Episodes Of Otitis Research Articles

A nation-wide, population-based survey of otitis media and school achievement

The purpose of the study was to evaluate whether there is an association between early recurrent otitis media and later school achievement. A nation-wide, population-based random cluster sampling of 1708 children in 119 school classes was performed throughout Finland. Data were collected with questionnaires sent to the parents and teachers of the children. Teachers evaluated each child's performance at school, and the association between the number of episodes of early otitis media and school achievement was determined. Recurrent otitis media episodes before the age of 3 years associated significantly with lower performance in mathematical skills (risk ratios [RR] 1.2–1.4, 95% confidence intervals [95% CI] 1.0–1.7, P-values 0.04–0.02) and classroom concentration (RR 1.4, 95% CI 1.1–1.8, P-value 0.02) among the girls. The boys with recurrent otitis episodes performed more poorly in reading (RR 1.3, 95% CI 1.0–1.6, P-value 0.05) and oral performance (RR 1.2, 95% CI 1.1–1.4, P-value 0.01). No association between otitis episodes after the age of 3 years and school achievement was found. Our findings suggest that recurrent otitis media episodes before the age of 3 years have adverse long-term consequences even when treated actively. Even though the risk ratios were low our finding is important because recurrent otitis media is a common problem during infancy and school achievement has many practical influences on a child's future.

Treatment of external auditory canal exostoses.

Exostoses of the external auditory canal can occur in patients living in coastal, southern California communities with a history of cold-water aquatic activities such as ocean surfing and swimming. Although most canal exostoses are asymptomatic, patients with canal obstruction greater than 80% can have recurrent episodes of external otitis and a related conductive hearing loss. In most cases, medical treatment resolves the symptomatic external otitis and related hearing loss. Patients recalcitrant to medical treatment are candidates for surgical removal of the exostoses. This report reviews the authors' surgical experience with 18 patients (27 ears) who have undergone surgical removal of exostoses. Their preferred surgical technique of transmeatal removal of exostoses with a specialized mallet and thin chisel under local anesthesia is described.

Prevention of acute otitis media

Breast-feeding, using family or small-group day care for infants and toddlers and avoiding exposure to household tobacco smoke are the main preventive measures against acute otitis media (AOM). It is also useful to immunize children who have recurrent otitis media with the influenza and the pneumococcal vaccines. Antibiotic prophylaxis is the most effective method to reduce the frequency of new episodes of otitis in children with recurrent AOM, but it should be used with caution. Tympanostomy tube placement and/or adenoidectomy can be considered as options in some situations. Now, probably, the best initial steps to take to prevent new episodes of otitis in children with recurrent AOM are antimicrobial treatment of each individual AOM episode and, in certain cases, antibiotic prophylaxis for short periods when an upper respiratory tract infection is present.

Recurrent otitis media during infancy and linguistic skills at the age of nine years.

To assess the effects of early recurrent otitis media on linguistic development in children. We especially wanted to determine the possible significant consequences of early recurrent otitis media at school age. We collected data retrospectively on recurrent otitis media episodes from the parents of 394 children in 18 school classes selected at random in a middle-sized city in Finland. Auditory comprehension was tested with a subtest of the Illinois Test of Psycholinguistic Ability, picture vocabulary with the Peabody Picture Vocabulary Test (revised test version), morphologic competence with a Finnish Morphological Test and reading comprehension with a test designed for this purpose. Children with more than four otitis episodes before the age of 3 years performed less well in the reading comprehension test (P = 0.01 to 0.02) than children with fewer otitis media episodes. Multiple regression analysis adjusted for the confounding variables showed early otitis media to be associated with impaired reading comprehension test scores (regression coefficient -0.1245, 95% confidence interval -0.2245 to -0.0245, P = 0.01), which also correlated significantly with the teachers' evaluation of the student's reading comprehension (Spearman rank correlation r = 0.5, P < 0.01). Otitis episodes after the age of 3 years were not associated with abnormal test results. Middle ear disease in infancy had a significant adverse effect on reading comprehension as late as 9 years of age, even among children whose acute episodes were effectively treated.

Quality Improvement: An ACQIP Exercise on the Management of Otitis Media

As part of Pediatrics in Review9s ongoing focus on quality improvement, we present a self-assessment exercise taken from the American Academy of Pediatrics9 Ambulatory Care Quality Improvement Program (ACQIP). Tabulated responses of pediatricians who completed this exercise as part of the ACQIP program are presented on pages 253 to 254, allowing readers to see how their own answers compare and providing material for thought and discussion. Readers are encouraged to participate in the ACQIP program. Additional information can be obtained by calling or writing the Division of Quality Care, American Academy of Pediatrics, Box 927, Elk Grove Village, IL 60009-0927. Monitoring Otitis Media EDUCATIONAL OBJECTIVES This exercise and the follow-up materials should help you identify areas of improvement in how your practice monitors and documents information for children with acute or chronic otitis. INSTRUCTIONS Beginning with tomorrow9s appointments, answer the questions below for the most recent, but not the current episode of otitis media in the first 10 patients you see who are younger than 4 years of age and experiencing at least their second episode of otitis. You will need to review charts to answer the questions. Put a check in each box in which you find the information in your medical record listed.

