Diagnosis Of Secretory Otitis Media Research Articles

Predictive Value of Adenoid-Nasopharyngeal Ratio in the Diagnosis of Secretory Otitis Media.

To explore the associated factors of otitis media with effusion (OME) and analyze the diagnostic value of the adenoid-nasopharyngeal (A/N) ratio to OME. Patients with adenoid hypertrophy (AH) recently in 2years were collected, including sex, age, duration, with/without rhinosinusitis, and examination results, including Cone Beam Computerized Tomography (CBCT) sinus imaging, tympanometry, pure tone audiometry (PTA), blood test, and allergen detection. According to Liden/Jerger's classification, the patients were divided into two groups: Type B and type C, which were defined as the tympanometry abnormal group (TAG), and the rest were classified as the tympanometry normal group (TNG). A total of 316 children were included in this study. Age and duration were significantly younger and shorter in TAG (6.0(4.0-9.0) vs.5.0(4.0-7.0)); 12.0(4.0-24.0) vs.6.0(2.0-12.0)). Compared to TNG, the allergen test results of fx5 (protein, milk, cod, wheat, peanut, and soybean) in TAG were higher (0.09(0.04-0.25) vs.0.14(0.05-0.45)), but eosinophilia in blood was lower (count: 0.21(0.13-0.35) vs. 0.18(0.12-0.27); ratio: 3.10 (1.90-4.70) vs. 2.50 (1.65-3.80)). A/N ratio and Visual obstruction ratio had a statistical difference (Z = -3.770, P < .01) but the two ratios didn't have too much disparity (0.82(0.74-0.88) VS 0.80(0.75-0.80)), and they had a positive correlation (r = 0.345, P < .01). A/N ratio of TAG was higher than TNG (0.78(0.70-0.85) vs. 0.86(0.82-0.90)) and had a positive correlation with increasing negative middle ear pressure (r = -3.777, P < .01). A/N ratio was an associated factor of OME (OR:1355.611, P = .006), the cut-off value of A/N ratio was 0.815(sensitivity: 75.3%, specificity: 64.3%, area under the curve (AUC): 0.747). A/N ratio indirectly reflected the abnormality of tympanometry in this study. When A/N ratio reaches 0.815, patients are at a higher risk of having OME so it could be a predictor of OME in patients with adenoid hypertrophy.

Diagnostic value of ABR wave and DPOAE test in 65 infants with secretory otitis media

Objective To study and analyze the diagnostic value of auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) in infants with secretory otitis media. Methods From June 2016 to June 2018, 65 infants (120 ears) with secretory otitis media who were treated at the First People's Hospital of Taizhou were selected.All the 120 ears were diagnosed by ABR wave test and DPOAE test machine.The results of different diagnostic methods were observed and compared. Results Among 65 cases (120 ears), 60 ears (50.00%) with mildly abnormality, 43 ears (35.83%) with moderate abnormality and 17 ears (14.17%) with normal ABR wave Ⅴ response threshold.There was no statistically significant difference in Ⅰ-Ⅴ wave interval between the mild abnormal group and the normal group (P>0.05), but Ⅰ-Ⅴ wave interval in the moderate abnormal group[(4.27±0.27)ms in moderate abnormal group] was significantly shorter than that in the normal group[(4.75±0.31)ms] and the mild abnormal group[(4.73±0.21)ms], the differences were statistically significant(t=5.949, 9.722, all P<0.05). The Ⅴ response threshold of bone-guided ABR wave was normal in 108 ears(90.00%, 108/120). The Ⅴ latency of bone guided wave was (8.16±0.22)ms, and abnormal in 12 ears (10.00%, 12/120). With the increase of the gas conduction reaction threshold, the bone conduction ABR reaction threshold also increased, but it was not as obvious as the air conduction.The wave Ⅴ latency in the normal BRT group was significantly lower than that in the abnormal group (compared with mild abnormal group, t=17.400, P<0.05; compared with moderate abnormal group, t=130.015, P<0.05). DPOAE test failed 86 ears (71.67%, 86/120), passed through 34 ears (28.33%, 34/120). Conclusion The latency of ABR wave I is sensitive to the diagnosis of secretory otitis media in infants.The combination of DPOAE and ABR is helpful to the early diagnosis of the disease.ABR and DPOAE tests have high value and are worthy of popularizing in clinic. Key words: Otitis media; Evoked potentials, auditory, brain stem; Distortion product otoacoustic emissions; Air-guided ABR waves; Bone-guided ABR waves; Wave I latency

The opportunities of optical coherence tomography in the diagnosis of secretory otitis media

The article describes the method of in-life noninvasive examination of the middle ear structures in the normal condition and in the patients with secretory otitis media – optical coherence tomography (OCT). The authors present the opportunities of OCT in the identification of pathological exudate in the tympanic cavity and suggest the use of OCT in various measurement modes to improve the quality and informativity of the image. The article establishes the possibility of assessment of physical properties of the middle ear exudate (viscosity) based on the comparison of optical properties of the exudate and the reference fluid.

