Otovent Nasal Balloon for Otitis Media with Effusion
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Hearing Thresholds, Tinnitus, and Headphone Listening Habits in Nine-Year-Old Children
International Journal of Audiology ISSN: 1499-2027 (Print) 1708-8186 (Online) Journal homepage: http://www.tandfonline.com/loi/iija20 Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children Sara Båsjö, Claes Möller, Stephen Widén, Göran Jutengren & Kim Kähäri To cite this article: Sara Båsjö, Claes Möller, Stephen Widén, Göran Jutengren & Kim Kähäri (2016) Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children, International Journal of Audiology, 55:10, 587-596, DOI: 10.1080/14992027.2016.1190871 To link to this article: http://dx.doi.org/10.1080/14992027.2016.1190871 © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Published online: 22 Jun 2016. Submit your article to this journal Article views: 456 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iija20 Download by: [Linköping University Library] Date: 07 November 2016, At: 05:25 International Journal of Audiology 2016; 55: 587–596 Original Article Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children Sara Ba˚sjo¨1,2, Claes Mo¨ller1, Stephen Wide´n1,Go¨ran Jutengren3 & Kim Ka¨ha¨ri4 1Audiological Research Centre, School of Health and Medical Sciences / Swedish Institute for Disability Research, O¨ rebro University Hospital, O¨ rebro University, O¨ rebro, Sweden, 2HEAD Graduate School, Linko¨ping University, Linko¨ping, Sweden, 3School of Health Sciences, University of Bora˚s, Bora˚s, Sweden, and 4Division of Audiology, Sahlgrens’ Academy at Go¨teborg University, Go¨teborg, Sweden ABSTRACT Objective: Investigate hearing function and headphone listening habits in nine-year-old Swedish children. -
Introduction to Tympanometry
Tympanometry – Quick Guide Page 1 of 6 Introduction to Tympanometry This is an introduction to understanding and reporting on tympanometry measurements. This guide should be used in conjunction with your own clinic’s protocols and current research in the area of acoustic immittance testing. Some Useful Terminology Ear Canal Volume “The equivalent ear canal volume (ECV) is an estimate of the volume of air medial to the probe, which includes the volume between the probe tip and the tympanic membrane if the tympanic membrane is intact, or the volume of the ear canal and the middle ear space if the tympanic membrane is perforated” (Fowler & Shanks, 2002, p. 180). Averages Children 3 – 5yrs: 0.4cc to 1.0cc Adults: 0.6cc to 1.5cc Ear canal volume with an ECV >2.0 with a type B tympanogram in children suggests a perforated TM or patent grommet. Very small ECV with a type B tympanogram suggested impacted wax or middle ear pathology (glue ear?). Tympanometric Peak Pressure/Middle Ear Pressure Tympanometric peak pressure (TTP) or middle ear pressure (MEP) is the ear canal pressure at which the peak of the tympanogram occurs (Margolis & Hunter, 2000). Static Compliance Static compliance (SC) “is the greatest amount of acoustic energy absorbed by the middle ear system (the vertical peak of the tympanic tracing)” (Onusko, 2004, p. 1716). Gradient “Tympanogram gradient is an objective measure that describes the steepness of the slope of the tympanogram near the peak” (Fowler & Shanks, 2002, p.182). The gradient is not commonly used in Australia to analyse -
Acute Otitis Media, Acute Bacterial Sinusitis, and Acute Bacterial Rhinosinusitis
Acute Otitis Media, Acute Bacterial Sinusitis, and Acute Bacterial Rhinosinusitis This guideline, developed by Larry Simmons, MD, in collaboration with the ANGELS team, on October 3, 2013, is a significantly revised version of the Recurrent Otitis Media guideline by Bryan Burke, MD, and includes the most recent information for acute otitis media, acute bacterial sinusitis, and acute bacterial rhinosinusitis. Last reviewed by Larry Simmons, MD on July 5, 2016. Preface As the risk factors for the development of acute otitis media (AOM) and acute bacterial sinusitis (ABS)/ acute bacterial rhinosinusitis (ABRS) are similar, the bacterial pathogens are essentially the same for both AOM and ABS/ABRS, and since the antimicrobial treatments are similar, the following guideline is based, unless otherwise referenced, on recently published evidenced-based