Chronic Otitis Media With Effusion Research Articles

Central auditory and tinnitus consequences of pediatric chronic otitis media with effusion.

To evaluate the role of orthodontic and craniofacial orthopaedic interventions in the prevention and management of otitis media with effusion (OME), focusing particularly on rapid maxillary expansion (RME) and its implications for Eustachian tube function. A comprehensive search was conducted in PubMed, Embase, and Web of Science using a structured combination of MeSH terms by two expert researchers from inception to December 2024. Randomised and non-randomised prospective studies involving pediatric patients (2-18 years) with chronic OME were included. The effectiveness of preventive measures was compared with alternative treatments or no interventions. Study quality was assessed using the ROBINS-I v2 tool. RME emerges as a promising preventive option for managing OME particularly in patients with orthodontic indications. By addressing structural contributors to Eustachian tube dysfunction, RME improves middle ear health and complements otolaryngological interventions. Integrating orthodontic and otolaryngological strategies represents an effective multidisciplinary approach to reducing OME incidence and recurrence. Further studies are needed to confirm the long-term stability and the generalisability of these observed benefits.

Comparison of tympanostomy tube insertion with and without radiofrequency ablation eustachian tuboplasty for treating chronic otitis media with effusion.

To analyze the outcomes and safety of pediatric Balloon Dilation of Eustachian Tube (BDET). Retrospective pooled analysis. Records of 219 patients (425 ears) were analyzed. The inclusion criteria included children 17 years old and younger who underwent BDET with or without adjunctive procedures. Patients had a diagnosis of chronic otitis media with effusion (COME) or recurrent acute otitis media (RAOM) refractory to prior surgical treatment. Procedures were performed by a total of seven surgeons at six surgical centers. Pooled analysis was performed on efficacy, complications, BDET failure, and tympanograms. No major complications were reported; however, minor adverse events occurred in 5.9% of patients. BDET had a 1-year failure-free probability of 93.8% (95% CI: 89.7%-96.3%); at 2 years, it was 87.2% (95% CI: 81.9%-91.0%). Tympanograms improved in 83.7% of ears. BDET in pediatric patients demonstrated a favorable safety profile, while being effective and exhibiting long-lasting durability.

IgE-mediated allergies play a significant role in respiratory diseases. Given the similar mucosal epithelium of the upper and lower respiratory tracts and their shared (patho)physiological immune responses, the "unified airways" concept views these tracts as a single system. Recently, this model has been extended to include the middle ear, with studies confirming that the Eustachian tube and middle ear are both anatomically and functionally part of the upper airways. However, the relationship between allergies and middle ear disorders remains controversial, with conflicting findings regarding pathogenesis and treatment. The increasing prevalence of allergies highlights the importance of further research. In Germany, the current sensitization rate to aeroallergens is 33.6%, with similar trends across Europe, where rates commonly range up to 30%. This widespread increase underscores the urgent need for a deeper understanding of the correlation between allergies and middle ear disorders across diverse European populations. Ineffective pharmacotherapy or possibly harmful medication for acute and chronic OME, such as systemic steroids, is most likely used globally in an uninformed way, due to a lack of evidence on the connection between allergic inflammation and eustachian tube dysfunction. Further research is essential to clarify the mechanisms linking IgE-mediated allergies to middle ear pathologies and to develop effective treatment strategies. Addressing these knowledge gaps is critical for improving patient outcomes and managing the rising burden of allergic diseases.

Otitis media with effusion (OME) is common in children with Down syndrome (DS), affecting 93% of children by age 1 year and 68% of children by age 8 years ( 1,2 ). Resultant conductive hearing loss is present in up to 80% of children with DS and OME, making prompt treatment imperative to prevent adverse effects on language and development ( 2-4 ). Placement of tympanostomy tubes is common treatment for chronic OME with associated conductive hearing loss. However, tympanostomy tube insertion can be challenging in the DS population due to stenotic external auditory canals, a morphologically defining characteristic of DS seen in 40 to 50% of individuals ( 4 ). Adequate visualization is paramount not only for safe tympanostomy tube placement but also to allow for surveillance for retraction pockets, atelectasis, and cholesteatoma. Here, we demonstrate how the use of an endoscope can improve visualization and aid in difficult tube placement in this patient population.

