Objective: To describe the temporal pattern of otitis media with effusion (OME) resolution for a cohort of nonsyndromic cleft palate children enrolled before palatoplasty and followed through 5 years of age.
Design: This is a prospective, longitudinal study of the time course for OME resolution in infants and children with palatal clefts.
Setting: Cleft Palate Craniofacial Center of a tertiary care pediatric hospital.
Objectives/hypothesis: Test the hypothesis that the eustachian tube (ET) function measured using standard manometric test methods is different between groups of ears with tympanostomy tubes inserted for recurrent acute otitis media (RAOM) and for chronic otitis media with effusion (COME).
Study Design: A cross-sectional study of ET function in populations of young children with different otitis media expressions.
Methods: The results for forced-response testing of ET function were compared using a general linear model between 37 ears of 26 children and 34 ears of 26 children, aged 3 and 4 years, with ventilation tubes inserted for COME and RAOM, respectively.
Objectives/hypothesis: In children with ventilation tubes (VTs) inserted for chronic otitis media with effusion (COME), the authors sought to determine whether any parameter of Eustachian tube (ET) function measured by the forced response test (FRT) predicts disease recurrence after the VT becomes nonfunctional.
Study Design: Prospective study of those factors that predict disease recurrence in children with VTs inserted for COME.
Methods: Forty-nine subjects (73 ears; 28 male, 34 white, aged 5.
Hypothesis: Eustachian tube function is stable over time in children with ventilation tubes for chronic otitis media with effusion.
Background: Clinical studies report that Eustachian tube function tests in patients with a persistent tympanic membrane perforation predict the success of myringoplasty, and those in patients with ventilation tubes for chronic otitis media predict disease recurrence after the tubes become nonfunctional. In those studies, Eustachian tube function was usually tested only once, which presumes a semi-stable basal level of function for greatest diagnostic and prognostic usefulness.
Int J Pediatr Otorhinolaryngol
March 2012
Objective: One past study conducted in 1986 reported Eustachian tube dilation with swallowing during the forced response test (FRT) in a very high percentage (>80%) of cleft palate patients both before and after palatoplasty. The present study was designed to determine the reproducibility of those results.
Methods: The FRT was used to evaluate Eustachian tube function in a cohort of cleft palate children before and after palatoplasty.
Conclusions: When used to test 3-year-old children within 3 months of tympanostomy tube placement for recurrent acute otitis media (rAOM) or chronic otitis media with effusion (cOME) the forced response test (FRT) showed relatively minor differences in the active and passive functions of the eustachian tube. While the sample size was small, the high variability in all test parameters suggests that the FRT alone is not capable of distinguishing between children with different expressions of otitis media.
Objective: The FRT was designed to measure the passive and active properties of the eustachian tube.
Cleft Palate Craniofac J
July 2012
Objective: To characterize Eustachian tube function using the forced response test in young children with cleft palate with or without cleft lip after palatoplasty with tympanostomy tubes inserted prepalatoplasty and compare these results with those of a 1986 study that evaluated a similar population using identical methods.
Setting: Outpatient research clinic.
Patients/participants: A total of 34 children with cleft palate were tested at an average age of 18.
Conclusion: The hypothesis that the human tympanic membrane (TM) is permeable to CO(2) and O(2) at physiologic pressure gradients is supported but additional experiments need to be done to validate this methodology.
Objective: Gas exchange between the middle ear and adjacent compartments determines the trajectory of middle ear pressure change. Little information is available regarding the permeability of the TM to physiological gases.
Nasal inflammation (NI) resulting from allergy or virus infection is causally associated with otitis media. Impaired Eustachian tube (ET) function consequent to NI may mediate this relationship. Moreover, the functional demand placed upon the ET for gas supply may be increased by NI, a hypothesis tested here.
View Article and Find Full Text PDFIntroduction: Experimental infection of adults with influenza A virus, rhinovirus or RSV causes abnormal ME pressure in some, but not all subjects. The hypothesis tested in this study is that the response variability is caused by constitutional differences in the functioning of the Eustachian tube.
Methods: 18 adult subjects were experimentally infected with influenza A virus.
Otolaryngol Head Neck Surg
July 1999
Recent clinical trials have renewed interest in middle ear inflation as a treatment for otitis media with effusion. However, air inflation in human beings with significant negative middle ear pressures was shown to be followed by a rapid pressure decrease to approach the preinflation values. In this experiment, the middle ears of anesthetized rhesus monkeys with unilateral inflammation were inflated at different times with air or N2, and pressures were recorded by tympanometry until they had stabilized or the animal had recovered from anesthesia.
View Article and Find Full Text PDFAuris Nasus Larynx
January 1999
Objective: The purpose of the study was to estimate the exchange constants for Argon and N2 across the middle ear mucosa of monkeys for use in mathematical models of middle ear pressure regulation.
Methods: In five anesthetized monkeys, the tympanic membrane was perforated and, with the animal breathing room air, a 13-ml probe attached to an Argon gas source and to a pressure transducer was introduced into the ear canal and sealed. The probe and middle ear volume was washed with Argon and then closed to the gas source.
The exchange rates of CO2 and He across the tympanic membrane were estimated in 5 monkeys. For these experiments, the monkey was anesthetized and one arm of a polyethylene "T" tube was introduced into the external canal of the test ear and sealed to the ambient environment with wax. One arm of the T tube was attached to a pressure transducer and the other to an argon gas source via a valve.