guidelines by the American Academy of Pediatrics (AAP) for AOM,1,2 and by the Infectious Diseases Society of 3 America (IDSA) for ABRS. This guideline applies to children 6 months to 12 years of age and otherwise healthy children without pressure equalizer (PE) tubes, immune deficiencies, cochlear implants, or anatomic abnormalities including cleft palate, craniofacial anomalies, and Down syndrome. However, the IDSA ABRS guideline includes recommendations for children and adult patients. Key Points Acute otitis media (AOM) is characterized by a bulging tympanic membrane (TM) + middle-ear effusion. Antibiotic treatment is indicated in children ≥6 months of age with severe AOM, children 6-23 months of age with mild signs/symptoms of bilateral AOM. In children 6-23 months of age with non-severe unilateral AOM, and in children ≥24 months of age with bilateral or unilateral 1 AOM who have mild pain and low fever <39°C/102.2°F, either antibiotic treatment or observation is appropriate. -
Rate of Concurrent Otitis Media in Upper Respiratory Tract Infections with Specific Viruses
ORIGINAL ARTICLE Rate of Concurrent Otitis Media in Upper Respiratory Tract Infections With Specific Viruses Cuneyt M. Alper, MD; Birgit Winther, MD, PhD; Ellen M. Mandel, MD; J. Owen Hendley, MD; William J. Doyle, PhD Objective: To estimate the coincidence of new otitis me- Results: A total of 176 children (81%) had isolated PCR dia (OM) for first nasopharyngeal detections of the more detection of at least 1 virus. The OM coincidence rates common viruses by polymerase chain reaction (PCR). were 62 of 144 (44%) for rhinovirus, 15 of 27 (56%) for New OM episodes are usually coincident with a viral up- respiratory syncytial virus, 8 of 11 (73%) and 1 of 5 (20%) per respiratory tract infection (vURTI), but there are con- for influenza A and B, respectively, 6 of 12 (50%) for ad- flicting data regarding the association between specific enovirus, 7 of 18 (39%) for coronavirus, and 4 of 11 (36%) viruses and OM. for parainfluenza virus detections (P=.37). For rhinovi- rus, new OM occurred in 50% of children with and 32% Design: Longitudinal (October-March), prospective fol- without a concurrent CLI (P=.15), and OM risk was pre- low-up of children for coldlike illness (CLI) by diary, middle dicted by OM and breastfeeding histories and by daily ear status by pneumatic otoscopy, and vURTI by PCR. environment outside the home. Setting: Academic medical centers. Conclusions: New OM was associated with nasopha- ryngeal detection of all assayed viruses irrespective of Participants: A total of 102 families with at least 2 chil- the presence or absence of a concurrent CLI. -
Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects
Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects Phillip Huyett MD, Yael Raz MD, Barry E Hirsch MD, and Andrew A McCall MD BACKGROUND: This study was conducted to determine the incidence of and risk factors associ- ated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of Pittsburgh Medical Center neurologic ICU from April 2013 through April 2014 were retrospectively reviewed. Images were reviewed for absent, partial, or complete opacification of the mastoid air cells and middle ear space. Exclusion criteria were temporal bone or facial fractures, transmastoid surgery, prior sinus or skull base surgery, history of sinonasal malignancy, ICU admission < 3 days or inadequate imaging. RESULTS: At the time of admission, of subjects subsequently (31 ؍ of subjects had radiographic evidence of ME/MEE; 10.3% (n 3.7% developed new or worsening ME/MEE during their ICU stay. ME/MEE was a late finding and was found to be most prevalent in subjects with a prolonged stay (P < .001). Variables associated with ME/MEE included younger age, the use of antibiotics, and development of radiographic sinus opacification. The proportion of subjects with ME/MEE was significantly higher in the presence of an endotracheal tube (22.7% vs 0.6%, P < .001) or a nasogastric tube (21.4% vs 0.6%, P < .001). CONCLUSIONS: Radiographic ME/MEE was identified in 10.3% of ICU subjects and should be considered especially in patients with prolonged stay, presence of an endotracheal tube or naso- gastric tube, and concomitant sinusitis. -
Strand B, Rapid Assessment of Other Health Technologies Such As Medical Devices, Surgical Interventions Or Diagnostics
