Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and meth...Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and methods:This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected. Results: All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t ? ?25.95 and ?14.09, respectively for CAP and SIR, p<0.05). Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI. Copyright ? 2015, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child wit...Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child with OME is not at risk for speech/language/or learning problems. Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate. Complementary or alternative medicine is not recommended as a treatment for OME. This paper provides a systematic review of management of OME, which we hope will be helpful for clinicians.展开更多
Objective:To compare the therapeutic effects of two types of tympanostomy tube,in terms of extrusion time and recurrence rate,after endoscopic ventilation tube placement in adults with otitis media with effusion.Mater...Objective:To compare the therapeutic effects of two types of tympanostomy tube,in terms of extrusion time and recurrence rate,after endoscopic ventilation tube placement in adults with otitis media with effusion.Materials and methods:The clinical data for 125 ears from 91 patients who underwent endoscopic ventilation tube placement was retrospectively reviewed.The ears included in the study were divided into groups A and B.The Shepard tube was used in all ears from group A.The T-tube was used in all ears from group B.Extrusion time and recurrence rate were recorded and statistically analyzed.Results:Group A included 103 ears(82.4%).Group B included 22 ears(17.6%).The average extrusion time for group A was significantly shorter than that for group B(160.5±106.6 days vs 274.1±120.5 days,p<0.05).No significant difference in recurrence rate was observed between groups A and B(72.8%vs 63.6%,p=0.44).Conclusion:Compared with the Shepard tube,the T-tube lasts longer in the ear drum in adult patients with otitis media with effusion.However,use of the Shepard tube,compared with use of the T-tube,does not significantly reduce the recurrence rate after extrusion.展开更多
Background: The aim of the study was to analyze the performance of PCR-DGGE based assay and its applicability as a tool for the identification of bacteria in the middle ear of children with otitis media with effusion ...Background: The aim of the study was to analyze the performance of PCR-DGGE based assay and its applicability as a tool for the identification of bacteria in the middle ear of children with otitis media with effusion (OME). Methods: The middle ear effusions from 20 children with OME were analyzed both by bacterial culture and by 16S rDNA-gene-targeted PCR assay, DGGE fingerprinting and sequencing analysis. Results: In bacterial culture assay, only three middle ear effusions (15%) showed bacterial growth. None of the samples were positive for anaerobic culture. The PCR assay with 16S rDNA-gene-targeted universal primers was positive in 10 (50%) cases. The subsequent DGGE fingerprinting and 16S rDNA sequencing analysis revealed that the most commonly encountered bacteria in the middle ear effusions of children with OME are Haemophilus influenzae, Alloiococcus otitidis and Bacteroides spp. Conclusions: The present study demonstrated the applicability of PCR-DGGE based assay and 16S rDNA sequencing for analyzing of bacterial diversity in the middle ear effusion of children OME. The results of our study may contribute to a better understanding of the etiology of OME.展开更多
Background Otitis media with effusion (OME) is a disease with complicated pathogeneses which are not clearly known Increasing interest has been focused on immunological cells, cytokines and their roles in chronic in...Background Otitis media with effusion (OME) is a disease with complicated pathogeneses which are not clearly known Increasing interest has been focused on immunological cells, cytokines and their roles in chronic inflammatory states. This study was designed to disclose the existence and roles of interleukin-10 (IL-10) and transforming growth factor beta1 (TGF-β1) in the cause of OME in adults, and to investigate the probable role of Foxp3^+CD4^+CD25^+ T cells in OME. Methods The concentrations of IL-10 and TGF-β1 in the middle ear effusions (MEEs) and plasmas of 36 adults (45 ears) with OME were measured by means of enzyme linked immunosorbent assay (ELISA). As contrast, the concentrations of IL-10 and TGF-131 in the plasma of 30 normal volunteers were measured using the same method. Furthermore, the proportion of Foxp3^+CD4^+CD25^+ T cells in CD4^+ T cells of blood was tested by flow cytometry. Results (1) The concentrations of IL-10 in all MEEs and plasmas of the chronic OME patients were higher than those in patients with acute OME (both P 〈0.05), so was TGF-131 (both P 〈0.01). The concentration of IL-10 in MEEs was significantly higher than that in plasmas, not only in acute OME (P〈0.01), but also in chronic OME (P〈0.01). In chronic OME, the concentration of TGF-β1 in MEEs had no statistical difference with those in plasmas of the