Treatment Of Secretory Otitis Media Research Articles

Harnessing astaxanthin-loaded diselenium cross-linked apotransferrin nanoparticles for the treatment of secretory otitis media

Secretory otitis media (SOM) is a clinical condition characterized by the accumulation of fluids and oxidative stress in the middle ear, leading to hearing impairment and infection complications. One potential solution for mitigating oxidative stress associated with SOM is the use of antioxidants such as astaxanthin. However, its effectiveness is limited due to its poor bioavailability and rapid oxidation. Herein, we developed a novel diselenium-crosslinked apotransferrin enriched with astaxanthin (AST@dSe-AFT) nanoparticles to augment the transport of astaxanthin across biological membranes, resulting in increased bioavailability and reduced oxidative stress in SOM. Our research demonstrated that AST@dSe-AFT efficiently accumulated in the middle ear, allowing for controlled delivery of astaxanthin in response to reactive oxygen species and reducing oxidative stress. Additionally, AST@dSe-AFT stimulated macrophages to polarize towards M2 phenotype and neutrophils to polarize towards N2 phenotype, thereby facilitating an anti-inflammatory response and tissue restoration. Importantly, AST@dSe-AFT exhibited no toxicity or adverse effects, suggesting its potential for safety and future clinical translation. Our findings suggested that AST@dSe-AFT represents a promising approach for the treatment of secretory otitis media and other oxidative stress-related disorders.

Retracted: Efficacy and Safety of Endoscopic Tympanic Membrane Catheterization Plus Ofloxacin Ear Drops in the Treatment of Secretory Otitis Media in Infants and Toddlers.

[This retracts the article DOI: 10.1155/2022/3732243.].

Efficacy and Safety of Endoscopic Tympanic Membrane Catheterization Plus Ofloxacin Ear Drops in the Treatment of Secretory Otitis Media in Infants and Toddlers.

Objective To investigate the efficacy and safety of endoscopic tympanic membrane catheterization and ofloxacin ear drops in the treatment of secretory otitis media in infants and toddlers. Methods A total of 80 children suffering from secretory otitis media who underwent treatment in our hospital from July 2018 to April 2020 were divided into the control group (n = 40) and experimental group (n = 40) by randomization. The control group was treated with endoscopic tympanic membrane catheterization alone, while the experimental group was treated with ofloxacin ear drops based on the same treatment as the control group. The treatment effect, air conduction hearing level, clearance rate of pathogenic bacteria secreted by the ear canal, recurrence rate, and adverse reactions were compared between the two groups. Results The treatment in the experimental group led to a significantly better outcome than that in the control group (P < 0.05). After treatment, a substantially improved air conduction hearing level in the experimental group was observed (P < 0.001). A chi-square test showed a significantly higher clearance rate of pathogenic bacteria secreted from the ear canal of the children in the experimental group compared to that of the control group (P < 0.05). The treatment in the experimental group resulted in a lower recurrence rate and adverse reaction rate as compared to the control group (P < 0.05). Conclusion Concurrent endoscopic tympanic membrane catheterization and ofloxacin ear drops showed excellent efficacy in the treatment of secretory otitis media in infants and toddlers. The therapy offers promising solutions for the improvement of hearing level, increase of clearance rate of pathogenic bacteria secreted from the ear canal, and decrease of disease recurrence and adverse reactions during treatment.

Effect of the diameter of tympanostomy with CO₂ laser on secretory otitis media after radiotherapy