333 EUnetHTA WP5 Joint Action 2 (2012-2015) Strand B, Rapid assessment of other health technologies such as medical devices, surgical interventions or diagnostics Pilot rapid assessment of other health technologies using the HTA Core Model® for Rapid Relative Effectiveness Assessment Balloon Eustachian tuboplasty for the treatment of Eustachian tube dysfunction Pilot ID: SB-13 Version 5.0, February, 2015 Final Version EUnetHTA JA2 Balloon Eustachian tuboplasty for the treatment of Eustachian tube dysfunction WP5B DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 26 August 2014 V1.0 = First draft V2.0 29 September 2014 Updated following review by dedicated reviewers V 3.0 13 November 2014 Updated version based on comments from external clinical experts, WP5 strand B members and manufacturers V 4.0 15 December 2014 Updated version based on the comments and corrections from medical editing V 5.0 3 February Updated version based on comments from LBI This assessment was produced by experts from the institutions listed below, and was reviewed by members of Work Package 5 (WP5) Joint Action 2 of the EUnetHTA network; the whole process was coordinated by the Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA). Disclaimer The assessment represents a consolidated view of the EUnetHTA network members and is in no case the official opinion of the participating institutions or individuals. EUnetHTA Joint Action 2 is supported by a grant from the European Commission. The sole responsibility for the content of this document lies with the authors and neither the European Commission nor EUnetHTA are re- sponsible for any use that may be made of the information contained therein. -
Audiometric Test Procedures
Audiometric Test Procedures 101 This information is meant to help you better understand the various test procedures as well as some of the terms you might see on an audiometric report. By Larry Medwetsky individual could, in fact, exhibit nor- In the previous issue of Hearing mal hearing acuity across these three Loss Magazine, I provided an over- Anyone who has ever had their frequencies, yet, exhibit a significant view concerning hearing threshold hearing tested should know how hearing loss in the higher frequencies results as recorded on the audiogram to read the audiogram, but that’s (3000-8000 Hz). Thus, it is important and an explanation of the pure-tone easier said than done. Hopefully, to examine the SRT in the context of audiogram. In this article, I will after reading this article you will the other audiometric test findings. describe various test procedures have a greater understanding of the Speech Awareness Threshold that are typically administered in principles discussed and use your (SAT): an audiometric evaluation and what knowledge going forward—be it in Compound words are pre- information the tests provide. reviewing hearing test results you sented, the goal being to determine already have or when discussing your the softest level one can detect the Audiometric Test Procedures results at your next hearing test. presence of words. This test is often Pure-tone Audiometry: Tones of used when an individual’s hearing loss different frequencies are presented; the is so great that the person is unable goal is to find the softest sound level relatively flat hearing losses, and the to recognize/repeat the words, yet is which one can hear (threshold) the average of 500 and 1000 Hz for those aware that words have been presented. -
Chapter 9 Hearing Loss
Chapter 9 Hearing loss 9.1 Estimation of noise induced hearing loss on the basis of the record of past noise exposure Noise-induced hearing loss is considered to become a detectable per- manent hearing loss through the repetition of temporary hearing loss and its recovery that starts an undetectable infinitesimal permanent hearing loss and its accumulation. The past noise exposure during the Vietnam War era was estimated in the previous section using measurements recorded at the residential areas in the vicinity of Kadena airfield in 1968 and 1972. The estimated WECPNL was around 105, and the equivalent continuous sound pressure level, LAeq, for averaging time of 24 hours came to 83 dB. These values are serious when com- pared with the permissible