higher in CSOM patients than in controls. Iron deficiency may be considered a potential risk factor for chronic suppurative otitis media, and serum iron parameters should be evaluated in these CSOM patients and further studies should be conducted to better understand the potential link between iron deficiency and CSOM.


Assuntos
Deficiências de Ferro , Otite Média Supurativa , Criança , Adulto , Humanos , Estudos de Casos e Controles , Otite Média Supurativa/complicações , Doença Crônica , Ferritinas , Ferro
15.
Nanoscale ; 16(6): 3006-3010, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38226693

RESUMO

We report a Janus mesoporous organosilica/platinum (MOS/Pt) nanomotor for active targeted treatment of suppurative otitis media, as a new type of multi-functional ear drop. The efficient propulsion of MOS/Pt nanomotors in hydrogen peroxide ear-cleaning drops significantly improves their binding efficiency with Staphylococcus aureus and enhances their antibacterial efficacy.


Assuntos
Otite Média Supurativa , Humanos , Otite Média Supurativa/tratamento farmacológico , Otite Média Supurativa/microbiologia , Platina , Peróxido de Hidrogênio , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Staphylococcus aureus
16.
Int J Audiol ; 63(4): 242-249, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36803034

RESUMO

OBJECTIVE: This study aimed to determine the prevalence of dizziness and its associated factors in patients with COM at two otologic referral centres in a middle-income country. DESIGN: Cross-sectional study. Adults with and without COM diagnosis from two otology-referral centres in Bogotá (Colombia) were included. Dizziness and quality of life were assessed using the "Chronic Suppurative Otitis Media Questionnaire-12" (COMQ-12), and sociodemographic questionnaires were applied. Otoscopic evaluation and audiometric data were collected. STUDY SAMPLE: A total of 231 adults. RESULTS: Of the 231 participants, up to 64.5% (n = 149) reported at least mild inconvenience due to dizziness. Factors associated with dizziness included female sex (aPR: 1.23; 95% CI: 1.04-1.46), chronic suppurative otitis media (aPR: 3.02; 95% CI: 1.21-7.52), and severe tinnitus (aPR: 1.75; 95% CI: 1.24-2.48). An interaction was found between socioeconomic status and educational level, with more frequent reports of dizziness in the middle/high economic status and secondary education (aPR: 3.09; 95% CI: 0.52-18.55; p < 0.001). Differences of 14 points in symptom severity and 18.5 points in the total score of the COMQ-12 were found between the groups with dizziness and without dizziness. CONCLUSIONS: Dizziness was frequent in patients with COM and was associated with severe tinnitus and quality of life deterioration.


Assuntos
Otite Média Supurativa , Otite Média , Zumbido , Adulto , Humanos , Feminino , Otite Média Supurativa/diagnóstico , Tontura , Estudos Transversais , Colômbia/epidemiologia , Qualidade de Vida , Otite Média/complicações , Otite Média/diagnóstico , Otite Média/epidemiologia , Vertigem , Doença Crônica , Inquéritos e Questionários
17.
Clin Otolaryngol ; 49(1): 62-73, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37794685

RESUMO

OBJECTIVES: Chronic suppurative otitis media (CSOM) is defined as persistent discharge through a tympanic membrane perforation for greater than 2 weeks. It is associated with a significant disease burden, including hearing loss, and reducing its incidence could significantly improve short- and long-term health. We aimed to identify risk factors associated with the development of CSOM in children. DESIGN AND SETTING: Systematic review and meta-analysis of studies set in community, primary and secondary care settings, identified from Medline, Embase and Cochrane databases from 2000 to 2022. PARTICIPANTS: Children 16 years old and below. MAIN OUTCOME MEASURES: Clinical diagnosis of CSOM. RESULTS: In total, 739 papers were screened, with 12 deemed eligible for inclusion in the systematic review, of which, 10 were included in the meta-analysis. Risk factors examined included perinatal, patient, dietary, environmental and parental factors. Meta-analysis results indicate that atopy (RR = 1.18, 95% CI [1.01-1.37], p = .04, 2 studies); and birth weight <2500 g (RR = 1.79 [1.27-2.50], p < .01, 2 studies) are associated with an increased risk of CSOM development. Factors not associated were male sex (RR = 0.96 [0.82-1.13], p = .62, 8 studies); exposure to passive smoking (RR = 1.27 [0.81-2.01], p = .30, 3 studies); and parental history of otitis media (RR = 1.14 [0.59-2.20], p = .69, 2 studies). CONCLUSION: Optimal management of risk factors associated with CSOM development will help reduce the burden of disease and prevent disease progression or recurrence. The current quality of evidence in the literature is variable and heterogeneous. Future studies should aim to use standardised classification systems to define risk factors to allow meta-analysis.


