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The South African Journal of... Nov 2022Middle ear pathologies are associated with and persist in individuals living with human immunodeficiency virus (HIV). Yet, limited research exists on middle ear... (Review)
Review
BACKGROUND
Middle ear pathologies are associated with and persist in individuals living with human immunodeficiency virus (HIV). Yet, limited research exists on middle ear pathologies in children living with human immunodeficiency viruses.
OBJECTIVE
To systematically review evidence of middle ear pathologies in children living with HIV, how it is described, measures used to describe it and other relevant information.
METHODS
This study was a scoping review. The data were collected from different electronic databases including PubMed, Scopus, Science Direct, ProQuest, and Web of Science. The electronic database search was conducted for articles published between January 2010 and December 2020. Keywords used for searching relevant articles included 'middle ear pathology', 'middle ear disorder', 'children', 'HIV', 'otitis media (OM)', 'hearing loss (HL)', 'hearing impairment', 'paediatric', 'minors', 'infants' and 'HIV/AIDS'. Only articles that were published in English and reported on the middle ear function and pathologies of children living with HIV were considered.
RESULTS
A total of 350 articles were extracted through databases, but only six studies were eligible and included for further analysis. Studies reviewed suggested that middle ear pathologies in children living with HIV exist and are common. Recurrent OM, type B tympanogram, chronic OM and HL with conductive element were common. Tympanometry with a 226 Hz probe tone and air bone gap were used commonly to establish the presence of middle ear pathology.
CONCLUSION
The findings of this study highlighted that despite the dearth of evidence in this area, available evidence indicates that children living with HIV are at increased risk of middle ear pathology. However, studies in this review have mostly used middle ear measures with poor sensitivity and specificity. Therefore, the prevalence and nature of middle ear pathologies in studies reviewed may have been underreported. Further research using sensitive measures such as wideband acoustic immittance is required. Despite the paucity of evidence, the current findings raise important clinical implications for the assessment and management of middle ear pathologies in children living with HIV.Contribution: This study makes a significant contribution to the literature regarding middle ear pathologies and HIV, particularly in children.
Topics: Infant; Child; Humans; Ear, Middle; Acoustic Impedance Tests; Deafness
PubMed: 36453796
DOI: 10.4102/sajcd.v69i1.934 -
Hearing Research Dec 2023We recently discovered a unique type of otoacoustic emission (OAE) time-locked to the onset (and offset) of saccadic eye movements and occurring in the absence of... (Review)
Review
We recently discovered a unique type of otoacoustic emission (OAE) time-locked to the onset (and offset) of saccadic eye movements and occurring in the absence of external sound (Gruters et al., 2018). How and why these eye-movement-related eardrum oscillations (EMREOs) are generated is unknown, with a role in visual-auditory integration being the likeliest candidate. Clues to both the drivers of EMREOs and their purpose can be gleaned by examining responses in normal hearing human subjects. Do EMREOs occur in all individuals with normal hearing? If so, what components of the response occur most consistently? Understanding which attributes of EMREOs are similar across participants and which show more variability will provide the groundwork for future comparisons with individuals with hearing abnormalities affecting the ear's various motor components. Here we report that in subjects with normal hearing thresholds and normal middle ear function, all ears show (a) measurable EMREOs (mean: 58.7 dB SPL; range 45-67 dB SPL for large contralateral saccades), (b) a phase reversal for contra- versus ipsilaterally-directed saccades, (c) a large peak in the signal occurring soon after saccade onset, (d) an additional large peak time-locked to saccade offset and (e) evidence that saccade duration is encoded in the signal. We interpret the attributes of EMREOs that are most consistent across subjects as the ones that are most likely to play an essential role in their function. The individual differences likely reflect normal variation in individuals' auditory system anatomy and physiology, much like traditional measures of auditory function such as auditory-evoked OAEs, tympanometry and auditory-evoked potentials. Future work will compare subjects with different types of auditory dysfunction to population data from normal hearing subjects. Overall, these findings provide important context for the widespread observations of visual- and eye-movement related signals found in cortical and subcortical auditory areas of the brain.
Topics: Humans; Tympanic Membrane; Hearing; Otoacoustic Emissions, Spontaneous; Acoustic Impedance Tests; Sound
PubMed: 37979436
DOI: 10.1016/j.heares.2023.108899 -
Diving and Hyperbaric Medicine Mar 2021Middle ear barotrauma (MEBt) is the most common medical complication in diving, posing a serious risk to dive safety. Given this prevalence and the continuing growth of...
INTRODUCTION
Middle ear barotrauma (MEBt) is the most common medical complication in diving, posing a serious risk to dive safety. Given this prevalence and the continuing growth of the diving industry, a comprehensive overview of the condition is warranted.
