The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media

Jensen, Ruth Helkiær; Koch, Anders; Homøe, Preben

doi:10.1016/j.ijporl.2013.06.025

Cited by 93 publications

(80 citation statements)

References 24 publications

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“…Some wildtype individuals do have persistently chronic otitis media beyond 13 years old (Figure 2C), and for these specific individuals the possibility of a second otitis media susceptibility variant is currently being investigated. Thus among indigenous populations where socio-economic background may favor an increase in prevalence of otitis media, 5–6 the indigenous Filipino population is unique in having at least one rare mutation that confers susceptibility to otitis media and favors carriage of specific middle ear pathogens, 10,12 and which also influences disease patterns including chronicity and onset.…”

Section: Discussionmentioning

confidence: 99%

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Santos‐Cortez

Reyes-Quintos

Tantoco

et al. 2016

Otolaryngol.--head neck surg.

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Objective To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population Study Design Cross-sectional study Setting Indigenous Filipino community Subjects and Methods Clinical history and information on breastfeeding, tobacco smoke exposure and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for presence and character of perforation or discharge. An A2ML1 duplication variant that confers otitis media susceptibility was Sanger-sequenced in all DNA samples. Co-occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to A2ML1 genotype and social cluster. Results The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; p=0.004), however age was non-significant as a bi-stratal or continuous variable. There was no association between otitis media and gender, body mass index, breastfeeding, tobacco exposure or deep swimming. In multivariate analyses, A2ML1 genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95%CI: 1.3, 10.8; p=0.005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life and chronic otitis media persisted up to adulthood, particularly in A2ML1 variant carriers. Conclusion Among indigenous Filipinos, A2ML1 genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome and social clusters might modulate the effect of the A2ML1 genotype.

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Section: Discussionmentioning

confidence: 99%

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Santos‐Cortez

Reyes-Quintos

Tantoco

et al. 2016

Otolaryngol.--head neck surg.

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“…The loss of outer and inner hair cells in the basal turn of the cochlea has been observed in CSOM patients (Huang et al, 1990;Cureoglu et al, 2004). The majority of SNHL in CSOM patients is in the high-frequency range and is unilateral (Jensen et al, 2013). A recent study has also shown that bacterial toxins found in the middle ear during CSOM can pass into the cochlea and result in cochlear pathology (Joglekar et al, 2010).…”

Section: Hearing Lossmentioning

confidence: 99%

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Mittal

Lisi

Gerring

et al. 2015

Journal of Medical Microbiology

199

161

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Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. IntroductionOtitis media (OM) refers to a group of complex infectious and inflammatory diseases affecting the middle ear (Dickson, 2014). OM in general is very common, as studies show that around 80 % of children should have experienced at least one episode by their third birthday (Teele et al., 1989). OM has been broadly classified into two main types, acute and chronic. Acute OM (AOM) is characterized by the rapid onset of signs of inflammation, specifically bulging and possible perforation of the tympanic membrane, fullness and erythema, as well as symptoms associated with inflammation such as otalgia, irritability and fever (Pukander, 1983;Harkness & Topham, 1998). Despite appropriate antibiotic therapy, AOM may progress to chronic suppurative OM (CSOM) characterized by persistent drainage from the middle ear associated with a perforated ear drum (Wintermeyer & Nahata, 1994;Harkness & Topham, 1998). When examined by otoscope, the middle ear looks red and inflamed with purulent discharge in CSOM patients (Figs 1 and 2). It is one of the most common chronic infectious diseases worldwide especially affecting children (Roland, 2002; Verhoeff et al., 2006). Hearing impairment is one of the most common sequelae of CSOM (Aarhus et al., 2015). The resultant hearing loss can have a negative impact on a child's speech development, education and behaviour (Olatoke et al., 2008; Khairi Md Daud et al., 2010). Mortality due to complications of CSOM is typically higher than other types of OM (Yorgancilar et al., 2013a;Qureishi et al., 2014). Intracranial complications like brain abscess and meningitis are the most common causes of death in CSOM patients (Dubey et al., 2010;Chew et al., 2012;Sun & Sun, 2014).In this article, the rec...

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“…3 It is the leading cause of hearing loss and is associated with significant morbidity. 4–7 Children are at greater risk and suffer most frequently from OM. This can cause serious deterioration in the quality of life.…”

Section: Introductionmentioning

confidence: 99%

Role of innate immunity in the pathogenesis of otitis media

Mittal

Kodiyan

Gerring

et al. 2014

International Journal of Infectious Diseases

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Summary Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.

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The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media

Cited by 93 publications

References 24 publications

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Role of innate immunity in the pathogenesis of otitis media

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