Helicobacter pylori, causing chronic systemic infection, may colonize in middle ear milieu and conduce to effusion collection. Many investigations on relationship between pathogenesis of otitis media with effusion (OME) and Helicobacter pylori yielded conflicting results. We investigated Helicobacter pylori presence in effusion and adenoid samples of children having OME and in middle ear and adenoid samples of children with healthy middle ears to elucidate its role on OME pathogenesis. This prospective case-control study included 300 patients aged 1-12 years. One-hundred effusion samples collected from 100 children undergoing ventilation tube insertion and adenoidectomy due to chronic OME and adenoid hypertrophy formed study group, and 100 adenoid samples collected from adenoids of these children formed Group-1. One-hundred healthy-looking middle ear irrigation solutions collected from 100 children undergoing cochlear implantation formed Group-2. One-hundred adenoid samples collected from 100 children having no effusion and only undergoing adenoidectomy formed Group-3. After DNA isolation of samples, Helicobacter pylori 16S rRNA and 23S rRNA gene for clarithromycin-resistance were investigated by real time-polymerase chain reaction (Rt-PCR). The median age of 300 children was 5, and 179 were boys and 121 were girls. Helicobacter pylori was detected by Rt-PCR in none (%0) of the 400 samples (200 middle ear, 200 adenoid). In this largest sample-size study utilizing updated molecular methods to date, negative results indicate that Helicobacter pylori does not play role as an active pathogen in polymicrobiality of OME, and adenoids do not serve as a reservoir for Helicobacter pylori in this process.

Chronic otitis media with effusion (COME) has amajor impact on achild's physical and social development. Socioeconomic risk factors as well as new insights gained with modern laboratory technology and large demographic studies of COME in Central Europe are discussed. In total, 428articles from the past 8years on PubMed were reviewed as well as current guidelines of German- and English-speaking countries on COME in children. Problems of many original studies include small patient numbers and bias. In addition, aclear distinction between acute otitis media and COME is often missing. Microbiomic profiles and biofilms seem to play amajor role in COME. Established theories on the multifactorial origin of COME are mostly supported by new studies, including new insights into immunological and nutritional risk factors. In addition, the socioeconomic background of achild with COME must not be underestimated, even in first-world countries.

Effects of trypsin and pepsin detection on chronic otitis media with effusion

Objective: This study evaluated the effects of radiofrequency ablation (RFA) eustachian tuboplasty on the treatment of chronic otitis media with effusion (COME), and associated complications, in patients with premature extrusion of the tympanostomy tube (TT). Materials and Methods: Tuboplasty and T-tube reinsertion were performed in 23 ears with COME, a history of premature TT extrusion, and thickened mucus. Tube retention, perforation closure, hearing improvement, and complications were evaluated. Results: All 23 patients with COME and previous premature TT extrusion had remarkable mucosal hypertrophic disease or mucosal polypoid changes in the posterior cushion or posterior wall in the nasopharyngeal eustachian tube (ET) orifice. All surgeries were completed within 20 minutes after general anesthesia and were performed in the operating room. Pre-and post-air-bone gap gain was 18.3 ± 2.5 dB. The TT was retained for at least 12 months in 19 patients, whereas intentional premature removal at postoperative 8 to 9 months was required in 2 patients and premature extrusion occurred in 2 patients. Thus, the tube retention success rate was 91.3% (21/23). Of the 21 ears with intentional removal, the perforation closure rate was 81.0% (17/21). None of the patients reported RFA-related serious adverse events or a patulous ET. However, a scar synechia of the anterior-posterior wall was seen in 1 ET orifice, and stenosis of the ET orifice in 4 patients. Conclusions: RFA eustachian tuboplasty combined with TT insertion is a simple and minimally invasive technique for the treatment of intractable COME in patients with a thickened mucosa of the nasopharyngeal ET orifice. This technique may prevent premature TT extrusion.

