Myringosclerosis incidence among children with acute otitis media in relation to the isolated pathogens

Patients with acute otitis media [AOM] or otitis media with effusion [OME] and treated with tympanostomy tube insertion can develop myringosclerosis. The aim of this study was to investigate and compare the incidence of myringosclerosis among children with acute otitis media in relation to the isolated aerobic and anaerobic pathogens in their ear discharge. This study as conducted on two groups of patients. Group [1] included 23 subjects of OME had been treated with tympanostomy tubes and some of them had the complication of otorrhea, and group [2] included 48 subjects with AOM with or without otorrhea. Otorrhea of discharging ears of both groups was cultured and the status of their tympanic membranes was followed regularly by otoscopic examination during follow-up duration in scheduled visits to detect the incidence rate, time of appearance and severity of myringosclerosis in relation to the type of isolated pathogens. [GI] had 6 cases [10 ears] of myringosclerosis detected at 2-3 months average duration, and [G II] had 11 cases [20 ears] of myringosclerosis detected at 1-2 months average duration. The highest number of isolated pathogens was Streptococcus pneumoniae [S.P] and Haemophilus influenzae [H.I], and they were the only pathogens accompanied the incidence of myringosclerosis with more incidence and severity in [S.P] infected ears. These findings support the inflammatory theory of development of myringosclerosis. Our study considered myringosclerosis an inflammatory condition rather than to be traumatic reaction from tympanostomy tubes insertion, where Streptococcus pneumoniae is the most liable organism can induce myringosclerosis in improper treated cases of AOM .Anaerobic organisms cannot afford the hyperoxic environment which is suggested by some researchers to be a necessary factor in the development of myringosclerosis and proper treatment of cases of AOM diminishes the chance of incidence of myringosclerosis

Aerodynamic analysis of hoarseness of voice pre and post-antireflux therapy in GERD cases with reflux posterior laryngitis

To evaluate the hoarseness of voice by aerodynamic analysis in cases of GERD with reflux posterior laryngitis before and after empiric therapy of omeprazole. Out of 154 newly diagnosed GERD cases with posterior laryngitis, sixty four patients with persistent hoarseness were evaluated clinically, examined by digital videolaryngoscope and underwent aerodynamic analysis in comparison to 22 controlled patients before and after empiric therapy of omeprazole. First group involved 52 patients showed improvement by following the pre and post- hoarseness scores, pre and post endoscopic laryngeal findings scores, and the pre and post- aerodynamic parameters in comparison to the normal controlled group. Second group involved 12 non improved patients. Hoarseness patients in our study fall predominantly into the atypical GERD group [silent refluxers]. It seems that the main value of aerodynamic measurements is to evaluate the levels of hoarseness in GERD cases and monitoring the pre and posttherapeutic changes of voice disorders, and they have limitations in identifying which patient will respond or not to empirical treatment