criteria of occupational noise exposure for hearing conservation recommended by Japan Society for Occupational Health which is 80 dB for 24 working hours a day. The criteria is provided in the expectation that average hearing loss can be controlled after prolonged exposure of over years under 20 dB for the test frequency of 4 kHz. 9.1.1 Estimation of TTS due to aircraft noise A method of computation of average temporary threshold shift (TTS) (Takagi K, Hiramatsu K & Yamamoto T; 1988) is available if the temporal and spectral features of noise exposure are given; in its turn, permanent aver- age hearing loss can be estimated to a certain extent from past measurement of noise exposure. The method consists of two stages. One is the critical band theory with respect to TTS, which deals with the spectral aspect of the exposure noise. -
Effectiveness of Intranasal Live Attenuated Influenza Vaccine Against All-Cause Acute Otitis Media in Children Heikkinen Et Al Terho Heikkinen, MD, Phd,* Stan L
Mary INF VACCINE REPORTS 203098 LAIV and Acute Otitis Media Effectiveness of Intranasal Live Attenuated Influenza Vaccine Against All-cause Acute Otitis Media in Children Heikkinen et al Terho Heikkinen, MD, PhD,* Stan L. Block, MD,† Seth L. Toback, MD,‡ Xionghua Wu, PhD,‡ and Christopher S. Ambrose, MD‡ cute otitis media (AOM) remains the most common bacterial Background: Acute otitis media (AOM) is a frequent complication of influ- infection and the most frequent reason for antibiotic treatment enza in children, and influenza vaccination helps protect against influenza- A Pediatr Infect Dis J in infants and young children. Although the incidence of AOM associated AOM. A live attenuated influenza vaccine (LAIV) approved for peaks around the age of 1 year, the rates of AOM are substantial eligible children aged ≥2 years for the prevention of influenza also effec- in older children.1,2 The high prevalence of antimicrobial resistance tively reduces influenza-associated AOM. However, the annual effective- among common bacteria causing AOM has substantially compli- Lippincott Williams & Wilkins ness of LAIV against all-cause AOM is unknown. cated the management of AOM, and efforts to reduce the use of Methods: AOM rates in children aged 6–83 months from 6 randomized, antibiotics for this disease are being assessed. As a consequence, placebo-controlled trials and 2 randomized, inactivated influenza vaccine- prevention of AOM through vaccination is an important area of controlled trials were pooled and analyzed. To enable comparison with Hagerstown, MD research.3,4 studies of AOM prevention by pneumococcal conjugate vaccines, 12-month Pneumococcal conjugate vaccines (PCVs) are currently effectiveness was calculated assuming that LAIV had no effect outside of used in most developed countries to prevent severe invasive pneu- influenza seasons. -
Benign Paroxysmal Positional Vertigo and Tinnitus
DOI: 10.5935/0946-5448.20130003 ORIGINAL ARTICLE International Tinnitus Journal. 2013;18(1):16-19. Benign paroxysmal positional vertigo and tinnitus Stefania Barozzi1 Marina Socci1 Daniela Ginocchio1 Eliana Filipponi2 Maria Grazia Troja Martinazzoli1 Antonio Cesarani1 Abstract Introduction: In our clinical experience, some of the patients affected by benign paroxysmal positional vertigo (BPPV) reported the onset of tinnitus shortly before or in association with the positional vertigo. Objectives: The aim of this study was to describe the prevalence and the clinical patterns of tinnitus episodes which occurred in association with BPPV and to suggest possible interpretative hypotheses. Methods: 171 normal hearing patients affected by BPPV (50 males and 122 females; age range: 25-77 years; mean age 60.3 years ± 14.9) underwent pure tone audiome- try, immittance test and a clinical vestibular evaluation before and after repositioning manoeuvers. Those suffering from tinnitus were also assessed using visual analogue scales and tinnitus handicap inventory. Results: 19.3% of the patients reported the appearance of tinnitus concurrently with the onset of the positional vertigo. It was mostly unilateral, localized on the same ear as the BPPV, slight in intensity and intermittent. Tinnitus disappeared or decreased in all patients except two, either spontaneously, before performing the therapeutic manoeuvers, or shortly after. Conclusions: A possible vestibular origin of tinnitus determined by the detachment of macular debris into the ductus reuniens and cochlear duct is discussed. Keywords: tinnitus, vertigo, vestibular diseases. 1 Audiology Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano; Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico. E-mail: [email protected]. -
