ABSTRACT
@#BACKGROUND. The most complications of inflammation of the middle ear temporal bone and skull brain are otitis media, suppurative otitis media, meningitis and skull brain abscess. Aim:To diagnose otitis media, to find the complication of suppurative skull brain and to study the treatment issues as well as to decrease the complication. METHOD. We treated that the patients who was treated the otitis media and complicated with suppurative skull brain between 2014-2015, also the treatment was studied by us in department of otolaryngology surgery of Shastin Central Hospital. RESULTS. In our study, we found the following results: It was a high prevalence with chronic otitis media with effusion in 60 (28.8%) people of younger age group with 25-35 years old. It was a female preponderance with 66% by prevalence. Chronic otitis media with effusion 120 (57.6%), chronic otitis media with mastoiditis 79 (37.9%), total number of patients chronic otitis media with and without mastoiditis 199 (95.5%). It shows disease are easy to throne to the complicated stage of its disease. There was 1 case (0.48%) with intracranial complication. We manage the 8 (4%) patients by antibiotic therapy, 200 (96%) patients by combined with medical and surgical therapy with average 9-12 days of hospital bed days. During 2014-2015, there was only 1 case with intracranial complication from chronic otitis media, shows our early diagnostic level of medical service are quite well. CONCLUSION. Therefore we conclude that prevention, early diagnosis are the main way to decrease the disease. The most important issue is to manage acute otitis media as early as possible before converting it chronic form.
ABSTRACT
Purpose: Chronic otitis media with effusion (OME) is the leading cause of hearing loss during childhood. In bacterial etiology of OME, the most frequent pathogens responsible are Haemophilus influenzae followed by Streptococcus pneumoniae and Moraxella catarrhalis . This study aimed at evaluating the accuracy of nasopharyngeal (NP) specimens in the identification of pathogens in the middle ear fluid (MEF) in patients with OME. Materials and Methods: In this cross sectional, case-control study, 95 MEFs and 53 NP secretion specimens were obtained from 53 children. As a control group, 102 NP specimens were taken from children having an operation other than an otological disease. Conventional culture methods and multiplex-PCR method have been used to determine the etiology of OME; NP carriage between cases and control groups were compared using conventional culture methods. Pearson Chi-Square and Fisher's Exact tests were used in statistical analysis. Results : Bacteria were isolated by culture in 37.9% of MEF specimens, 14.7% of which belonged to the group H. influenzae , S. pneumoniae and M. catarrhalis. PCR was positive in 30.5% specimens targeting the same pathogens. There was a two-fold increase in carriage rate of S. pneumoniae and H. influenzae in patients than controls for each pathogen. Conclusion: PCR is a more reliable method to detect middle ear pathogens in MEF in comparison with the conventional culture methods. The NP colonization wasn't found to be an indicator of the pathogen in MEF although middle ear pathogens colonize more in nasopharynx of diseased children.
ABSTRACT
BACKGROUND: From a pharmacokinetic standpoint, middle ear effusion (MEE) acts as a sequestered compartment since diffusion of antibiotics from serum and to this compartment is limited. The effectiveness of an antibiotic to eradicate infection within an anatomic compartment is related to both its ability to penetrate and the susceptibility of the causative pathogen. OBJECTIVE: The goal of this study was to determine the steady state plasma and MEE concentrations of cefprozil in pediatric chronic otitis media with effusion (COME). MATERIALS AND METHODS: Twenty-five children with COME were enrolled, and MEE was collected using a ventilation tube insertion after 0.5, 2, 3, 5, and 6 hours of single oral administration of 15 mg Cefprozil/kg body weight. Blood samples were also collected as soon as the MEE was collected, and analyzed in order to measure the concentration of Cefprozil using the validated high performance liquid chromatography (HPLC) method. RESULTS: The mean concentrations of cefprozil in MEE ranged from 0.4 to 4.4 ug/ml. The penetration of cefprozil into the MEE was rapid and effectively. Cefprozil in the MEE was maintained at a greater level than MIC90 in Streptococcus pneumoniae for at least 6 hours after administration of 15mg/kg. CONCLUSION: Cefprozil penetrates well into MEE in patients with pediatric COME.
Subject(s)
Child , Humans , Administration, Oral , Anti-Bacterial Agents , Body Weight , Chromatography, Liquid , Diffusion , Ear, Middle , Otitis Media with Effusion , Otitis , Plasma , Streptococcus pneumoniae , VentilationABSTRACT
BACKGROUND AND OBJECTIVES: Chronic otitis media with effusion is common in the pediatric population. One of the treatment options, which has been met with some criticism, may be the placement of tympanosotmoy tubes. This study was designed to analyze the outcome of children who have undergone tympanosotmoy tubes for the treatment of chronic otitis media with effusion. In addition, we investigated the efficiency of secondary tympanosotmoy tube insertion. MATERIALS AND METHODS: A retrospective study was carried out on 513 ears of children aged under 16 years and treated with tympanosotomy tubes. We documented the resolution rate of effusion, duration in situ of the tubes, prognostic factors, and the rate of complications. We also compared the treatment outcomes of the use of the secondary tympanosotomoy tube with that of the primary tube. RESULTS:The resolution rate of effusion was 87.1% and 70.0% for the primary tubes and the secondary tubes, respectively. The duration in situ of the secondary tube was shorter than that of the primary tube. The rates for complications of using tympaonosotomy tubes such as otorrhea, perfroation, cholesteatoma were relatively low. There were no significant differences between the complication rates of the primary and the secondary tympaonsotmoy tubes. CONCLUSION: This study indicates that the use of tympanosotomy tube is effective in treating chronic otitis media with effusion in children. The complication rates of' the secondary tube for recurred or persisted effusion after extrusion of the primary tube are low enough to support further use of this method of therapy.
Subject(s)
Child , Humans , Cholesteatoma , Ear , Middle Ear Ventilation , Otitis Media with Effusion , Otitis Media , Otitis , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Complications of a knife myringotomy with ventilation tube insertion is rather frequently encountered. To reduce such complications, we have performed myringotomy using a contact Nd: YAG laser. The purpose of this study was to evaluate the efficacy and safety of laser assisted myringotomy (LAM). MATERIALS AND METHODS: Sixty three patients (106 ears) of ages 1 to 7 were investigated retrospectively. Under the intravenous general anesthesia, LAM was performed to create a 2.0 mm sized perforation. After LAM, a ventilation tube was inserted. RESULTS: All ears underwent successful placement of ventilation tubes. Compared with knife myringotomies, LAM was safe to use in the atrophic tympanic membrane. There were also less intraoperative bleeding and tube plugging, with much lower postoperative otorrhea and myringosclerosis compared to knife myringotomies. Granuloma around the tube did not occurred. Postoperative improvement of air-bone gap reflects that LAM does not damage the inner ear. CONCLUSION: LAM with ventilation tube insertion is more effective than the previous knife myringotomy.