Suppurative Otitis Media Research Articles

Temporomandibular disorder: A previously unreported complication of chronic suppurative otitis media

ABSTRACT Objective The aim of the current clinical study was to test the hypothesis that chronic suppurative otitis media (CSOM) might be significantly associated with signs of temporomandibular joint (TMJ) internal derangement. Methods The study involved 79 patients with CSOM and 79 control subjects. The TMJ was clinically examined in both groups. Results Signs of internal derangement of the TMJ(s) were found in 67.1% of CSOM patients versus 26.6% of control subjects (p = .001). Conclusion CSOM may be associated with the extension of the inflammatory process into the TMJ, thereby predisposing to internal derangement of the joint.

Ototoxicity of Topical Antibiotic Ear Drops in Chronic Suppurative Otitis Media in Humans: A Review of the Literature.

An electronic search of the literature was performed for reported cases of ototoxicity associated with the use of topical antibiotic ear drops in humans. The dosage, duration, and type of ototoxic preparations involved were recorded. Due to the scant quantity of low-quality information that is currently available, there was uncertainty about the usefulness of topical antibiotics in enhancing the resolution of ear discharge in patients with chronic suppurative otitis media. However, despite this uncertainty, there are some data to show that using topical antibiotics in comparison to a placebo or in conjunction with a systemic antibiotic may be useful. Additionally, there is ambiguity regarding the relative efficacy of various kinds of antibiotics; it is impossible to say with absolute certainty whether quinolones are superior to or inferior to aminoglycosides. Although the adverse impact profiles of these two classes of chemicals varied, there are not enough data from the included trials to draw any conclusions about them. Negative effects were generally underreported.

Outcomes of Complications of Chronic Otitis Media in Tertiary Care Facilty in Western Uttar Pradeh

Objectives: This study aims to investigate the frequency and management of complications of chronic suppurative otitis media(CSOM).Patients and Methods: Out of 376 patients with CSOM, 44 patients (25 males, 19 females; mean age 48.5±3.5 years; range 21to 76 years) meeting study criteria were enrolled in this descriptive cross sectional study which was conducted at the Department of Ear Nose and Throat, Head and Neck Surgery. All newly diagnosed patients having CSOM with complications were enrolled. The complications were treated first. Intracranial abscesseswere evacuated by neurosurgeons. Radical and modified radical mastoidectomy were performed.Results: Majority of the patients presented in the second and third decade of life (21-30 years: 27.27%, 31-40 years: 18.18%).Most of the patients (59.1%) had lower socioeconomic status. Canal wall down mastoidectomy was the most common (79.5%) procedure performed. Cholesteatoma was the most common operative finding (100%). Among extracranial complications, subperiosteal abscess was the most common finding (38.63%), while extradural abscess outnumbered (22.72%) in intracranial complications.Conclusion: Complications of CSOM commonly affect younger people with low socioeconomic status. Collaborating withneurosurgeons may assist in the successful management of this infection.

Molecular characterization of metallo-beta lactamase geneblaimp-1 in imipenem resistant Pseudomonas aeruginosa isolates from patients of chronic suppurative otitis media at a tertiary care hospital

Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity, persisting for more than 2 weeks. is one of the most common organisms to cause CSOM. Carbapenems are among the most effective antibiotics used against infections resistant to carbapenems is often associated with production of metallo-ß-lactamases strains. Detection of MBLs producing strains can be effective for optimal treatment of patients for the control and spread of resistance. The main purpose of the study is to determine the imipenem resistant carrying metallo-ß-lactamase (MBL) genebla in Patients of Chronic Suppurative Otitis Media at a Tertiary care hospital”This was a cross sectional study carried out in the Department of Microbiology and ENT Department for a period of 1 year between July 2021 to July 2022. A total of 185 patients clinically suspected cases for CSOM were studied. Swabs taken from discharging ears were sent for Gram’s staining, culture and antibiotic sensitivity test as per the latest CLSI guidelines. The isolates were further tested for MBL by screening test, by Imipenem – EDTA combined disc test, and MBL E test (Imipenem). The DNA was extracted by using Qiagen DNA Extraction kit and gene for isolates was detected by conventional PCR.In our study the number of cases clinically diagnosed of having CSOM was 185, out of which 63 (34%) was found to be culture positive for CSOM infection. Males were 38 (60.3%) as compared to that of female 25 (39.6%), Both the ears affected were almost in equal distribution, with the left ear being 32 (50.7%) and the right ear being 28 (44.4%) while in 3 cases (4.7%) it was bilateral. Gram negative bacilli were (74.6%), being the most common isolate with 47.6% followed by 19% and among the Gram positive isolates (25.3%). (12.6%) was the most common isolate. Colistin (96.6%), Piperacillin‑tazobactam (73.3%), Amikacin (76.6.3%), and Cefepime (73.3%) were found to be the most effective Antibiotics. The resistance to ciprofloxacin was (56.6%), Levofloxacin (50%), Piperacillin (46.6%), Gentamicin(36.6%), Imipenem (36.6%), Tobramycin (30%), Ceftazidime (30%). Out of 30 isolated 11(36.6%) were screening test-positives for MBL by Imipenem – EDTA combined disc test, and MBL E test (Imipenem). The bla gene was detected in all 11 (36.6%) of the isolates of In the present study being the most common isolate with Colistin, Piperacillin‑tazobactam, Amikacin, and cefepime to be the most effective antibiotics. Resistance of isolates to Imipenem due to MBL enzymes is increasing in the Kanpur region (36.6%). Judicial use of broad spectrum antibiotics, like Imipenem is the need of the hour, hence knowledge of the etiological agents of CSOM and their antibiogram is of paramount importance for an efficient treatment and prevention of both disease complications and antimicrobial resistance.

Relationship of Hearing Loss and Tympanic Membrane Perforation Characteristics in Chronic Suppurative Otitis Media Patients.

Objective The objective of this study is to assess the relationship between the site of tympanic membrane (TM) perforation and the type and degree of hearing impairment. The secondary objectivewas to compare the duration of the disease and the degree of hearing loss. Study design This is a prospective observational study. Place and duration of the study This study was carried out in the Department of Otolaryngology/Head and Neck Surgery at the Pakistan Institute of Medical Sciences, Islamabad, from May 2021 to April 2022. Patients and methods Of all the screened patients, 77 fulfilled the inclusion criteria. Patients aged 10-40 years with inactive mucosal chronic otitis media and unilateral perforation in one quadrant were included. The site of TM rupture was observed, and audiometric analysis was performed. Results The mean age of participants was 25 ± 8.61 years, with a preponderance of the female gender (57.1%). A total of 32 (41.6%), 19 (24.7%), 19 (24.7%), and seven(9.1%) perforations involved posterosuperior, anterosuperior, anteroinferior, and posteroinferior quadrants respectively. Conductive, mixed, and sensorineural hearing loss was found in 52 (67.5%), 18 (23.4%), and seven (9.1%) cases, respectively. Of all the subjects, 13 (16.9%) had the disease for < one year, 39(50.6%) for one to five years, 17 (22.1%) for five to 10 years, and eight (10.4%) for > 10 years. There was a statistically significant association between the degree of hearing loss and the site of perforation. No significant association was found between the site of perforation and thetype of hearing loss. Duration of disease and degree of hearing loss also had no significant association. Conclusion The extent of hearing loss was found to be directly influenced by the anatomical site of perforation, with the posterosuperior quadrant perforation producing the greatest degree of impairment.

Postauricular Cutaneous Mastoid Fistula Surgically Closed by a Temporalis Muscle Rotational Flap: A Case Report

Background: Postauricular cutaneous mastoid fistula (PCMF) is quite rare. Possible triggers include a radical mastoidectomy, chronic suppurative otitis media (CSOM), or the spontaneous exteriorization of a mastoid cholesteatoma through the postauricular skin surface. Case Report: This study reported a 62-year-old woman who presented with a right-sided discharging postauricular lesion for two years and a history of ear discharge over the past 20 years. Physical examination revealed a 10×8 mm fistula with a pearly white tissue at the opening and mucoid discharge. Otoscopy represented an attic cholesteatoma as the potential underlying cause, and computed tomography demonstrated a soft-tissue density in the middle ear extending into the mastoid cavity and towards the cutaneous postauricular area. The PCMF was surgically closed using a temporalis muscle rotational flap with no recurrence at the 6-month follow-up. Conclusion: Overall, surgical closure with a temporalis muscle rotational flap appears to be an effective technique for treating PCMF.

