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Cameron C Wick, Daniel E Killeen, Michael Clark, Joe Walter Kutz, Brandon Isaacson
OBJECTIVE: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa. STUDY DESIGN: Retrospective case review. SETTING: Tertiary university hospital. PATIENTS: Adult patients from 2005 to 2015 who underwent surgical repair of a spontaneous lateral skull base CSF leak with intraoperative confirmation of a posterior fossa leak source...
October 14, 2016: Otology & Neurotology
Vanessa Duah, Zhen Huang, Stephanie Val, Christie DeMason, Marain Poley, Diego Preciado
BACKGROUND: Chronic otitis media (COM) is one of the most common childhood diseases. Its pathophysiology is complex and multifactorial. The role of specific mucin glycoprotein subtypes in OM is only recently being elucidated. OBJECTIVE: To determine the relationship between middle ear fluid mucins and clinical variables of patients needing tympanostomy tubes (TT). METHODS: Middle ear effusions (MEE) from children receiving TT were collected over a 2-year period...
November 2016: International Journal of Pediatric Otorhinolaryngology
Devin M Parker, Laura Schang, Jared R Wasserman, Weston D Viles, Gwyn Bevan, David C Goodman
OBJECTIVES: To compare rates of typmanostomy tube insertions for otitis media with effusion with estimates of need in 2 countries. STUDY DESIGN: This cross-sectional analysis used all-payer claims to calculate rates of tympanostomy tube insertions for insured children ages 2-8 years (2007-2010) across pediatric surgical areas (PSA) for Northern New England (NNE; Maine, Vermont, and New Hampshire) and the English National Health Service Primary Care Trusts (PCT)...
September 30, 2016: Journal of Pediatrics
Eleonora Dehlink, Claire Hogg, Siobhan B Carr, Andrew Bush
INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare, mostly autosomal-recessive disorder of motile cilia, characterized by chronic lung disease, rhinosinusitis, hearing impairment, and subfertility. PCD is still often missed or diagnosed late since symptoms overlap with common respiratory complaints, but should be considered if one or more of the cardinal clues are present. AREAS COVERED: We provide an overview on clinical presentations of PCD and clues for when to consider PCD, these include unexplained neonatal respiratory distress, persistent rhinitis from the first days of life, situs anomalies, or otorrhoea following tympanostomy tube insertion...
September 28, 2016: Expert Review of Respiratory Medicine
Adel Alrwisan, Almut G Winterstein, Patrick J Antonelli
OBJECTIVE: To quantify the incidence of persistent tympanic membrane perforation (TMP) after tympanostomy tube (TT) surgery using a large population-based cohort. STUDY DESIGN: A retrospective cohort study. SETTING: Medicaid claims data from 1999 to 2006. PATIENTS: We studied healthy children who had Medicaid eligibility within 6 months of birth that received TTs and had 2 to 7 years of follow-up. MAIN OUTCOME MEASURES: We operationalized persistent TMP by a charge for tympanoplasty and/or one or more diagnoses of TMP...
October 2016: Otology & Neurotology
Sharon Ovnat Tamir, Tal Marom, Batya Zacks, Doron Steinberg
In vitro growth of Pseudomonas aeruginosa biofilm on tympanostomy tubes showed that in Armstrong T-tubes, biofilm colonies were mainly located in the perpendicular junction between the body and the flanges, but in Paparella-type tube, they concentrated on the round rims. These 'weakness' zones can be the future target areas for geometry changes, and can be specifically coated with anti-biofilm materials.
September 12, 2016: Pediatric Infectious Disease Journal
Mirabelle Sajisevi, Kristine Schulz, Derek D Cyr, Daniel Wojdyla, Richard M Rosenfeld, Debara Tucci, David L Witsell
OBJECTIVE: To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideline (CPG). STUDY DESIGN: Analysis of the Truven Health MarketScan Research Databases (2010-2012). SUBJECTS AND METHODS: Medical claims data from 2010 to 2012 were analyzed. Children aged ≤12 years with otitis media (OM)-related diagnoses were identified...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Anne-Charlotte Hessén Söderman, Johan Knutsson, Claudia Priwin, Magnus von Unge
OBJECTIVE: To compare four different types of tympanostomy ventilation tubes (VT); long-shaft and short-shaft silicone tubes and long-shaft and short-shaft fluoroplastic tubes, regarding time to extrusion and events of otorrhea. METHODS: A prospective randomized controlled trial in children with bilateral recurrent acute otitis media or secretory otitis media; four hundred children were randomized to receive one type of VT in the right ear and another type in the left ear...
October 2016: International Journal of Pediatric Otorhinolaryngology
Anu Laulajainen-Hongisto, Antti A Aarnisalo, Jussi Jero
Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered...
October 2016: Current Allergy and Asthma Reports
Anne G M Schilder, Tasnee Chonmaitree, Allan W Cripps, Richard M Rosenfeld, Margaretha L Casselbrant, Mark P Haggard, Roderick P Venekamp
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...
2016: Nature Reviews. Disease Primers
Svetlana Diacova, Thomas J McDonald, Ion Ababii
We conducted a prospective, observational study over a 3-year period to compare the clinical, functional, and surgical findings in children with chronic bilateral otitis media with effusion who underwent one of three different types of treatment. Our study population was made up of 150 patients-79 boys and 71 girls aged 24 to 84 months-who were randomly assigned to one of the three treatment groups of 50 patients each. One group was treated with myringotomy, tympanostomy tube insertion, and adenoidectomy (T+A group); another with a combination of physical conservative treatment and adenoidectomy (P+A group); and the third with physical conservative treatment alone (P-only group)...