Objective:To investigate the postoperative effect of different diameters of CO₂ laser tympanostomy in the treatment of secretory otitis media caused by radiotherapy in patients with head and neck tumor, and to find out the best diameter range of tympanostomy according to the curative effect. Methods:The 40 ears after radiotherapy in the otorhinolaryngology department. The average 40 ears were divided into two groups: the diameter of perforation ≤3 mm and the diameter of perforation > 3 mm. Each group was 20 ears. Both groups were compared with tympanum and pure tone threshold after perforation, and then performed pure tone threshold measurement, tympanoplasty, and otoendoscopy 1,3,6 month after operation respectively. Meanwhile, patients were asked to assist in filling in the score scale of eustachian tube dysfunction（ETDQ-7）, to understand the difference in clinical symptoms and to count the complications after the operation. The changes of the size of the holes were compared with the corresponding attractors during the follow-up. Results:①After the operation, the mean value of pure tone hearing threshold air bone conduction difference in the diameter of perforation ≤3 mm group was significantly lower than that in the diameter of perforation >3 mm group （P<0.05）, indicating that the postoperative hearing recovery in the diameter of perforation ≤3 mm group was better than that in the diameter of perforation >3 mm group. ②Within six months after the operation, the tympanic membrane in the group a healed more than that in the diameter of perforation >3 mm group（P< 0.01）; in patients with an unclosed tympanic membrane in the diameter of perforation ≤3 mm group and the diameter of perforation >3 mm group, the number of smaller tympanic membrane diameter in the diameter of perforation ≤3 mm group was more than that in the diameter of perforation >3 mm group（P< 0.01）. ③The effective rates of the diameter of perforation≤3 mm group and the diameter of perforation>3 mm group were 75% and 35%, respectively. ④The incidence of postoperative complications such as middle ear infection and tympanic membrane nonunion in the diameter of perforation ≤3 mm group and the diameter of perforation>3 mm group were 25% and 45%, respectively, the incidence of postoperative complications in the diameter of perforation ≤3 mm group was significantly lower than that in the diameter of perforation>3 mm group（P<0.05）. ⑤The subjective feelings of patients in the diameter of perforation ≤3 mm group was significantly improved after the operation（P<0.01）. Compared with the postoperative questionnaire, the scores of Eustachian tube dysfunction score in the the diameter of perforation ≤3 mm groups after treatment were significantly better than the diameter of perforation>3 mm group（P<0.01）. Conclusion:According to this experimental study, in the range of 2-4 mm, 2.5 mm ≤ diameter ≤ 3.0 mm, the postoperative effect is better.

Efficacy and safety of ambroxol hydrochloride in the treatment of secretory otitis media: a systematic review and meta-analysis.

BackgroundSecretory otitis media is a very common nonsuppurative inflammatory disease in otorhinolaryngology. Ambroxol hydrochloride helps to improve ciliary movement in the ear canal and promote the dissolution and discharge of secretions. However, its effect still lacks systematic evaluation. We conducted a meta-analysis of clinical studies to systematically evaluate the application effect of ambroxol hydrochloride.MethodsA computer-based search of the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), PubMed, and Web of Science databases was conducted using the keywords “Ambroxol hydrochloride” & “secretory otitis media”. Randomized controlled trials published after 2015 were selected and then screened and analyzed using RevMan 5.4 software.ResultsTen studies involving a total of 998 patients were included. Meta-analysis showed that adding ambroxol hydrochloride to the original glucocorticoid treatment improved therapeutic efficacy [odds ratio (OR) =4.95, 95% confidence interval (CI): 3.27, 7.50, P<0.00001], reduced tympanic pressure after treatment [mean difference (MD) =−19.04, 95% CI: −22.72, −15.36, P<0.00001], and increased the pure tone threshold (MD =6.37, 95% CI: 5.36, 7.37, P<0.00001), without increasing adverse reactions (OR =0.51, 95% CI: 0.14, 1.85, P=0.30).DiscussionOn the basis of the original treatment of secretory otitis media, adding ambroxol hydrochloride treatment improved the therapeutic effect, reduced tympanic pressure after treatment, and improved the pure tone threshold (hearing), without increasing adverse reactions.

