OBJECTIVES: This study determined the initial otoacoustic (OAE) hearing screening results of newborns with collapsed ear canals and vernix caseosa in the ear canal and compared these to ears that were patent.
METHODS: Two hundred term newborns (400 ears) with normal APGAR scores, birth weight, maternal and gestational history, who were born between August 2013 to October 2013 and who had OAE hearing screening test done by trained midwives were included in this study. All of them underwent otoscopy after the OAE hearing screening test was done to determine patency of the ear canal and presence of vernix caseosa. The examining physician was blinded to the OAE results. Comparison between the OAE results and the otoscopic findings were done.
RESULTS: Four hundred ears were included in the study. Two hundred and fifty one ears (62.8%) had vernix caseosa and 42 ears (10.5%) had collapsed ear canal. The overall initial OAE hearing screening test pass rate of the newborns tested was 69.5%. The initial OAE hearing screening test pass rate of newborns those with ear canal vernix caseosa or collapsed ear canal, were 72.1% and 47.6%, respectively. Patent ears were found in 107 (26.7%) with a pass rate of 71.9%.
CONCLUSION:The pass rates of ears with vernix caseosa and collapsed ear canal were 72.1% and 47.6%, respectively. There was no significant difference between the OAE hearing screening test pass rates of ears with patent canal and ears that were collapsed and/ or had vernix caseosa. However, there was a statistically significant difference in pass rates between patent ear canals and collapsed ear canal

Background and Objective: To design and fabricate a suction port adapter to use various sizes of suction cannulas with a wireless otoendoscope enabling ear cleaning under endoscopic guidance demonstrated using an ear examination simulator. Methods: Design: Instrument Innovation. Setting: Tertiary Private Training Hospital. Patient: Ear Examination Simulator. Results: The fabricated suction port adapters were able to hold the wireless otoendoscope and suction cannulas together, allowing simultaneous inspection of the ear canal and suctioning of ear canal debris using the Ear Examination Simulator. Conclusion Our prototype 3D-printed suction port adapters for a wireless otoendoscope may improve ear cleaning by enhancing the accuracy of suctioning debris and decreasing duration since they hold the suction cannulas in place under endoscopic guidance. They may aid ENT physicians in easier visualization and simultaneous ear cleaning of patients and improve ear cleaning techniques and times, especially among less experienced physicians, but actual clinical trials are needed to confirm this.
Printing, Three-Dimensional ; Cerumen ; Otoscopy

OBJECTIVE: To compare the incidence of acute otitis media among children aged 2 to 6 months old in Sampaloc, Manila who were previously given 3 doses of pneumococcal conjugate vaccine (Non-Typeable Haemophilus influenzae (NTHi) protein D, diphtheria or tetanus toxoid conjugates) and those who did not receive the vaccine over a period of one year.
METHODS:
Design: Cohort Study
Setting: Primary Health Center in Sampaloc, Manila, Philippines
Participants: Medical records of well children aged 2 to 6 months were reviewed for inclusion. Participants were categorized into vaccinated and unvaccinated groups. Both groups underwent baseline history and physical examination including otoscopy and any signs and symptoms of active ear infection were noted. Subjects were followed up for a period of one year on a monthly basis for signs or symptoms of acute otitis media.
RESULTS: A total of 176 subjects participated in the study. The overall incidence of AOM among participants was 5.11% (9 out of 176). An AOM incidence of 3.75% (3 out of 80) and 6.25% (6 out of 96) was found among the exposed and unexposed groups, respectively. Fisher's exact test (one-tailed) p value= .34, relative risk (RR) .6 (95% Cl 0.155, 2.323).
CONCLUSION: The results of this study showed no difference in the development of AOM in the two groups. However, based on the relative risk, Pneumococcal conjugate vaccine is still beneficial in preventing AOM in children.