same patients. However, the concentration of TGF-β1 in plasmas of patients with chronic OME was significantly higher than that in plasmas of normal volunteers (P 〈0.01). (2) The concentrations of IL-10 and TGF-β1 in MEEs of the patients who had been treated more than once were higher than those MEEs of the patients who were treated for the first time, respectively (P〈0.05, P〈0.01). The level of TGF-β1 in plasmas of the patients who had been treated more than once was higher than in those of the patients who were treated firstly (P 〈0.05), while the level of IL-10 in plasmas had no difference. The concentration of IL-10 in mucoid MEEs was higher than those in serous ones (P〈0.05), while TGF-β1 had no statistical difference between mucoid and serous MEEs (P〉0.05). The concentration of IL-10 in MEEs had a strong correlation with the duration of the illness (r=0.547, P〈0.01). The same correlation was also found between the concentration of TGF-β1 in MEEs and the times patients being treated (r=0.579, P 〈0.01). (3) The proportion of Foxp3^+CD4^+CD25^+T/CD4^+ T cells in the blood of chronic OME was not only significantly higher than that in the acute OME (P〈0.01), but also higher than that in normal volunteers (P 〈0.01). In chronic OME, there was a correlation between the proportion of Foxp3^+CD4^+CD25^+ T/CD4^+ T cells in the blood and the concentration of IL-10 in the plasmas (r=0.602, P 〈0.05). Conclusions IL-10 and TGF-β1, as two important immunoregulatory mediators, participate in middle ear inflammatory response, especially in chronic course of OME in adults. Foxp3^+CD4^+CD25^+ T cells may play some immunoregulatory roles in the course of this disease.展开更多
Objective:We conducted this study to determine the associations of possible risk factors and prevalence of recurrent otitis media with effusion(OME)in a cohort of children in Upper Egypt.Methods:This was a cross-secti...Objective:We conducted this study to determine the associations of possible risk factors and prevalence of recurrent otitis media with effusion(OME)in a cohort of children in Upper Egypt.Methods:This was a cross-sectional study undertaken in two tertiary referral centers in Upper Egypt.Associations of possible risk factors with prevalence of recurrent OME were studied.Multi-factor logistic regression analysis was done to recognize the statistically significant risk factors associated with recurrent OME.Results:We collected the data of 2003 pediatric patients,of which 1016 were males(50.7%).A total number of 310 children have OME,including 159 males(51.3%).The prevalence rate of OME in our cohort was 15.5%.Multi-factor logistic regression analysis of the risk factors related to recurrent OME showed it was strongly associated with adenoid hypertrophy(P<0.0001),tonsil hypertrophy(P<0.0001),sinusitis(P<0.0001),posterior nostril polyps(P =0.009),allergic rhinitis(P<0.0001),recurrent URTIs(P=0.029)and gastroesophageal reflux(P=0.031).Conclusions: Our study showed that recurrent OME in children in Upper Egypt is a common multifactorial problem, especially in young age. In our locality, allergic rhinitis, recurrent upper respiratory tract infections, gastroesophageal reflux, adenoid and tonsil hypertrophy were the most important associated factors related to the etiopathogenesis of OME.展开更多
Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-section...Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-sectional retrospective study.Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi.Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020.Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.Results:Out of 400 children enrolled in this study,108(27.0%)had OME,out of which 65(60.2%)were males and 30(27.8%)were of age group 2-3 years.Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring(P<0.001),last year symptoms(attack of ear aches with hearing loss[P=0.002]),drugs(URTI antibiotics[P=0.026],All 3 drugs[P=0.013]).Conclusions:We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems.Control of its etiopathogenic factors can play a major role in its prevention.展开更多
BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the inv...BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.展开更多
Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogen...Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogenesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic administration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre-and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 cases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P > 0.05). The rate of normal hearing following treatment in G3 was 70% or 7 / 10, higher than in G1(41.7% or 5 / 12) and G2 (54.5% or 6 / 11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8 / 10 in G2 and G3, respectively, higher than that in G1(50.0% or 6 / 12)(P < 0.05). Conclusions Therapeutic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In addition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.展开更多
