History Of Otitis Research Articles

Incidence of Seromucous Otitis in Schools in Southern Algeria

Introduction: Seromucous otitis (SMO) is a very common pathology, affecting almost 50% of children. It is a benign condition, but should be investigated in adults for neoplasia of the nasopharynx. It is bilateral in 85% of cases, with an average age of 5 years. Although the evolution of this pathology is often favorable in children, with a tendency to spontaneous regression, in adulthood these ears can evolve into simple or dangerous chronic otitis. Aim: To assess the incidence of seromucous otitis in children in southern Algeria (Laghouat), where the hot season is longer than in temperate or cold regions, and to detect and treat chronic forms. Materials & Methods: This is a monocentric, prospective study involving all schoolchildren aged between 3 and 12, with no history of otitis (chronic otitis) or sensorineural hearing loss, over a 13- month period (October 2020 to October 2021). The diagnosis of sensorineural hearing loss is based on anamnesis and confirmed by clinical examination and functional hearing tests. Results: Of the 340 children examined over a one-year period, 28 presented with seromucous otitis, i.e. 8.2% of the sample size, with a peak in frequency between the ages of 4 and 6. There was also a slight male predominance. Promiscuity was the most frequent risk factor, observed in 64% of cases. Spontaneous regression of seromucous otitis was observed in 10 children (35.7%), and surgical treatment with a trans-tympanic aerator with or without adenoidectomy was instituted in 13 children. Conclusion: The natural evolution of SMO does not always lead to spontaneous regression, and many cases require early management and strict monitoring to prevent complications. It is therefore necessary to introduce screening as part of school hygiene in order to reduce the incidence of chronic otitis in adults.

Retrospective study of acute mastoiditis in children in Spain attended in a Pediatric Emergency department

ObjectiveTo analyze the cases of acute mastoiditis, characteristics, management and complications in children attended in the emergency department. MethodsRetrospective study of acute mastoiditis in a Spanish tertiary hospital over a 6-year period (2018–2023). ResultsOne hundred two episodes of acute mastoiditis were analyzed (54% males, median age 1.8 years). Microorganisms were isolated in one third of cases, mainly Streptococcus pyogenes (64% of ear secretion cultures). Complications occurred in 27.5%, primarily subperiosteal abscess. A younger age, absence of vaccination schedule, previous history of otitis, cochlear implant carriers or white blood cell counts and C-reactive protein levels were not associated with complications. Complicated cases had longer hospitalizations. Treatment included antibiotics, corticosteroids, and surgery in 50% of cases. ConclusionsThis study shows an increase of acute mastoiditis during 2023, with a relevant role of S. pyogenes. A younger age, absence of vaccination, personal history of otitis or cochlear implant, blood cell counts and C-reactive protein levels were not associated with complications.

Retrospective study of acute mastoiditis in children in Spain attended in a Pediatric Emergency department

ObjectiveTo analyze the cases of acute mastoiditis, characteristics, management and complications in children attended in the emergency department. MethodsRetrospective study of acute mastoiditis in a Spanish tertiary hospital over a 6-year period (2018–2023). ResultsOne hundred two episodes of acute mastoiditis were analyzed (54% males, median age 1.8 years). Microorganisms were isolated in one third of cases, mainly Streptococcus pyogenes (64% of ear secretion cultures). Complications occurred in 27.5%, primarily subperiosteal abscess. A younger age, absence of vaccination schedule, previous history of otitis, cochlear implant carriers or white blood cell counts and C-reactive protein levels were not associated with complications. Complicated cases had longer hospitalizations. Treatment included antibiotics, corticosteroids, and surgery in 50% of cases. ConclusionsThis study shows an increase of acute mastoiditis during 2023, with a relevant role of S. pyogenes. A younger age, absence of vaccination, personal history of otitis or cochlear implant, blood cell counts and C-reactive protein levels were not associated with complications.

Epidemiologic, Imaging, and Clinical Issues in Bezold's Abscess: A Systematic Review.

