Ear Diseases In Children Research Articles

Ear Diseases in Children Presenting at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh

Introduction: Ear diseases have been found to be important health problems among children. Nearly one third of Otorhinolaryngology outdoor attendance in the hospital comprised of paediatric age group. The problem is compounded by the fact that the children are economically dependent on their parents who are largely poor. However, the cause of hearing loss in children is more varied, including the etiologies. Objective: To find out ear diseases in children presenting at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Materials and Methods: This hospital-based prospective study was carried at Department of ENT & Head-Neck Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to December 2021. 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. All patients aged 16 years or younger presenting with ear diseases to the ENT clinic of the hospital and seen by ENT surgeons were enrolled into the study. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. Five hundred and sixty one (64.4%) were males. The male to female sex ratio was 1.8:1. Table 2 the various types of ear disease were as CSOM (Chronic Suppurative Ottitis Media), ASOM (Acute Suppurative Ottitis Media) and OME (Ottitis Media with Effusion). Wax (33.6%) followed by CSOM (18.7%) and ASOM (13.8%) were the most common ear diseases in paediatric patients in tertiary care centre. Ear diseases commonly found in this study were in the age group of 6-10 years and most ear diseases were more common in boys. It was found that wax (33.6%) was the most common diagnosed ear disease. Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. Improvement of health care facilities and awareness amongst health care providers would definitely be helpful in reducing the prevalence of ear diseases in developing countries.

Intelligent smartphone-based multimode imaging otoscope for the mobile diagnosis of otitis media.

Otitis media (OM) is one of the most common ear diseases in children and a common reason for outpatient visits to medical doctors in primary care practices. Adhesive OM (AdOM) is recognized as a sequela of OM with effusion (OME) and often requires surgical intervention. OME and AdOM exhibit similar symptoms, and it is difficult to distinguish between them using a conventional otoscope in a primary care unit. The accuracy of the diagnosis is highly dependent on the experience of the examiner. The development of an advanced otoscope with less variation in diagnostic accuracy by the examiner is crucial for a more accurate diagnosis. Thus, we developed an intelligent smartphone-based multimode imaging otoscope for better diagnosis of OM, even in mobile environments. The system offers spectral and autofluorescence imaging of the tympanic membrane using a smartphone attached to the developed multimode imaging module. Moreover, it is capable of intelligent analysis for distinguishing between normal, OME, and AdOM ears using a machine learning algorithm. Using the developed system, we examined the ears of 69 patients to assess their performance for distinguishing between normal, OME, and AdOM ears. In the classification of ear diseases, the multimode system based on machine learning analysis performed better in terms of accuracy and F1 scores than single RGB image analysis, RGB/fluorescence image analysis, and the analysis of spectral image cubes only, respectively. These results demonstrate that the intelligent multimode diagnostic capability of an otoscope would be beneficial for better diagnosis and management of OM.

A Study of Middle Ear Diseases in Children with Congenital Bilateral Severe to Profound Sensorineural Hearing Loss.

(1) To find the presence of middle ear diseases present in the patients with congenital bilateral severe to profound SNHL (2) If it poses as a threat to rehabilitative efforts for the existing severe to profound SNHL. Study setting: Department of ENT, C U Shah medical college and hospital. Study design: Prospective study Study population: Patients attending ENT department with complaints of congenital bilateral severe to profound sensorineural hearing loss. A total of 50 cases were studied during the study period. Methods of data collection: The Proforma was designed based on objective of the study. Detailed history was taken followed by thorough ENT and systemic examinations. Otoscopy and otoendoscopy were carried out and all patients were subjected to hearing tests consisting of Pure Tone Audiometry (PTA), Impedance Audiometry (IA), Brainstem Evoked Response Audiometry (BERA) and Oto Acoustic Emissions (OAE). HRCT and MRI scanning of temporal bones of all the patients was included as a part of the routine workup. Out of the 50 children with bilateral congenital hearing loss studied in this study, 13(26%) children were observed to have concurrent middle ear pathologies. 2 patients had bilateral retracted drum with tympanosclerosis; 3 had bilateral retraction pocketswith mastoiditis; 1 had bilateral SOM; 1 had right SOM and left retracted drum; 2 had bilateral PSQ cholesteatoma; 1 had left SOM and right sided tympanic membrane perforation, 3 had right sided tympanic membrane perforation with left sided normal ears. Children with congenital bilateral severe to profound hearing loss should be examined for middle ear pathologies, which can most often be overlooked otherwise, hence rendering the patient unfit for definitive management of the severe to profound SNHL in the form of Hearing Aid trial or Cochlear Implantation, further delaying the development of speech. Hence, all children with congenital bilateral severe to profound hearing loss should undergo regular screening for assessment of middle ear pathologies with prompt treatment when any middle ear pathology is encountered, therefore rendering the patient fit for fitting of cochlear implantation at the earliest possible to decrease permanent impairment of speech.

