Search Results (26)

Background: Primary ciliary dyskinesia (PCD) is a rare hereditary disorder caused by defective motile cilia, predominantly affecting the respiratory system. Conductive hearing loss (CHL) due to chronic otitis media with effusion (OME) is a typical feature of PCD, particularly in childhood. However, the underlying mechanisms contributing to sensorineural hearing loss (SNHL) in patients with PCD remain unclear. Methods: We present the case of a 52-year-old male with a clinical diagnosis of PCD, confirmed by the presence of situs inversus, chronic respiratory symptoms, and ultrastructural ciliary defects. Results: Despite a history of recurrent acute otitis media (AOM), the patient developed severe bilateral SNHL, a relatively uncommon and poorly understood manifestation of PCD. Genetic testing revealed a pathogenic SH3TC2 variant, a gene classically associated with Charcot–Marie–Tooth disease type 4C (CMT4C), raising the possibility of an alternative or contributory genetic etiology for the patient’s auditory dysfunction. Conclusions: This case highlights the importance of comprehensive audiological and genetic evaluations in PCD patients, particularly those presenting with progressive or atypical HL. The presence of a pathogenic SH3TC2 mutation suggests a potential neuropathic component to the patient’s HL, underscoring the need for further research into the intersection between ciliary dysfunction and genetic neuropathies. Early identification and intervention are critical to optimizing auditory outcomes and quality of life in affected individuals. Full article

Background and Aim: Probiotics, prebiotics, and synbiotics have been documented to modulate the microbiota, enhance immunity, and reduce antibiotic resistance, making them a promising alternative in the management of acute otitis media (AOM). Accordingly, the aim of this study was to determine their effectiveness in the prevention and treatment of AOM in patients. Methods: A systematic review and meta-analysis of randomized controlled trials published between 2000 and 2024 was conducted using Science Direct, PubMed, LILACS, SCOPUS, Web of Science, and Cochrane Clinical Trials, following PRISMA guidelines. The methodological quality was evaluated using the Jadad scale, and the meta-analysis was performed with RevMan 5.4^® and Jamovi 2.3.28^®. Results: A total of 16 trials with 4034 patients were included. The meta-analysis showed that the intervention did not affect the time to AOM presentation (MD: −7.98; 95% CI: −19.74 to 3.78; p = 0.18), the recurrence of the disease (RR: 0.99; 95% CI: 0.74–1.33; p = 0.96), or the requirement for antibiotics (RR: 1.31; 95% CI: 0.92 to 1.84; p = 0.13); however, it was associated with a reduced probability of developing AOM (RR: 0.80; 95% CI: 0.66 to 0.96; p = 0.02). Subgroup analysis suggests that the effect of probiotic supplementation on AOM incidence is influenced by treatment duration, patient age, and the number of probiotic strains in the product. Conclusions: Supplementation with probiotics, prebiotics, or synbiotics is associated with a significant reduction in the incidence of AOM in children, although no significant impact was observed on other key clinical parameters. These interventions may be considered as a complementary strategy to conventional treatments; however, further high-quality, standardized trials are needed to confirm these findings and to define optimal protocols. Full article

Background/Objectives: Otitis media (OM) is a common pediatric condition that significantly impacts hearing, language development, and quality of life. Emerging evidence suggests that vitamin D plays a crucial role in immune regulation and that deficiency may predispose children to recurrent OM. This study aimed to evaluate whether low serum vitamin D levels are associated with increased incidence and severity of OM in children aged 2–7 years. Methods: A cross-sectional study was conducted at a pediatric otolaryngology clinic in northwest Romania between November 2023 and April 2024. A total of 118 children were enrolled, including 87 children with documented episodes of OM within the preceding six months and 31 quasi-controls without recent OM episodes. Participants were stratified into three age groups (2–3, 4–5, and 6–7 years) and classified into clinical subtypes of OM (Acute Suppurative Otitis Media, Serous Otitis Media, and Acute Congestive Otitis Media). Serum 25-hydroxyvitamin D levels were measured using a chemiluminescence immunoassay and categorized as deficient (≤20 ng/mL), insufficient (21–29 ng/mL), or sufficient (≥30 ng/mL). Statistical analyses included one-way ANOVA with post-hoc tests, chi-square tests, linear regression, logistic regression, and Poisson regression. Results: Children with OM exhibited significantly lower vitamin D levels compared to controls, with the most pronounced deficiency observed in the Acute Suppurative OM group. One-way ANOVA revealed significant differences among the groups (F(3,114) = 82.30, p < 0.001), and linear regression demonstrated a strong inverse correlation between vitamin D levels and the frequency of OM episodes (r = −0.793, adjusted R² = 0.63, p < 0.001). Logistic regression indicated that vitamin D insufficiency significantly increased the odds of OM (OR ≈ 120.74, p < 0.001), while Poisson regression showed incidence rate ratios of 13.62 for deficient and 10.47 for insufficient vitamin D status (p < 0.001). Conclusions: The findings indicate that low serum vitamin D levels are significantly associated with an increased risk and frequency of otitis media in preschool-aged children. These results support the role of vitamin D deficiency as an independent, modifiable risk factor for recurrent OM, suggesting that vitamin D screening and supplementation could be beneficial in reducing the clinical and economic burden of this condition. Full article