Clinical Analysis of Tympanesis Combined with Dexamethasone Tympanum Injection in the Treatment of Secretory Otitis Media

Clinical Analysis of Tympanesis Combined with Dexamethasone Tympanum Injection in the Treatment of Secretory Otitis Media

Impact of adenoidectomy alone or with ventilation tube for treatment of secretory otitis media in children

Background: Adenoid surface in patients suffering from secretory otitis media is usually associated with bacterial biofilm. Adenoidectomy is thought to be effective in treatment of cases associated with secretory otitis media. Objective: Evaluating the role of adenoidectomy alone or in combination with ventilation tube insertion in improving the outcome of OM with effusion associated with adenoid hypertrophy. Patients and methods: This study included 40 children with recurrent or persistent secretory OM despite proper medical treatment for 3-6 months. They were divided into 2 equal groups. Group A treated by adenoidectomy with ventilation tube insertion and the group B was treated by adenoidectomy alone. These patients were evaluated preoperatively by plain X-ray nasopharynx lateral view and audiological assessment, adenoid specimen was taken for scanning by electron microscope for adenoid surface biofilm detection and grading. Postoperatively, we followed up the patients for 1 year to assess improvement and post-operative complications. Results: At the 1st follow up visit, Group A had higher rate of improvement than those who had adenoidectomy alone. Long term follow up (1 year) show significant higher rate of complications in those who were treated by adenoidectomy with ventilation tube 5 cases in comparison to only 2 cases of in Group B. There is no significant association between adenoid size and biofilm formation. Adenoid size and biofilm extension grade had no significant relation to postoperative outcome. Conclusion: Removal of adenoid was associated with relieve of OM with significant higher rate of complications in those undergoing adenoidectomy with ventilation tube insertion.

Treatment of Secretory Otitis Media by Wind Based on the Relationship Between Lung and Ear

Treatment of Secretory Otitis Media by Wind Based on the Relationship Between Lung and Ear

Different Methods of Treatment of Secretory Otitis Media in Children; A Meta-Analytical Study

Different Methods of Treatment of Secretory Otitis Media in Children; A Meta-Analytical Study

Can Reflux Symptom Index and Reflux Finding Score Be Used to Guide the Treatment of Secretory Otitis Media in Adults?

Background:At present more attention is paid to the treatment of secretory otitis media in children, but there is also a high incidence of adult patients. The etiology of secretory otitis media in adults is complex and related to many factors. Objectives: The aim of this study was to evaluate the correlation between the Reflux Symptom Index (RSI)/Reflux Finding Score (RFS) and secretory otitis media in adults, and to explore further treatment methods. Material and Methods:Taking outpatients in the otology department from January 2017 to May 2019 as the object of study, acoustic immittance tests were performed and the results analyzed. Patients with secretory otitis media received tympanocentesis or tympanotomy and the related components were analyzed.The patients were followed up and the curative effects of different treatment schemes were compared. Results: There were 67 patients with secretory otitis media. The prevalence of secretory otitis media in patients with RSI >13 was significantly higher than that in patients with RSI <13. The prevalence of secretory otitis media in patients with RFS >7 was significantly higher than that in patients with RFS <7 (p < 0 05). The RSI/RFS score of B tympanogram was significantly higher than that of A and C maps (p < 0.05). Among the patients with type B, the serous type was higher in those with an RSI score <13, and the mucus was higher in those with an RSI score >13 (p < 0.05). There was no significant difference in the proportion of glue patients (p > 0.05). In type B patients, the detection rate of pepsin in the experimental group was significantly higher than that in the control group (p < 0.05), and the scores of RSI/RFS in the pepsin-positive group were significantly higher than those in the negative group (p < 0.05). Treatment with acid-suppressive drugs in patients with abnormal RSI/RFS achieved better results (p < 0.05). Conclusions: RSI/RFS may be related to the development of secretory otitis media in adults, and could play a guiding role in its treatment.

鼓膜切开联合地塞米松鼓室冲洗治疗分泌性中耳炎临床诊治分析

鼓膜切开联合地塞米松鼓室冲洗治疗分泌性中耳炎临床诊治分析

Comparison of tympanocentesis, CO₂ laser tympanostomy and grommet insertion in the treatment for secretory otitis media in children