View Article and Find Full Text PDFSusceptible adults (n = 105) were enrolled into a randomized double-blind study of rimantadine treatment of experimental influenza A infection. Subjects were cloistered for 8 days and challenged with a rimantadine-sensitive strain of influenza A H1N1 virus at the end of the first day. Forty-eight hours after challenge and for 8 days, 54 subjects received placebo and 51 received rimantadine (100 mg orally, twice a day).
View Article and Find Full Text PDFIn this study, magnetic resonance imaging (MRI) was used to define in vivo the effect of experimental functional obstruction of the eustachian tube (ET) on vascular permeability and the development of middle ear (ME) effusion. After collection of baseline data for ME pressure and MRI, the right tensor veli palatini muscle of 10 cynomolgus monkeys was injected with botulinum toxin A to induce ET obstruction. The left tensor veli palatini muscle was injected with saline in 4 monkeys.
View Article and Find Full Text PDFInt J Pediatr Otorhinolaryngol
December 1996
A variety of recent evidence documents that otitis media is a frequent complication of upper respiratory tract viral infections. This relationship has been attributed to the interaction of a number of virus-provoked host responses, including eustachian tube dysfunction, changes in nasopharyngeal bacterial flora and suppressed immune function. The present study examined the effect of experimental influenza A virus infection on immune function as assessed by delayed skin test reactivity to candida, tetanus, and diphtheria/tetanus antigens in healthy adults with (n = 12) and without (n = 15) allergic rhinitis.
View Article and Find Full Text PDFThis study determined the influence of serum neutralizing antibody titers on infection rate, symptom manifestations, and provoked signs and pathophysiologies in adults experimentally exposed to rhinovirus type 39 (RV-39). Antibody status was determined for 151 healthy volunteers who were then cloistered in a hotel for 6 days. At the end of the first cloister day, the volunteers were challenged with RV-39 in a median tissue culture infective dose of 100.
View Article and Find Full Text PDFAm J Respir Crit Care Med
September 1996
Acute asthma is considered a complication of respiratory viral infections. This investigation assessed the effects of influenza A virus infection on both the patency and responsiveness of the lower airways. Subjects with allergic rhinitis (AR; n = 21) and without AR (non-AR; n = 25) were intranasally inoculated with influenza A virus and monitored for 8 d in a cloistered environment for changes in symptoms, signs, and airway physiology (pulmonary function, bronchial methacholine provocation).
View Article and Find Full Text PDFBecause of the increasing frequencies of recovery of penicillin-resistant Streptococcus pneumoniae from the middle ears of children with acute otitis media, non-beta-lactam antibiotics are being explored as treatment alternatives to amoxicillin. In this study, the efficacy of a 10-day course of clarithromycin was evaluated with chinchillas. After the pharmacokinetic profiles for clarithromycin were established, 180 animals were assigned to one of three susceptibility groups (n = 60/group; penicillin-susceptible, -intermediate, and -resistant S.
View Article and Find Full Text PDFAcute asthma is considered to be a complication of respiratory viral infections. This investigation assessed the effects of rhinovirus 39 (RV-39) infection both on the patency and responsiveness of the lower airways. Subjects with allergic rhinitis (AR; n = 50) and without AR (non-AR; n = 46) were intranasally inoculated with RV-39, and monitored for 8 days in an enclosed environment for changes in symptoms, signs, and airway physiology (pulmonary function, bronchial methacholine provocation).
View Article and Find Full Text PDFTo better understand the significance of viral upper respiratory tract infections in the pathogenesis of acute otitis media (OM), 27 adults underwent intranasal inoculation with influenza A virus. Monitoring consisted of antibody titer determination, tympanometry, and otoscopy. Microbiologic analysis consisted of cultures and polymerase chain reaction (PCR)-based detection for influenza A virus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
View Article and Find Full Text PDFArch Otolaryngol Head Neck Surg
August 1995
Objective: To estimate the rate of exchange of selected gases across the middle ear (ME) mucosa and define the exchange limitations.
Design: At separate sessions, the ME was inflated via the eustachian tube with a bolus of pure nitrogen, carbon dioxide, oxygen, or nitrous oxide, and ME pressures were recorded by tympanometry at selected intervals for up to 4 hours. The slope of the function relating pressure change to pressure was calculated by least squares regression and used as an estimate of the rate constant for exchange of that gas (experiment 1).
In this study, magnetic resonance imaging (MRI) was used to define, in vivo, the effect of acute middle ear (ME) underpressures on vascular permeability and the development of effusion. The MEs of four cynomolgus monkeys were unilaterally inflated with oxygen and carbon dioxide on different occasions and followed for a period of approximately 4 hours by tympanometry and MRI scanning. Carbon dioxide inflations caused the rapid development of ME underpressures of less than -600 mm H2O by 10 minutes.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
April 1995
In an effort to further validate an animal model and to better define the mechanisms relating viral upper respiratory tract infections and acute otitis media, we infected 10 ferrets intranasally with influenza A virus. Infection was monitored by cultures and antibody titers, illness was monitored by signs and temperatures, and otologic complications were monitored by otoscopy, tympanometry, and eustachian tube function testing. All animals became infected.
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