METHODS
This was a survey study. An anonymous, electronic questionnaire was distributed to 7,060 recipients: professional divers of the Finnish Border Guard, the Finnish Rescue Services, and the Finnish Heritage agency; and recreational divers registered as members of the Finnish Divers' Association reachable by e-mail (roughly two-thirds of all members and recreational divers in Finland). Primary outcomes were self-reported prevalence, clinical characteristics, and health effects of MEBt while diving. Secondary outcomes were adjusted odds ratios (OR) for frequency of MEBt with respect to possible risk factors.
RESULTS
A total of 1,881 respondents participated in the study (response rate 27%). In total, 81% of the respondents had experienced MEBt while diving. Of those affected, 38% had used medications and 1% had undergone otorhinolaryngology-related surgical procedures due to MEBt. Factors most associated with MEBt were poor subjective success in Valsalva ('occasionally' versus 'always' successful: OR 11.56; 95% CI 7.24-18.47) and Toynbee ('occasionally' versus 'always' successful: OR 3.51; 95% CI 1.95-6.30) manoeuvres.
CONCLUSIONS
MEBt is common in both recreational and professional divers, having affected 81% of the respondents. The main possible risk factors include poor success in pressure equalisation manoeuvres.
Topics: Acoustic Impedance Tests; Barotrauma; Diving; Ear, Middle; Eustachian Tube; Finland; Humans
PubMed: 33761540
DOI: 10.28920/dhm51.1.44-52 -
Seminars in Hearing Feb 2023As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of...
As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of frequency in children with various middle ear pathologies. More recently, the use of wideband tympanometry has enabled clinicians to conduct WBA at ambient pressure (WBA ) as well as the pressurized mode (WBA ). This article reviews evidence for the ability of WBA measurements to accurately characterize the normal middle ear function across a wide range of frequencies and to aid in differential diagnosis of common middle ear disorders in children. Absorbance results in cases of otitis media with effusion, negative middle ear pressure, Eustachian tube malfunction, middle ear tumors, and pressure equalization tubes will be compared to age-appropriate normative data. Where applicable, WBA as well as WBA will be reviewed in these conditions. The main objectives of this article are to identify, assess, and interpret WBA and WBA outcomes from various middle ear conditions in children between the ages of 3 and 12 years.
PubMed: 36925660
DOI: 10.1055/s-0043-1763294 -
BMC Family Practice Dec 2014Tympanometry and pneumatic otoscopy are recommended for diagnosis of otitis media, but are not frequently used by general practitioners (GPs). We examined how, after...
BACKGROUND
Tympanometry and pneumatic otoscopy are recommended for diagnosis of otitis media, but are not frequently used by general practitioners (GPs). We examined how, after targeted short training, GP diagnosis and management of childhood ear disease was changed by the addition of these techniques to non-pneumatic otoscopy. We further explored factors influencing the uptake of these techniques.
METHODS
Between 2011 and 2012, we used a crossover experimental design to determine associations between tympanometry and pneumatic otoscopy and the GP diagnosis and management of ear disease in children aged 6 months to 6 years. GPs recorded a diagnosis and management plan after examining ears using non-pneumatic otoscopy, and another after using either tympanometry or pneumatic otoscopy. We compared diagnosis, prescription of oral antibiotics and planned GP follow-up at these two steps between the tympanometry and pneumatic otoscopy groups. We interviewed participants about their views regarding these techniques and analysed these data thematically.
RESULTS
Thirteen GPs recorded 694 ear examinations on 347 children: 347 examinations with non-pneumatic otoscopy; then 196 using tympanometry; and 151 using pneumatic otoscopy. Tympanometry was more likely to be associated with changes in diagnosis (χ (2) = 28.64, df 1, p < 0.001) and planned GP follow-up (χ (2) = 9.24, df 1, p < 0.01) than pneumatic otoscopy. Change in oral antibiotic prescription was no different between the two techniques. GPs preferred tympanometry to pneumatic otoscopy, but cost was a barrier to ongoing use. Pneumatic otoscopy was considered the more difficult skill. GPs were not convinced that the increased detection of middle ear effusion afforded by tympanometry and pneumatic otoscopy resulted in benefit to general practice patients.
CONCLUSION
Tympanometry was more likely than pneumatic otoscopy to change GP diagnoses and follow-up plans of childhood ear disease. Tympanometry may require less training than pneumatic otoscopy. GPs preferred tympanometry due to ease of use and interpretation; however, perceived high cost inhibited their intent to use it in the future. Training, cost and perceived lack of patient benefit are barriers to the use of tympanometry and pneumatic otoscopy in general practice.
Topics: Acoustic Impedance Tests; Adult; Attitude of Health Personnel; Child; Child, Preschool; Cross-Over Studies; Female; General Practice; Humans; Infant; Male; Middle Aged; Otitis Media; Otoscopy
PubMed: 25522872
DOI: 10.1186/s12875-014-0181-x -
International Journal of Pediatric... Feb 2022This study aims to investigate the inter-rater reliability and agreement of the diagnosis of otitis media with effusion, acute otitis media, and no effusion cases based...