Objective:To compare adenoidectomy combined tympanocentesis, CO₂ laser tympanostomy and grommet insertion in the treatment for secretory otitis media (SOM) in children, and to provide basis for selection of surgical treatments. Method: Four hundred and twenty-six ears in 244 children with adenoid hypertrophy and SOM were divided into 3 groups which were: group A, 80 cases (142 ears) were treated with adenoidectomy combined with tympanocentesis; group B, 86 cases (145 ears) were treated with adenoidectomy combined with CO₂ laser tympanostomy; group C, 78 cases (139 ears) were treated with adenoidectomy combined with grommet insertion. Endotoscopy, tympanometry and PTA (or ABR) were conducted. Based on the characters of the middle ear effusion in operation, each ear were divided into two groups: Serous group and Mucus group. All patients conducted PTA (or ABR) 6 months after surgery and they were followed up until 1 year after surgery. The efficacy and postoperative complications and recurrence rate were compared among 3 groups, the prognosis of both serous group and mucus group were analyzed. Result:The effective rate of 3 groups at 6 months postoperative were 89.44%, 90.34% and 96.40% respectively, which showed no statistical difference among 3 groups and statistical difference between group C and group A, B was found. No statistical difference was found among 3 groups in serous group. The effective rate of group C was higher than that of group A and group B, with statistical difference. The rate of postoperative complications (permanent tympanic membrane perforation, middle ear infection postoperative, tympanic tube blockage or detachment, etc.) during 1 year postoperative in 3 groups were: 16.20%, 13.10%, 33.81%, respectively. The recurrence rates were: 11.02%, 12.98%, 3.73%, respectively, and the reoperation rate in all 3 groups were 0. Conclusion:In the treatment for SOM in children with adenoid hypertrophy, adenoidectomy combined with tympanocentesis or combined with CO₂ laser tympanostomy showed a similar effects, which was slightly lower than adenoidectomy combined with gromment insertion. Considering the complications postoperative and recurrence rates of different operations, tympanocentesis or CO₂ laser tympanostomy is recommended to be conducted as routine, and grommet insertion is recommended to be conducted when mucus-like middle ear effusion is found during surgery.

Ефективність застосування топічного кортикостероїдного препарату «Флікс» при лікуванні секреторного середнього отиту у дітей

Ефективність застосування топічного кортикостероїдного препарату «Флікс» при лікуванні секреторного середнього отиту у дітей

Application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy

Objective To investigate the application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy. Methods 80 secretory otitis media children with ineffective drug therapy were selected as the research subjects.According to the random number table method, all patients were divided into treatment group and control group, 40 cases in each group.The observation group received otoendoscopic tympanic membrane tube surgery treatment, the control group received auripucture with otic endoscope surgery treatment.The complications of the two groups were observed, and the clinical curative effect and postoperative recurrence were compared. Results The recurrence rate of the observation group was 5.00%, which was significantly lower than 20.00% of the control group (χ2=4.114, P=0.042). The middle ear effusion time of the observation group was (8.53±1.25)d, which was significantly shorter than (10.46±1.44)d of the control group (t=5.074, P=0.000). In the observation group, 37 patients after treatment had change, the total effective rate was 92.50%.In the control group, 28 patients after treatment had change, the total effective rate was 70.00%, the total effective rate of the observation group was significantly higher than the control group, the difference was statistically significant (χ2=6.646, P=0.009). The incidence rate of complication in the observation group was 7.50%, which was significantly lower than 32.50% in the control group (χ2=7.812, P=0.005). Conclusion Tympanostomy tube under ear endoscope surgery for the treatment of drug refractory secretory otitis media in children has good effect, the recurrence rate is relatively lower, has less complications, high safety, it is worthy of clinical application. Key words: Otitis media, effusion; Ear endoscope; Insertion tube; Puncture; Children

Therapeutic Proposal to Clinical Treatment for Tympanometric Improvement in Patients with Otitis Media Secretory