ObjectiveTo assess natural history of otitis media with effusion (OME)-related hearing loss and OME causing hearing loss in children under 12 years.MethodsEmbase, MEDLINE, CINAHL, INAHTA database, CENTRAL, CDSR, Epistemonikos and...

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.

Otitis Media With Effusion After the COVID-19 Pandemic: Return to the Past and New Lessons.

Background. Otitis Media (OM) is a widespread problem that has an incidence of 10.85% worldwide, 51% occurring under the age of 5. Emergence of drug resistant bacteria contribute to high incidence of recurrent acute otitis media (AOM) and chronic otitis media with effusion (COME). Despite this, the standard of care for treatment is empiric antibiotics. Molecular microbiology diagnostics may enable clinicians to provided pathogen directed antibiosis. Nanopore sequencing is a highly accurate method of identifying a broad range of pathogens when compared with multiplex PCR. We hypothesize that nanopore sequencing is an effective method for detection of pathogens in the middle ear and nasopharynx of patients with recurrent or chronic OM. Methods. Bacterial Culture, multiplex PCR (BioFire PNA panel), and nanopore sequencing (MinIon, Oxford Nanopore Technologies) were tested on 60 middle ear and nasopharynx samples. Chi-Square test was used to examined differences in bacterial identification among the methods. Results. Bacterial identification using nanopore proves to be more sensitive in identification of 16 of the 18 unique pathogens when compared with multiplex testing. Of the 5 most common OM bacterial pathogens (S. pneumoniae, M. catarrhalis, H. influenza, S. aureus, P. aeruginosa), nanopore identified 3 pathogens (S. pneumoniae, M. catarrhalis, P. aeruginosa) at higher levels, 1 at the same rate (H. influenza), and 1 did not receive any readings (S. aureus). Conclusion. This is the first study to utilize nanopore sequencing to assess pathogens in the middle ear fluid of children with OM. While nanopore genomic sequencing is still in the early stages of use, it has potential to comprehensively identify bacteria with more sensitivity when compared to the current clinical standards. The next step of data analyzation will include bacterial identification in nanopore that multiplex PCR and traditional bacterial cultures cannot test for.

Background: Otitis media with effusion (OME), sometimes referred to as secretory or severe otitis media, is among the most common conditions in children. An estimated 80% of all children have had at least 1 episode of OME by the age of 10 years, with a peak of prevalence in the first 2 years of life. Objectives: The aim of the study was to evaluate the effects of COVID-19 on otitis media with effusion in a tertiary care hospital. Methods: This cross-section observational study Rangpur Medical College & Hospital Rangpur, Bangladesh. The duration of the period from July 2021 to July 2022. A total of 80 children, Age <6 months or >12 years with Otomicroscopic evidence of tympanosclerosis, choesteatoma, eardrum perforation, or complete stenosis or atresia of the external auditory canal were included in the study. Severely ill children and not willing to participate were excluded. After collection, the data were checked and cleaned, followed by editing, compiling, coding and categorizing according to the objectives and variable to detect errors and to maintain consistency, relevancy and quality control. Statistical evaluation of the results used to be obtained via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS- 24). Results: Before pandemic 9.52% of the respondents had <3 years of age, 23.80% were 3-7 years, 57.14% were 7-10 years and 10% had 10-12 years of age. During pandemic 11.42% of the respondents had <3 years of age, 19.04% were 3-7 years, 61.90% were 7-10 years and 7.62% had 10-12 years of age. No significant difference in mean age before and during pandemic. Before pandemic 65% of the respondents were male and 35% were female. During pandemic 40% of the respondents were male and 60% were female. Before pandemic 28.57% respondents were underweight, 57.14% were in normal range and 14.28% were overweight. During pandemic 26.67% were underweight, 55.23% were in normal range and 18% were overweight. The prevalence of OME was 40.6% before pandemic and 2.3% during pandemic. Children with chronic OME had a higher rate of disease resolution during pandemic (95%) than those examined before pandemic (5%, P \.001). Conclusion: The findings of our study, in our opinion, have important clinical implications, implying that keeping children at home for as little as 2 months may allow for the resolution of most cases with severe and refractory OME. This method, while possibly advantageous for all age groups, should be given special consideration for young children, who are the most susceptible to otitis.