Bezold’s abscess is a deep neck abscess related to otomastoiditis. Due to the insidious clinical presentation, diagnosis can be extremely challenging, leading to delays in treatment and possible life-threatening complications. The literature currently provides a fragmented picture, presenting only single or small number of cases. The present study aims at examining our experience and the literature findings (based on PRISMA criteria) of 97 patients with Bezold’s abscess, summarizing their epidemiology, pathogenesis, clinical presentation, imaging findings, and treatments. Bezold’s abscess is found at any age, with overt male prevalence among adults. The clinical presentation, as well as the causative pathogens, are strikingly heterogeneous. Otomastoiditis and cholesteatoma are major risk factors. A clinical history of otitis is commonly reported (43%). CT and MRI are the main diagnostic tools, proving the erosion of the mastoid tip in 53% of patients and the presence of a concomitant cholesteatoma in 40%. Intracranial vascular (24%) or infectious (9%) complications have also been reported. Diagnosis might be easily achieved when imaging (CT) is properly applied. MRI has a limited diagnostic role, but it might be crucial whenever intracranial complications or the coexistence of cholesteatoma are suspected, helping to develop proper treatment (prompt antibiotic therapy and surgery).

Tympanic Retraction Pockets: Diagnostic and Therapeutic Aspect

<i>Background</i>: Retraction pockets represent a form of chronic otitis considered to be a precholesteatomatous stage. This study aims to study the diagnostic and therapeutic aspects of tympanic retraction pockets in the ENT department of the University Hospital Center “Gabriel Touré”. <i>Patients and Method</i>: This was a prospective longitudinal study extended over 15 months; from February 1, 2020 to May 31, 2021 from the files of patients received as an outpatient in the ENT and Cervicofacial Surgery department of the CHU Gabriel Touré in Bamako. Were included any patient seen in an outpatient department at the otorhinolaryngology and head and neck surgery department of the CHU Gabriel Touré in Bamako with a pocket of tympanic retraction and who had consented to the study. Data collection was done using a previously established survey form. Data were entered in Word 2016 and analyzed using SPSS software. <i>Results</i>: The prevalence of retraction pockets was estimated at 1.2% of all consultations. The most represented age group was that of (25-39 years), i.e. 25.0%. The average age was 44.91 ± 20.05 years. The extremes of ages were 10 years and 81 years. The female sex was the most represented, at 63.9% with a sex ratio ꞊ 0.6. A history of otitis was present in half of the cases. Tinnitus was the main reason for consultation (50% of cases) followed by hearing loss (25%). The otoendoscopic examination had noted a predominance of lesions on the left (52%) and an attical seat in 30.6% of cases. The pockets were controllable and self-cleaning in all cases, and peelable in 75% of cases (stage I of the weevil classification) and non-peelable and controllable in 25% of the cases (stage II of weevil). Conductive hearing loss was found in 8.3% of cases, mixed hearing loss in 5.6% of cases and sensorineural hearing loss in 2.8% of cases. CT of the rock was performed in two patients, and showed erosion of the attic wall associated with tissue hypodensity in the attic. Medical treatment based on systemic corticosteroids and nasal decongestant was initiated in all our patients associated with quarterly monitoring for stages I of charachon, i.e. 75% of the workforce. The placement of a tympanostomy tube was performed in 8 patients classified (stage II of charachon) ie (2, 88%). Antroatticotomy associated with reinforcement tympanoplasty was performed in a patient (0,36%).

Development of language and arithmetic skills: risk and protective factors. Comparative cross-sectional study.