Objectives: Serous otitis media is very frequent in children, especially those between 3 and 6 years of age. The diagnosis of otitis media is often difficult. Otomicroscopy and tympanometry can improve diagnostic quality by the indication of fluid in the middle ear and thereby improve the quality of treatment. The aim of this ongoing study is to describe the variations in tympanometry in patients undergoing clinical treatment alone. Methods: This was a prospective study of 25 patients diagnosed with secretory otitis media, treated with oral antibiotics, nasal corticosteroid spray, and nasal N-acetylcystein from January 2013 to January 2014 in the Otorhinolaryngology Department, Juiz de Fora University Medical School, Brazil. The inclusion criteria were age between 2 and 12 years and altered otoscopy and tympanometric examination. The exclusion criteria were antibiotic use during the previous month and history of chronic otologic disorder or congenital abnormalities. All were evaluated by tympanometry in the week of diagnosis and after treatment, at 30 days from the first review. Results: A total of 25 patients, of which 11 (44%) were girls, and 14 (56%) were boys (3 to 15 years old). Of the 50 ears assessed in the first week of diagnosis, 28 (56%) had curve B and 20 (40%) had curve C. At the last evaluation, only 8 ears (16%) remained with curve B. 12 (24%) had curve C and 30 (60%) had curve A. Conclusions: Treatment with corticosteroids via nasal spray combined with oral antibiotics and nasal N-acetylcysteine can be a good therapeutic option for the treatment of secretory otitis media.

Efficacy of adenoidectomy combined myringotomy in treatment of children with secretory otitis media

Objective To evaluate the efficacy of combination of myringotomy adenoidectomy in treatment of children with secretory otitis media.Methods 36 children patients with secretory otitis media from March 2010 to February 2013 in our hospital were randomly divided into two groups,a control group of 18 patients taking endoscopic tympanostomy tube treatment; 18 cases in observation group took endoscopic tympanostomy tube joint adenoidectomy treatment,the incidence of the two groups were observed as well as the efficacy and complications.Results The total effective rate in observation group was 94.4％,while 83.2％ in the control group,showing statistical significant difference (P ＜ 0.05).Complications occurred in the observation group was 16.7％; while it was 36.1％ in the control group,showing statistical significant difference (P ＜ 0.05).Conclusion The combination of myringotomy and adenoidectomy has good clinical efficacy in the treatment of secretory otitis media,which is good for children,with high safety factor,deserved to be promoted in clinical practice. Key words: Adenoidectomy; Myringotomy; Secretory otitis media; Efficacy

Wpływ zmian strukturalnych błony bębenkowej na wyniki audiometrii impedancyjnej i tonalnej w rozszerzonym zakresie częstotliwości

The aim of the study is to analyze the relationship between otoscopic tympanic membrane abnormalities, results of impedanace and extended-high-frequency audiometry in subjects with history of treatment of secretory otitis media (SOM) and ventilation tube insertion. 97 subjects treated because of SOM were examined in years 1999-2000. Videootoscopic examinations, extended-high-frequency audiometry and tympanometry with ispilateral acoustic reflex were performed in each patient. The results were analysed in three groups: no otoscopic abnormalities (BZO), retraction pockets (KR) and atrophy and myringosclerosis (AM). The results were compared to otologicaly healthy control group in the same age. The most common tympanic membrane abnormality were focal atrophy (64.7%) of ears and myringosclerosis (37.2%). Mean pure-tone audiometric threshold were significantly higher in groups KR and AM than in control and BZO groups. Low degree of positive correlation was found between the presence of myringosclerosis and atrophy and audiometric thresholds above 1 kHz. No such correlation was observed with the presence of retraction pockets. In the BZO group middle ear admittance was observed significantly higher than in control group. The absent ipsilateral stapedial reflex was observed in 10.8% ears in BZO group, 16.9% in AM and 33.3% in KR. No correlation was found between the parameters of tympanometric evaluation and results of extended-high-frequency audiometry. In ears treated because of SOM with ventilation tube insertion the middle ear compliance is higher. In the presence of myringosclerosis and atrophy higher audiometric thresholds are observed. Tympanic membrane abnormalities have been more clearly indicated by the absent ipsilateral stapedial reflex than tympanometry.

