Based on the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,by reference to clinical diagnostic criteria,efforts were made to analyze and establish the Western medical diagnostic criteria and traditional Chinese medicine( TCM) syndrome differentiation criteria for secretory otitis media,and summarize the modeling methods and model characteristics of secretory otitis media animal models. According to the clinical diagnostic criteria and symptom characteristics,the coincidence degree between the existing animal models and clinical symptoms was evaluated,and its advantages and disadvantages were defined. On the basis of the statistical results,there were fewer methods for modeling secretory otitis media animal models,and only a specific relevant pathogenic mechanism could be revealed. Among them,the model with a higher coincidence degree was genetic engineering technology modeling and injection into the middle ear vesicles. The two modeling methods of bacterial factors highly coincided with the clinical symptoms of Western medicine,but both failed to reflect the TCM syndrome type. Therefore,establishing an animal model that simultaneously reflects the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,and improving the evaluation criteria of secretory otitis media based on animal models are the main tasks of future studies on secretory otitis media.
Animals ; China ; Disease Models, Animal ; Medicine ; Medicine, Chinese Traditional ; Otitis Media with Effusion/drug therapy*

OBJECTIVE: To investigate the curative effect of corticosteroid on acute otitis media (AOM) with middle ear effusion. METHOD: Forty-three children (43 ears) with AOM and abnormal tympanogram were enrolled in a prospective, randomized trial. Twenty-three cases (23 ears) were treated with Dexamethasone and Cefuroxime Sodium, while the other 20 cases (20 ears) were only treated with Cefuroxime Sodium. RESULT: The period of normalization of tympanometric findings in Dexamethasone treatment group was (54.6+/-6.2) days, which was much longer than that in the group without Dexamethasone treatment (38.5+/-6.1). Three months after treatment, the curative rate of Dexamethasone treatment group was higher than that of the group without Dexamethasone treatment. CONCLUSION Corticosteroid can obviously improve middle ear effusion and shorten the duration of middle ear effusion of AOM in the first 2 weeks. To some extent, corticosteroid can also improve middle ear effusion in long term. It indicates that corticosteroid be used as an effective adjunctive drug in treating AOM with middle ear effusion.
Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Infant ; Male ; Otitis Media ; drug therapy ; Otitis Media with Effusion ; drug therapy ; Prospective Studies

Objective: To study the effect of the inhibitor of Notch signaling pathway-γ-secretase inhibitor DAPT on the ultrastructures of middle ear in the ovalbumin (OVA)-mediated allergic OME in vivo. Methods: Male Sprague-Dawley (SD) rats, weighing 250-300 g, were completely and randomly divided into three groups (5 rats, 10 ears in each group):(1)Control group(2)OME group(3)OME+DAPT group. Rats in the OME group underwent systemic and local sensitization by intraperitoneal and intratympanic injection of ovalbumin to make the model of OVA-induced OME. Rats in the control group were sensitized with PBS. On the basis of establishing the OME model, OME+DAPT group were intraperitoneal injected with DAPT (10 mg/kg) for seven consecutive days and were administered before intratympanic injection of ovalbumin. After the model was successfully established, endoscopy,H&E staining and scanning electron microscopy were used to study the histology and mucous-ciliary ultrastructures of the non-ciliated and ciliated mucosa in the middle ear of each group. One-way ANOVA and Tukey methods were used for statistical analysis. Results: H&E staining showed that the three groups had statistically significant differences in submucosal thickness both in non-ciliated and ciliated regions (non-ciliated area:(6.83±1.47)μm, (38.58±9.57)μm, (32.17±11.89)μm, respectively. F=107.9;cilia area:(26.69±3.22)μm, (30.41±6.75)μm, (26.76±4.06)μm, respectively. F=5.62,both P<0.01). The thickness of the submucosa in the non-ciliated area and the cilia area of the OME group were significantly thicker than that of control group (F=42.08 and 4.40,both P<0.05); the thickness of the non-ciliated area and the ciliated area in OME+DAPT group were reduced compared to OME group(F=1.55 and 2.77,both P<0.05). Scanning electron microscopy showed that the array of cilia on the middle ear mucosa was disorderly arranged and inversed, this phenomenon was relieved in the OME+DAPT group. The number of goblet cells in the control group, OME group, and OME+DAPT group were 9.87±1.92; 15.67±5.77; 10.33±1.99 respectively and the difference between them was statistically significant (F=11.43, P<0.01). The number of goblet cells in the OME group were significantly higher than those in the control group (F=9.00,P<0.01) and the number of goblet cells in the OME+DAPT group were decreased compared to those of OME group (F=8.41, P<0.01). Conclusions: The study demonstrates the pathological changes of the ultrastructure in middle ear in OVA-induced OME and the effect of the γ-secretase inhibitor on it. In OME group, the cilia are disorderly arranged and inversed, the number of goblet cell is increased and they are swelled which suggest the hypersecretion of the mucus. DAPT can regulate OVA-induced allergic inflammation and relieve pathological changes of ultrastructure in middle ear mucociliary transport system through alleviating submucosal inflammation, reducing the hypersecretion of goblet cell and the morphological damage of cilia through the Notch signaling pathway.
Amyloid Precursor Protein Secretases ; Animals ; Ear, Middle ; Male ; Otitis Media with Effusion/drug therapy* ; Ovalbumin ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the clinical efficacy of Qingqiao Capsule (QQC) in treating patients with secretory otitis media (SOM).

