Chronic Suppurative Otitis Research Articles

Complicated suppurative otitis media in a Greek diver due to a marine halophilicvibriosp.

Halophilic vibrios are distinct from non-cholera vibrios and have been recognized increasingly as potentially pathogenic bacteria in extraintestinal infections. A case of suppurative chronic otitis media in a Greek diver with Vibrio alginolyticus recovered from an ear drainage culture, is reported. The patient received appropriate antimicrobial therapy and her hearing improved significantly after a tympanoplasty type I was performed. The association of halophilic Vibrio spp. infections with prolonged seawater contact, particularly in subtropical climates, is discussed. In swimmers with extensive exposure to salt water, individual preventive measures and aetiological treatment of ear infections seems to be required in order to reduce the severity of possible Vibrio spp. ear infections.

Relevant demographic factors and hearing impairment in Saudi children: epidemiological study.

A representative sample of 6421 Saudi children were clinically examined and screened for hearing loss. Hearing impairment was detected in 494 children (7.7 per cent). In 326 of the children it was due to chronic secretory and suppurative otitis media (5.07 per cent) and in 168 of them sensorineural hearing loss (2.6 per cent). The study revealed that parental education, low income, and employment of the mother showed a slightly higher at risk rate of hearing impairment. Children from related parents were also at a higher risk of hearing impairment and they demonstrated a marked adverse effect on the incidence of hereditary sensorineural hearing impairment. Comparison with other surveys of school children in developed and developing countries has been carried out.

Malignant tumours of the middle ear

The authors present 15 patients with middle ear malignant tumours, of which 13 were squamous cell carcinomas, one was a rhabdomyosarcoma and one a malignant lymphoma. In 11 of 13 patients with squamous cell carcinoma, long-standing chronic otitis media preceded the malignant process and only in 2 patients did the tumour develop without previous chronic infection. Most of the patients presented at an advanced stage of the disease: in 6 the tumour had destroyed surrounding bone, commonly involving the endocranium; in 7 the facial nerve was paralysed and in 8 patients there was total hearing loss. The diagnosis of malignant tumour was established before surgery in 5 patients, but 8 patients were operated upon for suspected chronic otitis. Three patients died without treatment and 10 were treated: 3 with radiotherapy because the tumour was inoperable, 3 had surgery only and 4 patients had surgery and received radiotherapy post-operatively. Of 7 operated patients only 2 are alive without signs of tumour. Our findings suggest that otologists should bear in mind this disease in patients with chronic suppurative otitis and accompanying suspected symptoms. In 2 patients with rare types of sarcoma of the middle ear the diagnosis of tumour was established at an advanced stage and they could not be treated.

Chronic Otitis Media and Sequelae in the Population of Greenland

It is generally recognized that chronic otitis media and sequelae of this disease are frequently encountered among the native population of Greenland, but the prevalence of chronic otitis in Greenland has not previously been systematically traced. Treatment for this disease has improved and we expect an increased demand for treatment of this disease among Greenland natives. To evaluate the need of treatment the prevalence of chronic otitis media in two large Greenland towns was assessed. The study population included 303 persons aged 11-20 years and 305 aged 41-50 years. Medical histories were recorded and objective examinations were performed using e.g. oto-microscopy. Among the young participants, 8% had chronic suppurative otitis and 14% sequelae of chronic otitis media. Among the older participants, 2% had suppurative otitis and 13% sequelae of chronic otitis. It is estimated, using Scandinavian criteria, that 8.6% of the participants would have benefitted from an ear operation either to stop otorrhea and/or to improve the hearing. The launching of an oto-surgical effort in Greenland is considered justifiable on the grounds of the importance of hearing to communication and the isolation in point of the native Greenland population.

Otitis media in children: to treat or not to treat?

OTITIS media is the most frequent diagnosis made by physicians who care for children.1 , 2 Acute otitis media is usually suppurative or purulent, but serous middle-ear effusions may also have an acute onset. Chronic otitis media with effusion has many synonyms, including such terms as secretory, and nonsuppurative otitis media and glue ear. 3 A chronic effusion may be serous, mucoid, or even purulent. In some instances, the eardrum may be retracted or collapsed without a middle-ear effusion; this condition is termed atelectasis of the tympanic membrane and is the result of persistent or intermittent negative middle-ear pressure. Chronic suppurative otitis . . .

