Otitis Media Module in the Pediatric Preclerkship Educational Exercises (PRECEDE) Curriculum.

Introduction: The Johns Hopkins Pediatrics Clerkship developed the PRECEDE (preclerkship educational exercises) curriculum with the primary goal of offering students formative instruction in essential pediatric clinical skills to prepare them for their clerkship. PRECEDE sessions occur at the beginning of each basic clerkship for new clinical clerkship students. The otitis media module is one in a series of modules presented in the curriculum and consists of a lecture and four short skills-development stations, each with a faculty facilitator.

Acute Otitis Media and Group A Streptococcal Pharyngitis: A Review for the General Pediatric Practitioner.

For pediatric practitioners, acute otitis media (AOM) and group A streptococcal pharyngitis are two of the most common infections seen in ambulatory practices. The purpose of this article is to review these conditions with the focus of highlighting evidence-based guidelines. AOM in children is a visual diagnosis and not one that can be made on history alone.

Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure.

Pneumatic otoscopy to assess the mobility of the tympanic membrane (TM) is a highly recommended diagnostic method of otitis media (OM), a widespread middle ear infection characterized by the fluid accumulation in the middle ear. Nonetheless, limited depth perception and subjective interpretation of small TM displacements have challenged the appropriate and efficient examination of TM dynamics experienced during OM. In this paper, a pneumatic otoscope integrated with low coherence interferometry (LCI) was adapted with a controlled pressure-generating system to record the pneumatic response of the TM and to estimate middle ear pressure (MEP).

iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents?

Objectives: Tele-otoscopy has been validated for tympanostomy surveillance and remote diagnosis when images are recorded by trained professionals. The CellScope iPhone Otoscope is a device that may be used for tele-otoscopy and it enables parents to record their children's ear examinations and send the films for remote physician diagnosis. This study aims to determine the ability to diagnose, and the reliability of the diagnosis when utilizing video exams obtained by a parent versus video exams obtained by an otolaryngologist.

Improving learning and confidence through small group, structured otoscopy teaching: a prospective interventional study.

Background: Otologic diseases are common and associated with significant health care costs. While accurate diagnosis relies on physical exam, existing studies have highlighted a lack of comfort among trainees with regards to otoscopy. As such, dedicated otoscopy teaching time was incorporated into the undergraduate medical curriculum in the form of a small group teaching session.

Otoscopic diagnosis of otitis media.

Accurate diagnosis of otitis media is important to prevent suffering and complications when infection is present, and unnecessary antibiotic use when infection is absent. The usual signs and symptoms of acute otitis media are unreliable guides in infants and young children. Similarly, middle ear effusions may present with little discomfort in older children.

Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children?

Objective: Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians' time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spectral gradient acoustic reflectometry (SG-AR) to exclude AOM.

Design: Three nurses were trained, who performed examinations with tympanometry and SG-AR.

Parental role in the diagnostics of otitis media: can layman parents use spectral gradient acoustic reflectometry reliably?

Objective: Spectral gradient acoustic reflectometry (SG-AR) can be used to detect middle ear effusion (MEE). Since both families and primary health care systems carry the burden of otitis media, our aim was to determine whether layman parents could be taught to use the SG-AR reliably.

Methods: We enrolled 359 children (age 6-35 months) whose parents were willing to use SG-AR at home.

Can nurses exclude middle-ear effusion without otoscopy in young asymptomatic children in primary care?

Objective: Scandinavian guidelines recommend controlling middle-ear effusion (MEE) after acute otitis media. The study aim was to determine whether nurses without otoscopic experience can reliably exclude MEE with tympanometry or spectral gradient acoustic reflectometry (SG-AR) at asymptomatic visits.

Design: Three nurses were taught to perform examinations with tympanometry and SG-AR.

A double-blind randomized placebo-controlled trial of topical intranasal mometasone furoate nasal spray in children of adenoidal hypertrophy with otitis media with effusion.

Purpose: To study the effects of topical intranasal mometasone furoate nasal spray for management of otitis media with effusion in children aged 2-12 years with adenoidal hypertrophy and its impact on change in quality of life.

Method: A prospective randomized double blind interventional placebo control study was conducted. Hundred patients of endoscopic grade 3 or 4 adenoidal hypertrophy aged 2-12 years were enrolled in this study.

Comparison of spectral gradient acoustic reflectometry and tympanometry for detection of middle-ear effusion in children.

Background: Spectral gradient acoustic reflectometry (SGAR) and tympanometry are handy methods to aid in the diagnostics of middle-ear diseases, but no prior studies have directly assessed the correlation between SGAR and tympanometry readings in children.

Methods: We compared SGAR and tympanometry in 2152 otoscopic examinations among 600 children aged 0.6-14 years, who were examined for signs and symptoms of respiratory infection in a primary care setting; 677 (31.

A low cost-video assisted-pneumatic oto-endoscopy system.

Pneumatic otoscopes do not support video assisted clinical examination, as they are not equipped with built-in cameras, so diagnosis is based on real-time direct observation rather than on video studying. On the other hand, classic rigid endoscopes usually provide otologists with a clear view of the tympanic membrane and its mobility, allowing subsequent video recording. Unfortunately, rigid endoscopes cannot be used for pneumatic otoscopy, unless they are properly fitted for such use.

Prevalence of Otitis Media with Effusion among Primary School Children in Eastern Black Sea, in Turkey and the Effect of Smoking in the Development of Otitis Media with Effusion.