A Comparative Study of Tympanoplasty with or without Mastoidectomy in Tubotympanic Type of Chronic Suppurative Otitis Media

Background: One of the most frequent ear illnesses in underdeveloped countries is chronic suppurative otitis media (CSOM). In the treatment of CSOM, otolaryngologists debate whether to perform tympanoplasty with or without cortical mastoidectomy. Objective: To compare the outcome of tympanoplasty with or without cortical mastoidectomy in the treatment of tubotympanic type chronic suppurative otitis media. Methods: This comparative study was carried out in the Department of Otolaryngology - Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2017 to June 2019 over a period of 02 years. A total number of 60 patients who underwent type 1 tympanoplasty with or without cortical mastoidectomy were enrolled in this study. After enrollment the condition of the pinna, preauricular region, postauricular region and external auditory cannal were examined. On otoscopy, site and size of perforation of tympanic membrane, condition of the rest of the tympanic membrane, condition of the middle car mucosa and the ossicles were also examined. Tuning fork tests, test for facial nerve integrity and fistula test were performed. Hearing level was assessed by pure tone audiometry with masking. Enrolled patients were grouped into two groups. Patients who underwent type- 1 tympanoplasty alone kept in group A and who underwent type 1 tympanoplasty with cortical mastoidectomy kept in group B. Complete blood count, blood urea, serum creatinine, random sugar, ECG and X-ray chest P/A view were done routinely. Results: Females were 76.7% in group-A and 53.3% in group-B. All patients were of age between 16 to 60 years and most of them were in the age group of 21-30 years. Majority of the patients were from rural area and maximum patients were from middle class family. In most of the patients unilateral ear involvement was observed. Perforation site was central malleolar in maximum cases followed by anterior central and posterior central. Perforation size was ........

Outcome of Tympanoplasty with Cortical Mastoidectomy in Tubotympanic Type of CSOM

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in under developing countries. Otolaryngologists debate whether to perform tympanoplasty with or without cortical mastoidectomy when treating CSOM. Objective: To see the outcome of tympanoplasty with cortical mastoidectomy for hearing gain and grafting success. Methods: This observational study was carried out in the Department of Otolaryngology - Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2018 to June 2020. A total of 30 patients who underwent type 1 tympanoplasty with cortical mastoidectomy were enrolled in this study. Following enrollment, the condition of the pinna, preauricular region, postauricular region, and external auditory canal were examined. The location and extent of the tympanic membrane perforation, the state of the remaining tympanic membrane, the health of the middle ear mucosa, and the ossicles were all examined during the otoscopy. Tuning fork tests, tests for facial nerve integrity, and fistula tests were also carried out. The hearing level was assessed by pure-tone audiometry with masking. Results: Among 30 patients’ females were 53.3% and males were 46.7%. All of the patients ranged in age from 16 to 60, with the majority of them falling between the ages of 21 and 30. Most of the patients came from middle-class families, and the majority of patients were from rural areas. The majority of patients showed unilateral ear involvement. Most often, the central malleolar region was perforated, then the anterior central region and the posterior central region. The most frequent perforation size was medium, followed by small, large, and subtotal. The pre- treatment bone conduction threshold was 11.74± 4.42 dB, which was reduced to 10.14 ±3.70 dB after treatment (p&lt;0.05). The pre-treatment air conduction threshold was 39.78± 8.76 dB, which was reduced to 26.45 ±9.19 dB after treatment (p&lt;0.05). The pre-treatment air-bone ..

Otitis Media Prevalence in Children Below 18 Years of Age of India and the Associated Risk Factors: A Systematic Review and Meta-Analysis.

Ear ailments in children are a major public health problem in India. This systematic review and meta-analysis aim to quantitatively pool the epidemiologic evidence on the prevalence of all forms of otitis media in children of India. In this review PRISMA guidelines (preferred reporting items for systematic reviews and meta-analysis) were followed. We did extensive literature search in PubMed, Embase, Cinahl and Web of Science to identify relevant community based cross sectional studies that investigated the prevalence of otitis media in children of India. We used STATA version 16.0 software to perform meta-analysis. Six studies reporting the prevalence of otitis media in children were included in the final analysis. Based on the results of the random-effects sub-group meta-analysis model, the pooled estimated prevalence of Chronic suppurative otitis media in children of India was 3.78% (95% CI 2.72-4.84), Otitis media with effusion was found to be 2.68% (95% CI 1.80, 3.55) and Acute suppurative otitis media to be 0.55 (95% CI 0.32, 0.78). This review suggests substantial otitis media related disease burden in children of India. But due to lack of epidemiological studies, the actual disease burden remains concealed. It is imperative to promote more epidemiological studies that will aid policy makers in recommendation of preventive, diagnostic and treatment strategies for this disease.