Middle ear and Eustachian tube lining in chronic otitis media

By means of histological observations we have tried to find morphological data on which to classify non-suppurative and suppurative chronic otitis media. There was also evidence of pathophysiological features which may have direct influence upon the development and behaviour of chronic inflammations of the tympanic cleft, such as disorders of ventilation and reaction of the mucoperiosteal layer. Local defence mechanisms, the species and virulence of infection also play an important role. It appears that the Eustachian tube is a very effective mechanical and immunological barrier against ascending infection which may perhaps be assisted by antibiotic treatment. Certainly non-suppurative chronic otitis media is more frequent now than in pre-antibiotic days.

Inflammatory Middle Ear Diseases in Patients with Cystic Fibrosis

111 patients with cystic fibrosis (CF), aged 7 months to 29 years, were examined to detect inflammatory middle ear diseases. 35% had a history of one or more attacks of acute otitis media, an incidence at the same level as in non-CF patients. None had chronic suppurative otitis. Only 4 out of the 88 patients able to cooperate in audiometry had a hearing impairment. In 2, the hearing loss was perceptive, in 3 very mild, and in the fourth case, moderately severe. The middle ear pressure was measured in 108 patients, in 86 of whom it proved normal. In 15 patients the middle ear pressure was lower than--100 mmH2O, indicating tubal occlusion, and in 7 patients the impedance minimum was lacking, indicating an accumulation of mucus. These 7 patients (6%) had secretory otitis media. Nasal polyps were or had been present in 32%. There was no correlation between nasal polyps and tubal occlusion or secretory otitis. The incidence of inflammatory middle ear diseases in CF patients was in the same range as in non-CF patients, a finding at variance with some previous investigations showing middle ear pathology in 25--48%.

Chronic Secretory Otitis Media

212 of 242 patients (88%) treated for chronic secretory otitis media in 1972 were re-examined 5 years later. A total of 668 otological procedures has been performed, 99 patients being treated only once, while one patient received 12 procedures. The pure tone threshold was 20 dB or less in 88% of the ears in 1977, whilst only 57% had a type A tympanogram. Normal otoscopy was found in 40.5% of the ears, persisting secretory otitis in 11%, atelectasis in 2.8% and chronic suppurative otitis in 2.6%; the remaining 42.9% showed varying degrees of scarring and myringosclerosis.

Production of mucus in the middle ear and Eustachian tube. Embryology, anatomy, and pathology of the mucous glands and goblet cells in the Eustachian tube and middle ear.

On the basis of quantitative studies of the mucus elements in 144 temporal bones and more than 5,000 biopsies the mucus producing capacity of the mucosa in the middle ear and Eustachian tube under normal conditions as well as in acute and chronic middle ear diseases is reviewed. In completely normal middle ears there was a very low goblet cell density and no mucous glands. Production of mucus does take place, but it is very slight. In acute conditions the goblet cell density in the Eustachian tube and middle ear increases, and metaplastic changes of the mucosa may occur, with formation of subepithelial and intraepithelial mucous glands. In chronic diseases, such as secretory otitis, there is a high gland and goblet cell density, which explains the increased production of mucus. In adhesive otitis the gland density is great, it is true, but most glands have become inactive and have degenerated. In chronic suppurative otitis, cholesteatoma, and sequelae to chronic otitis the goblet cell and gland density is moderately increased, but there are very marked individual variations which explain the great difference in the production of mucus. In active chronic diseases the mucus elements may increase enormously, and the mucus producing capacity of the epithelium may reach the heights of that of the respiratory mucosa.

The submucous layer of the middle ear in chronic otitis media. II. Chronic suppurative otitis media. A histological and ultrastructural study.

