Tympanic Membrane Changes Research Articles

Middle ear disorders in patients with alpha 1-antitrypsin deficiency.

As it is not known whether individuals with alpha 1-antitrypsin deficiency show increased sequelae following otitis media, 52 patients with alpha 1-antitrypsin deficiency were studied with respect to history of middle ear disease, presence of irreversible pathologic changes of the tympanic membranes, and hearing ability. The middle ear status was determined on otomicroscopy, tympanometry, and pure-tone audiometry. The frequency of individuals with a history of otitis media was 50%. The frequency of individuals with pathologic tympanic membrane changes was no different from that shown in the results obtained in a Swedish normal population study. Minor conductive hearing losses were found in three patients of which only one was related to a history of middle ear disease. However, the history of acute severe complications from otitis media revealed a higher frequency in those individuals with alpha 1-antitrypsin deficiency as compared to normals.

Panel discussion: pathogenesis of otitis media. Pathology and microbiology of otitis media.

Otitis media (OM) can be subdivided into purulent, serous, mucoid, and chronic forms. It may occur in the absence of tympanic membrane changes and involve the inner ear. Purulent otitis media is characterized early by edema, hyperemia, and polymorphonuclear leukocyte infiltration in the subepithelial space (SES) and later by mucosal metaplasia, granulation tissue, and osteitis. S. pneumoniae and H. influenza are most commonly identified. Serous and mucoid OM frequently develop from eustachian tube dysfunction. Serous transudate from vessels in the SES passes to the middle ear (serous otitis media). Basal cells differentiate into goblet cells and subepithelial glandular formation occurs. This secretory activity, coupled with fluid reabsorption, results in a mucoid effusion. Bacteria can be cultured from about 30% of these effusions. Chronic otitis media denotes irreversible tissue pathology. It may be sterile although S. aureus and coliform bacteria are frequently isolated.

Tympanic membrane changes after installation of polyethylene grommets. An experimental study in the rat.

The object of this study was to establish the morphological changes which occur when a polyethylene grommet is implanted in the normal tympanic membrane of experimental animals. We found a serous effusion around the grommet and in the attic during the first weeks after installation. All the grommets had been displaced away from the tympanic memebrane in a medical direction into the middle ear cavity. The displacement was most likely brought about by a squamous cell epithelial and connective tissue hyperplasia, which reached its maximum after 2--3 weeks. Neither atrophy, atelectasis, nor retraction was observed, whether in the pars flaccida or the pars tensa. A greyish, horseshoe-shaped configuration was seen in all specimens in the undisturbed front quadrants. No firm histo-pathological correlation was found to explain these changes. In these studies in the rat, the perforation appeared to heal, although delayed, in the same way as after a central perforation, once the polyethylene grommet had been ejected.

Volume displacement of the tympanic membrane in the sitting position as a function of middle ear muscle activity. A quantitative microflow method.

An open microflow meter system has been worked out for quantitative recording of the volume displacement of the tympanic membrane and its movement direction at stapedius reflex. An acoustically elicited M. stapedius contraction can be recognized by the characteristic response and latency time. The stapedius reflex contraction causes an outward or inward movement of the tympanic membrane. The magnitude of the volume displacement of the tympanic membrane is influenced by the middle ear pressure and in some ears the movement direction of the tympanic membrane changes.

Evoked potentials of acoustic nuclei and character of hearing inRana temporaria

1. The chief parameters of evoked potentials recorded in response to acoustic stimulation (clicks, tones) in the acoustic nuclei of the medulla (dorsal cochlear nucleus, olivary nucleus) inRana temporaria are described. 2. The maxima of frequency sensitivity of medullary evoked potentials lie in the region 0.4–1.4 kHz. The frequency curves exhibit variability and dependence on stimulus intensity. 3. Extirpation of the columella and tympanic membrane changes the frequency curve, and the amplitude of responses to clicks and tones falls. It may be assumed that columellar transmission of sound in frogs is not the only channel of sound conduction. 4. Recovery cycles obtained during the action of paired clicks have a mean duration of 30 msec for medullary potentials. 5. An increase in duration of the front of tonal stimuli from 0 to 3 msec leads to a sharp decrease in amplitude of the medullary responses. With a further increase in duration of the fronts, the response amplitude shows a smaller change. It is also dependent on stimulus frequency.

NASOGASTRIC INTUBATION AND OTITIS MEDIA IN CHILDREN.

A nasogastric tube is very commonly used when performing abdominal surgery in children. It is assumed by some pediatric surgeons that febrile episodes following this surgery is in part due to middle ear infection as a result of nasogastric intubation. A review of the literature failed to disclose any previous information on this subject. Therefore, I was prompted to undertake a study to determine whether nasogastric intubation commonly causes otitis media in children. No attempt has been made to investigate other possible complications following the use of the nasogastric tube. Method A review was made of the charts of children admitted for intestinal obstruction to the Babies Hospital at the Columbia-Presbyterian Medical Center from 1945 to 1963. The charts of 137 children treated with nasogastric intubation were examined to determine the number of these patients that exhibited clinical evidence of otitis media, ie, a temperature elevation and tympanic membrane changes

The nasal airway and hearing in patients with cleft palate.

In a series of 63 cases of cleft palate or cleft lip and palate, the majority of which were repaired, tympanic membrane changes were encountered in 56 per cent and auditory impairment in 49 per cent. Narrowing of the nasal airway was demonstrated by an objective method in 45 per cent. The incidence of both aural pathology and nasal obstruction was significantly higher in the cases of cleft lip and palate than in those of palatine deformity only. The middle ear and nasal cavity changes appeared to be related. The narrowing of the nasal airway was caused by hyperplasia of the conchae, deviation of the septum or nasal aperture stenosis. Almost without exception, the latter two factors caused homolateral narrowing in cases of unilateral cleft lip and palate. Submucous septal resection and correction of deformed nasal alae, where needed, should be considered in patients with cleft lip and palate or cleft palate, whereas continued limitation of the use of adenoidectomy is recommended. The investigation emphasizes that the treatment of these deformities should include (1) a regular check on the condition of the ears from earliest infancy and consultation with an otologist whenever an ear affection is suspected, and (2) measures to improve the nasal airway if obstruction is present.