In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed. To ascertain the risk and protective factors relating to development of language and arithmetic. Observational comparative cross-sectional study at a public elementary school in Ribeirão Preto (SP), Brazil. A total of 66 children (41% females) attending first to fifth grades participated in this study. They were divided into two groups: G1, children classified as presenting language or arithmetic deficits; G2, average performance. Language (oral and written) and arithmetic skills were assessed through standardized tests. Variables relating to social skills, home environment resources and behavioral problems were assessed through standardized scales. Data on other variables (pre, peri and postnatal complications, maternal variables and others) were collected through interviews. The logistic regression technique with LASSO was used (α = 0.05). Teenage pregnancy and consumption of psychoactive substances during pregnancy or complications during pregnancy were risk factors for performance regarding arithmetic and language. Higher schooling level for the mother was a protective factor in the development of arithmetic and language. Being female and having a history of otitis were risk factors for language. Altered social skills (responsibility and civility) and complaints of inattention were risk factor for arithmetic. Adequate linguistic development was a protective factor for the development of arithmetic. The risk/protective factors included variables relating to the gestational period, mother's age when pregnant, mother's schooling, social skills, behavior and development issues.

Study of Binaural Auditory Cortical Response in Children with History of Recurrent Otitis.

Introduction Any type of sensory deprivation in childhood resulting from conductive hearing loss may impair the development of peripheral and central auditory pathway structures with negative consequences for binaural processing. Objective To characterize and compare monoaural and binaural auditory responses in neonates and children without and with a history of recurrent otitis. Methods The study included participants from 0 to 8 years and 11 months old, in good general health conditions, of both genders, divided into a control group, with no history of otitis, and a study group, with history of recurrent otitis. Cortical potential with speech stimulus /ba/-/da/ was used as collection procedure. The arithmetic calculation of the 512 points of the wave was performed to obtain the grand average of the waves of the subjects in both groups. The Shapiro-Wilk and mixed repeated measures analysis of covariance (ANCOVA) statistical tests were performed to analyze the group effect, the condition, and the interaction (group versus condition) controlling the effect of the age-sex covariable. Results There was a statistically significant difference between the groups for all latency values; and for the P1, N1, P2, and N2 latencies, the differences between the groups occurred in the three analyzed conditions (right and left ears and binaural), revealing the influence of sensory deprivation. There were no significant differences in relation to wave amplitudes. Conclusion There are differences in the cortical potential with speech stimuli and in the binaural interaction component of children with and without history of recurrent otitis.

Prevalence and risk factors of otitis media with effusion in primary school children in Mersin

Aim: To investigate the prevalence of otitis media with effusion (OME) and related risk factors among primary school children in Mersin.&#x0D; Material and Method: The study was conducted at eight primary government schools in the distinct socioeconomic district between October 2018 and December 2018. Using the combined physical examination and otoscopic evaluations, a total of 960 children included the study. &#x0D; Findings: Of the children who were screened, 53.2% were girls and the mean age was 7.57 ± 0.45 years (min: 5 - max: 11 years). In this study, OME prevalence was 2,6% (20 of 761 children) and all children had bilateral OME. There was no statistically significant difference between the presence of OME and the number of people at home, incoming level, month of birth, birth weight, duration of breastfeeding, age average, class, gender, smoking in the house, presence of hearing loss in the family, history of otitis in the family, use of pacifier, use of baby bottle, presence of allergy, previous history of otitis, the presence of open mouth, snoring and tonsil grades.&#x0D; Conclusion: Although the low prevalence of OME in our study, considering that OME and its possible preventive severe complications, screening for OME should be a part of preventive health services, particularly for primary school children.

Prevalence of hearing loss in a population of schoolchildren with Down syndrome from Bogotá, Colombia.

Children with Down syndrome have a higher prevalence of hearing disorders, secondary to anatomical and physiological variations. No universal hearing screening is implemented in Colombia, so there are no data available on the prevalence of hearing loss in this population. The objective of this study was to determine the frequency and type of such disorders in this population based on hearing tests. This was a cross-sectional study conducted at two institutions specialized in accompanying and supporting the families of children with Down syndrome in Bogotá, D.C., Colombia. Between October 2017 and September 2018, a behavioral and/or pure-tone audiometry and an impedance audiometry were done in 40 and 37 children respectively. Subjects attended the institutions twice a week and were integrated at school, up to fifth grade. Prevalence was estimated and characteristics, clinical history, and language developmental milestones were described. The sample was made up of 40 children (22 girls) aged 6-18 years (mean: 11.23). A history of otitis was found in 19 children and of mild to moderate hearing loss, in 17, predominately conductive. A delay in language developmental milestones was observed, apparently not associated with hearing loss. A sample of children with Down syndrome from Bogotá showed a high prevalence of hearing loss, consistent with the results of previous studies. These data stress the need for a strict control of hearing status based on standardized parameters and guidelines.