In continuation of a previous study on the submucous layer of the middle ear in chronic secretory otitis, the authors describe the same structure in chronic suppurative otitis. The changes proved to be identical with those of chronic secretory otitis, only far more pronounced. As a sign of the suppurative nature of the inflammation, there was marked infiltration of the tissue by neutrophilic leukocytes. Eosinophilic leukocytes were not demonstrated. In the stroma there was an increase in the number of collagen fibrils more marked than in secretory otitis. There were also signs of degenerative changes of the collagen fibrils, in the form of fibrinoid transformation, fibrolysis, and possibly also hyaline transformation. In the present study it was not possible to investigate necrosis, if any, of the bone beneath the submucosa. However, it is a fact that chronic suppurative otitis often involves necrosis of the ossicles. This has previously been explained as a consequence of anoxia caused by the suppurative inflammation, but the proliferation of the capillary network with increased blood flow found in the present study militates against this theory. In a subsequent study it will be endeavoured to elucidate whether such necrosis may be caused, under certain circumstances, by an increased number of histiocytes and neutrophilic leukocytes with a content of lysosomes.

Hearing test for conductive deafness

test has become important for tympanoplasty because it indicates the location of lesion and predicts postoperative hearing. However the basic knowledge has not yet been accumulated enough to establish this method. Therefore, the author measured the mechanical characteristics of a nylon which was attached to a bone conduction receiver. It was found that this Sonde was hardly influenced by the pressure when it was pressed on the subject's ear drum, Moreover, this Sonde had no appreciabie amolitude distortion. Then the author carried out hearing test using this Sonde in 136 cases of conductive deafness. This Sonde was proved to be available in clinical use because of little pain in its application to the ear drum. Hearing loss measured by the Sonde corre- sponded with air conduction loss in cases of oto- sclerosis and pseudo-otosclerosis in which the mobi- lity of the ossicular chain was affected. On the other hand, hearing loss measured by the Sonde did not always correspond with air conduction loss in adhesive otitis, cholesteatoma otitis, and chronic suppurative otitis. This fact depended upon whe- ther the mobility of the ossicular chain was affe- cted in these cases or not. When the ossicular chain was intact in mobility, no hearing loss was detected by the Sonde and vice versa. Therefore, when hearing loss by the Sonde was more than 20 dB, it was diagnosed as the disorders of the ossi- cular chain. But when hearing loss was within 20 dB, the ossicular chain was regarded as intact or as of the type of continuity by the connective tissue. In this case liquid-conduction test and the test using the artificial ear drum should be applied to confirm the diagnosis made by Schallsonde test'

Experiences in the Use of TERRA-CORTRIL Aural Drops in Suppurative Otitis Media

Therapeutic effect of TERRA-CORTRIL aural drops composed of oytetracycline and hydrocortisone was tested by using it in the treatment of 16 ears affected with acute suppurative otitis media, 16 ears with chronic suppurative otitis media.Once a day the ear under treatment was filled with 0. 2-0. 5 ml of TERRA-CORTRIL aural drops.In acute suppurative otitis media the agent was effective in establishing a cure in 100% of total number ; in chronic otitis media, 88%.

Pathogenesis and histopathology of chronic adhesive otitis.

SOME FACTS speak in favor of the assumption that in present-day otology chronic adhesive otitis, instead of manifest suppurative chronic otitis, will become the commonest inflammatory disease of the middle ear leading to serious deterioration of hearing. Thanks to modern antibacterial agents, it seems possible that development of manifest suppurative chronic otitis can in most cases be prevented by proper therapy. In spite of the new drugs, prevention of chronic adhesive otitis can hardly be equally successful, owing to the somewhat obscure origin and insidious development of this disease. On the contrary, there is reason to believe that some conditions which previously would have resulted in manifest suppurative chronic otitis may now develop into chronic adhesive otitis. It thus seems that a reconsideration of chronic adhesive otitis is appropriate. As regards clinical characteristics, there is a close resemblance between chronic adhesive otitis and otosclerosis. Probably some of the lesions diagnosed

XXVIII. Chronic Recurrent Suppurative Otitis Media and Its Relation to Mastoid and Intracranial Complications

XXVIII. Chronic Recurrent Suppurative Otitis Media and Its Relation to Mastoid and Intracranial Complications

VIII. A Brief Consideration of Prognosis in Chronic Suppurative Otitis, Based on the Results of a Year's Treatment of Such Cases

VIII. A Brief Consideration of Prognosis in Chronic Suppurative Otitis, Based on the Results of a Year's Treatment of Such Cases

A review of the present position of intra‐tympanic surgery in chronic suppurative otitis and in sclerosis of the middle ear

A review of the present position of intra‐tympanic surgery in chronic suppurative otitis and in sclerosis of the middle ear