METHODSA total of 90 patients were randomly assigned into the treated group (n = 45) and the control group (n = 45). Patients in the treated group were administrated with QQC, 5 capsules each time, 3 times a day for totally 10-14 days, and those in the control group were given per os cefaclor capsules 0.5 g each time for adult, 3 times a day, or 20 mg/(kg.d) for children, for 10-14 days. The therapeutic efficacy of treatment on the patients was observed and compared after treatment and followed up for 3-6 months.

RESULTS(1) The clinical efficacy in the treated group was superior to that in the control group with significant statistical difference (P < 0.01); (2) Comparison of the efficacies in patients of three different TCM syndrome types (the external pathogenic wind invasion caused auditory orifice stuffiness type, the Gan-Dan damp-heat steaming up auditory orifice type and the Pi-deficiency dysfunction induced dirty dampness blocking ear type) showed no statistically significant difference (P > 0.05); (3) The vanishing rate and time needed of the main symptoms and signs in the treated group were superior to those in the control group on ear muffle, tinnitus, hearing impairment, hydrotypanum, pure tone threshold and abnormal tongue figure, and the difference was statistically significant (P < 0.05 or P < 0.01), only those of earache, otopiesis and abnormal pulse figure were insignificantly different between the two groups (P > 0.05).

CONCLUSIONQQC is an effective Chinese composite medicine on patients with SOM, and shows no obvious adverse reaction.

Adolescent ; Adult ; Capsules ; Cefaclor ; therapeutic use ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Otitis Media with Effusion ; drug therapy ; Syndrome ; Treatment Outcome

OBJECTIVE: To analyze the correlation of the tympanic injection of triamcinolone acetonide, middle ear pressure (MEP) and radioactive secretory otitis media (RSOM) with nasopharyngeal carcinoma (NPC) after radiotherapy. METHOD: Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups. 17 cases with 34 ears were distributed into treatment group I, and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-7 weeks 1 times a week. Treatment group I had 17 cases with 34 ears,and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-12 weeks 1 times a week. And control group consisted of 18 cases with 36 ears who didn't accept such treatment. In all 104 ears, MEP was tested at the begin of radiotherapy and the end of 1st, 2nd, 3rd month after radiotherapy. RESULT: From the beginning of radiotherapy to the end of th 1st, 2nd, 3rd month after radiotherapy, the morbidity of RSOM gradually increased and MEP decreased in the treatment group I , II and the control group, in which treatment group II showed the lowest morbidity of RSOM and MEP was maximum (P < 0.01), and the treatment group I showed the lower morbidity of RSOM and MEP was greater (P < 0. 05), while the control group showed the highest morbidity of RSOM and MEP was minimum (P > 0.05). CONCLUSION Tympanic injection of triamcinolone acetonide could reduce radiation injury, and medication time was positively correlated with the MEP, and a negative correlation with RSOM morbidity, and the longer treatment, the more significant the effect is. The difference is most obvious at the end of 3rd month after radiotherapy. It may be due to the more active repairation after radiation damage in middle ears, but long-term efficacy must continue to observe.
Anti-Inflammatory Agents ; administration & dosage ; Carcinoma ; Ear, Middle ; Humans ; Injections ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; drug therapy ; Radiation Injuries ; Triamcinolone Acetonide ; administration & dosage

Rhinitis is a disease of the upper airway characterized by runny and/or blocked nose and/or sneezing. Though not viewed as a life threatening condition, it is also recognized to impose significant burden to the quality of life of sufferers and their caretakers and imposes an economic cost to society. Through a PubMed online search of the literature from 2006 to September 2011, this paper aims to review the published literature on rhinitis in young children below the age of 6 years. It is apparent from epidemiology studies that rhinitis in this age group is a relatively common problem. The condition has a heterogenous etiology with classification into allergic and non-allergic rhinitis. Respiratory viral infections may play a role in the pathogenesis of long standing rhinitis, but definitive studies are still lacking. Treatment guidelines for management are lacking for this age group, and is a significant unmet need. Although the consensus is that co-morbidities including otitis media with effusion, adenoidal hypertrophy and asthma, are important considerations of management of these children. Pharmacotherapy is limited for young children especially for those below the age of 2 years. This review underscores the lack of understanding of rhinitis in early childhood and therefore the need for further research in this area.
Adenoids ; Asthma ; Child ; Classification ; Consensus ; Drug Therapy ; Epidemiology ; Humans ; Hypertrophy ; Nose ; Otitis Media with Effusion ; Prevalence ; Quality of Life ; Rhinitis ; Risk Factors ; Sneezing