Herein, we report an unusual case of large tonsillolith presented with acute otalgia. Since the tonsils and tonsillar fossa are supplied by the glossopharyngeal nerve, any irritation or pain can be referred to the ear along the tympanic branch of the glossopharyngeal (Jacobson's) nerve. Also, it is worth re-emphasizing that normal otoscopy must be followed by inspection of the nasal cavities, oral cavity, and oropharynx, with particular note given to the floor of mouth, teeth, tongue, and tonsils because the identification of a causative etiology is necessary to successfully treat referred otalgia.
Ear ; Earache ; Glossopharyngeal Nerve ; Mouth ; Mouth Floor ; Nasal Cavity ; Oropharynx ; Otoscopy ; Palatine Tonsil ; Tongue ; Tooth

BACKGROUND AND OBJECTIVES: The clinical utility of otoacoustic emissions (OAEs) has been well established in childhood hearing screenings. As middle ear negative pressure prevails in normal children, and since all OAEs must be transmitted through the middle ear before they can be measured in the ear canal, OAEs can be affected by middle ear negative pressure. The purpose of this study is to elucidate the effect of middle ear negative pressure on the detectability of OAEs. MATERIAL AND METHODS: TEOAEs were recorded for 36 ears using click before & after tonsillectomy and, or adenoidectomy (T and, or A) operations. Before & after T and or A operations, DPOAEs were generated at six geometric mean frequencies between 1-6 kHz for two different groups, Group I (40 ears) and Group II (36 ears). Group I: 3(f2/f1) ratios (1.21, 1.22 and 1.23) were used at the fixed stimulus level (70-70 dB SPL). Group II:3 stimulus levels were used (70-70 dB SPL, 60-70 dB SPL and 30-40 dB SPL). RESULTS: The negative middle ear pressure attenuated low frequency emission more than high frequency emission. CONCLUSION: Negative middle ear pressure may increase false alarm. So pneumatic otoscopy and aural immittance testing should be utilized to predict the feasibility of applying OAEs in childhood hearing screening test.
Adenoidectomy ; Child ; Ear ; Ear Canal ; Ear, Middle* ; Hearing ; Humans ; Mass Screening ; Otoscopy ; Tonsillectomy

BACKGROUND AND OBJECTIVE: Infeared tympanic membrane thermometer (ITMT) provides an accurate estimate of tympanic membrane temperature in healthy children and may accurately reflect core body temperature. This study was undertaken to determine if temperature readings using this newly designed ITMT are affected by the presence of acute suppurative otitis media (ASOM) in children. MATERIALS AND METHODS: Forty children with unilateral acute suppurative otitis media were enrolled in the study. Temperature of ASOM was measured in both ears using ITMT and compared to 20 normal children. RESULTS: In acute suppurative otitis media, the mean temperature in infected ears was 1.28t higher than that in uninfected ears (p(0.05). The mean temperature of normal children was 36.34C and there was statistically significant difference between normal and unilateral acute otitis media. CONCLUSION: The ITMT was found to be accurate, rapidly responding and easy to use. It may help to diagnose acute unilateral suppurative otitis media combined with pneumatic otoscopy md tympanogram.
Body Temperature ; Child ; Ear ; Humans ; Otitis Media ; Otitis Media, Suppurative* ; Otoscopy ; Reading ; Thermometers ; Tympanic Membrane*

The feasibility of virtual otoscopy (VO) imaging was evaluated in five dogs with experimentally induced otitis media, two control dogs, and two canine patients with otitis media. VO images of the tympanic cavity and ossicles were generated with commercially available software using raw computed tomography (CT) data. Eight out of 10 ears inoculated with pathogen exhibited obvious clinical signs associated with otitis externa. CT images revealed soft tissue density material occupying the tympanic bulla compatible with otitis media in three dogs with experimentally induced otitis media and two patients. No remarkable features were observed on the radiographs. Four different VO views (ear canal, tympanic bulla, eustachian tube, and ossicular chain) were created. Promontory, cochlea window, tympanic, and septum bulla as well as ossicles were easily and clearly distinguished except for the incus and stapes of the clinical patients. VO images were not more suitable than images created with conventional CT for accurately diagnosing otitis media in this study. However, it appears that VO could be more feasible for assessing the complex structure of the inner ear in dogs with fluid-filled tympanic cavities since fluid accumulation within the tympanic bulla did not affect the evaluation of bony tissue in the middle ear on VO images.
Animals ; Blister ; Cochlea ; Dogs ; Ear ; Ear, Inner ; Ear, Middle ; Eustachian Tube ; Incus ; Otitis Externa ; Otitis Media ; Otoscopy ; Stapes