Factors affecting the results of conservative treatment of secretory otitis media in children

Objective: There is only limited knowledge of the factors influencing the results of nonsurgical treatment of secretory otitis media (SOM). The present study was carried out to determine the effect of middle ear inflation and to examine the factors affecting the results of conservative treatment of SOM in children. Methods: A total of 158 children with SOM were randomized to either a group receiving treatment with middle ear (ME) inflation for 10 days 3/day, or to a group receiving ME inflation and antibiotics (oral Amoxicillin 50 mg/kg 3/day) for 10 days, or to a control group. A wide variety of anamnestic and clinical pre-treatment variables were assessed by administered questionnaires. Pneumo-otoscopy, tympanometry and pure-tone audiometry were performed before the treatment and at the 3rd–5th, 10th±2 and 60th±5 days of the study. For the prognostic factors, univariate analyses were first performed to determine the significant predictors, which were afterwards entered into a stepwise logistic regression model. Results: There was no difference in the effectiveness of treatment between Groups A and B, neither on the 10th (46.1% and 52.2%, respectively, controls: 9%, p<0.001) nor on the 60th day (37.3% and 42.4%, control group: 15.7%, p<0.001), of the study. The most important prognostic criteria were defined by analysing the dynamics of tympanometry (OR: 3.24) and audiometry (OR: 8.77) during conservative treatment. The results of the treatment were related to age, the duration of the disease, the previous otologic history, and the nasopharyngeal colonization and the position of the adenoids. Conclusion: The results suggest that daily middle ear inflation can be an effective treatment of SOM for children, having regard to the factors significant for the prognosis of treatment.

Prognostic factors of results of conservative treatment of secretory otitis media for adults

Objective: The object of the study was to determine the effect of the middle ear (ME) inflation and to clear up the factors affecting the results of conservative treatment of secretory otitis media (SOM) in adults. Methods: A total of 146 adult patients were treated by middle ear inflation (group A) or by inflation and antibiotics (group B) for 10±2 days. Pneumootoscopy, pure tone audiometry and impedansometry were carried out on the 3rd–5th, 10th and 60th day of the study. To determine the relative importance of analyzed findings as a prognostic contributive factor, stepwise logistic regression was carried out and positive/negative prognostic value of these factors was assessed. Results: The effectiveness of treatment was 50.6% in group A and 58.7% in group B (control group—11%, p<0.001). The results of treatment were stable and were found unchanged 6 weeks after the treatment. The most important prognostic criteria were defined by analyzing the dynamics of tympanometry (OR-2.17) and pure tone audiometry (OR-10.27) during conservative treatment and after it. The results of the treatment were related to the mastoid pneumatization, the pathology of paranasal sinuses, the previous history of SOM, the age and the pre-treatment otoscopic data.

Factors affecting the results of nonsurgical treatment of secretory otitis media in adults

Objective: There is only limited knowledge of the factors influencing the results of nonsurgical treatment of secretory otitis media (SOM) in adults. The present study was carried out to determine the effect of the middle ear (ME) inflation and to clear up the factors affecting the results of conservative treatment of SOM. Methods: A total of 198 adult patients were randomized to either a group receiving treatment with ME inflation for 10 days or to a group receiving ME inflation and antibiotics (oral Amoxicillin 500 mg 3/day) for 10 days or to a control group. A wide variety of anamnestic and clinical pre-treatment variables were assessed by administered questionnaires. Pneumo-otoscopy, tympanometry and pure-tone audiometry were performed before the treatment and at the 3–5th, 10th±2 and 60th±5 day of the study. For the prognostic factors, univariate analyses were first performed to determine the significant predictors, which were afterwards entered into a stepwise logistic regression model. Results: The effectiveness of treatment was 50.6% in Group A and 58.7% in Group B (control group—11%, P<0.001). The results of treatment were stable and were found unchanged 6 weeks after the treatment. The most important prognostic criteria were defined by analyzing the dynamics of tympanometry (OR, 2.17) and audiometry (OR, 10.27) during conservative treatment. The results of the treatment were related to the mastoid pneumatization, the pathology of paranasal sinuses, the previous history of SOM, the age, and the pre-treatment otoscopic data. Conclusions: The results suggest, that daily ME inflation can be effective treatment for adults patients with SOM having regard to the factors significant for the prognosis of treatment.