Objetivos: analisar a associação entre otite média crônica não colesteatomatosa (OMCNC) e os resultados obtidos no video head impulse test (vHIT). Delineamento: tipo transversal. Métodos: a amostra foi selecionada em ambulatório especializado de um hospital universitário. A inclusão dos pacientes neste estudo obedeceu aos seguintes critérios: idade entre 7 e 59 anos; diagnóstico de OMCNC unilateral, com orelha contralateral normal; não ter realizado cirurgia otológica prévia; não ter comprometimentos cognitivos e/ou neurológicos e/ou motores registrados nos prontuários. Os critérios de exclusão foram: impossibilidade de retirada de maquiagem nos olhos (impossibilita a execução do exame); não compreensão ou dificuldade na execução das ordens do exame. Os pacientes foram divididos em Grupo A (7 a 19 anos) e Grupo B (20 a 59 anos). Todos foram avaliados por meio de exame otorrinolaringológico padrão do ambulatório, anamnese e vHIT. Os exames com valor de ganho superior a 0,8 foram considerados normais. Os canais com valores de ganho entre 0,6 e 0,8 foram classificados, nesta pesquisa, como limítrofe. Nos casos considerados limítrofes, foi analisado o valor da assimetria para diagnóstico, que foi considerada anormal acima de 20%. Para o cálculo amostral evidenciou que o número mínimo de indivíduos avaliados seria de, 10 sujeitos no grupo A e 20 sujeitos no grupo B. Resultados: a amostra total foi composta por 32 indivíduos. O grupo A foi formado por 11 indivíduos, com idade média de 12,7 ± 3,9 anos e o grupo B por 21 indivíduos, com idade média de 46,3 ± 11,1 anos. A análise dos resultados do vHIT revelou que não houve diferença significativa entre o lado considerado normal e o lado considerado afetado, considerando-se a análise intragrupo e entre grupos. Conclusão: a pesquisa evidenciou que, na amostra estudada, não houve diferença nos resultados obtidos no vHIT entre os lados afetados e não afetados pela OMCNC. / Objectives: To analyze the association between chronic otitis media (COM) without cholesteatoma and results in the video head impulse test (vHIT). Design: Cross sectional. Methods: The sample was selected in a specialized clinic of a university hospital. Patient inclusion in this study obeyed the following criteria: age between 7 and 59 years; diagnosis of unilateral COM without cholesteatoma with normal contralateral ear; not having done previous ear surgery; not having cognitive impairment and / or neurological and / or motor recorded in the medical records. The exclusion criteria were: patients with eye makeup, which cannot be removed (makes it impossible to perform the exam); patients who did not understand the operation of the test and therefore could not accomplish it. Patients were divided in group A (7 to 19) and group B (20 to 59) years of age. Both groups performed standard outpatient otolaryngology evaluation, clinical history and video head impulse test. Exams with a gain above 0.8 were considered normal. Canals gain values between 0.6 and 0.8 were classified in this study as borderline. In borderline cases considered, we analyzed the value of asymmetry for diagnosis, which was considered abnormal over 20%. For sample size calculation showed that the minimum number of individuals assessed was of 10 subjects in group A and 20 subjects in group B. Results: The total sample consisted of 32 individuals. Group A consisted of 11 subjects mean with an average age of 12.7 ± 3.9 years and the group B of 21 subjects with an average age of 46.3 ± 11.1 years. Analysis of the vHIT results showed no significant difference between the side considered normal and the side considered affected, considering the intra-group and between groups analysis. Conclusion: The research showed that, in our sample, there was no difference in the results obtained in vHIT between the affected side and the not affected by COM without cholesteatoma.