LEMIERRE'S SYNDROME: A REVIEW

Lemierre's syndrome is a rare and less commonly occurring clinical condition that generally relates to the septic thrombophlebitis of the Internal Jugular vein. Mostly the clinicians have forgotten about this due to less incidence, the most common bacteria causing infection are and Streptococci followed by styaphylococci and Klebsiella [1] . The major proportion of cases that come to light are due to deep neck space infections that ultimately leads to thrombotic involvement of IJV, accounts for for majority of the cases. The other causes include complications of chronic suppurative otitis media and thrombosis occurring in deep veins. Since the Internal Jugular Vein is involved the infection can also undergo hematogenous spread. The infection generally spreads to Spleen, Liver, Kidney, Heart and Brain. [3][4] Lemierre's syndrome can be diagnosed on the basis of clinical symptoms, multitude of blood series and Imaging. Since it is an infectious condition the treatment involves systemic antibiotic therapy and early administration of broad spectrum antibiotics in high dose become necessary for prevention of complications and systemic spread of infection. [3][4] We are presenting a case series of 5 cases over a period of six years from November 2015 to November 2021.

Microbiology and Drug Susceptibility Pattern of Bacterial Isolates from Patients with Chronic Suppurative Otitis Media at a Tertiary Care Hospital in Somalia.

This study aimed to determine the microbiological profile and antibiotic susceptibility pattern of bacterial isolates obtained from patients with chronic suppurative otitis media (CSOM) presenting to the otorhinolaryngology clinic of a tertiary care hospital in Mogadishu, Somalia. A total of 225 patients diagnosed with chronic suppurative otitis media were included in the study. Samples of middle ear discharge were collected from each patient and cultured using standard microbiological techniques, and bacterial identification was performed. Drug susceptibility pattern was assessed according to the Clinical and Laboratory Standards Institute criteria. The study sample (n=225) comprised 122 females and 103 males. Among 225 samples tested, bacterial growth was present in 200 (88.9%) and absent in 25 (11.1%) samples. Of 200 samples with bacterial growth, monomicrobial growth was detected in 176 (88%). Gram-positive bacteria were observed in 40 (22.7%) and Gram-negative bacteria in 136 (77.3%) samples. The bacteriology of the samples with monomicrobial growth consisted of (in decreasing frequency) Pseudomonasspp,Staphylococcus aureus,Escherichia coli, Coagulase-negative staphylococci,Proteus mirabilis,andKlebsiella sp. A high rate of resistance was detected against penicillin antibiotics, erythromycin, tetracycline, and co-trimoxazole. Resistance to cephalosporins, clindamycin, vancomycin, linezolid, daptomycin, quinupristin/dalfopristin, levofloxacin, meropenem, and ertapenem was low. While the frequencies of isolated bacterial species were consistent with other reports from the region, differences were observed in the antibiotic resistance of bacterial isolates when examined individually for each antibiotic. Further studies are warranted in the same region and different parts of Somalia, coupled with ongoing assessment of antibiotic susceptibility patterns in CSOM.

Definite therapy of mixed infection alleviates refractory dilemma of adult chronic suppurative otitis media.

The characteristics, risk factors, microbial distributions and effective treatment regimens for Chronic suppurative otitis media (CSOM) patients intractable to empirical therapy were analyzed. Adult CSOM patients of China Medical University Hospital from 2018 to 2020 were included. Subjects of refractory and non-refractory groups were investigated for characteristics of age, sex, nation, comorbidities, otomycosis, and associated complications. Risk factors, microbiology distributions, and treatment regimens were analyzed. Twenty-six refractory patients (55.0±17.7 years) and 66 non-refractory patients (54.1±13.7 years) were studied. A significantly higher rate of otomycosis and CSOM complications was observed in refractory group than in non-refractory one (73.1% vs. 36.4%; p=0.002; 57.7% vs. 10.6%, p<0.001, respectively). Multivariate analysis revealed atopic diathesis (p=0.048), otomycosis (p=0.003) and CSOM complications (p<0.001) were risk factors of refractory CSOM. Coagulase-negative staphylococci (CoNS) and methicillin-resistant Staphylococcus aureus (MRSA) were the prevailing pathogens. Patients of refractory group tented to have higher rates of mixed infection (42.9%% vs. 23.7%) and significantly more included fungal pathogen (19.0% vs. 2.6%; p=0.049) than those of non-refractory cohort. Topical treatment of fungus significantly improved outcome of refractory CSOM. Atopic diathesis, otomycosis, and CSOM-associated complications were risk factors of refractory CSOM. Systemic and local treatment to possible drug-resistant pathogens, likely CoNS and fungus, possible improves recalcitrant CSOM. Correspondingly, early identification of CSOM complications, routine culture and susceptibility testing and treatment of resistant bacteria and fungus are key elements to the successful management of adult CSOM.