Balloon Eustachian Tuboplasty (BET) in Children: A Retrospective Multicenter Analysis.

Generation of pilot data for planning of prospective BET-studies for treatment of dilatory Eustachian tube (ET) dysfunction in children. Retrospective multicenter analysis. Nine ENT departments at tertiary care teaching hospitals. 4-12-year-old children with chronic otitis media with effusion (COME) for more than 3 months or more than 3 episodes of acute otitis media during the last year, having failed standard surgical therapy at least once. BET with or without paracentesis, ventilation tube insertion, or tympanoplasty. Tympanic membrane appearance, tympanometry, and hearing threshold. Two hundred ninety-nine ETs of 167 children were treated. Mean age was 9.1 years (95% confidence interval [95% CI]: 8.7-9.4 yr). In 249 ears (83.3%), COME and/or retraction of the tympanic membrane were the indication for BET. Median hearing threshold was 20 dB HL (95% CI: 0-46 dB). One hundred fifty-five ears (51.8%, 95% CI: 46.1-57.4%) showed a tympanogram type B. Treatment consisted of BET without other interventions ("BET-only") in 70 children, 128 ears. Median length of follow-up for 158 (94.6%) children was 2.6 months (95% CI: 0.3-16.1 mo). After treatment, the tympanic membrane appeared normal in 196 ears (65.6%, 95% CI: 60.0-70.8%, p < 0.001). Median hearing threshold improved to 10 dB HL (95% CI: 0-45 dB, p < 0.001). Tympanograms shifted toward type A and C (type A: 39.1%, 95% CI: 33.7-44.7, p < 0.001). These improvements were also observed in subgroup analyses of "BET-only" treatment and the indication of "COME" respectively. BET is improving a variety of dilatory ET dysfunction-related ear diseases in children. This study provides detailed data for design and planning of prospective studies on BET in children.

Clinical Study on Middle Ear Diseases in Children with Orofacial Clefts.

IntroductionOrofacial clefts are associated with middle ear diseases, but the magnitude of this problem is not generally well appreciated. The aim of this study was to describe the middle ear findings and audiological profile in children with orofacial clefts.Materials and methodsChildren with orofacial clefts attending plastic surgery and otorhinolaryngology departments of a tertiary hospital over one-year duration were included in this study. Ninety-six children with orofacial clefts were identified. They were categorized age-wise as zero to five years, more than five years to 10 years, and more than 10 years to 15 years. They underwent a detailed ear, nose, and throat examination followed by audiological tests, including brainstem evoked response audiogram (BERA), pure tone audiogram (PTA), and tympanometry.ResultsAmong 96 children with orofacial clefts, only 24 children (25%) had symptomatic ear problems, whereas on ear examination, 56 children (58.3%) had abnormal ear findings. Middle ear effusion (MEE) was the most common ear condition, and it was seen in 94 ears (48.9%). Cholesteatoma was noted in six children (3.1%). Out of 73 children in the zero to five age group, 58 children (79.5%) did not have any history of ear problem but 55.5% (81 ears) had features of MEE such as a dull tympanic membrane (TM). In the age group of more than five years to 10 years, only four children (28.5%) were symptomatic. Five children (55.5%) out of nine in the age group of more than 10 years had a symptomatic ear problem of which four children (44.4%) had chronic otitis media squamosal disease. The earlier age groups showed a trend of ear disease being asymptomatic compared to older children. Normal hearing was present in only 40 children (41.7%) and various degrees of hearing loss were seen in 56 children (58.3%). The mean air conduction threshold in the age group zero to five years, more than five years to 10 years, and more than 10 years were 33±8.3 decibels (dB), 25±6.2 dB, and 31.5±14 dB, respectively. Out of 144 ears (72 children) in the asymptomatic group, 67 ears (46.5%) had normal hearing. Seventy-seven ears (53.5%) had some degree of hearing loss. Mean air conduction hearing loss in the asymptomatic group was 29.8±7.3 dB.ConclusionThis study highlights the higher incidence of middle ear diseases compared to the presenting symptoms in children with orofacial clefts. This stresses on the need for a detailed otological evaluation to identify any middle ear pathology so that timely intervention can be taken.

