Background: Certain indigenous populations have been noted by the World Health Organization (WHO) to havethe highest prevalence ratesforchronicsuppurativeotitis media (CSOM), including the Australian Aborigines (28-43%), Greenlanders (2-10%) and Alaskan Eskimos (2-10%). Objectives: To determine the prevalence of common ear problems, particularly CSOM, among the indigenous Ati or Aeta community in Bolabog, Boracay, and to determine their hearing sensitivity using screening audiometry. Methods: Study Design - Descriptive cross-sectional study. Setting - A small Ati community in Bolabog, Boracay. Population - A total of 63 adults and children underwent medical interview and otoscopy. Additionally 24 had their hearing screened by audiometry. Results: About a quarter of the population participated in the study, including 41 children (40 percent of all children) and 22 adults (18 percent of all adults). Forty-six percent of children and 23 percent of adults who were examined had previous history of ear discharge, while 22 percent of children and 45 percent of adults who were examined had history of hearing loss. Seventeen percent of children had history of hearing loss in the family. CSOM was found in 18 (43.90 percent) children and 8 (36.36 percent) adults. Impacted cerumen was found in 17.1 percent of children. Eleven female children underwent screening audiometry. Of these, eight had normal hearing and three had abnormal findings. Thirteen adults were also tested, five of whom were male and had normal hearing bilaterally. Four of eight female adults had abnormal hearing, of which three were unilateral. Conclusions: The Ati population in Bolabog, Boracay belongs to a group with the highest prevalence rates for CSOM (27.0 percent). A bigger sample for screening audiometry is required for proper estimation of hearing loss prevalence. Both environmental and genetic factors may have increased the prevalence of CSOM in the Ati population of Boracay. (Author)
HEARING LOSS OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE

No abstract available.
Citric Acid ; Otitis Media, Suppurative

The early diagnosis and treatment of tuberculous otitis media can prevent it from becoming irreversible and spread to other organs. Only 0.04% of chronic suppurative otitis medias are tuberculous origin, so that the index of suspicion is often low. The clinical signs of the disease have changed in recent years, making it more difficult to recognize and thus investigate for. False negatives for culture often occur, due both to the fastidious nature of the tuberculous bacilli, and other bacteria in the specimen interfering with the growth of bacilli. Recently, We experienced four cases of pathologically confirmed primary tuberculous otitis media without pulmonary involvement, so report these cases with review of literature.
Bacteria ; Early Diagnosis ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Tuberculosis*

Humans ; Otitis Media, Suppurative ; Chronic Disease ; Biofilms ; Otitis Media

Objectives: To determine the initial clinical diagnoses of patients with tuberculous otitis media (TBOM), to determine the value of PCR test, biopsy, and ancillary diagnostic procedures in detecting middle ear TB infection, and to establish the differences in treatment outcomes. Methods: The clinical records of twenty-eight patients identified with middle ear TB infection by PCR test and biopsy, from January 2010 to December 2016, were reviewed to determine their initial clinical diagnoses. The positivity rates of PCR test and biopsy were compared. The records of 12 patients included in a previous publication were revisited and included in the present study population. The combined cases were classified according to clinical diagnosis to constitute a summary of demographic characteristics, clinical diagnoses, laboratory tests, and treatment outcomes. Results of diagnostic and surgical procedures were reviewed and analyzed. Clinical findings and hearing test results before and after treatment were compared. Results: Of the 28 patients, eight different clinical diagnoses of patients confirmed with middle ear TB were determined. PCR test diagnosed most cases belonging to the early and chronic stages of the disease process. Biopsy diagnosed mostly the chronic cases but failed to diagnose acute cases and late cases with diagnosis of chronic suppurative otitis media with cholesteatoma. By including the twelve cases that were published in 2011, the range of clinical diagnoses was expanded and an outcome of eleven clinical diagnoses confirmed with TB infection was established. Analysis of treatment outcomes showed that the clinical and hearing outcomes were better for patients managed at the early stage of the disease than for those presenting at the late stages of the disease process who underwent more complicated surgical procedures. Conclusion Our study supports the concept of tuberculous otitis media (TBOM) clinical spectrum, implying a paradigm shift in the established thinking that TBOM presents only as a chronic disease. The combined use of PCR and biopsy is a potential diagnostic tool to improve case detection rate, further broaden the scope of the clinical spectrum, and develop better control and preventive strategies for TBOM.
Otitis Media, Suppurative ; Polymerase Chain Reaction

Tuberculosis of the middle ear is a disease rarely encountered in recent years. Because what used to be the typical clinical signs of this disease have been changed in recent years and the index of suspicion being low, there is frequently a considerable delay prior to diagnosis. This can lead to irreversible complications. A case of tuberculous otitis media complicated with lateral sinus thrombosis and subperiosteal abscess is reported with review of the literature, emphasizing the fact that this entity must be considered in the differential diagnosis of persistent suppurative otitis media.
Abscess* ; Diagnosis ; Diagnosis, Differential ; Ear, Middle ; Lateral Sinus Thrombosis ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Tuberculosis