The influence of tympanic membrane perforation site on the hearing level of conductive hearing loss in chronic suppurative otitis media

Chronic suppurative otitis media (CSOM) is an infection of the middle ear cavity both partially and totally. It is characterized by ear discharge through a tympanic membrane perforation for over a period of 2 to 6 weeks. Hearing loss is the most common complication of CSOM. One of the degrees of hearing loss in tympanic membrane perforation is depending on the site of perforation, but this premise is still debatable because of pros and contras by some researchers. This study aimed to assess the degree of hearing loss in relation to the site of tympanic membrane perforation. A cross-sectional prospective study design was performed involving 43 patients of safe type CSOM who came to the Department of Otolaryngology Head and Neck Surgery from the period January 2016 to November 2018. All subjects were divided into 4 groups based on the site of perforation. There was a perforation in the posteroinferior, the posterosuperior, the anteroinferior, and the anterosuperior. A statistical analysis using Anova along with multivariate analysis was conducted. Our result showed that the most common site of tympanic membrane perforation was at the anteroinferior (30 samples, 59.8%). The highest hearing threshold was seen at posteroinferior with a mean hearing level of 37.7±2.0 dB, anteroinferior with a mean hearing level of 31.7±0.7 dB, anterosuperior with a mean hearing level 30.7±1.4 dB, and posterosuperior mean hearing level 28.9±1.5 dB. The difference was found significant with p=0.004. Posteroinferior tympanic membrane perforation had a higher number of hearing loss compared to the other sites. In conclusion, the tympanic membrane perforation site has an important role in the hearing level of conductive hearing loss in CSOM.

Characteristics of hearing loss in Dar es Salaam, Tanzania

Introduction: Hearing loss is a major public health problem in developed and developing countries. The objective of this study was to determine the causes and patterns of hearing loss at a private hospital that serves the largest number of patients with ear, nose and throat diseases in Tanzania’s largest city.&#x0D; Method: This was a hospital based descriptive cross-sectional study that was conducted at a private hospital in Dar es Salaam. Data were collected from January to June 2021 and analysed using Statistical Package for Social Sciences (SPSS) version 20. P-value&lt;0.05 was considered to be statistically significant.&#x0D; Results: Of the 250 patients recruited with hearing loss, there were 115 (46%) males and 135 (54%) females (F:M ratio of 1.2:1). The commonest cause of hearing loss was presbyacusis 132 (52.8%) followed by ototoxicity 26 (10.4%) and chronic suppurative otitis media 26(10.4%). Based on laterality, 73.2% of the patients had unilateral hearing loss whereas 26.8% had bilateral hearing loss. Regarding the type of hearing loss, 85.6% of the patients had sensorineural hearing loss followed by conductive type (13.2%) and mixed hearing loss (1.2%). Based on severity, 40.8% of the patients had moderate hearing loss followed by both moderately severe and severe hearing loss each accounting for 18% of cases.&#x0D; Conclusion: Sensorineural hearing loss was the commonest type of hearing loss in this study. Both unilateral hearing loss according to laterality and moderate hearing loss upon classifying by severity predominated. Age‑related hearing loss was the most common cause of hearing loss followed by ototoxicity and chronic suppurative otitis media.