Introduction. Chronic otitis media vis effusion (COME) is a disease characterized by the presence of exudate in the cavities of the middle ear and hearing loss. Predisposing factors to the development of COME can be recurrent upper respiratory tract infections.Aim. To study the effectiveness of the drug Sinupret® in children who have undergone surgical treatment for COMEMaterials and methods. A clinical study was conducted at the Department of Otorhinolaryngology of TMU and GBUZ TO OKB No. 2 in 2020–2021. This study involved 30 children (15 boys and 15 girls) with HESO. The mean age of all patients was 6.33 ± 0.31 years. In the 1st group of children, consisting of 15 people (10 boys and 5 girls), Sinupret® was prescribed in the postoperative period, in the 2nd group of children, consisting of 15 people (5 boys and 10 girls), Sinupret® was not prescribed. Diagnosis of chronic POE was carried out on the basis of clinical and instrumental examination and integral indices of peripheral blood. Conservative treatment consisted of topical decongestant therapy and rifamycin 2.6% ear drops for a week. The observation period included 12 months.Results. ARVI episodes during the year in group I were observed in 20%, in group II in 60% of children, the average duration of the disease in group I was 5 ± 0.71 days, in group II 7.8 ± 0.42 days (p = 0.01), stable hearing recovery in children of the 1st group was recorded in 100%. POE recurrence in children of group II was registered in 27% (4 people), which required repeated shunting to restore hearing.Conclusions. Prophylactic use of the drug Sinupret® in children who have undergone surgical treatment for chronic OME allows you to achieve a stable restoration of hearing and contributes to complete recovery.

Analysis of Paparella Type 1 tympanostomy tubes in pediatric patients: A single-center retrospective review

Background: Otitis media with effusion (OME), the most common ear disease in pediatrics, can lead to hearing loss (HL) and might have a significant impact on a child’s auditory and speech development. Objectives: This study was conducted to indicate the audiologic profile of children with chronic OME who were scheduled for tympanostomy tube placement. Methods: Otoscopy, pure-tone audiometry, and tympanometry assessments were carried out in 663 children (420 males and 243 females) who had a chronic OME diagnosis and were scheduled for ear surgery. They were selected consecutively at Imam Khomeini Hospital, Ahvaz, Iran. Results: The most frequent age groups affected by OME were 12 - 36 months (33.48%) and 36-72 months (31.67%). The majority of children (60.03%) showed retracted tympanic membrane (TM), and the most common color of the TM was yellowish-brown, observed in 74.20% of cases. Before surgery, the majority of patients demonstrated mild conductive hearing loss (61.08%) and a Type B tympanogram (73.75%). The myringotomy site of 61.53% of children was anterior-inferior. Four hundred-eight children indicated serous secretion. The mean pure-tone average before surgery was significantly reduced after surgery (45.23 ± 23.25 vs. 27.83 ± 15.86 dB HL, P = 0.001). This improvement was about 18 and 17 dB in the right and left ears 2 months after surgery, respectively. The postoperative findings also indicated that in 487 children (73.45%), hearing thresholds returned to normal limits. Conclusions: It is essential to address chronic OME promptly to prevent potential long-term impacts on a child’s hearing, speech, and language. Treatment options, such as watchful waiting or surgical intervention, depending on the severity and duration of the condition, are effective procedures in this group of patients.

Impacts of health insurance on tympanostomy tube outcomes in the pediatric population.

The effects of treating GERD on the outcomes of otitis media with effusion: A systematic review and meta-analysis