BACKGROUND: Otitis media with effusion(OME) is a very common disease in pediatric age. However, a few literatures on epidemiologic study of otitis media with effusion are available in Korea due to the great variability of its diagnostic criteria and clinical features. The aim of this study is to provide the estimate of silent otitis media prevalence for preschool age. METHODS: The study population includes 329 children enrolled in 6 kindergartens in Kunsan city from April 1 to 10, 1995. Silent otitis media was diagnosed with otoscopy, pneumatic otoscopy and impedance audiometry by DANAC 40 model impedance audiometer from DANA JAPAN Co. RESULTS: The prevalence of silent otitis media with effusion was 14.5% and peak at 6 years of age(17.8%).The prevalence of silent otitis media with effusion according to sex were 11.8% in boys group, 17.9% in girls group. Nine cases(11.8%) involved bilaterally. Forty three cases(89.6 %) were asymptomatic cases. CONCLUSIONS: Among 329 preschool children, the prevalence of silent otitis media with effusion was 14.5%. The prevalence by sex showed slightly higher in girls group than boys group. OME involved unilateral site mostly and subjective symptoms were rare.
Acoustic Impedance Tests ; Child ; Child, Preschool* ; Electric Impedance ; Epidemiologic Studies ; Female ; Humans ; Japan ; Jeollabuk-do* ; Korea ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopy ; Prevalence*

OBJECTIVES: Vascular tinnitus is the most common form of pulsatile tinnitus, particularly when the tinnitus corresponds with the pulse of patients. In this study, we reviewed the 10-year clinical data on vascular tinnitus of our tinnitus clinic to investigate the frequency of the underlying etiologies, to introduce a diagnostic protocol, and to evaluate the treatment outcomes. METHODS: We retrospectively collected the data of 57 patients who were diagnosed as vascular tinnitus between April 2001 and December 2011. Careful history taking, otoscopy, thorough physical examinations, audiometry, laboratory tests, as well as radiologic examinations were performed according to our diagnostic protocol to find the origin of pulsatile tinnitus. Treatment options were individualized based on the specific etiology, and the outcomes were assessed using patient's subjective reports at the follow-up interviews. RESULTS: High jugular bulb was the most common cause (47.4%) of vascular tinnitus, and venous hum was the next (17.5%). Dural arteriovenous fistula, intracranial aneurysm, atherosclerotic carotid artery disease, and hypertension were less common causes. Vascular tinnitus was alleviated in most patients after the appropriate treatment: surgical intervention, tinnitus retraining therapy, reassurance, and medications. CONCLUSION: Vascular tinnitus can be successfully diagnosed by the regular use of the suggested protocol. Many patients with vascular tinnitus have treatable underlying etiologies. Treatment of those etiologies or at least counseling about the tinnitus itself can benefit the patients with troublesome vascular tinnitus.
Arteriovenous Fistula ; Audiometry ; Carotid Artery Diseases ; Central Nervous System Vascular Malformations ; Counseling ; Follow-Up Studies ; Humans ; Hypertension ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Otoscopy ; Physical Examination ; Retrospective Studies ; Tinnitus*

OBJECTIVES: The problem of noise-induced hearing loss (NIHL) was objectively and systematically investigated by diagnosing three workers who complained of tinnitus and hearing disturbance. METHODS: Atypical hearing loss is diagnosed as a work-related disease by using general medical methods, such as environmental survey, neurological examination, otoscopy, pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), auditory-evoked potentials, and interview on the history of past disease, family and occupation. RESULTS: Three results were found according to the work-related hearing loss as follows; (1) hearing loss that is caused by exposure to continuous noise of less than 85 dB(A) or impact noise of greater than 135 dB peak, (2) mixed hearing loss that has progressed due to noise with past otitis media, and (3) atypical hearing loss that showed remarkable differences between air and bone conduction due to tinnitus. CONCLUSIONS: The criteria for work-related hearing loss should be carefully investigated by considering exposure to impact noise, the effect of continuous noise on mixed hearing loss patients, and the hearing loss caused by tinnitus.
Audiometry, Pure-Tone ; Audiometry, Speech ; Bone Conduction ; Hearing ; Hearing Loss ; Hearing Loss, Mixed Conductive-Sensorineural ; Hearing Loss, Noise-Induced* ; Humans ; Neurologic Examination ; Noise ; Occupations ; Otitis Media ; Otoscopy ; Tinnitus