Middle Ear Pathologies Persist in Adults Living With HIV Despite the Use of Antiretroviral Therapy

Middle Ear Pathologies Persist in Adults Living With HIV Despite the Use of Antiretroviral Therapy

The sensitivity pattern of ciprofloxacin and amoxicillin in chronic suppurative otitis media

Introduction: In both poor and developed countries, chronic suppurative otitis media affects 1-46 percent of the population. The incidence of chronic suppurative otitis media is much higher in Indonesia due to various of factors, including poor sanitation, low socio-economic and nutritional status, and high population density. To reduce the occurrence of chronic suppurative otitis media, an adequate treatment is required. Purpose: the study was to identify the bacteria that cause chronic suppurative otitis media and ciprofloxacin and amoxicillin antibiotic sensitivity pattern in Asri Medical Centre and PKU Muhammadiyah Gamping hospital, Yogyakarta. Patients and methods: This is a prospective descriptive study with 27 patients with chronic suppurative otitis media whom met the inclusion criteria. Bacteria were isolated from ear secretions and cultured on TSA and McConkey agar medium. The antibiotics ciprofloxacin and amoxicillin were tested for susceptibility, and Gram staining, catalase test, and biochemical test were used to identify bacteria. Results: 63 bacteria were isolated from 27 chronic suppurative otitis media patients, among of them positive-gram bacteria (52%) and negative-gram bacteria (48%). The sensitivity of positive-gram bacteria and negative-gram bacteria causing chronic suppurative otitis media to ciprofloxacin was 84% and 79%, respectively. The resistance of positive-gram bacteria and negative-gram bacteria to amoxicillin by 100%. Conclusion: Staphylococcus sp and Pseudomonas aeruginosa were the most caused chronic suppurative otitis media at the Asri Medical Centre and PKU Muhammadiyah Gamping hospital in Yogyakarta. The antibiotic ciprofloxacin is the most effective treatment for bacteria that cause chronic suppurative otitis media.

On the issue of effective engraftment of tissues in the plastic of the tympanic membrane

For a long time for otolaryngologists, the issues of identifying and treating such a formidable disease as chronic suppurative otitis media (CSOM) have been topical. This disease still haunts many specialists, as it leads to acquired hearing loss in people of working age. Only in the last ten years, the number of children of younger age groups with already manifested acquired hearing loss has increased. Along with the correct and timely diagnosis, it is very important to cure this disease once and for all, since exacerbations often disrupt not only the performance, but also the quality of life of the patient. The gold standard for the treatment of patients with CHSO is surgical – tympanoplasty. In the process of studying the pathological process in chronic suppurative otitis media and methods of its more effective surgical treatment, the results of tympanoplasty were analyzed. An illustrative clinical example has been chosen, with the help of which it is possible to trace all the stages of surgical intervention in chronic suppurative otitis media. An otoscopic examination was carried out at several stages of observation of this patient, as well as the determination of auditory function. The presented clinical case shows step by step the effectiveness of the scheme of surgical treatment and postoperative management. Thus, these steps are applicable to any myringoplasty with tympanic membrane defects of any size. It is tympanoplasty and control in the postoperative period that makes it possible to completely close the defect of the tympanic membrane and prevent chronic otitis media from recurring.

Hearing and Clinical Otologic Profile of Filipinos Living in Southern Tagalog Region IV-A (CALABARZON), Philippines: The Southern Tagalog ENT Hearing Specialists (STENTS) Survey 2012-2017

&#x0D; &#x0D; &#x0D; &#x0D; ABSTRACTObjective: To determine the prevalence of hearing loss and otologic diseases among Filipinos living in the Southern Tagalog Region IV-A: CALABARZON (Cavite, Laguna, Batangas, Rizal and Quezon), Philippines.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: &#x0D; Design: Retrospective Review of Community Survey Data&#x0D; Setting: Communities in Region IV-A provinces, Philippines&#x0D; Participants: 3267 residents of the five provinces aged 0 months and above&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Results: About 71.29% and 74.60% had at least mild hearing loss, in right and left ears, respectively. For disabling hearing impairment, overall prevalence was 26.33%, distributed into 11.87% among 4 to 18-year-olds; 8.97% for 19 to 64-year-olds; and 3.17% for 65-year-olds and above. Absence of prevalent and hearing loss-associated diseases: serous otitis media [OR 0.362, 95% CI 0.167 to 0.782, p = .010], CSOM [OR 0.407, 95% CI 0.236 to 0.703, p = .001] COM [OR 0.229, 95% CI 0.106 to 0.494, p &lt; .001] can decrease the risk for hearing loss development in the region. Prevention of noise-induced hearing loss or delay in the manifestation of presbycusis can reduce the risk of having hearing loss by as much as 75% [OR 0.253, 95% CI (0.180 to 0.355), p &lt; .001]. All pure tone audiometry measurements were obtained with surrounding median ambient noise of 55dB (IQR 46 to 60dB).&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Conclusion: The prevalence of hearing loss among surveyed residents of the Southern Tagalog Region IV-A provinces was high compared to the previous nationwide study but low compared to other low- and middle-income countries. The top otologic conditions of this population (ear occlusion with ear wax, chronic suppurative otitis media, chronic otitis media, presbycusis, noise- induced hearing loss) were associated with hearing loss and their absence decreased the risks for hearing impairment.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Hearing Evaluation Post Canal Wall-Up (CWU) Tympanoplasty on Patients with Safe Type Chronic Suppurative Otitis Media