Chronic otitis media with effusion in chronic sinusitis with polyps.

The relationship between otitis media with effusion (OME) and chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. We conducted a cross-sectional study of 80 consecutively presenting patients-42 males and 38 females, aged 15 to 76 years (median: 48)-who were diagnosed with CRSwNP. Our aim was to ascertain the prevalence of OME in CRSwNP patients, to determine whether the severity of CRSwNP affected OME, and to identify risk factors for OME in CRSwNP patients. The severity of CRSwNP was assessed on the basis of nasal symptoms, endoscopic nasal examinations, and Lund-Mackay staging scores. In addition to demographic data, we obtained information on each patient's history of otitis, otoscopic findings, and the results of pure-tone audiometry and tympanometry. We then compared the data between CRSwNP patients with OME (n = 20) and those without (n = 60). In the OME group, a conductive hearing loss was present in 16 patients (80.0%); all patients in the control group had normal hearing. With regard to symptoms, only rhinorrhea appeared to be more common in patients with OME than in those without, although the difference was not statistically significant. We found no significant difference in nasal polyposis grades between the two groups. Also, we found no correlations between the risk of OME and previous surgical treatment, asthma, allergy, aspirin intolerance, aspirin and/or NSAID intolerance, aspirin and/or sulfite intolerance, and aspirin-exacerbated respiratory disease. Based on our findings, we conclude that OME occurs frequently during the evolution of CRSwNP, even when the nasal disease is well controlled. This finding suggests the possible presence, in OME and/or CRSwNP, of a global inflammatory process that involves the epithelium in both the middle ear and upper airway.

Receptive and expressive language performance in children with and without Cleft Lip and Palate.

To compare the performance in the abilities of receptive and expressive language of children with cleft lip and palate with that of children without cleft lip and palate with typical 12 to 36-month chronological development. The sample consisted of 60 children aged 12 and 36 months: 30 with cleft lip and palate diagnosis and 30 without cleft lip and palate diagnosis with typical development. The groups were paired according to gender, age (in months), and socioeconomic level. The procedures consisted of analysis of medical records, anamnesis with family members, and valuation of the Early Language Milestone Scale (ELMS). The chart analysis showed 63.34% of the children with unilateral cleft lip and palate, 16.66% with bilateral incisive transforamen cleft, and 20% with post-foramen cleft. Children with cleft lip and palate underwent surgeries (lip repair and/or palatoplasty) at the recommended ages and participated in early intervention programs; 40% presented recurrent otitis history, and 50% attended schools. Statistical analysis included the use of the Mann Whitney test with significance level of p <0.05. There was a statistically significant difference between the groups regarding receptive and expressive skills. The group of children with cleft lip and palate showed statistically significant low performance in receptive and expressive language compared with children without cleft lip and palate.