August 2016: Ear, Nose, & Throat Journal
Oshri Wasserzug, Gadi Fishman, Dan Sternbach, Efrat Reindorf-Kfir, Eran Averbuch, Dan M Fliss, Yael Oestreicher-Kedem, Ari Derowe
OBJECTIVE: Informed consent is an important part of the surgical process. Based on our clinical experience, we hypothesized that parents providing consent for their children's tonsillectomy do not comprehend all the information that is given to them by the operating surgeon at the time of a conventional consent process. MATERIALS AND METHODS: Parents whose children were scheduled for tonsillectomy with or without adenoidectomy and/or tympanostomy tubes insertion were enrolled...
September 2016: International Journal of Pediatric Otorhinolaryngology
Carrie L Nieman, David E Tunkel, Emily F Boss
INTRODUCTION: Despite recent concerns about potential overuse of tympanostomy tube (TT) placement to treat otitis media in children, utilization of this common procedure in the U.S. has been shown to be relatively less common among minority children. It is not known if the indications for TT differ by child race/ethnicity and/or socioeconomic status (SES). Our objective is to analyze the association of patient- and neighborhood-level demographics and SES with clinical indications for TT...
September 2016: International Journal of Pediatric Otorhinolaryngology
Nikhila Raol, Christopher J Hartnick, Joel S Weissman
INTRODUCTION: Obtaining a preoperative audiogram prior to tympanostomy tube placement is recommended by the American Academy of Otolaryngology-Head and Neck Surgery clinical practice guideline (CPG): Tympanostomy tubes in Children, and this process measure is also used as a quality metric by payers. However, whether audiograms should be mandated in cases of tube placement for both chronic otitis media with effusion (COME) and recurrent acute otitis media (RAOM) is controversial. The objective of this study is to determine reports of practice patterns of pediatric otolaryngologists regarding obtaining audiograms before and after tympanostomy tube placement and opinions regarding utility of CPGs and use of this process measure as a quality metric...
September 2016: International Journal of Pediatric Otorhinolaryngology
Kenneth R Whittemore, Briana K Dornan, Jenna M Dargie, Guangwei Zhou
Importance: Obtaining hearing thresholds is an important step in the evaluation of a child with otitis media because decreased hearing in the presence of a chronic middle ear effusion factors into the decision to place tympanostomy tubes (TTs). Objective: To provide evidence regarding appropriate use of perioperative hearing evaluations in conjunction with TTs. Design, Setting, and Participants: Case series with medical record review of all patients aged 0 to 24 years who received TTs at a tertiary pediatric care facility from June 1, 2010, through June 1, 2011...
August 4, 2016: JAMA Otolaryngology—Head & Neck Surgery
Laura Toivonen, Sinikka Karppinen, Linnea Schuez-Havupalo, Tamara Teros-Jaakkola, Juho Vuononvirta, Jussi Mertsola, Qiushui He, Matti Waris, Ville Peltola
BACKGROUND: The burden of recurrent respiratory infections is unclear. We identified young children with recurrent respiratory infections in order to characterize the clinical manifestations, risk factors, and short-term consequences. METHODS: In this prospective cohort study, 1089 children were followed from birth to 2 years of age for respiratory infections by a daily symptom diary. Nasal swabs taken during respiratory infections were analyzed for viruses from 714 children...
July 22, 2016: Pediatric Infectious Disease Journal
Winslo K Idicula, Joseph A Jurcisek, Nathan D Cass, Syed Ali, Steven D Goodman, Charles A Elmaraghy, Kris R Jatana, Lauren O Bakaletz
OBJECTIVES/HYPOTHESIS: Otitis media is a common problem in the pediatric population. Despite antibiotic therapy, post-tympanostomy otorrhea can be difficult to treat. Biofilms have been shown to play a role in chronic and recurrent otitis media and are implicated in otorrhea. This study investigated both the microbial composition and the presence of biofilm fragments rich in extracellular DNA (eDNA) and the bacterial DNA-binding protein, integration host factor (IHF), in post-tympanostomy tube otorrhea...
August 2016: Laryngoscope
Alan E Simon, Emily F Boss, Carla E Zelaya, Howard J Hoffman
OBJECTIVES: Pressure equalization tube (PET) placement (also referred to as tympanostomy tube placement) is among the most common ambulatory surgical procedures performed on U.S. children. Over twenty years ago, differences by race/ethnicity in the national prevalence of having had PETs placed were documented. Whether these differences persist is unknown. METHODS: We used data from the 2014 National Health Interview Survey to examine the percentage of children 0-17 years of age that have ever undergone PET placement...
July 12, 2016: Academic Pediatrics
Douglas Hildrew, Austin Adams, Ryan Winters, Rizwan Aslam
BACKGROUND: There are over 183,000 patients living with a functioning solid organ transplant in the United States, and almost no data exist discussing complications of acute otomastoiditis in this vulnerable population. Early recognition and treatment of acute otomastoiditis is essential in patients whose immune system is not normal, as progression can lead to sepsis, meningitis, brain abscess, Bezold's abscess, sigmoid sinus thrombosis, or other potentially fatal sequelae. METHODS: Case report with extensive literature review...
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Pawina Jiramongkolchai, Manvinder S Kumar, Sivakumar Chinnadurai, Christopher T Wootten, Steven L Goudy
OBJECTIVE: The purpose of this study was to determine the prevalence and characterize the types of hearing loss in pediatric patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Fifty-eight patients were identified via retrospective chart review performed of patients with 22q11DS between 1996 and 2014. Patient demographics, pertinent family history, associated comorbidities, and degree and type of hearing loss were gathered for each patient. A literature review of the National Library of Medicine's database with a focus on hearing loss and 22q11DS was performed...
August 2016: International Journal of Pediatric Otorhinolaryngology
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