Burden of ear morbidities among children in primary care setting in Delhi

IntroductionEar diseases in children are a major public health problem in developing countries. Among the risk factors of ear morbidities, socio-demographic factors play an important role. ObjectiveTo determine prevalence of ear morbidities and its socio-demographic determinants in children 1–10 years in an urban primary health center in Delhi. Materials and methodsA cross-sectional study was conducted among 160 children aged 1–10 years in an urban primary health center situated in Delhi over a period of 3 months from January to March 2015. Primary caregivers (mother/father) of ill children aged 1–10 years who came to seek medical care for their children were interviewed using pre-tested, predesigned, semi-structured questionnaire schedule. Data was analyzed using SPSS software (version 17). Chi-square test was used to observe the differences between proportions. The results were considered statistically significant if “p” value was less than 0.05. ResultsThe study was conducted among 160 children of which 87 (54.4%) were males and 73 (45.6%) were females. Majority of families were Hindu (90.6%) and nuclear (53.8%) residing in same community. 30 (18.8%) children reported with ear complaints to out-patient department. 50 (31.2%) caregivers reported history of ear complaints in the child. Most common complaints were foreign body (14.37%), hearing loss (11.24%) and ear discharge (5.62%). No association was seen with age, gender and education of caregivers. Conclusion and recommendationsThere is a need to take immediate measures for prevention and control of common ear diseases in children.

Prevalence of ear diseases in the children of Delhi.

This study aimed to assess the prevalence and profile of ear diseases in children from Delhi, India. A population-based cross-sectional door-to-door survey was carried out in two districts of Delhi, and involved children of all demographic sections of the region. A total of 4626 children aged between 18 days and 15 years underwent examinations including otoscopy, impedance audiometry and hearing screening. In all, 14.8 per cent of the study sample was diagnosed with one or more ear morbidities, the most common being cerumen impaction (7.5 per cent) and chronic suppurative otitis media (3.6 per cent). There was clinical evidence of otitis media with effusion in 2 per cent of children, and 0.96 per cent had otitis externa (bacterial and fungal). The point prevalence of acute suppurative otitis media was 0.39 per cent. In all, 0.45 per cent of children were found to have an undiagnosed foreign body within the ear canal. The high prevalence of ear disease poses a significant public health problem in Delhi.

A comparative evaluation of ear diseases in children of higher versus lower socioeconomic status

This study was conducted with an aim to assess the prevalence and profile of ear diseases in children from the higher and lower socioeconomic strata of society. Two groups of schools within Delhi were selected. Group A comprised of government schools located in slum areas with an average parental income of INR (Indian National Rupees) 1050 per month and group B of elite private schools with an average family income of TNR 35,000 per month. Three thousand children between the ages of 5-12 years were screened with the help of a written proforma and ear examination. Tympanometry and audiometry were done, where required. 19.6 per cent of children of group A were found to be suffering from ear diseases compared to 2.13 per cent of group B children. The two groups were also compared for number of family members, status of hygiene and parental education.