Prevalence and Parental Awareness of Hearing Loss in Children with Down Syndrome

Background:To establish the prevalence of hearing deficit in children with Down syndrome (DS) in Hong Kong as measured by brainstem auditory evoked potentials (BAEP). The secondary objective is to examine the agreement between BAEP and clinical questioning in detecting hearing deficit in DS.Methods:Consecutive DS patients attending the Down's Clinic in a regional pediatric referral center were recruited into this cross-sectional study. BAEP data performed within 12 months were retrieved. The care-taker was interviewed with a structured questionnaire to detect any symptom of hearing impairment. BAEP findings and clinical questionings were compared in an agreement analysis using quadratic weighted kappa statistics.Results:Fifty DS patients (35 male, 15 female, mean age 11.70 years ± 5.74 standard deviation) were recruited. Eighteen patients (36.0%) were identified having hearing deficit by BAEP. Among patients with hearing impairment, 13 patients (72.2%) had a conductive deficit, and most have mild to moderate hearing loss. Five patients (27.8%) had sensorineural deficit and most have moderate to severe degree. Eight (44.4%) had bilateral hearing deficit. Care-takers of 13 patients (26.0%) reported symptoms of hearing impairment, with 9 (69.2%) having mild symptoms, 3 (23.1%) had moderate symptoms and 1 (7.7%) had severe symptoms. The weighted kappa was 0.045 (95.0% confidence interval − 0.138–0.229), indicating very poor strength of agreement between BAEP and clinical questioning. For patients with conductive hearing impairment, only 1 patients (7.7%) recalled history of otitis media.Conclusions:The estimated point prevalence of hearing impairment in Chinese DS children in Hong Kong is 36%. Our finding of poor strength of agreement between objective testing and symptom questioning reflects significant underestimation of hearing impairment by history taking alone. In view of the high prevalence and low parental awareness, continuous surveillance of hearing is mandatory for DS patients throughout childhood and adolescence.

What is behind the ear drum? The microbiology of otitis media and the nasopharyngeal flora in children in the era of pneumococcal vaccination.

AimThis study aims to describe the microbiology of middle ear fluid (MEF) in a cohort of children vaccinated with Streptococcus pneumoniae conjugate vaccine (PCV7) having ventilation tube insertion. Nasopharyngeal (NP) carriage of otopathogens in these children is compared with children without history of otitis media.MethodsBetween May and November 2011, MEF and NP samples from 325 children aged <3 years were collected in three major centres in New Zealand at the time of ventilation tube insertion. An age-matched non-otitis-prone comparison group of 137 children had NP samples taken. A questionnaire was completed by both groups.ResultsImmunisation coverage with at least one dose of PCV7 was 97%. Haemophilus influenzae was cultured in 19.4% of MEF and was polymerase chain reaction (PCR) positive in 43.4%. S. pneumoniae and Moraxella catarrhalis were cultured in <10% of MEF samples but were PCR positive for 23.1% and 38.7%, respectively. H. influenzae was the most common organism isolated from NP samples (60%) in the grommet group, while M. catarrhalis (56%) was the most common in the non-otitis prone group. S. pneumoniae was more commonly found in the nasopharynx of children with ear disease (41% vs. 29%). 19F was the most prominent S. pneumoniae serotype in NP samples of both groups, but no serotype dominated in MEF. Ninety-five per cent of H. influenzae isolates were confirmed to be non-typeable H. influenzae.ConclusionIn this cohort of children with established ear disease requiring surgical intervention, non-typeable H. influenzae is the dominant pathogen in both the nasopharynx and MEF.

Gradenigo syndrome: an unexpected otitis complication

Introduction : Gradenigo syndrome (also known as apical petrositis) is a clinical triad of otitis media, trigeminal neuralgia and ipsilateral abducens nerve palsy. In the era of antibiotic therapy, it is an exceptional but potentially life threatening complication of acute otitis media, requiring prompt diagnosis and treatment. Case report : A seven-year-old girl with previous history of otitis, presented with left ear pain, headache, diplopia and fever. Diagnosis of Gradenigo syndrome was established and she was treated with systemic broad-spectrum antibiotics and myringotomy with timpanostomy tube placement. Clinical outcome was favourable. Conclusion : This case documents therapeutic success and total recovery with a conservative approach in an immunocompe

Processamento auditivo em crianças com fissura labiopalatina com e sem história de otite