Background/Objectives: Recurrent acute otitis media (rAOM) is a common disease in childhood, but its impact on the vestibular system remains poorly understood. The present study aimed to evaluate the long-term effects of rAOM on balance and vestibular function in pediatric patients. Methods: A total of 55 children, aged 8 years (25 males and 30 females), with a documented history of rAOM, no AOM episodes in the past year, and no previous ear surgery were assessed. Static posturography was used to assess postural instability, measuring sway area (SX, mm²) under four conditions: eyes open and eyes closed, with and without foam pads. Vestibular function was evaluated using the video head impulse test (v-HIT) to quantify vestibulo–ocular reflex (VOR) gain and corrective saccades across all six semicircular canals. Results: Children with a history of rAOM demonstrated significantly greater postural instability than healthy controls (p < 0.001 for all test conditions). The number of AOM episodes was the primary factor influencing balance dysfunction, with children who had more than eight episodes showing the most pronounced deficits in postural stability (p < 0.05). In some cases, the v-HIT revealed hypofunction in the right anterior (14.5%), left posterior (7.3%), left lateral (5.5%), left anterior (3.6%), and right posterior (3.6%) semicircular canals. Conclusions: The results of this study suggest that rAOM can lead to lasting balance and vestibular dysfunction, highlighting the importance of early monitoring and potential rehabilitation. Full article

Background: This systematic review aimed to synthesize the existing evidence on the use of Streptococcus salivarius (S. salivarius) probiotics as prophylactic or therapeutic tools for pediatric oral, dental, and respiratory diseases. Methods: A comprehensive search was carried out across multiple databases using the following terms: S. salivarius, probiotic, children, pediatric. Results: The systematic literature search identified 613 publications, which were meticulously screened, and, ultimately, 15 suitable citations were included in this systematic review. Three strains of S. salivarius (M18, K-12, 24SMB) were used, and they all demonstrated positive benefits in pediatric pathology. Conclusions: Administration of S. salivarius has benefits, is effective, and is convenient (cost-effective) in pediatric prophylaxis. Oral administration as a chewable tablet or powder of S. salivarius M18 for 3 months is able to reduce the incidence of black stains, plaque, and tooth decay in children. S. salivarius K-12 treatment decreased the occurrence of pharyngeal, recurrent, and streptococcal disease, and the benefits also extend to a reduction of nonstreptococcal diseases, including tracheitis, viral pharyngitis, rhinitis, flu, laryngitis, acute otitis media, and enteritis. Administration of S. salivarius 24SMB as an intranasal spray was able to reduce the risk of acute otitis media in children prone to this condition. Full article

Biofilms, aggregates of bacteria enclosed in a self-produced matrix, have been implicated in various pediatric respiratory infections, including acute otitis media (AOM), otitis media with effusion (OME), adenoiditis, protracted bacterial bronchitis, and pulmonary exacerbations in cystic fibrosis. These infections are prevalent in children and often associated with biofilm-producing pathogens, leading to recurrent and chronic conditions. Biofilms reduce antibiotic efficacy, contributing to treatment failure and disease persistence. This narrative review discusses biofilm production by respiratory pathogens such as Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus. It examines their mechanisms of biofilm formation, antibiotic resistance, and the challenges they present in clinical treatment. Various antibiofilm strategies have shown promise in vitro and in animal studies, including the use of N-acetylcysteine, enzymes like dispersin B, and agents disrupting quorum sensing and biofilm matrix components. However, their clinical application, particularly in children, remains limited. Traditional treatments for biofilm-associated diseases have not significantly evolved, even with biofilm detection. The transition from experimental findings to clinical practice is complex and requires robust clinical trials and standardized biofilm detection protocols. Addressing biofilms in pediatric respiratory infections is crucial for improving treatment outcomes and managing recurrent and chronic diseases effectively. Full article