Importancia de la impedanciometría dentro de un programa de screening auditivo con otoemisiones en niños

The target of this paper is to evaluate the importance of Impedanciometry in a protocol with transient evoked otoacoustic emissions on high risk infant hearing screening. We used tympanometry and stapedious reflex only when otoacoustic emissions became altered. This method try to decrease the impact in this test caused for middle ear diseases. We realized an Impedanciometry study in all children with abnormal otoacoustic responses and then, we obtained normal otoacoustic responses when tympanometry normalize. In the other hand, the time of test wasn’t too large, between 15-20 minutes for child. The analysis of specificity and positive predictive value, of otoacoustic emissions without Impedanciometry was 89% and 45% respectively, however the same values with Impedanciometry was 96% and 75% respectively. In our opinion, high frequency of middle ear diseases in children, and our results, justify the introduction of Impedanciometry in a complete protocol of hearing screening with Otoacoustic Emissions, preventing appearance of false positive caused by these diseases.

Review : Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

This report presents a detailed review of the available epidemiological evidence concerning the prevalence of middle ear infections in children in relation to their expo sure to smoking by their parents or other household members and is based on English-language papers cov ering the period 1979-1998. Fifty-eight studies are in cluded in the review, with the most widely used index of exposure being parental smoking. Smoking by all house hold members, by either parent separately and by the mother during pregnancy were also considered in some of the studies. Only 3 studies attempted to quantify expo sure objectively, using measurements of cotinine and nicotine in hair, saliva and pericardial fluid. Tables listing unadjusted and adjusted relative risk estimates were constructed for both postnatal exposure to tobacco smoke and for maternal smoking during pregnancy. The results for postnatal exposure were separated into five disease categories. The overall data suggested some association of postnatal exposure to tobacco smoke with three categories; recurrent otitis media, otitis media with effusion and unspecified middle ear disease, with risk tending to increase with increasing exposure, but no association with acute otitis media or with persistent oti tis media with effusion. However, reported associations were generally quite weak, with relative risks typically below 1.5. Problems in interpreting the data arise from the difficulty of distinguishing possible effects of envi ronmental tobacco smoke and of maternal smoking dur ing pregnancy (for which the data also suggest an asso ciation), the possibility that the underlying cause of mid dle ear disease is in fact an infection, and from the var ious possibilities of bias inherent in epidemiological studies of a weak association, particularly due to inade quate control of confounding. Though it is prudent for parents not to expose their children to high doses of environmental tobacco smoke for long periods, the over all epidemiological evidence does not convincingly dem onstrate that exposure to environmental tobacco smoke increases the incidence of middle ear diseases in chil dren.

Pediatric Otoscopy and Photography of the Tympanic Membrane

A further miniaturization of the lens telescopes (Hopkins Rod) has resulted in a telescope (length, 6 cm; diameter, 2.7 mm) that is suitable for pediatric otoscopy. The adaptation of otoscopic specula, a lightweight motor-driven remote flash camera, and movie and video photography to this telescope has resulted in a system that represents a significant advance in the examination of the ear. In this study, we document ear diseases in children with the use of color photographs.

Rhabdomyosarcoma of the ear; a cause for suppurative ear diseases in children.

RHABDOMYOSARCOMA is an uncommon tumor which rarely originates in the temporal bone spaces. Nineteen such cases have been reported by Davidson, 1 though undoubtedly there are numerous other reported cases of this tumor. Stout, 2 in 1946, delineated the histopathological features of the sarcomas of skeletal muscle origin and showed that it is possible to classify certain tumors as rhabdomyosarcoma despite an inability to demonstrate striations. Prior to this, cross striations had to be demonstrated before the diagnosis could be accepted. Horn and Enterline 3 stated: Thus we have come to believe that rhabdomyosarcoma, while still not a common tumor, occurs much more frequently than was realized in the past. With the embryonal, botryoid, and alveolar tumors especially, the features that give the pathologists assurance of the diagnosis of rhabdomyosarcoma, longitudinal, and cross striations, are often found only after prolonged and painstaking search. The purpose of this publication is to

Importance of early diagnosis and treatment of middle ear diseases in children. M. P. Boebinoer, New Orleans Med.‐ and Surg. Jour., July, 1918

Importance of early diagnosis and treatment of middle ear diseases in children. M. P. Boebinoer, New Orleans Med.‐ and Surg. Jour., July, 1918