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

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.
Arteries ; Audiometry ; Basilar Artery ; Brain ; Cerebral Infarction ; Deafness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Otoscopy ; Vertebrobasilar Insufficiency

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.
Arteries ; Audiometry ; Basilar Artery ; Brain ; Cerebral Infarction ; Deafness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Otoscopy ; Vertebrobasilar Insufficiency

Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.
Adult ; Diagnosis, Differential ; Eosinophilia/*diagnosis/radiography/surgery ; Female ; Humans ; *Magnetic Resonance Imaging ; Otitis Media/*diagnosis/radiography/surgery ; Otoscopy ; Reoperation ; *Tomography, X-Ray Computed