An otoscope is traditionally used to examine the eardrum and ear canal.A diagnosis of otitis media(OM)relies on the experience of clinicians.If an examiner lacks experience,the examination may be difficult and time-co...An otoscope is traditionally used to examine the eardrum and ear canal.A diagnosis of otitis media(OM)relies on the experience of clinicians.If an examiner lacks experience,the examination may be difficult and time-consuming.This paper presents an ear disease classification method using middle ear images based on a convolutional neural network(CNN).Especially the segmentation and classification networks are used to classify an otoscopic image into six classes:normal,acute otitis media(AOM),otitis media with effusion(OME),chronic otitis media(COM),congenital cholesteatoma(CC)and traumatic perforations(TMPs).The Mask R-CNN is utilized for the segmentation network to extract the region of interest(ROI)from otoscopic images.The extracted ROIs are used as guiding features for the classification.The classification is based on transfer learning with an ensemble of two CNN classifiers:EfficientNetB0 and Inception-V3.The proposed model was trained with a 5-fold cross-validation technique.The proposed method was evaluated and achieved a classification accuracy of 97.29%.展开更多
Our study investigated the neurotoxicity of quinolinic acid(QA) to spiral ganglion cells(SGCs),observed the protective effects of N-methyl-D-aspartate(NMDA) receptor antagonist MK-801 and magnesium ions on the QA-indu...Our study investigated the neurotoxicity of quinolinic acid(QA) to spiral ganglion cells(SGCs),observed the protective effects of N-methyl-D-aspartate(NMDA) receptor antagonist MK-801 and magnesium ions on the QA-induced injury to SGCs,and analyzed the role of QA in otitis media with effusion(OME)-induced sensorineural hearing loss(SNHL).After culture in vitro for 72 h,SGCs were exposed to different media and divided into 4 groups:the blank control group,the QA injury group,the MK-801 treatment group,and the MgCl2 protection group.The apoptosis rate of SGCs was analyzed by Annexin V and PI double staining under the fluorescence microscopy 24 h later.SGCs were cultured in vitro for 72 h and divided into four groups:the low concentration QA group,the high concentration QA group,the MK-801 group,the MgCl2 group.The transient changes of intracellular calcium concentration were observed by the laser scanning confocal microscopy.Apoptosis rate in QA injury group was higher than that in blank control group and MgCl2 protection group(both P0.05).In high concentration QA group,there was an obvious increase of the intracellular calcium concentration in SGCs,which didn’t present in low concentration QA group.In MgCl2 group,the peak values of the intracellular calcium concentration in SGCs were reduced and the duration was shortened,but the intracellular calcium concentration in SGCs had no significant change in MK-801 group.It was concluded that QA could injure SGCs by excessively activating NMDA receptors on the cell membrane,which might be the mechanism by which OME induced SNHL,while Mg2+ could protect the SCGs from the neurotoxicity of QA.展开更多
基金supported by grants from the National Basic Research Program of China(973 Program)(#2012CB9679002011CBA01000)+1 种基金the National Natural Science Foundation of China(NSFC #81271082)the grants of the National Key Basic Research Program of China(973 Program),No.2014CB943003
文摘Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and methods:This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected. Results: All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t ? ?25.95 and ?14.09, respectively for CAP and SIR, p<0.05). Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI. Copyright ? 2015, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child with OME is not at risk for speech/language/or learning problems. Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate. Complementary or alternative medicine is not recommended as a treatment for OME. This paper provides a systematic review of management of OME, which we hope will be helpful for clinicians.
文摘Objective:To compare the therapeutic effects of two types of tympanostomy tube,in terms of extrusion time and recurrence rate,after endoscopic ventilation tube placement in adults with otitis media with effusion.Materials and methods:The clinical data for 125 ears from 91 patients who underwent endoscopic ventilation tube placement was retrospectively reviewed.The ears included in the study were divided into groups A and B.The Shepard tube was used in all ears from group A.The T-tube was used in all ears from group B.Extrusion time and recurrence rate were recorded and statistically analyzed.Results:Group A included 103 ears(82.4%).Group B included 22 ears(17.6%).The average extrusion time for group A was significantly shorter than that for group B(160.5±106.6 days vs 274.1±120.5 days,p<0.05).No significant difference in recurrence rate was observed between groups A and B(72.8%vs 63.6%,p=0.44).Conclusion:Compared with the Shepard tube,the T-tube lasts longer in the ear drum in adult patients with otitis media with effusion.However,use of the Shepard tube,compared with use of the T-tube,does not significantly reduce the recurrence rate after extrusion.
基金supported by SF109870 from Estonian Science Foundation.