Tympanometry EDWARD ONUSKO, M.D., Clinton Memorial Hospital, Wilmington, Ohio
Tympanometry EDWARD ONUSKO, M.D., Clinton Memorial Hospital, Wilmington, Ohio Tympanometry provides useful quantitative information about the presence of fluid in the middle ear, mobility of the middle ear system, and ear canal volume. Its use has been recommended in conjunction with more qualitative information (e.g., history, appearance, and mobility of the tympanic membrane) in the evaluation of otitis media with effusion and to a lesser extent in acute otitis media. It also can provide useful information about the patency of tympanostomy tubes. Tympanometry is not reliable in infants younger than seven months because of the highly compliant ear canals of infants. Tympanogram tracings are classified as type A (normal), type B (flat, clearly abnormal), and type C (indicating a significantly negative pressure in the middle ear, possibly indicative of pathology). According to the Agency for Healthcare Research and Quality guidelines on otitis media with effusion, the positive predictive value of an abnormal (flat, type B) tympanogram is between 49 and 99 percent. A type C curve may be useful when correlated with other findings, but by itself it is an imprecise estimate of middle ear pressure and does not have high sensitivity or specificity for middle ear disorders. (Am Fam Physician 2004;70:1713-20. Copy- right© 2004 American Academy of Family Physicians.) titis media with effusion (OME) tympanic membrane should be performed is defined as fluid in the middle before tympanometry.6 Using pneumatic ear without signs or symptoms otoscopy with tympanometry improves of ear infection.1 Acute otitis the accuracy of diagnosis because many O media (AOM) is defined as the presence of abnormalities of the eardrum and ear canal middle ear effusion in conjunction with the that might cause an abnormal tracing can recent, abrupt onset of one or more signs be visualized. -
An Integrated Osteopathic Treatment Approach in Acute Otitis Media
C A RF IC)RT S • An integrated osteopathic treatment approach in acute otitis media WILLIAM J. PINTAL, no MARGOT E. KURTZ, PhD Ear pain is a common patient pathogens, Streptococcus pneumoniae and Haemo- complaint in the practice of the primary philus influenzae, causative agents may include care physician. Acute otitis media can Streptococcus pyogenes, Staphylococcus aureus, My- affect a person of any age, although it is coplasma pneumoniae, and Corynebacterium diphth- more often seen in children than in adults. eriae. The disease is usually caused by Classically, the tympanic membrane is thick- Streptococcus pneumoniae (Diplococcus ened, and a gray or amber fluid is seen in the mid- pneumoniae) or Haemophilus influenzae. dle ear. Sometimes a fluid meniscus, air bubbles The differential diagnosis and subsequent of bluish fluid, may appear behind the tympanic treatment of otitis media is approximately membrane, the mobility of which is generally im- the same for children and adults. First-line paired. Depending on individual circumstances, the therapy usually consists of an antibiotic tympanic membrane may be either bulging or re- regimen of amoxicillin in combination with tracted. The bulging or retraction may result from autoinflation exercises. In the case the development of a positive or negative internal presented, a pharmacologic regimen was pressure, respectively, caused by dysfunction of the combined with osteopathic manipulation. eustachian tube. In the differential diagnosis, one must distin- guish between an acute purulent otitis media and In the course of caring for a wide range of pa- a serous or mucoid otitis media as well as between tients of different ages in a general practice–fam- the short-term perforation of the tympanic mem- ily medicine setting, one has the opportunity to care brane that is associated with acute purulent otitis for many ear infections.