Hearing impairment affects over two-thirds of adults with diabetes. We investigated whether rat models of type 1 and type 11 diabetes display impaired auditory function. Tympanometry measurements were conducted in Spr...Hearing impairment affects over two-thirds of adults with diabetes. We investigated whether rat models of type 1 and type 11 diabetes display impaired auditory function. Tympanometry measurements were conducted in Sprague-Dawley rats (control, n = 20), streptozotocin-induced type I diabetic Sprague-Dawley rats (n = 20) at 42 - 56 days old;Zucker rats (Hos: ZFDM-Lean (fa/+, n = 20) and Zucker Type 2 Diabetic rats (ZFDM (Hos: ZFDM-fa/fa);n = 20)), 90 days old. All rats were male. Control animals had normal type A tympanograms. Tweny one (75%) of the tympanic membranes in the diabetic type I group produced abnormal tympanograms: 46% were type B, 28% had no peak found, and 1% were type C. The ear canal measurements were lower in the left ear in type I mice (0.19 ± 0.07) and higher in the left ear for type II mice (0.23 ± 0.15 ml) compared to the controls of 0.39 ± 0.14 ml) and (0.2 ± 0.12 ml) respectively (P < 0.0001). The compliances for the right ear and left ear were lower for the type II diabetic group (0.18 ± 0.05 ml) and (0.18 ± 0.05 ml) compared to the control group (0.28 ± 0.19 ml) and (0.28 ± 0.49 ml) (P < 0.0001) respectively. In conclusion, control rats exhibited type A tympanograms with a highly functional middle ear system. Diabetic type I rats (n = 20) mostly exhibited type B tympanograms with a less compliant middle ear system. Compliance was reduced in the diabetic type I and II animals compared to the control. Future studies should utilise histological methods alongside tympanometry. Sections of the middle ear could be used to analyze ossicle size and confirm size differences. This information would be useful in avenues for treatment options for hearing loss in diabetes.展开更多
Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic memb...Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.展开更多
Otitis media is a frequent problem in preschool children and one of the most common reasons for treatment with antibiotics in children. The exact diagnosis is important for proper management. The diagnosis of otitis m...Otitis media is a frequent problem in preschool children and one of the most common reasons for treatment with antibiotics in children. The exact diagnosis is important for proper management. The diagnosis of otitis media is often difficult. Pneumatic otoscopy, otomicroscopy, and tympanometry can improve the diagnostic quality by indicating fluid or no fluid in the middle ear and thus improve the quality of treatment. The aim of this review is to explain why and how tympanometry can improve the diagnostic quality in otitis media, and to identify some barriers and difficulties encountered when using tympanometry in daily practice. The current literature on tympanometry and own experiences during 38 years are used to elucidate the aim. Tympanometry is difficult to understand and use, when the procedure is not properly trained. The problems are both of a technical nature, and it is difficult to understand and use the information from the curve and the figures on the display. If the use of tympanometry in general practice is increased, the diagnostic quality will improve and hopefully antibiotics will be prescribed on more appropriate indications and less frequently. More demand on tympanometry will hopefully reduce the price of the tympanometer, making it more accessible for GPs. First in that situation the use will be nearly as common as the use of the otoscope.展开更多
Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospectiv...Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.展开更多
Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertai...Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.展开更多
Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuff...Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ<sup>2</sup> = 14.62, df = 4, p value = 0.01, Type B χ<sup>2</sup> = 14.06, df = 4, p value = 0.01, Type C χ<sup>2</sup> = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.展开更多
Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-section...Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-sectional retrospective study.Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi.Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020.Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.Results:Out of 400 children enrolled in this study,108(27.0%)had OME,out of which 65(60.2%)were males and 30(27.8%)were of age group 2-3 years.Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring(P<0.001),last year symptoms(attack of ear aches with hearing loss[P=0.002]),drugs(URTI antibiotics[P=0.026],All 3 drugs[P=0.013]).Conclusions:We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems.Control of its etiopathogenic factors can play a major role in its prevention.展开更多
文摘Hearing impairment affects over two-thirds of adults with diabetes. We investigated whether rat models of type 1 and type 11 diabetes display impaired auditory function. Tympanometry measurements were conducted in Sprague-Dawley rats (control, n = 20), streptozotocin-induced type I diabetic Sprague-Dawley rats (n = 20) at 42 - 56 days old;Zucker rats (Hos: ZFDM-Lean (fa/+, n = 20) and Zucker Type 2 Diabetic rats (ZFDM (Hos: ZFDM-fa/fa);n = 20)), 90 days old. All rats were male. Control animals had normal type A tympanograms. Tweny one (75%) of the tympanic membranes in the diabetic type I group produced abnormal tympanograms: 46% were type B, 28% had no peak found, and 1% were type C. The ear canal measurements were lower in the left ear in type I mice (0.19 ± 0.07) and higher in the left ear for type II mice (0.23 ± 0.15 ml) compared to the controls of 0.39 ± 0.14 ml) and (0.2 ± 0.12 ml) respectively (P < 0.0001). The compliances for the right ear and left ear were lower for the type II diabetic group (0.18 ± 0.05 ml) and (0.18 ± 0.05 ml) compared to the control group (0.28 ± 0.19 ml) and (0.28 ± 0.49 ml) (P < 0.0001) respectively. In conclusion, control rats exhibited type A tympanograms with a highly functional middle ear system. Diabetic type I rats (n = 20) mostly exhibited type B tympanograms with a less compliant middle ear system. Compliance was reduced in the diabetic type I and II animals compared to the control. Future studies should utilise histological methods alongside tympanometry. Sections of the middle ear could be used to analyze ossicle size and confirm size differences. This information would be useful in avenues for treatment options for hearing loss in diabetes.
文摘Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.
文摘Otitis media is a frequent problem in preschool children and one of the most common reasons for treatment with antibiotics in children. The exact diagnosis is important for proper management. The diagnosis of otitis media is often difficult. Pneumatic otoscopy, otomicroscopy, and tympanometry can improve the diagnostic quality by indicating fluid or no fluid in the middle ear and thus improve the quality of treatment. The aim of this review is to explain why and how tympanometry can improve the diagnostic quality in otitis media, and to identify some barriers and difficulties encountered when using tympanometry in daily practice. The current literature on tympanometry and own experiences during 38 years are used to elucidate the aim. Tympanometry is difficult to understand and use, when the procedure is not properly trained. The problems are both of a technical nature, and it is difficult to understand and use the information from the curve and the figures on the display. If the use of tympanometry in general practice is increased, the diagnostic quality will improve and hopefully antibiotics will be prescribed on more appropriate indications and less frequently. More demand on tympanometry will hopefully reduce the price of the tympanometer, making it more accessible for GPs. First in that situation the use will be nearly as common as the use of the otoscope.
文摘Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.
文摘Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.
文摘Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ<sup>2</sup> = 14.62, df = 4, p value = 0.01, Type B χ<sup>2</sup> = 14.06, df = 4, p value = 0.01, Type C χ<sup>2</sup> = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.
文摘Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-sectional retrospective study.Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi.Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020.Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.Results:Out of 400 children enrolled in this study,108(27.0%)had OME,out of which 65(60.2%)were males and 30(27.8%)were of age group 2-3 years.Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring(P<0.001),last year symptoms(attack of ear aches with hearing loss[P=0.002]),drugs(URTI antibiotics[P=0.026],All 3 drugs[P=0.013]).Conclusions:We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems.Control of its etiopathogenic factors can play a major role in its prevention.
