Factors Associated with Poor Outcome in Children with Acute Otitis Media

Monobe, Hiroko; Ishibashi, Toshio; Fujishiro, Yoshinori; Shinogami, Masanobu; Yano, Jun

doi:10.1080/00016480310000755

Cited by 83 publications

(42 citation statements)

References 8 publications

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“…This has led to ‘hearing preservation’ cochlear implant designs [9,10,11] and soft surgical techniques [12,13] to minimize the risk, particularly to low-frequency acoustic hearing, during cochlear implantation. Despite these measures, the prevalence of significant hearing impairment following cochlear implantation is reported at 35–50% [14,15,16], which remains much higher than for stapedectomy, where the accepted rate of sensorineural hearing loss is approximately 0.5–2% [17,18,19,20,21]. …”

Section: Introductionmentioning

confidence: 99%

Targeted Therapy of the Inner Ear

et al. 2009

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Background: There is experimental evidence that targeted delivery of steroids to the inner ear can protect hearing during cochlear implant surgery. The best protection appears to be achieved through pre-treatment of the cochlea, but the time period required for treatment is long compared with the duration of surgery, and needs further optimization. The stability of hearing thresholds is determined over a 3-month period after hearing preservation cochlear implantation. Methods: Adult guinea pigs were implanted with a miniature cochlear implant electrode, and pure tone auditory brainstem response (ABR) thresholds were estimated in response to pure tones of 2–32 kHz immediately after surgery and at 1 week, 1 month and 3 months. Spiral ganglion cell (SGC) densities were estimated from mid-modular histological sections of the cochlea. Thirty minutes prior to implantation, a polymeric sponge (Seprapack^TM, Genzyme) was loaded with either a 2% solution of dexamethasone phosphate or normal saline (control) and placed onto the round window. Results: Implantation was associated with an immediate elevation in thresholds across frequencies, with a full recovery below 2 kHz over the next week and a partial recovery of thresholds at higher frequencies. These thresholds remained unchanged for the next 3 months. There was an immediate and sustained reduction in the elevation of thresholds at 32 kHz in dexamethasone-treated animals. SGC densities were greater in steroid-treated animals than controls in the basal turn of the cochlea (at the region of implantation) 3 months after implantation. Conclusion: It is concluded that ABR thresholds remain stable for 3 months after cochlear implantation in the guinea pig, and that local application of steroids to the inner ear prior to implantation is an effective method of preserving SGC populations when there is residual hearing at the time of implantation.

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Section: Introductionmentioning

confidence: 99%

Targeted Therapy of the Inner Ear

et al. 2009

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“…We then obtained informed consent for study participation from the parents or guardians of all children. [6] …”

Section: Patientsmentioning

confidence: 97%

“…A child was defined as having AOM if pneumatic otoscopic findings suggested middle ear effusion, and at least one of the following symptoms or signs was present: otalgia, tugging or rubbing of the ear, temperature of at least 37.5 8C, irritability, disturbed sleep and concurrent respiratory infection by the otolaryngologic specialists [6][7][8]. Patients with tympanostomy tubes, spontaneous perforation of the tympanic membrane, or antibiotic treatment within 1 week preceding enrollment were excluded.…”

Section: Patientsmentioning

confidence: 99%

Effect of myringotomy on prognosis in pediatric acute otitis media

Nomura

Ishibashi

Yano

et al. 2005

International Journal of Pediatric Otorhinolaryngology

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“…As there is increasing interest in the possibility of implanting patients with high-frequency hearing loss but good low-frequency hearing, it has become an important goal to perform the implantation with minimal damage to residual hearing [72,73,74]. Other drug candidates include the use of neurotrophins to preserve spiral ganglion cells [75] and apoptosis inhibitors to minimize insertion trauma [76].…”

Section: Delivery Systems and Protocolsmentioning

confidence: 99%

“…Other drug candidates include the use of neurotrophins to preserve spiral ganglion cells [75] and apoptosis inhibitors to minimize insertion trauma [76]. There are several possible strategies of intracochlear drug delivery in combination with cochlear implants, including applications to the RWM prior to surgery [77], one-shot injections into the ST at the time of implantation [78,79], ‘bathing’ the electrode in drug solution or a gel preparation prior to insertion into the cochlea, drug release from the electrode carrier itself which also functions as a scaffold, drug release from a reservoir in the electrode carrier, drug injection through an incorporated channel attached to a pump [80,81], or by surface coating of the electrode carrier with a controlled-release formulation [82]. …”

Section: Delivery Systems and Protocolsmentioning

confidence: 99%

Principles of Local Drug Delivery to the Inner Ear

2009

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As more and more substances have been shown in preclinical studies to be capable of preventing damage to the inner ear from exposure to noise, ototoxic drugs, ischemia, infection, inflammation, mechanical trauma and other insults, it is becoming very important to develop feasible and safe methods for the targeted delivery of drugs to specific regions in the inner ear. Recently developed methods for sampling perilymph from the cochlea have overcome major technical problems that have distorted previous pharmacokinetic studies of the ear. These measurements show that drug distribution in perilymph is dominated by passive diffusion, resulting in large gradients along the cochlea when drugs are applied intratympanically. Therefore, in order to direct drugs to specific regions of the ear, a variety of delivery strategies are required. To target drugs to the basal cochlear turn and vestibular system while minimizing exposure of the apical cochlear turns, single one-shot intratympanic applications are effective. To increase the amount of drug reaching the apical cochlear turns, repeated intratympanic injections or controlled-release drug delivery systems, such as biodegradable biopolymers or catheters and pumps, are more effective. However, if the applied substance does not easily pass through the round window membrane, or if a more widespread distribution of drug in the ear is required, then intralabyrinthine injections of the substance may be required. Intralabyrinthine injection procedures, which are currently in development in animals, have not yet been proven safe enough for human use.

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Factors Associated with Poor Outcome in Children with Acute Otitis Media

Abstract: In selected cases, injection of 40 units of BTX-A into the turbinates, as a single agent, may help the symptomatic control of AR for up to 8 weeks.

Cited by 83 publications

References 8 publications

Targeted Therapy of the Inner Ear

Targeted Therapy of the Inner Ear

Effect of myringotomy on prognosis in pediatric acute otitis media

Principles of Local Drug Delivery to the Inner Ear

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