Free-text information represents a valuable resource for epidemiological surveillance. Its unstructured nature, however, presents significant challenges in the extraction of meaningful information. This study presents a deep learning model for classifying otitis using pediatric medical records. We analyzed the Pedianet database, which includes data from January 2004 to August 2017. The model categorizes narratives from clinical record diagnoses into six types: no otitis, non-media otitis, non-acute otitis media (OM), acute OM (AOM), AOM with perforation, and recurrent AOM. Utilizing deep learning architectures, including an ensemble model, this study addressed the challenges associated with the manual classification of extensive narrative data. The performance of the model was evaluated according to a gold standard classification made by three expert clinicians. The ensemble model achieved values of 97.03, 93.97, 96.59, and 95.48 for balanced precision, balanced recall, accuracy, and balanced F1 measure, respectively. These results underscore the efficacy of using automated systems for medical diagnoses, especially in pediatric care. Our findings demonstrate the potential of deep learning in interpreting complex medical records, enhancing epidemiological surveillance and research. This approach offers significant improvements in handling large-scale medical data, ensuring accuracy and minimizing human error. The methodology is adaptable to other medical contexts, promising a new horizon in healthcare analytics. Full article

Background: Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. Method: A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. Results: A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician’s appointment and immediately administered antibiotics without the physician’s prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). Conclusions: A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures. Full article

Background: Chronic otitis media is recurrent infection of the middle ear and mastoid air cells in the setting of perforation of the tympanic membrane. Risk factors for chronic otitis media include predisposing characteristics such as gender, allergies, Eustachian tube dysfunction, history of acute otitis media, and upper respiratory tract infection. The purpose of this study was to evaluate the potential relationship between chronic otitis media and epitympanic recess volume. Materials and Methods: A total of 197 patients with chronic otitis media had their epitympanic recess volume compared to the epitympanic volume of 99 healthy controls. The epitympanic recess volume was measured via the 3D volumetric measurement tool of the local PACS. Epitympanic recess volume measurement was performed using axial sections in a plane starting from the level of the malleus head–anvil body in the craniocaudal direction to the tegmen tympanum. Results: It was shown that patients with bilateral involvement had an epitympanic recess volume of 75.00 mm³, compared to 72.30 mm³ in those with unilateral chronic otitis media. The healthy control group’s median value for the epitympanic recess was 74.73 mm³. Conclusions: Epitympanic volume values did not differ substantially between patients with chronic otitis media and healthy persons, and epitympanic volume was not recognized as a predisposing factor (p = 0.686). Full article

The aim of this comprehensive review was to present the current knowledge on the role of microRNAs (miRNAs) in acute, recurrent, and chronic forms of otitis media. Special attention was focused on cholesteatoma of the middle ear. MicroRNAs modulate gene expression, which, in turn, influences the development and likelihood of the recurrence of acute and aggressive chronic middle ear inflammatory processes. Moreover, this study discusses the modulating role of a specific subgroup of noncoding RNA, circular RNA (circRNA). Recognizing the precise potential pathways and the mechanisms of their function may contribute to a better understanding of the molecular bases of middle ear diseases and identifying novel methods for treating this demanding pathology. Articles published between 2009 and 2022 were used in this analysis. In this review, we provide a complete overview of the latest progress in identifying the role and mechanisms of particular miRNAs and circRNAs in acute, recurrent and chronic forms of otitis media. Full article

Background: Chronic media with effusion (COME) and recurrent acute otitis media (RAOM) are closely related clinical entities that affect childhood. The aims of the study were to investigate the microbiological profile of otitis-prone children in the post-PCV7 era and, to examine the biofilm-forming ability in association with clinical history and outcome during a two-year post-operative follow-up. Methods: In this prospective study, pathogens from patients with COME and RAOM were isolated and studied in vitro for their biofilm-forming ability. The minimum inhibitory concentrations (MIC) of both the planktonic and the sessile forms were compared. The outcome of the therapeutic method used in each case and patient history were correlated with the pathogens and their ability to form biofilms. Results: Haemophilus influenzae was the leading pathogen (35% in COME and 40% in RAOM), and Streptococcus pneumoniae ranked second (12% in COME and 24% in RAOM). Polymicrobial infections were identified in 5% of COME and 19% of RAOM cases. Of the isolated otopathogens, 94% were positive for biofilm formation. Conclusions: This is the first Greek research studying biofilm formation in complex otitis media-prone children population in the post-PCV7 era. High rates of polymicrobial infections, along with treatment failure in biofilms, may explain the lack of antimicrobial efficacy in otitis-prone children. Full article

Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided. Full article

Common health issues have been less examined in studies of early language development, particularly in relation to the child’s sex. Respiratory tract infections, often complicated by acute otitis media, are common in children during the first years of life, when early vocabulary development takes place. The present study, conducted in Finland, aimed to investigate whether possible associations between recurrent respiratory tract infections, background factors, and vocabulary growth differ in boys and girls aged 13 to 24 months. The participants (N = 462, 248 boys and 214 girls) were followed for respiratory tract infections and acute otitis media from 0 to 23 months of age. The parents completed daily symptom diaries of respiratory symptoms, physician visits, and diagnoses. The expressive vocabulary was measured with parental reports. We found that recurrent respiratory tract infections were not associated with slower vocabulary development in boys or girls. In fact, boys with recurrent respiratory tract infections had more vocabulary growth during the second year than boys who were less sick. We found that vocabulary growth was associated differently with respiratory tract infections and background factors as a function of the child’s sex. The vocabulary growth of boys seems to be more influenced by environmental factors than that of girls. Full article

Introduction: Acute Otitis Media (AOM) is the most commonly-occurring bacterial complication in childhood. After making certain corrections to the patients’ dietary habits, which we found to be excessively high in animal-based and industrially-processed foods, we observed a significant reduction in recurrent colds and their bacterial complications. We promote an original way of treating these diseases, since until now the conventional treatment is based on pharmacological and surgical treatment. From our point of view, the mucosa that covers the entire ENT area is in a pro-inflammatory and hyper-reactive state, as a consequence of the alterations produced by an inadequate diet. For us there is no difference in the nutritional treatment of the different mucous membranes that cover the ENT area. The purpose of the study was to assess the effects of the Traditional Mediterranean Diet (TMD) on patients diagnosed with Recurring Acute Otitis Media (RAOM). Methods: prospective pre-postest comparison study with 48 girls and 42 boys aged 1–5 years, each of whom had been and included on the 1-year programme “Learning to eat the Mediterranean Way”, designed to encourage the adoption of the TMD. We studied clinical and therapeutic variables and various anthropometric parameters. Results: all the symptomatic indicators studied (number and intensity of episodes of otitis and emergency admissions) showed a positive and statistically significant evolution in RAOM. By the end of the study, none of the patients met the criteria for classification as RAOM, and 60% percent of patients did not present any further episodes of AOM. In line with the above, the use of anti-microbial drugs and symptomatic treatments reduced considerably; the use of antibiotics dropped from 4.30 occasions/patient/year, to 0.66 (p < 0.001), and the used of symptomatic treatments dropped from 7.63 to 2.75 (p < 0.001). The level of family satisfaction was very high. Conclusions: the adoption of the Traditional Mediterranean Diet has been demonstrated to significantly reduce occurrence of acute otitis media and may contribute to the treatment of patients diagnosed with recurrent acute otitis media. Full article

Acute otitis media (AOM) constitutes a multifactorial disease, as several host and environmental factors contribute to its occurrence. Prevention of AOM represents one of the most important goals in pediatrics, both in developing countries, in which complications, mortality, and deafness remain possible consequences of the disease, compared to in developed countries, in which this condition has an important burden in terms of medical, social, and economical implications. The strategies for AOM prevention are based on reducing the burden of risk factors, through the application of behavioral, environmental, and therapeutic interventions. The introduction of culture-independent techniques has allowed high-throughput investigation of entire bacterial communities, providing novel insights into the pathogenesis of middle ear diseases through the identification of potential protective bacteria. The upper respiratory tract (URT) is a pivotal region in AOM pathogenesis, as it could act as a source of pathogens than of protective microorganisms for the middle ear (ME). Due to its direct connection with the external ambient, the URT is particularly exposed to the influence of environmental agents. The aim of this review was to evaluate AOM environmental risk factors and their impact on URT microbial communities, and to investigate AOM pathogenesis from the microbiota perspective. Full article