OBJECTIVE: To analysis the correlation between the otitis media with effusion and allergic rhinitis in children with adenoidal hypertrophy groups. METHOD: Retrospective analysis of cases of adenoidal hypertrophy in children associated with the incidence of otitis media with effusion, with or without allergic rhinitis history, with or without nasal steroid hormone use history information. RESULT: In the 287 cases of adenoidal hypertrophy in children cases, does not consider the role of nasal steroid hormones, the incidence of merger cases of allergic rhinitis and otitis media with effusion is 25.56%, compared to the incidence of control group is 32.47%, there is no significant difference (X=1.643, P>0.05). Not use a nasal steroid hormone therapy cases are grouped analysis, the combined incidence of allergic rhinitis group of otitis media with effusion 51.11%, higher than that in the control group to 32. 26% (2=5.019, P<0.05). Merger cases of allergic rhinitis, nasal steroid hormone group OME incidence of 12.50%, significantly below the 51.11% of the OME incidence of nasal steroid therapy group (2=23.32, P<0.01). CONCLUSION In children with adenoidal hypertrophy groups associated with a higher prevalence of otitis media with effusion, allergic rhinitis is an important factor in secretory otitis media. The use of nasal steroid hormones can reduce the incidence of secretory otitis media and may have some effect on the treatment of otitis media. Specific efficacy assessment and treatment mechanism needs further study.
Adenoids ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Hypertrophy ; complications ; epidemiology ; Male ; Otitis Media with Effusion ; drug therapy ; epidemiology ; Retrospective Studies ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; drug therapy ; epidemiology ; Steroids ; therapeutic use

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.
Age Factors ; Anti-Bacterial Agents/therapeutic use ; Asian Continental Ancestry Group ; Caregivers/education ; Child ; Drug Therapy, Combination ; Fever ; Hearing Tests ; Humans ; Otitis Media/*diagnosis/drug therapy ; Otitis Media with Effusion/diagnosis/surgery ; Pneumococcal Infections/prevention & control ; Republic of Korea ; Risk Factors ; Vaccines, Conjugate/immunology

OBJECTIVETo study the relationship between the fibrinogen content in middle ear effusion (MEE) and the protracted inflammation of secretory otitis media (SOM) and to explore the possible mechanism of batroxobin in treatment of SOM.

METHODSThe fibrinogen content of middle ear effusion from 156 patients with SOM was investigated with concretion technique at different stages. After two times punctuation of tympanum, the recurrence patients were randomly divided into two groups: batroxobin and dexamethasone group, and 0.5 ml (2 BU/ml) batroxobin or dexamethasone (2 mg/ml) was injected into middle ear cavity. The therapeutic effects were investigated.

RESULTSThe concentration of fibrinogen in the recurrence group of SOM patients was higher than that in the cured group, and even higher in the second recurrence group than in the first recurrence group (P < 0.01). There was significantly different (P < 0.001) in the therapeutic efficacy between the batroxobin group (91.6%) and the dexamethasone group (62. 5%); the difference of the fibrinogen content in MEE and air conduction of pure tone audiometry at frequencies (0.5, 1.0, 2.0 kHz) between the two groups after treatment were also significant (P < 0.01).

CONCLUSIONSFibrinogen may play a significant role in the occurrence and development of secretory otitis media. Batroxobin had better therapeutic effect on SOM than dexamethasone. The mechanism of batroxobin in the treatment of SOM may be that the batroxobin can relief the depressant effect of fibrinogen on surface active agents of the Eustachian tube and prevent the fibrinogen from turning into insoluble fibrin polymer by means of fibrinolysis.

Adolescent ; Adult ; Aged ; Batroxobin ; therapeutic use ; Dexamethasone ; therapeutic use ; Ear, Middle ; secretion ; Female ; Fibrinogen ; analysis ; metabolism ; Humans ; Inflammation ; Male ; Middle Aged ; Otitis Media with Effusion ; drug therapy ; metabolism ; Young Adult

OBJECTIVE: Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion. METHOD: We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively. RESULT: In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P<0. 01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P < 0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P < 0.01). There were no both statistical significance in the variation of air-bone-gap and tympanogram of comparison with results between three months and six months, six months and one year postoperatively (P > 0.05). CONCLUSION This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.
Acoustic Impedance Tests ; Adult ; Audiometry, Pure-Tone ; Cryosurgery ; Eustachian Tube ; surgery ; Humans ; Lost to Follow-Up ; Otitis Media with Effusion ; drug therapy ; surgery ; Plasma Gases ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tympanoplasty