INTRODUÇÃO: Considerando que perdas auditivas e complicações otológicas podem interferir no processo de maturação do sistema nervoso central, este estudo teve como objetivo verificar o desempenho de crianças com FLP com e sem histórico de otite média na avaliação do processamento auditivo. MÉTODO: Estudo prospectivo. Foram avaliadas 20 crianças com fissura labiopalatina operada, na faixa etária de 7 a 10 anos, divididas em grupo I - 10 crianças com fissura labiopalatina com história de otite - e grupo II - constituído de 10 crianças com fissura labiopalatina sem história de otite. Foram realizados testes dióticos, monóticos e dicóticos. RESULTADOS: Todas as crianças apresentaram desempenho ruim em pelo menos um teste dicótico. Nos testes dióticos os maiores índices de desempenho ruim foram das crianças pertencentes ao grupo I, enquanto que nos testes monóticos, o desempenho ruim foi encontrado em maior número nas crianças do grupo II. CONCLUSÃO: Tanto as crianças com história de otite como as sem história de otite apresentaram desempenho ruim nos testes do processamento, ou seja, algum tipo de alteração central foi encontrada em 100% das crianças estudadas em ambos os grupos.

Acute otitis media severity: Association with cytokine gene polymorphisms and other risk factors

Background We have previously shown an association between polymorphisms of proinflammatory cytokine genes and susceptibility to upper respiratory tract infection and acute otitis media. It has not been known whether polymorphisms or risk factors are associated with the severity of acute otitis media. Objective To evaluate the influences of proinflammatory cytokine gene polymorphisms and other risk factors on severity of acute otitis media following upper respiratory tract infection. Methods In a prospective, longitudinal study, children aged 6–35 months were followed for one year for occurrences of upper respiratory tract infection and acute otitis media. Children were studied for TNFα −308, interleukin (IL)-6 −174 and IL-1β +3953 polymorphisms, taking into account age, gender, race, family history of otitis, tobacco smoke exposure, breast feeding, day of upper respiratory tract infection at the time of diagnosis and pneumococcal vaccine status. Symptoms and signs of acute otitis media were graded according to a validated scale. The association between acute otitis media clinical severity, polymorphic genotypes, and risk factors were analyzed using statistical models that account for multiple episodes of acute otitis media per child. Results A total of 295 episodes of acute otitis media in 128 subjects was included. More severe acute otitis media symptoms were associated with young age ( P = 0.01), family history of acute otitis media ( P = 0.002), tobacco smoke exposure ( P = 0.008), and early diagnosis of otitis after onset of upper respiratory tract infection ( P = 0.02). Among children with a bulging or perforated tympanic membrane (206 episodes, 104 subjects), those who had the IL-1 β +3953 polymorphism, experienced higher symptom scores ( P < 0.02). Conclusion This is the first report of the association between risk factors and acute otitis media severity. Risk factors such as tobacco smoke exposure and a positive family history appear to be more significantly associated with acute otitis media severity than proinflammatory gene polymorphisms. Clinical severity may be an important factor contributing to the incidence and costs of acute otitis media, because children with more severe symptoms might be more likely to be brought for a medical visit, receive a diagnosis of acute otitis media, and be prescribed an antibiotic.

Serous otitis media in the 20th and 21st centuries: evolving views and treatments

Conclusions. The historical study of serous otitis media (SOM) demonstrates steps in recognition of the disease, shifts in prevalence, and relationships between the disease's affect and evolving economic bases of society. Objective. SOM, although noted in early Roman and Arabic medicine, was only identified as a distinct and significant pathology in the last half of the 20th century. This paper examines the development of understanding of SOM, and ways in which it has been cared for during the 20th and 21st centuries. Materials and methods. The medical literature from antiquity to the present was reviewed for mention of otological conditions that related to SOM. For this report, the primary source of each notation was examined. Results. The first part of the 20th century saw little change from earlier times in the recognition or treatment of SOM. Our current 21st century conceptualization and concern for SOM has come about from five advances: antibiotics, the rediscovery of the tympanostomy tube, the clinical use of middle ear impedance, the association of a history of otitis with linguistic deficiency, and recognition of the significance of transformation to a communication-based economy.