OBJECTIVES: The aim of this study was to compare the hearing outcomes between canal wall up mastoidectmy (CWUM) and canal wall down mastoidectmy (CWDM). METHODS: One hundred seventy one chronic suppurative otitis media (CSOM) patients were enrolled in this retrospective study. The patients who underwent the second staged ossiculoplasty at least 6 months after mastoidectomy and who had an intact, well aerated tympanic cavity as well as intact mobile stapes at the time of operation were selected from the medical record. Based on the type of mastoid surgery, the patients were categorized into two groups: the CWUM (n=38) and CWDM groups (n=133). The hearing results of the CWUM and CWDM groups were compared using the pre- and post-operative air-bone gap (ABG) at 3 months after ossiculoplasty. RESULTS: The preoperative ABG in both groups (CWUM and CWDM) were 28.4+/-15.6 dB and 31.8+/-14.5 dB, respectively (P=0.18). Both groups didn't show any significant difference (10.9 dB vs. 13.5 dB, respectively) (P=0.21) for the postoperative ABG closure. The proportion of patients with an ABG less than 20 dB was 58.6% of the CWDM patients and 68.4% of the CWUM patients (P=0.25). CONCLUSION: The type of mastoid surgery (CWUM and CWDM) did not affect the hearing results of CSOM patients. When choosing the type of mastoidectomy procedure for CSOM surgery, the hearing outcomes are basically the same for both types of procedure.
Ear, Middle ; Hearing ; Humans ; Mastoid ; Medical Records ; Otitis Media ; Otitis Media, Suppurative ; Retrospective Studies ; Stapes

Background: Pure tone audiometry is routinely used to determine conductive and sensorineural hearing status. Ossicular discontinuity is usually assessed intra-operatively. If ossicular discontinuity can be predicted by pure tone audiometry, perhaps the operative procedure of choice and prognosis for hearing can also be anticipated. Objective: To determine the predictive value of preoperative pure tone audiometry on the presence of gross ossicular discontinuity in chronic otitis media. Methods: Records of 205 patients, 7 to 75 years of age undergoing their first operation for chronic otitis media were reviewed. Preoperative audiograms and operative records for tympanomastoidectomy were evaluated. A total of 162 patients meeting inclusion criteria were included in the study. Likelihood ratios for positive and negative ossicular discontinuity for frequency-specific air-bone gap cut-offs were determined. Multiple logistic regression analysis for pure tone audiometry and operative findings to predict ossicular discontinuity was performed and a model for predicting ossicular discontinuity using logistic regression obtained. Results and Conclusion: Frequency-specific air bone gap (ABG) cut-off values can predict ossicular discontinuity in chronic suppurative otitis media namely: < 20 dB ABG at 500 Hz predicts absence of ossicular discontinuity while > 50 dB ABG at 500 Hz, >30 dB ABG at 2 KHz, and > 50 dB ABG at 4 KHz best predict the presence of ossicular discontinuity in general. In the absence of cholesteatoma, the air bone gaps of <30 dB at 500 Hz and <20 dB at 1 KHz decrease probability of ossicular discontinuity from 32.97 percent to 2.54 percent. Combination of air bone gaps of >50 dB at 500 Hz, >20 dB at 2 KHz and >40 dB at 4 KHz increase the probability of ossicular discontinuity from 32.97 percent to 85.9 percent. These findings suggest that ossicular exploration may not be necessary for the former while an evaluation of the ossicular chain may be mandatory for the latter in the setting where cholesteatoma is not present or suspected. Presence of cholesteatoma, granulation tissue and size of tympanic membrane perforation are important factors to consider in predicting ossicular discontinuity. (Author)
AUDIOMETRY AUDIOMETRY ; PURE-TONE OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE LOGISTIC MODELS HEARING TESTS SUPPURATION

Objectives: To identify the bacterial pathogens associated with chronic suppurative otitis media and their antimicrobial sensitivity and resistance. Study Design: Cross-sectional survey. Setting: The study was carried out from July 2004-July 2005 at the outpatient clinic of a government tertiary hospital. Number of subjects: A total of 32 patients (54 ears) with unilateral or bilateral active chronic suppurative otitis media. Results: Bacterial pathogens of 54 ear discharge samples from CSOM were studied. Among them, 42 (78 percent) were pure cultures and 9 (16.7 percent) were mixed, only 3 (5.6 percent) of the submitted samples had no growth. There were 42 pure isolates, the most common of which was Staphylococcus aureus 21 (50 percent), followed by Pseudomonas aeruginosa 14 (33.3 percent). Drug sensitivity pattern of Staphylococcus aureus showed that 61.9 percent were resistant to Penicillin while more than 90 percent were sensitive to Aminoglycosides and Clindamycin. Pseudomonas aeruginosa was resistant to penicillin in 64.3 percent of cases and Ciprofloxacin was active against pseudomonas in 85.7 percent. Conclusion: The most common bacterial pathogens from CSOM include Staphylococcus aureu and Pseudomonas aeruginosa. Majority of the isolates of Staphylococcus aureus were resistant to penicillin. Aminoglycosides, macrolides and quinolones were effective against most of the isolates of Staphylococcus aureus. (Author)
OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE TYMPANIC-MEMBRANE MASTOIDITIS CROSS-SECTIONAL STUDIES

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*