Humans ; Otitis Media ; classification ; diagnosis ; therapy

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.
Adult ; Ear Canal/anatomy & histology ; Eustachian Tube/physiology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/classification/*diagnosis ; Tomography, Optical Coherence/instrumentation/*methods ; Tympanic Membrane/*physiology

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.
Adult ; Ear Canal/anatomy & histology ; Eustachian Tube/physiology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/classification/*diagnosis ; Tomography, Optical Coherence/instrumentation/*methods ; Tympanic Membrane/*physiology

Tinnitus is a perception of sound without external stimuli. The increase of noise from industrialization, complex psychological state, increase of old age people, and excessive medication make tinnitus a more common disease than ever before. However, the knowledge regarding diagnosis and treatment of tinnitus is still limited. Tinnitus can be categorized into paraauditory tinnitus and sensory neural tinnitus. Paraauditory tinnitus may occur from the sound generated by the vessel near the ear such as an arteriovenous fistula, abnormal vessel, a tumor around vessel, palatal myoclonus, and patent E tube. Sensory neural tinnitus can arise from senile hearing loss, noise-induced hearing loss, sudden deafness, sensorineural hearing loss associated with chronic otitis media, excessive medication, and so on. But there are many cases in which the specific cause cannot be defined. Diagnosis needs thorough history taking, physical examination, and radiologic and audiologic examination. Treatments for the paraauditory tinnitus are vessel ligation or coil embolization of arteriovenous fistula and removal of the causative factors. Although there are many treatment modalities for managing sensory neural tinnitus, a standardized treatment modality has not been established. Sensory neural tinnitus can be managed with tinnitus retraing therapy and electrical stimulation therapy. Although tinnitus is essentially not a life-treatening disease, advancing quality of life and the increasing number of patients with tinnitus mandate health-care providers to be more concerned with the disease tinnitus.
Arteriovenous Fistula ; Classification ; Deafness ; Diagnosis ; Ear ; Electric Stimulation Therapy ; Embolization, Therapeutic ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Ligation ; Myoclonus ; Noise ; Otitis Media ; Physical Examination ; Quality of Life ; Tinnitus*

Allergic rhinitis is defined as an immunologic response moderated by IgE and is characterized by sneezing, rhinorrhea, nasal congestion, and nasal itching. Allergic rhinitis represents a global health problem. It is an extremely common disease worldwide affecting 10 to 25% of the population. Because of its increasing prevalence over the last decades, allergic rhinitis has been identified as one of the top ten reasons for visits to primary care clinics. Although allergic rhinitis is not a severe disease usually, it significantly affects the social life of patients and compromises school performance as well as work productivity. In addition, allergic rhinitis is associated with asthma, sinusitis, otitis media, nasal polyposis, lower respiratory tract infection and dental occlusion. Therefore, the cost incurred by rhinitis is substantial. Allergic rhinitis was previously classified into seasonal, perennial, and occupational. From a therapeutic point of view, however, it is often difficult to differentiate between seasonal and perennial symptoms. In 2001, therefore, a new classification has been proposed by the ARIA as 'ntermittent' or 'persistent' rhinitis. The severity of allergic rhinitis can be classified as 'mild' or 'moderate-severe' on the basis of symptoms as well as the quality of life of the patient. Treatment of allergic rhinitis involves allergen avoidance, pharmacotherapy, and in selected cases, immunotherapy. Surgical procedures can be performed in refractory cases. This article reviews the predisposing factors to allergic rhinitis, clinical presentation, diagnosis, and the recommended treatment options.
Asthma ; Causality ; Classification ; Dental Occlusion ; Diagnosis ; Drug Therapy ; Efficiency ; Estrogens, Conjugated (USP) ; Humans ; Immunoglobulin E ; Immunotherapy ; Otitis Media ; Prevalence ; Primary Health Care ; Pruritus ; Quality of Life ; Respiratory Tract Infections ; Rhinitis* ; Seasons ; Sinusitis ; Sneezing