Quality Improvement: An ACQIP Exercise on the Management of Otitis Media

As part of Pediatrics in Review's ongoing focus on quality improvement, we present a self-assessment exercise taken from the American Academy of Pediatrics' Ambulatory Care Quality Improvement Program (ACQIP). Tabulated responses of pediatricians who completed this exercise as part of the ACQIP program are presented on pages 253 to 254, allowing readers to see how their own answers compare and providing material for thought and discussion. Readers are encouraged to participate in the ACQIP program. Additional information can be obtained by calling or writing the Division of Quality Care, American Academy of Pediatrics, Box 927, Elk Grove Village, IL 60009-0927. Monitoring Otitis Media EDUCATIONAL OBJECTIVES This exercise and the follow-up materials should help you identify areas of improvement in how your practice monitors and documents information for children with acute or chronic otitis. INSTRUCTIONS Beginning with tomorrow's appointments, answer the questions below for the most recent, but not the current episode of otitis media in the first 10 patients you see who are younger than 4 years of age and experiencing at least their second episode of otitis. You will need to review charts to answer the questions. Put a check in each box in which you find the information in your medical record listed.

Influenza A Vaccine and the Incidence of Otitis Media-Reply

Titles can be misleading, but the text is not. Reading the Objective and Conclusion in the abstract at the beginning of the article, 1 and the Conclusions section at the end of the article, makes it very clear that we feel that the data we report are consistent with their being a reduction in the number of otitis episodes in influenza-vaccinated children during the influenza season, in particular when the circulating wild influenza strain was the same as in the vaccine. Dr Aligne's point about their being an equal number of cases for the whole winter misses, in my mind, the main epidemiologic point, ie, that the influenza-vaccinated group had fewer episodes of otitis during the influenza period compared with the non–influenza-vaccinated group. This was in spite of the fact that the influenza-vaccinated children could be considered to be more otitis prone, having had an increased number of past episodes

Evaluation of recurrent respiratory tract infections in children

Past medical history: 6 to 8 episodes of otitis by age 3 years Chronic mouth breathing and snoring Persistent nasal drainage Ventilating tubes and tonsillectomy at 2 years Wheezing with viral infections Diagnosis of sinusitis by previous physician Social history: Oldest of two children Mother remarried Day care 8 hours/day, with 15 other children Mother and stepfather smoke at home Natural father has asthma Physical examination: Retracted eardrums with tympanosclerosis Negative flattened peaks on tympanogram Aflergic shiners and purulent nasal drainage Absent tonsils, posterior pharyngeal lymphatic studding Shotty cervical nodes Transmitted inspiratory rhonchi

Otitis Media in Children

The frequency of otitis media is one of a number of factors causing physicians to seek out the most cost-effective clinical strategies for managing the condition. It is estimated that, by the time they reach two years of age, all the children in the United States currently under that age will have had a total of 9.3 million episodes of acute otitis media,1 and that approximately 17 percent of children have three or more episodes during a six-month period.2 Frequent episodes of otitis disrupt child-care arrangements and work schedules and generate parental anxiety and stress. The annual cost of the . . .

The effects of otitis media on the attention skills of day-care-attending toddlers.

The purpose of this study was to try to understand whether otitis media (OM) affected toddlers' attention to language. The children in the sample were seen in their day care at 12 or 18 months of age in a book-reading task when they had OM and when they were well. Children's hearing was evaluated and they were given the Sequenced Inventory of Communication Development at 24 months of age. Over half of the sample could be classified as having chronic OM (about 5 months per year). Half of the children were in high-quality and half in low-quality day care. Results suggested that children with chronic OM in low-quality care showed the most negative effects on attention during episodes of otitis, with the children with chronic OM displaying less attention during book reading and twice as often off-task in comparison with the nonchronic children

Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media

Objective. This study was designed to assess the relation of exclusive breast-feeding, indepen- dent of recognized risk factors, to acute and recurrent otitis media in the first 12 months of life. Methods. Records of 1220 infants who used a health maintenance organization and who were followed dur- ing their first year of life as part of the Tucson Children's Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute otitis media and recurrent otitis media, defined as three or more episodes of acute otitis media in a 6-month period or four episodes in 12 months, were the outcome variables. Results. Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of otitis and 169 (17%) had recurrent otitis media. Infants exclusively

Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media

This study was designed to assess the relation of exclusive breast-feeding, independent of recognized risk factors, to acute and recurrent otitis media in the first 12 months of life.Records of 1220 infants who used a health maintenance organization and who were followed during their first year of life as part of the Tucson Children's Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute otitis media and recurrent otitis media, defined as three or more episodes of acute otitis media in a 6-month period or four episodes in 12 months, were the outcome variables.Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of otitis and 169 (17%) had recurrent otitis media. Infants exclusively breast-fed for 4 or more months had half the mean number of acute otitis media episodes as did those not breastfed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months. The recurrent otitis media rate in infants exclusively breast-fed for 6 months or more was 10% and was 20.5% in those infants who breast-fed for less than 4 months. This protection was independent of the risk factors considered.These findings suggest that exclusive breast-feeding of 4 or more months protected infants from single and recurrent episodes of otitis media.

Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media

This study was designed to assess the relation of exclusive breast-feeding, independent of recognized risk factors, to acute and recurrent otitis media in the first 12 months of life. Records of 1220 infants who used a health maintenance organization and who were followed during their first year of life as part of the Tucson Children's Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute otitis media and recurrent otitis media, defined as three or more episodes of acute otitis media in a 6-month period or four episodes in 12 months, were the outcome variables. Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of otitis and 169 (17%) had recurrent otitis media. Infants exclusively breast-fed for 4 or more months had half the mean number of acute otitis media episodes as did those not breastfed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months. The recurrent otitis media rate in infants exclusively breast-fed for 6 months or more was 10% and was 20.5% in those infants who breast-fed for less than 4 months. This protection was independent of the risk factors considered. These findings suggest that exclusive breast-feeding of 4 or more months protected infants from single and recurrent episodes of otitis media.

MONO‐OLIGOCLONAL PRODUCTION OF IMMUNOGLOBULINS IN A CHILD WITH THE WISKOTT‐ALDRICH SYNDROME

British Journal of HaematologyVolume 75, Issue 3 p. 436-438 MONO-OLIGOCLONAL PRODUCTION OF IMMUNOGLOBULINS IN A CHILD WITH THE WISKOTT-ALDRICH SYNDROME Jean-Daniel Tissot, Jean-Daniel Tissot Centre de Transfusion Sanguine CRS, Lausanne, SwitzerlandSearch for more papers by this authorPhilippe Schneider, Philippe Schneider Centre de Transfusion Sanguine CRS, Lausanne, SwitzerlandSearch for more papers by this authorBernard Pelet, Bernard Pelet Service de Pédiatrie, Universitaire Vaudois, Lausanne, SwitzerlandSearch for more papers by this authorPhilippe C. Frei, Philippe C. Frei Division d'Immunologie et d'Allergologie du Centre Hospitalier, Universitaire Vaudois, Lausanne, SwitzerlandSearch for more papers by this authorDenis Hochstrasser, Denis Hochstrasser Clinique Médicale, Hôpital Cantonal Universitaire, Genève, SwitzerlandSearch for more papers by this author Jean-Daniel Tissot, Jean-Daniel Tissot Centre de Transfusion Sanguine CRS, Lausanne, SwitzerlandSearch for more papers by this authorPhilippe Schneider, Philippe Schneider Centre de Transfusion Sanguine CRS, Lausanne, SwitzerlandSearch for more papers by this authorBernard Pelet, Bernard Pelet Service de Pédiatrie, Universitaire Vaudois, Lausanne, SwitzerlandSearch for more papers by this authorPhilippe C. Frei, Philippe C. Frei Division d'Immunologie et d'Allergologie du Centre Hospitalier, Universitaire Vaudois, Lausanne, SwitzerlandSearch for more papers by this authorDenis Hochstrasser, Denis Hochstrasser Clinique Médicale, Hôpital Cantonal Universitaire, Genève, SwitzerlandSearch for more papers by this author First published: July 1990 https://doi.org/10.1111/j.1365-2141.1990.tb04362.xCitations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume75, Issue3July 1990Pages 436-438 RelatedInformation

Gamma-globulin treatment of recurrent acute otitis media in children

This study examined the hypothesis that children prone to acute otitis media have a reduced concentration of circulating antibodies of the IgG2 subclass and that this defect can be compensated for by gamma-globulin treatment. Infants and children below 18 months of age with at least three episodes of acute otitis media were randomized to intramuscular gamma-globulin or no treatment and were followed for 6 months. We could demonstrate neither reduced IgG2 nor specific anti-polysaccharide antibody activity in the otitis-prone children. In contrast they had higher concentrations of IgG2 and antibodies to phosphorylcholine than did age-matched controls. There was neither a relationship between the IgG2 concentration and the number of otitis episodes prior to enrollment nor a reduction in otitis frequency in the gamma-globulin-treated group.