OBJECTIVES
This study aims to investigate the inter-rater reliability and agreement of the diagnosis of otitis media with effusion, acute otitis media, and no effusion cases based on an otoscopy image and in some cases an additional wideband tympanometry measurement of the patient.
METHODS
1409 cases were examined and diagnosed by an otolaryngologist in the clinic, and otoscopy examination and wideband tympanometry (WBT) measurement were conducted. Afterwards, four otolaryngologists (Ear, Nose, and Throat doctors, ENTs), who did not perform the acute examination of the patients, evaluated the otoscopy images and WBT measurements results for diagnosis (acute otitis media, otitis media with effusion, or no effusion). They also specified their diagnostic certainty for each case, and reported whether they used the image, wideband tympanometry, or both, for diagnosis.
RESULTS
All four ENTs agreed on the diagnosis in 57% of the cases, with a pairwise agreement of 74%, and a Light's Kappa of 0.58. There are, however, large differences in agreement and certainty between the three diagnoses. Acute otitis media yields the highest agreement (77% between all four ENTs) and certainty (0.90), while no effusion shows much lower agreement and certainty (34% and 0.58, respectively). There is a positive correlation between certainty and agreement between the ENTs across all cases, and both certainty and agreement increase for cases where a WBT measurement is shown in addition to the otoscopy image.
CONCLUSIONS
The inter-rater reliability between four ENTs was high when diagnosing acute otitis media and lower when diagnosing otitis media with effusion. However, WBT can add valuable information to get closer to the ground-truth diagnosis without myringotomy. Furthermore, the diagnostic certainty increases when the WBT is examined together with the otoscopy image.
Topics: Acoustic Impedance Tests; Humans; Infant; Otitis Media; Otitis Media with Effusion; Otoscopes; Otoscopy; Reproducibility of Results
PubMed: 35033784
DOI: 10.1016/j.ijporl.2021.111034 -
International Archives of... Oct 2013Introduction For infants under 6 months, the literature recommends 1,000-Hz tympanometry, which has a greater sensitivity for the correct identification of middle ear... (Review)
Review
Introduction For infants under 6 months, the literature recommends 1,000-Hz tympanometry, which has a greater sensitivity for the correct identification of middle ear disorders in this population. Objective To systematically analyze national and international publications found in electronic databases that used tympanometry with 226-Hz and 1,000-Hz probe tones. Data Synthesis Initially, we identified 36 articles in the SciELO database, 11 in the Latin American and Caribbean Literature on the Health Sciences (LILACS) database, 199 in MEDLINE, 0 in the Cochrane database, 16 in ISI Web of Knowledge, and 185 in the Scopus database. We excluded 433 articles because they did not fit the selection criteria, leaving 14 publications that were analyzed in their entirety. Conclusions The 1,000-Hz tone test has greater sensitivity and specificity for the correct identification of tympanometric curve changes. However, it is necessary to clarify the doubts that still exist regarding the use of this test frequency. Improved methods for rating curves, standardization of normality criteria, and the types of curves found in infants should be addressed.
PubMed: 25992044
DOI: 10.1055/s-0033-1351678 -
Ear, Nose, & Throat Journal Mar 2021Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this...
Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid ( value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.
Topics: Acoustic Impedance Tests; Adenoids; Child; Child, Preschool; Correlation of Data; Ear, Middle; Female; Humans; Hypertrophy; Labyrinthine Fluids; Male; Oman; Otitis Media with Effusion; Prospective Studies; Viscosity
PubMed: 31547716
DOI: 10.1177/0145561319875438 -
Audiology Research Jul 2023to evaluate recent contributions to the literature on prognostic factors of hearing preservation in small vestibular schwannoma microsurgery. (Review)
Review
OBJECTIVE
to evaluate recent contributions to the literature on prognostic factors of hearing preservation in small vestibular schwannoma microsurgery.
METHODS
review of the most recent studies.
RESULTS
factors such as tumor size, preoperative hearing status, tumor growth rate, tumor origin, surgical approach, radiological characteristics, results of preoperative neurophysiological tests, preoperative symptoms and demographic features have been investigated and some of them reported to be significant in the prediction of hearing preservation.
CONCLUSIONS
tumor size and preoperative hearing status are the most impactful factors and play a key role in patient selection for hearing preservation surgery. Other features such as fundal extension, tumor origin and impaired ABR could have prognostic value on hearing preservation. Tumor growth rate, preoperative impedance, cVEMPs and age have also recently been found to be significant, but more studies are needed. The role of preoperative tinnitus, vertigo and gender is lacking and controversial, whereas the differences between available surgical approaches have been smoothed out in recent years.
PubMed: 37489378
DOI: 10.3390/audiolres13040042 -
Ear, Nose, & Throat Journal Apr 2021
Review
Topics: Acoustic Impedance Tests; Audiometry, Pure-Tone; COVID-19; Hearing Loss; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Otitis Media; Otoacoustic Emissions, Spontaneous; SARS-CoV-2
PubMed: 32755405
DOI: 10.1177/0145561320946902