文摘Background: The aim of the study was to analyze the performance of PCR-DGGE based assay and its applicability as a tool for the identification of bacteria in the middle ear of children with otitis media with effusion (OME). Methods: The middle ear effusions from 20 children with OME were analyzed both by bacterial culture and by 16S rDNA-gene-targeted PCR assay, DGGE fingerprinting and sequencing analysis. Results: In bacterial culture assay, only three middle ear effusions (15%) showed bacterial growth. None of the samples were positive for anaerobic culture. The PCR assay with 16S rDNA-gene-targeted universal primers was positive in 10 (50%) cases. The subsequent DGGE fingerprinting and 16S rDNA sequencing analysis revealed that the most commonly encountered bacteria in the middle ear effusions of children with OME are Haemophilus influenzae, Alloiococcus otitidis and Bacteroides spp. Conclusions: The present study demonstrated the applicability of PCR-DGGE based assay and 16S rDNA sequencing for analyzing of bacterial diversity in the middle ear effusion of children OME. The results of our study may contribute to a better understanding of the etiology of OME.
文摘Background Otitis media with effusion (OME) is a disease with complicated pathogeneses which are not clearly known Increasing interest has been focused on immunological cells, cytokines and their roles in chronic inflammatory states. This study was designed to disclose the existence and roles of interleukin-10 (IL-10) and transforming growth factor beta1 (TGF-β1) in the cause of OME in adults, and to investigate the probable role of Foxp3^+CD4^+CD25^+ T cells in OME. Methods The concentrations of IL-10 and TGF-β1 in the middle ear effusions (MEEs) and plasmas of 36 adults (45 ears) with OME were measured by means of enzyme linked immunosorbent assay (ELISA). As contrast, the concentrations of IL-10 and TGF-131 in the plasma of 30 normal volunteers were measured using the same method. Furthermore, the proportion of Foxp3^+CD4^+CD25^+ T cells in CD4^+ T cells of blood was tested by flow cytometry. Results (1) The concentrations of IL-10 in all MEEs and plasmas of the chronic OME patients were higher than those in patients with acute OME (both P 〈0.05), so was TGF-131 (both P 〈0.01). The concentration of IL-10 in MEEs was significantly higher than that in plasmas, not only in acute OME (P〈0.01), but also in chronic OME (P〈0.01). In chronic OME, the concentration of TGF-β1 in MEEs had no statistical difference with those in plasmas of the same patients. However, the concentration of TGF-β1 in plasmas of patients with chronic OME was significantly higher than that in plasmas of normal volunteers (P 〈0.01). (2) The concentrations of IL-10 and TGF-β1 in MEEs of the patients who had been treated more than once were higher than those MEEs of the patients who were treated for the first time, respectively (P〈0.05, P〈0.01). The level of TGF-β1 in plasmas of the patients who had been treated more than once was higher than in those of the patients who were treated firstly (P 〈0.05), while the level of IL-10 in plasmas had no difference. The concentration of IL-10 in mucoid MEEs was higher than those in serous ones (P〈0.05), while TGF-β1 had no statistical difference between mucoid and serous MEEs (P〉0.05). The concentration of IL-10 in MEEs had a strong correlation with the duration of the illness (r=0.547, P〈0.01). The same correlation was also found between the concentration of TGF-β1 in MEEs and the times patients being treated (r=0.579, P 〈0.01). (3) The proportion of Foxp3^+CD4^+CD25^+T/CD4^+ T cells in the blood of chronic OME was not only significantly higher than that in the acute OME (P〈0.01), but also higher than that in normal volunteers (P 〈0.01). In chronic OME, there was a correlation between the proportion of Foxp3^+CD4^+CD25^+ T/CD4^+ T cells in the blood and the concentration of IL-10 in the plasmas (r=0.602, P 〈0.05). Conclusions IL-10 and TGF-β1, as two important immunoregulatory mediators, participate in middle ear inflammatory response, especially in chronic course of OME in adults. Foxp3^+CD4^+CD25^+ T cells may play some immunoregulatory roles in the course of this disease.