Assuntos
Perda Auditiva , Otite Média Supurativa , Otite Média , Criança , Humanos , Masculino , Adolescente , Feminino , Otite Média Supurativa/complicações , Otite Média Supurativa/epidemiologia , Doença Crônica , Otite Média/complicações , Perda Auditiva/etiologia , Fatores de Risco
18.
Am J Otolaryngol ; 45(1): 104024, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37647777

RESUMO

OBJECTIVE: To evaluate the efficacy of tympanomastoidectomy versus parenteral antibiotic therapy for otorrhea as a result of chronic suppurative otitis media (CSOM) without cholesteatoma in the pediatric population. METHODS: A retrospective review of 221 patients treated for otorrhea at a tertiary academic pediatric hospital was performed to evaluate the impact of tympanomastoidectomy versus parenteral antibiotic therapy on resolution of otorrhea. Inclusion criteria were age 0-18 years, prior treatment with otic and/or oral antibiotic, prior history of tympanostomy tube placement for recurrent otitis media, history of otorrhea, treatment with tympanomastoidectomy or parenteral antibiotic therapy, and follow-up of at least 1 month after intervention. Time to resolution was compared between the two modalities adjusting for age, bilateral ear disease status, and comorbidities using a Cox proportional hazard model. RESULTS: Eighty-three ears from 58 children met the inclusion criteria. Ears that initially underwent tympanomastoidectomy had a significantly shorter time to resolution of symptoms (median time to resolution) 9 months (95 % confidence interval CI: 6.2-14.8) vs. 48.5 months (95 % lower CI 9.4, p = 0.006). On multivariate analysis, however, only bilateral ear disease status was independently associated with time to resolution of symptoms (hazard ratio 0.4, 95 % CI 0.2-0.9, p = 0.03). There was no statistically significant difference in the rate of treatment-related complications when comparing tympanomastoidectomy to parenteral antibiotic therapy (p = 0.37). CONCLUSION: When adjusting for age, bilateral ear disease status, and comorbidities, there does not appear to be a significant difference in time to resolution of symptoms when comparing parenteral antibiotic therapy to tympanomastoidectomy. An informed discussion regarding risks and benefits of each approach should be employed when deciding on the next step in management for patients with CSOM who have failed more conservative therapies.


Assuntos
Otite Média Supurativa , Otite Média , Criança , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Antibacterianos/uso terapêutico , Ventilação da Orelha Média/efeitos adversos , Otite Média Supurativa/complicações , Otite Média Supurativa/tratamento farmacológico , Otite Média Supurativa/cirurgia , Otite Média/complicações , Quimioterapia Combinada , Resultado do Tratamento
19.
Vestn Otorinolaringol ; 88(6): 38-41, 2023.
Artigo em Russo | MEDLINE | ID: mdl-38153891

RESUMO

OBJECTIVE: Improving the effectiveness of inpatient care for children with acute purulent otitis media. MATERIAL AND METHODS: 100 children at the age from 0 to 18 years were inspected from January to August 2021. The main diagnostic methods included otoscopy, pharyngoscopy, rhinoscopy. Bacteriological examination of the pus from the ear was done for all patients. RESULTS: Acute purulent otitis media is a common cause of hospitalization in children aged 0 to 3 years. The main causative agents of the disease in toddlers are Staphylococcus aureus and pneumococcus (38%), in preschoolers and primary school children - pyogenic streptococcus and pneumococcus (30%), in high school students - Staphylococcus aureus.


Assuntos
Otite Média Supurativa , Otite Média , Humanos , Lactente , Criança , Otite Média Supurativa/complicações , Otite Média Supurativa/diagnóstico , Otite Média Supurativa/epidemiologia , Otite Média/diagnóstico , Otite Média/terapia , Streptococcus , Streptococcus pneumoniae , Endoscopia , Doença Aguda
20.
Medicentro (Villa Clara) ; 27(4)dic. 2023.
Artigo em Espanhol | LILACS | ID: biblio-1534854

RESUMO

El concepto de biopelículas ha surgido de forma paulatina durante un largo período; se presentan como estructuras tridimensionales compuestas por células sésiles de microorganismos que crecen y se adhieren irreversiblemente a superficies, tanto vivas como inertes. Su capacidad de desarrollarse, tanto en superficies bióticas como abióticas, es una característica que los relaciona directamente con la salud humana. Distintas infecciones óticas se han inculpado a la presencia de biopelículas en las mucosas como en la otitis media con efusión, de igual forma se manifiestan en la aparición y persistencia de la otitis media crónica. Las biopelículas afines con otitis media, generalmente, contienen uno o múltiples especies de bacterias otopatógenas primarias. La comprensión de la biopelicula auxiliará el progreso de nuevas terapias y estrategias de control, al evitar enfermedades infecciosas ya que las bacterias formadoras de biopelículas son una seria amenaza para la salud pública debido a su alta resistencia a los antimicrobianos.


The concept of biofilms has emerged gradually over a long period; they appear as three-dimensional structures composed of sessile cells of microorganisms that grow and adhere irreversibly to surfaces, both living and inert. Their ability to develop, both on biotic and abiotic surfaces, is a characteristic that directly relates them to human health. Different ear infections have been blamed on the presence of biofilms on the mucous membranes, such as otitis media with effusion, in the same way they manifest themselves in the appearance and persistence of chronic otitis media. Otitis media-related biofilms generally contain one or multiple species of primary otopathogenic bacteria. The understanding of the biofilm will help us refine new therapies and control strategies, by avoiding infectious diseases since biofilm-forming bacteria are a serious threat to public health due to their high resistance to antimicrobials.


Assuntos
Biofilmes , Otite Média Supurativa , Orelha
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