Objective: To analyze the incidence and risk factors of otologic disorders in patients with Turner syndrome (TS), so as to provide management strategies for ear health. Methods: This study is a prospective study based on questionnaires and a cross-sectional study. The TS patients who visited our hospital from 2010 January to 2021 March were included (A total of 71 patients with TS were included in this study. the age of TS diagnosed was 3- to 11-year-old, age of visiting ENT department was 4- to 27-year-old) and the incidence of otologic diseases in different age groups was investigated by questionnaires. The cross-sectional study included ear morphology and auditory function assessment, and further analysis of the risk factors that related to ear disease. Prism was used for data analysis. Results: The investigation found that the incidence of acute otitis media in patients aged 3-6 and 7-12 years was higher than that of patients over 12 years old, which was 33.8%(24/71), 42.9%(30/70)and 23.5%(8/34), respectively; 21.1% (15/71) of patients were recurrent acute otitis media in patients aged 3-6 years, and about 46.6% (7/15)of them persisted beyond 6-year. The prevalence of otitis media with effusion in the three groups was 32.4%(23/71), 34.3%(24/70)and 38.2%(13/34), respectively; the recurrence rate of tympanocentesis was 100%(7/7), 42.9%(3/7)and 50.0%(1/2), which was significantly higher than that of grommet insertion. For age groups of 3-6 and 7-12 years, the prevalence of acute otitis media and secretory otitis media was lower in the X chromosome structure abnormal patients; while for patients older than 12 years, otitis media with effusion was the highest prevalence in Y-chromosome-containing karyotypes. In addition, the prevalence of acute otitis media and otitis media with effusion in patients with other system diseases were increased significantly. A cross-sectional study found that 7.0% (5/71)of the lower auricular, 4.2% (3/71)of the external auditory canal narrow, and 38.0% (27/71)of the tympanic membrane abnormality. 35.2%(25/71) had abnormal hearing, including 17 cases of conductive deafness, 6 cases of sensorineural hearing loss, and 2 cases of mixed deafness. The rest of the patients had normal hearing, but 6 of them had abnormalities in otoacoustic emission. Eustachian tube function assessment found that the eustachian tube dysfunction accounted for 38%(27/71). Hearing loss and abnormal Eustachian tube function were not significantly related to karyotype(Chi-square 2.83 and 2.84,P value 0.418 and 0.417), but significantly related to other system diseases(Chi-square 13.43 and 7.53,P value<0.001). Conclusions: The incidence of TS-related otitis media and auditory dysfunction is significantly higher than that of the general population. It not only occurs in preschool girls, but also persists or develops after school age. Accompanied by other system diseases are risk factors for ear diseases. Clinicians should raise their awareness of TS-related ear diseases and incorporate ear health monitoring into routine diagnosis and treatment.
Adolescent ; Adult ; Child ; Child, Preschool ; Cross-Sectional Studies ; Deafness/etiology* ; Female ; Humans ; Middle Ear Ventilation/adverse effects* ; Otitis Media/complications* ; Otitis Media with Effusion/complications* ; Prospective Studies ; Turner Syndrome/therapy* ; Young Adult

Body Fluids ; Child ; Humans ; Otitis Media ; Otitis Media with Effusion/therapy*

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*

Body Fluids ; Child ; Humans ; Infant ; Otitis Media ; Otitis Media with Effusion/therapy* ; Risk Factors

Body Fluids ; Child ; Humans ; Otitis Media ; Otitis Media with Effusion/therapy*

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 discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children.

METHODSA total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group Al, group B1, and group Cl matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and Al accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and Cl accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared.

RESULTSThe control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times.

CONCLUSIONSOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate.

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

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

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