文摘Objective:We conducted this study to determine the associations of possible risk factors and prevalence of recurrent otitis media with effusion(OME)in a cohort of children in Upper Egypt.Methods:This was a cross-sectional study undertaken in two tertiary referral centers in Upper Egypt.Associations of possible risk factors with prevalence of recurrent OME were studied.Multi-factor logistic regression analysis was done to recognize the statistically significant risk factors associated with recurrent OME.Results:We collected the data of 2003 pediatric patients,of which 1016 were males(50.7%).A total number of 310 children have OME,including 159 males(51.3%).The prevalence rate of OME in our cohort was 15.5%.Multi-factor logistic regression analysis of the risk factors related to recurrent OME showed it was strongly associated with adenoid hypertrophy(P<0.0001),tonsil hypertrophy(P<0.0001),sinusitis(P<0.0001),posterior nostril polyps(P =0.009),allergic rhinitis(P<0.0001),recurrent URTIs(P=0.029)and gastroesophageal reflux(P=0.031).Conclusions: Our study showed that recurrent OME in children in Upper Egypt is a common multifactorial problem, especially in young age. In our locality, allergic rhinitis, recurrent upper respiratory tract infections, gastroesophageal reflux, adenoid and tonsil hypertrophy were the most important associated factors related to the etiopathogenesis of OME.
文摘Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-sectional retrospective study.Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi.Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020.Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.Results:Out of 400 children enrolled in this study,108(27.0%)had OME,out of which 65(60.2%)were males and 30(27.8%)were of age group 2-3 years.Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring(P<0.001),last year symptoms(attack of ear aches with hearing loss[P=0.002]),drugs(URTI antibiotics[P=0.026],All 3 drugs[P=0.013]).Conclusions:We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems.Control of its etiopathogenic factors can play a major role in its prevention.
文摘BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.
文摘Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogenesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic administration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre-and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 cases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P > 0.05). The rate of normal hearing following treatment in G3 was 70% or 7 / 10, higher than in G1(41.7% or 5 / 12) and G2 (54.5% or 6 / 11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8 / 10 in G2 and G3, respectively, higher than that in G1(50.0% or 6 / 12)(P < 0.05). Conclusions Therapeutic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In addition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.
基金This study was supported by a Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT&Future Planning NRF-2020R1A2C1014829the Soonchunhyang University Research Fund.
文摘An otoscope is traditionally used to examine the eardrum and ear canal.A diagnosis of otitis media(OM)relies on the experience of clinicians.If an examiner lacks experience,the examination may be difficult and time-consuming.This paper presents an ear disease classification method using middle ear images based on a convolutional neural network(CNN).Especially the segmentation and classification networks are used to classify an otoscopic image into six classes:normal,acute otitis media(AOM),otitis media with effusion(OME),chronic otitis media(COM),congenital cholesteatoma(CC)and traumatic perforations(TMPs).The Mask R-CNN is utilized for the segmentation network to extract the region of interest(ROI)from otoscopic images.The extracted ROIs are used as guiding features for the classification.The classification is based on transfer learning with an ensemble of two CNN classifiers:EfficientNetB0 and Inception-V3.The proposed model was trained with a 5-fold cross-validation technique.The proposed method was evaluated and achieved a classification accuracy of 97.29%.
基金supported by a grant from the National Natural Sciences Foundation of China (No.30872866)
文摘Our study investigated the neurotoxicity of quinolinic acid(QA) to spiral ganglion cells(SGCs),observed the protective effects of N-methyl-D-aspartate(NMDA) receptor antagonist MK-801 and magnesium ions on the QA-induced injury to SGCs,and analyzed the role of QA in otitis media with effusion(OME)-induced sensorineural hearing loss(SNHL).After culture in vitro for 72 h,SGCs were exposed to different media and divided into 4 groups:the blank control group,the QA injury group,the MK-801 treatment group,and the MgCl2 protection group.The apoptosis rate of SGCs was analyzed by Annexin V and PI double staining under the fluorescence microscopy 24 h later.SGCs were cultured in vitro for 72 h and divided into four groups:the low concentration QA group,the high concentration QA group,the MK-801 group,the MgCl2 group.The transient changes of intracellular calcium concentration were observed by the laser scanning confocal microscopy.Apoptosis rate in QA injury group was higher than that in blank control group and MgCl2 protection group(both P0.05).In high concentration QA group,there was an obvious increase of the intracellular calcium concentration in SGCs,which didn’t present in low concentration QA group.In MgCl2 group,the peak values of the intracellular calcium concentration in SGCs were reduced and the duration was shortened,but the intracellular calcium concentration in SGCs had no significant change in MK-801 group.It was concluded that QA could injure SGCs by excessively activating NMDA receptors on the cell membrane,which might be the mechanism by which OME induced SNHL,while Mg2+ could protect the SCGs from the neurotoxicity of QA.