The opportunities of optical coherence tomography in the diagnosis of secretory otitis media

The opportunities of optical coherence tomography in the diagnosis of secretory otitis media

Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study.

Secretory otitis media (SOM) remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM), is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®). After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations.

Predictive value of acoustic reflectometry (angle and reflectivity) and tympanometry

Objective: Tympanometry and acoustic reflectometry are suggested tools for confirmation of otoscopic diagnosis of secretory otitis media. The issues on sensitivity and specificity of both devices are contradictory. In this study, our purpose was to compare sensitivity and specificity of both devices and to look for whether it is possible to reach higher values by combining them. Methods: This study included 150 normal ears and 150 ears with chronic effusion. In tympanometry, only B tracings were accepted as predictor of effusion. In acoustic reflectometry, reflectivity (cut point: 5) and curve angle with two cut-points (75° and 90°) were used. Results: Acoustic reflectometry presented higher specificity by both reflectivity (cut point: 5) and by curve angle (cut point: 75°) (99.33% by both) than tympanometry (92%) ( χ 2 analysis, P<0.001). But, their sensitivities (65.33 and 78%) were lower than tympanometry (96%) ( χ 2 analysis, P<0.001). With curve angle of 90°, specificity of acoustic reflectometry decreased to 85.33%, sensitivity increasing to 97.33%, which was not different from tympanometry ( χ 2 analysis, P>0.1). When data of curve angle and tympanometry were combined, specificity and sensitivity of the combined test were found to be 91.33 and 100%, respectively. Conclusions: (i) Acoustic reflectometry should not be proposed as a better device than tympanometry, because its test efficiency was not higher than tympanometry. (ii) The only advantage of AR (reflectivity ≥5 and curve angle ≤75°) was its high specificity to effusion. In addition, higher curve angles than 90° were found to be highly predictive for normal ears as much as tympanometry. But, predictivity of curve angle between 76° and 90° was low. (iii) When tympanograms and curve angle were combined, it was found that prediction of this combination for curve angles between 76° and 90° was perfect. (iv) We consider that both test devices provide complementary data to each other, which would be particularly important for screening studies and that they are good tools for confirmation of clinical impression, particularly for less experienced clinicians.

Otoscopy and tympanometry in the diagnosis of secretory otitis media

OBJECTIVE: To study the sensitivity and specificity of otoscopy and tympanometry in the diagnosis of secretory otitis media. METHODS: A prospective study was performed in 98 children (196 ears) with indication of myringotomy with placement of tympanostomy tube because of the diagnosis of secretory otitis media. All these patients had conductive hearing loss and/or delay of speech and/or low school performance. To evaluate the diagnostic power of the tests, both otoscopy and tympanometry were performed. Myringotomy was established as the gold-standard. The statistical analysis was done using the chi-square test, being significant a p<0.05.RESULTS: The mean age of the patients was 6.02 years (sd: 2.93 years). The otoscopy presented sensitivity of 87.5% and specificity of 61.1% and the tympanometry presented sensitivity of 93.75% and specificity of 72.2%. CONCLUSIONS: There was no statistically significant difference in sensitivity between otoscopy and tympanometry for the diagnosis of secretory otitis media, however, tympanometry was significantly more specific than otoscopy (p< 0.01).

Consensus: How is a Diagnosis of Secretory Otitis Media Arrived at, and What Diagnostic Methods are Available for Establishing the Degree of Severity?

Consensus: How is a Diagnosis of Secretory Otitis Media Arrived at, and What Diagnostic Methods are Available for Establishing the Degree of Severity?

Middle ear dynamic characteristics of patients obtained by a newly developed measuring apparatus

A tympanometer is well known to be a valuable apparatus for the diagnosis of secretory otitis media (SOM). However, it is insufficient for the diagnosis of ossicular chain disorders. Therefore, an attempt was made to develop a new measuring apparatus, which had a function of sweeping both frequency and pressure and was measurable the absolute sound pressure variations at the external auditory canal, owing to the carefully designed probe. In the previous papers, the middle ear dynamical characteristics of normal subjects were measured by this apparatus, and the measurement results were compared with the theoretical analysis. In this paper, the middle ear dynamical characteristics of patients were measured, and the effects of various kinds of middle ear diseases upon its dynamical characteristics were examined. The measurement results of the patients with ossicular chain separation, ossicular chain fixation, SOM and tympanic membrane perforation had their own distinctive patterns, and were also clearly different from those of normal subjects. Therefore, this apparatus seems to have a high degree of the clinical applicability to the diagnosis of these diseases.