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

Otoscopy ; Infant, Newborn ; Vernix Caseosa

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.

Human ; Male ; Female ; Infant ; Diphtheria ; Otoscopy ; Inflammation

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 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*

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

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

INTRODUCTIONThe present study aimed to obtain preliminary tympanometric data of young Malay adults and to compare the results between genders.

METHODS96 undergraduate students (49 males and 47 females), aged 19-25 (mean and standard deviation 21.14 +/- 1.31) years, participated in this study. Otoscopic examination, pure tone audiometry, qualitative tympanogram and ipsilateral acoustic reflex were measured to ensure a clear ear canal, normal hearing and normal middle ear function, prior to tympanometric measurement. As a result, a total of 154 ears (80 ears from males and 74 ears from females) were selected for further statistical analyses. The tympanometric parameters measured were peak compensated static acoustic admittance (Peak Y(tm)), tympanometric width (TW) and equivalent ear canal volume (V(ea)).

RESULTSThe results showed that the mean Peak Y(tm), V(ea) and TW for males were 0.81 mmhos, 1.48 cubic cm and 113.67 daPa, respectively. The mean Peak Y(tm), V(ea) and TW for females were 0.63 mmhos, 1.12 cubic cm and 98.04 daPa, respectively. Males were found to have significantly higher mean V(ea) and mean Peak Y(tm) than females. However no significant gender difference was observed in the mean TW.

CONCLUSIONThe current study suggests that young Malay adults may require gender-specific Peak Y(tm) and V(ea) values when implementing a quantitative approach in tympanogram interpretation.

Acoustic Impedance Tests ; methods ; Acoustics ; Audiometry ; methods ; Audiometry, Pure-Tone ; Ear Canal ; pathology ; Ethnic Groups ; Female ; Humans ; Malaysia ; Male ; Otoscopy ; methods ; Reference Values ; Sex Factors ; Young Adult

BACKGROUNDOtitis media with effusion is a highly concurrent disease in young children with adenoid hypertrophy. The aim of this study was to assess the middle ear effusion and audiological characteristics in children with adenoid hypertrophy and compare the various assessment methods.

METHODSTwo hundred and seven candidates who were to undergo adenoidectomy were analyzed using otoscopy, tympanometry, air-conduction auditory steady-state responses (AC-ASSR), and computerized tomography (CT) before adenoidectomy.

RESULTSAbout 73.4% (304/414) of ears were confirmed to have middle ear effusion (MEE) by otoscopy; 75.4% (312/414) of ears revealed MEE by CT. CT scan correctly predicted all the myringotomy results, giving 100% accuracy on the diagnosis of MEE. Additionally, CT revealed two children with inner ear malformations. Type B tracing tympanogram provided a sensitivity of 91.7% and a specificity of 92.2%. Type C tympanogram with peak pressure < -200 daPa indicated effusion; type C tympanogram having acoustic stapedius reflex could exclude MEE. We excluded the AC-ASSR results of the 4 ears with malformation; 54.4% (223/410) of ears were confirmed of hearing loss. Furthermore, 5.2% (16/310) of the ears with MEE suffered from severe to profound hearing loss. The average threshold level in the 0.25 kHz frequency of children was found to have poorer hearing thresholds than those in the 0.5, 1, 2, and 4 kHz (P < 0.001) frequencies; 29.7% (92/310) of ears with MEE were regarded as normal hearing level. About 55.8% (173/310) of ears with MEE were classified as having slight-mild hearing loss.

CONCLUSIONSThe practitioners should pay much attention to the middle ear condition and be aware of a possible development of severe to profound hearing loss during the course of MEE in young children with adenoid hypertrophy. CT scan is good for the assessment of MEE before ventilation tube insertion.

Acoustic Impedance Tests ; Adenoids ; diagnostic imaging ; pathology ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Otitis Media with Effusion ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Otoscopy ; Prospective Studies ; Radiography

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*