Otitis media

Abstract

Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.

Speech-Language Disorders in Children with Hearing Loss Connected with Otitis Media with Effusion

“…Handzic and all showed ear side related differences of hearing loss in OME children with orofacial clefts and out of malformations. Previous studies indicated that CHL (conductive hearing loss) profoundly affects short term synaptic depression and spike adaptation, increases synaptic latencies and evoked postsynaptic potentials were longer and more variable [3]. Females have advantage in process of hearing, it was not described if there exist gender differences in sensitivity for hearing loss in case of prolonged presence of conductive hearing loss to the central auditory processing.…”

Acute Otitis Media- An Update

“…Certain vitamin and dietary deficiencies can be found in cases of AOM and rOM; like vitamin A, zinc, EPA (an omega 3 fatty acid) and selenium deficiencies [13]. There are other risks factors that are related to AOM, like younger age [1,14], attendance to day care centers [3,8,10], prematurity [8], increased number of siblings, dummy use [1,8], Autumn and winter seasons [1], craniofacial anomaly [14], asthma [3] and atop [3,14] (Table 1). …”

“…The importance of other environmental factors cannot be underestimated in the pathogenesis of AOM; Paternal smoking is one of OM risk factors [1,3,8,10,14]; it causes mucosal inflammation, goblet hyperplasia and an increase in the production of mucus, by this it impairs mucosal immunity and increases bacterial colonization by enhancing bacterial binding to respiratory epithelium [1,10]. Children of mothers who smoked during pregnancy and stopped after delivery still have higher incidence of AOM [10].…”

“…URTI causes nasopharyngitis which affects the Eustachian tube (ET), as a result negative pressure is created and that causes suction of the mucus of the nasopharynx inside the middle ear; that explains why aspirate of AOM can show bacteria like Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis [2,8], which are commensal to nasopharynx [16]. The initial course of the disease is thought to be viral in origin with bacterial superinfection occurs after that [2,12], many viruses have been implemented as a causative agents which are found in 90 % of AOM cases, like rhinovirus, coronavirus, enterovirus, respiratory syncytial virus (RSV), parainfluenza type 1, 2 or 3, influenza A or B, and adenovirus [1,2,7,14,17]. Among all of these RSV is believed to have the best association with AOM [12].…”

Welcome to Journal of Otorhinolaryngology, Hearing and Balance Medicine

“…The diagnosis and retraining therapy for tinnitus have also seen breakthroughs [6]. Advances have been made in assessment of otitis media, and its classification and treatment [7]. A groundbreaking discovery in the pathogenesis of allergic rhinitis-allergic rhinitis and its impact on asthma (ARIA)-has redefined the classification of rhinitis and allergic rhinitis [8], and the mechanism and treatment of sinusitis [9].…”