Objective: Otitis media is a contagious inflammatory illness of the middle ear that might have a sudden onset and a complete resolution, or it can have a persistent presentation and long-term implications. Surgical treatment is available for all kinds of otitis media. Different types of operations include canal wall-up, canal wall-down, and their variations. The wall-up approach of the two canals with or without posterior tympanotomies, also known as tympanoplasty surgery, preserves the rear wall of the ear canal. Material and Methods: Hearing evaluation was conducted after canal wall-up tympanoplasty surgery at the outpatient clinic, Department of Otorhinolaryngology, Dr. Soetomo Hospital, Surabaya, Indonesia over a period of two years (2018-2019). Results: Two hundred and thirty-seven patients underwent from January 1, 2018 to December 31, 2019. However, only 74 (31.2%) of them had complete medical records after surgery. Fifty-nine ears (79.7%) experienced a better hearing threshold, six ears (8.1%) did not improve, and nine ears (12.2%) deteriorated. The hearing threshold improvement was of a magnitude of 10.9 dB; before surgery, it was 56.6 dB, and after surgery, it became 45.6 dB. Conclusion: A 10.9-dB improvement in hearing threshold mean was observed among patients undergoing canal wall-up tympanoplasty, whereas the bone gap improvement between pre- and post-tympanoplasty was 6.9 dB.

Association Between Social Disadvantage and Otitis Media Treatment in US Children With Commercial Insurance

It is well established that social disadvantage is associated with earlier, more frequent, and more severe otitis media in children. Appropriate medical and surgical treatment of otitis media can prevent hearing loss and other complications, which may affect future academic and employment opportunities in socially disadvantaged populations. Clinical treatment patterns for otitis media in the US are unclear. To describe and quantify social disparities in the treatment patterns of otitis media in children in the US. This cross-sectional study included claims data from the Optum Clinformatics Data Mart Database between January 1, 2003, and March 31, 2021, with linked inpatient, outpatient, and pharmaceutical claims for 4 831 408 children with otitis media. Age at first otitis media diagnosis, sex, environmental allergies, gastroesophageal reflux, adenotonsillar hyperplasia, zip code, social deprivation index score, social vulnerability index score. Treatment of recurrent and suppurative otitis media in children, insertion of tympanostomy tubes, and treatment for severe complications of undertreated otitis media. The principal measure of social disadvantage was the social deprivation index. The social vulnerability index was used for sensitivity analyses to ensure external validity. Multiple logistic regression analyses were used to quantify the association of all projected variables with the study outcomes. Among 4 831 408 US children with otitis media (median [IQR] age, 4 [1-8] years; 2 491 557 boys [51.57%]), 994 921 (20.59%) were treated for recurrent otitis media, 717 978 (14.86%) were treated for suppurative otitis media, 335 949 (6.95%) received tympanostomy tubes, and 10 975 (0.23%) had severe complications of otitis media. In multivariable regression models including patient factors and social indices, earlier age at diagnosis, male sex, environmental allergies, gastroesophageal reflux, and adenotonsillar hyperplasia were associated with increased treatment for otitis media, whereas social deprivation index was associated with lower odds of medical treatment for recurrent otitis media (odds ratio [OR], 0.86; 95% CI, 0.85-0.87), suppurative otitis media (OR, 0.61; 95% CI, 0.60-0.62), and insertion of tympanostomy tubes (OR, 0.76; 95% CI, 0.75-0.78) but higher odds of having severe complications (OR, 1.28; 95% CI, 1.19-1.37). The findings of this cross-sectional study suggest that children with otitis media who were socially disadvantaged were less likely to receive treatment and more likely to experience complications for undertreated otitis media. As otitis media is a modifiable risk factor for hearing loss, efforts need to be made to ensure equitable access to treatment for all children.