A longitudinal study of the detection of otitis media in the first two years of life

A number (210) of children were followed longitudinally through the first two years of life with pneumatic otoscopy and electroacoustic immitance, tympanometry, at every physician encounter. Tympanometry proved to have a high predictive value (86%) for detecting normal ears but relatively poor predictive value (58%) for detecting abnormal ears when utilized as a routine screening procedure with every clinic visit. In part the tympanometrically abnormal ears which appeared normal in otoscopic exam were temporally related to recent episodes of otitis and concurrent upper respiratory congestion, but many were unrelated to detectable middle ear pathology. These observations detract from the utility of tympanometry as a screening tool for middle ear pathology.

A randomized clinical trial of two topical preparations (framycitin/gramicidin and oxytetracycline/ hydrocortisone with polymyxin B) in the treatment of external otitis

In a randomized trial, 55 patients with acute external otitis were treated with either topical framycitin/gramicidin (Sofradex) or oxytetracycline/hydrocortisone (Terracortril) with polymyxin B (TPB) ear-drops for 1 week. Staphylococcus aureus and Pseudomonas pyocyanea were the bacteria most frequently found in the ear canal; 78% of the patients were cured. However, no significant differences in therapy were found when either of the preparations was used. S. aureus seemed to be most resistant to treatment, while P. pyocyanea was less of a therapeutic problem. Additionally, previous episodes of external otitis or other skin diseases did not seem to influence any treatment given.

Size of the Mastoid Air Cells and Otitis Media

Repetitive tympanometric screenings were performed in 79 randomized, otherwise healthy children from 2 to 7 years old. A total of nine screenings, of which three included otomicroscopy, were performed. When the children were 7 years of age, radiographs were made of their mastoid processes in Runstrøm's lateral projection. The median size of the cell system was 8.25 cm2. The cell systems were significantly larger (9 cm2) in girls than in boys (7.5 cm2). A significant correlation was found between the size of the cell system and the duration of secretory otitis media; thus, the smallest air cell systems occurred in the children with the longest episodes of secretory otitis, and the largest cell systems in children with no history of secretory otitis. Eardrum changes occurred at the ages of 5, 6, and 7 years in 21%, 32%, and 25% of the children, respectively. Children in whom the same eardrum changes were present at all three examinations had significantly smaller cell systems than those with either no changes or changes only at a few of the examinations. No differences in extent of pneumatization were found, regardless of whether the children had had episodes of acute otitis, had been treated for secretory otitis, or had had neither. In our opinion, this study supports the theory that hypocellularity is a sequela of secretory otitis rather than a cause of the disease.

Attachment of Streptococcus pneumoniae to human pharyngeal epithelial cells in vitro--mechanism of binding.

To colonize mucosal surfaces and to invade underlying tissues, bacteria need to bind to components of the mucosa. Unattached bacteria are transported away from the surface with the fluid flow. By binding to the nasopharyngeal mucosa, Streptococcus pneumoniae causing otitis media may persist at the site of infection. High binding capacity of the bacterium and increased receptivity of the epithelial cells for attaching bacteria may both contribute to the susceptibility of patients prone to otitis. Thus, epithelial cells from children with frequent episodes of otitis bind attaching bacteria more readily than do cells from age-matched controls. The binding mechanism probably involves bacterial surface proteins and epithelial cell surface glycoconjugate receptors. Evidence is presented that phosphorylcholine, a component of the bacterial surface, as well as epithelial cell receptor analogues, that is, natural or synthetic saccharides analogous to the lactoneoseries of glycolipids, inhibits pneumococcal attachment. Inhibition of bacterial binding in vivo may be a new approach to prophylaxis against otitis media.

Otitis Media and Fever

<h3>To the Editor.—</h3> Schwartz and his colleagues reported that 23% of their patients with acute otitis media were febrile and that this contrasts to the much higher incidence of fever reported in other studies. They speculate that their population of white middle-class patients visits private physicians much more promptly thanmight patients from lower socioeconomic groups attending hospital outpatient departments. They thus imply that fever develops as a later feature of acute otitis media. This would account for the higher incidence of 64% of patients with fever in Mortimer and Watterson's report¹and the 67% in the series of Halstead et al²for example. We think this conclusion is intriguing but unsupported by any data. During the period March 10 to May 27, 1981, there were 1,641 children seen in the emergency room of the Children's Mercy Hospital whose conditions were diagnosed as an acute episode of otitis