Failure to Achieve Early Bacterial Eradication Increases Clinical Failure Rate in Acute Otitis Media in Young Children

The objective of this study was to determine the association between early bacteriologic failure and clinical failure in acute otitis media (AOM). Children with AOM aged 3-35 months enrolled in studies documenting both bacteriologic outcomes by tympanocentesis on day 4-6 and clinical outcomes on day 11-16 (immediate posttreatment visit) constituted our study group. Bacteriologic outcomes were studied for children with AOM caused by Streptococcus pneumoniae, nontypeable Haemophilus influenzae or both. The relative risk (RR) for clinical failure of children with bacteriologic failure compared with children with bacteriologic eradication was the main outcome measure. Nine hundred seven episodes were analyzed. Clinical failure occurred in 7.3% of 660 patients with bacterial eradication versus 32.8% of 247 patients with bacteriologic failures. The overall RR (95% confidence interval) for clinical failure was 4.41 (95% CI: 3.19-6.11), with little variation between pathogens. After correction for age, gender, ethnic origin, previous otitis history, and previous antibiotic treatment, the rate was 6.52 (95% CI: 4.26-9.99). Across clinical studies with 8 antibiotic drug regimens for AOM, the rate of clinical failure correlated with bacteriologic failure (r = 0.8967; P = 0.003). In young children with culture-positive AOM, failure to eradicate the pathogen from middle ear fluid within the first few days of treatment leads to a significant risk for clinical failure.

Características fonológicas de crianças com transtorno fonológico com e sem histórico de otite média

OBJETIVO: Verificar o número de tipos, a ocorrência total e a média de processos fonológicos em crianças com transtorno fonológico com e sem o histórico de otite média. MÉTODOS: A casuística foi composta de 44 crianças diagnosticadas com transtorno fonológico, metade com histórico de otite média e metade sem esse histórico do Laboratório de Investigação Fonoaudiológica em Fonologia do Curso de Fonoaudiologia da Faculdade de Medicina da USP-SP. Foram aplicadas as provas de nomeação e imitação (Wertzner, 2000) para a análise dos processos fonológicos. RESULTADOS: No grupo com otite, o processo fonológico mais ocorrente na prova de nomeação foi o ensurdecimento de fricativas e, na imitação, a simplificação de líquidas. No grupo sem otite, a simplificação do encontro consonantal foi mais empregada na nomeação e, o ensurdecimento de fricativas na imitação. Somente a simplificação do encontro consonantal na prova de nomeação apresentou diferença entre os grupos. Não houve diferença estatística em relação à média de tipos de processos fonológicos. CONCLUSÃO: Apesar de a otite média estar presente em parte das crianças com o transtorno fonológico, a análise realizada não permitiu a identificação de marcadores lingüísticos que separassem os grupos estudados.

Histomorphometric Estimation of Air Cell Development in Experimental Otitis Media

The objectives of this study were to examine the effect of acute otitis media on the bony development of the growing middle ear air cell system with a reliable and concise stereologic histomorphometric method and to generate a standard baseline growth plot for the middle ear of the rat. The authors conducted a histomorphometric analysis of bullar volume during the entire growth period after early induction of unilateral otitis media. The authors conducted undecalcified processing of 27 rat skulls sectioned horizontally at various ages from 20 to 83 days after unilateral transtympanic injection of Streptococcus pneumoniae at 19 days postpartum. Stereologic estimation of bullar volume was performed in the experimental and the control ear with Cavalieri's principle. Body mass and air cell volume were plotted as functions of subject age using standard developmental equations on the experimental results. Volumes of the middle ear air cell system were consistently smaller in the otitis ears. Bullar growth was completed at 60 days regardless of otitis history, but body mass was increasing throughout the experimental period. A single incident of otitis media introduced early in life is sufficient to significantly reduce the final volume of the bulla in rats. This finding may mimic the effect of otitis media contracted in early childhood on the development of the mastoid air cells. The standard growth plot provides a timeframe for studies of signaling molecules responsible for bone modeling in pneumatization.