The aim of this study was to determine the prevalence of otitis media with effusion (OME) in primary school children in Rize (Eastern Black Sea Region) and the impact of tobacco smoke exposure in the development of OME in primary school children. This study involved a total of 2960 children who appeal for ENT examination to our department at Rize Training and Research Hospital between November 2007 and April 2009. All children were evaluated with regard to OME and exposure to cigarette smoke.

Acoustic reflectometry in discrimination of otoscopic diagnoses in young ambulatory children.

Background: Studies concerning spectral gradient acoustic reflectometry (SG-AR) have analyzed middle ear effusion only as 1 entity. The usefulness of SG-AR to detect specific otoscopic diagnoses of otitis media in young children is unknown.

Methods: Among 515 children aged 6-35 months, we compared SG-AR with pneumatic otoscopy and evaluated the proportions of 5 manufacturer-recommended SG-AR levels in relation to specific otoscopic diagnoses in 2802 and 1240 examinations at symptomatic and asymptomatic visits, respectively.

Tympanometry in discrimination of otoscopic diagnoses in young ambulatory children.

Background: Tympanometry can indicate middle ear effusion in children referred for tympanostomy tube placement. In outpatient setting, objective adjunctive tools are needed to diagnose the otitis media spectrum.

Methods: We enrolled and followed 515 children aged 6-35 months at primary care level.

Otitis media with effusion with or without atopy: audiological findings on primary schoolchildren.

Objective: The objective of the study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school, focusing on the audiometric and tympanometric measurements among atopic and nonatopic subjects suffering from OME.

Materials And Methods: Three hundred ten children (5-6 years old) were screened in Western Sicily by skin tests and divided into atopics (G1) and nonatopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram, and acoustic reflex tests.

Association of otoscopic findings and hearing level in pediatric patients with otitis media with effusion.

Objective: To find the association between the abnormalities of tympanic membrane characteristics and the hearing level in pediatric patients with otitis media with effusion.

Methods: Sixty-three pediatric patients with otitis media with effusion had undergone ear examinations by pneumatic otoscopy to assess the color, transparency, mobility, fluid level and retraction of the tympanic membrane. An audiogram was done in the same setting, average hearing threshold and air-bone gap were measured.

The role of atopy in otitis media with effusion among primary school children: audiological investigation.

The objective of this study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school in western Sicily focusing on the audiological characteristics among atopic and non-atopic subjects suffering from OME. A total of 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non-atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests.

The point prevalence of otitis media with effusion among primary school children in Western Sicily.

The objective of this study is to identify the prevalence of otitis media with effusion (OME) in primary school children and to value the possible predisposing factors focusing on relationship between allergy and OME in Western Sicily. 2,097 children attending primary school were screened from September 2006 to June 2007 in Sciacca. Children underwent pneumatic otoscopy, skin tests, tympanogram and acoustic reflex tests.

Prevalence and risk factors for persistent otitis media with effusion in primary school children in Istanbul, Turkey.

Objective: To determine the impact of environmental, epidemiologic and familial factors in the development of persistent otitis media with effusion (OME-OME treated with antibiotics and followed additional 12 weeks) in primary school children in Istanbul.

Materials And Methods: A total of 1800 children who were attending 4 different primary schools in Sisli and Beyoglu districts of Istanbul were screened and 1740 children who met the inclusion criteria were enrolled into this study. Questionnaires prepared in the Otorhinolaryngology Clinics of Taksim Research and Training Hospital and the forms were delivered to the parents to be filled the day before examination of each child.

[The new Siegle's otoscope - a step by step manual for converting a 0 degrees telescope into a pneumatic video-otoscope].

The simple technique of Siegle's otoscope has unfortunately passed out of date. Ever since, tympanometry gives a general view over pressure conditions in the middle ear in a fast way. Only with pneumatic otoscopy, the examiner gets more detailed information if the tympanic membrane is sclerotic or retracted.

Temporal relationships between colds, upper respiratory viruses detected by polymerase chain reaction, and otitis media in young children followed through a typical cold season.

Introduction: Otitis media is a frequent complication of a viral upper respiratory tract infection, and the reported co-incidence of those diseases increases with assay sensitivity and sampling density. We determined the incidence of otitis-media complications in young children when referenced to cold-like illnesses and to concurrent virus recovery from the nasopharynx.

Methods: A total of 60 children from 24 families were followed from October 2003 through April 30, 2004, by daily parental recording of illness signs, weekly pneumatic otoscopic examinations, and periodic polymerase chain reaction assay of collected nasal fluids for common viruses.

Video otoscopy: bringing otoscopy out of the "black box".

Background: Several billion dollars are spent each year on otitis media, a diagnosis for which educational approaches and diagnostic skills are suboptimal. The Center for Disease Control has identified improvement in otoscopy skills as a key intervention to curb inappropriate antibiotic usage. Educators are looking for interventions to both improve and assess otoscopy skills.

Comparison of performance by otolaryngologists, pediatricians, and general practioners on an otoendoscopic diagnostic video examination.

Objective: To compare the performance of United States, South African, and Greek otolaryngologists, pediatricians, and general practitioners in recognizing the otoscopic examination findings of acute otitis media (AOM) and otitis media with effusion (OME) as presented in an otoendoscopic video evaluation test.

Design/subjects: Otolaryngologists, pediatricians, and general practitioners from the United States (n = 273, 2190, and 360 respectively), South Africa (n = 36, 36, and 206), and Greece (n = 58, 115, and 126) viewed nine different video-recorded otoscopic examinations, including pneumatic otoscopy of tympanic membranes. The ability to differentiate AOM, OME, and normal was ascertained.