Objetivos: Descrever o perfil audiológico de indivíduos com fissura labiopalatina (FLP) submetidos à palatoplastia primária, comparando os resultados da entrevista audiológica (EA), audiometria tonal liminar (ATL) e medidas de imitância acústica (MIA) nos períodos pré e pós-palatoplastia (PRÉ/PÓS) e aqueles obtidos em diferentes intervalos de tempo pós cirúrgico. Modelo: estudo retrospectivo em prontuários de indivíduos com FLP, avaliados nos períodos PRÉ/PÓS, divididos em 2 grupos: grupo 1 (G1) avaliação entre 1 e 5 anos e 11 meses e grupo 2 (G2) entre 6 e 12 anos e 11 meses pós palatoplastia. Consideramos o nível de significância de 5%. Local: Setor de Fonoaudiologia - HRAC-USP. Participantes: 162 prontuários de indivíduos submetidos à palatoplastia com idade entre 7 e 12 anos, 87 (G1) e 75 (G2). Intervenções: EA, ATL e MIA. Resultados: A maioria dos indivíduos não apresentou queixa auditiva nos períodos PRÉ/PÓS nos G1 e G2 (84% / 78% e 80% / 83% respectivamente). Na ATL observamos maior ocorrência de alterações no PRÉ (G1-52% e G2-59%). Já no PÓS observamos melhora (G1-44% e G2-39%), sendo a perda auditiva condutiva leve bilateral a mais freqüente. Na MIA observamos maior ocorrência de alterações no PRÉ/PÓS (G1-61%, 62% e G2-71%, 55% respectivamente), sendo a curva timpanométrica tipo B a mais freqüente. Conclusões: A audição é uma função que se encontra alterada nos indivíduos com FLP, caracterizada na maioria por perda auditiva do tipo condutiva, de grau leve, com tendência a uma proporção maior de alterado para normal quando analisado a longo prazo. / Objectives: To describe the audiological profile of individuals with cleft lip and palate (CLP) submitted to primary palatoplasty, comparing the results of auditory interview (AI), threshold tone audiometry (TTA) and acoustic immitance measures (AIM) at the periods before and after palatoplasty (PRE/POST) and those obtained at different time periods postoperatively. Design: Retrospective study of records of individuals with CLP, evaluated at the PRE/POST periods, divided into 2 groups: Group 1 (G1), evaluated from 1 year to 5 years 11 months; and Group 2 (G2), evaluated from 6 years to 12 years 11 months after palatoplasty. A significance level of 5% was adopted. Setting: Speech Therapy and Audiology sector, HRAC-USP. Participants: 162 records of individuals submitted to palatoplasty at 7 to 12 years of age: 87 (G1) and 75 (G2). Interventions: AI, TTA and AIM. Results: Most individuals did not have auditory complaints at the periods PRE/POST for both G1 and G2 (84% / 78% and 80% / 83%, respectively). Assessment by TTA revealed higher occurrence of disturbances at PRE (G1-52% and G2-59%). On the other hand, improvement was observed at the POST period (G1-44% and G2-39%), with highest frequency of mild bilateral conductive hearing loss. The AIM revealed higher occurrence of disturbances at PRE/POST (G1-61%, 62% and G2-71%, 55%, respectively), with highest frequency of type B tympanometric curve.Conclusions: Hearing is an altered function in individuals with CLP, especially characterized by mild conductive hearing loss, with a tendency of higher altered/normal ratio when analyzed in the long term.

'A face de cada um de nós apresenta características únicas. Resultado da combinação de tipos variados de mandíbulas, maxilas, órbitas, é o que nos faz reconhecer cada indivíduo. As crianças apresentam proporções faciais distintas dos adultos. O processo de crescimento e desenvolvimento craniofacial é influenciado por diversos fatores: tanto sistêmicos (genéticos, metabólicos, etc.) quanto locais (respiração nasal, dentição, hábitos orais). Sabe-se que a incidência de otites na infância é maior que em adultos e o que se atribui `a posição mais horizontal da tuba auditiva, em relação `a base do crânio nas crianças. A tuba auditiva é parte da orelha média que se estende desde o osso temporal até a nasofaringe, cujo desenvolvimento é influenciado pelo crescimento craniofacial. As doenças da orelha média influenciadas pela função da tuba auditiva, também ocorrem em adultos, ainda que em menor proporção. Uma vez que a menor incidência das doenças em adultos é atribuída ao crescimento da tuba auditiva, e este é dependente do crescimento craniofacial, deve haver relação entre as doenças da orelha média em adultos com as características morfológicas da face. Desse modo, o objetivo deste estudo foi correlacionar as doenças da orelha média, influenciadas pela função da tuba auditiva com a morfologia e tipologia craniofacial e determinar um traçado cefalométrico como fator prognóstico para estas doenças. Foram selecionados 66 pacientes, entre 18 e 40 anos, do Ambulatório da Divisão de Clínica Otorrinolaringológica da FMUSP. Os indivíduos foram divididos em 2 grupos sendo 32 com doença da orelha média e 34 sem, que constituiu o grupo controle. Os indivíduos não apresentavam nenhum dos fatores de exclusão a seguir: história pessoal ou familiar de fissura palatina, cirurgia bucal, maxilar, faríngea, nasal ou facial prévias, tratamento ortodôntico ou processos obstrutivos do óstio da tuba auditiva. Os pacientes foram submetidos a exame físico otorrinolaringológico, videotoscopia, fibronasofaringoscopia e telerradiografia de perfil. As telerradiografias foram analisadas através de traçado cefalométrico. Observou-se diferenças das grandezas cefalométricas no grupo de indivíduos com doença da orelha média, referentes a base do crânio, projeção da maxila e altura facial. Não houve predomínio de um tipo facial em especial. Dessa forma, o seguinte traçado apresenta valor preditivo para a evolução das doenças da orelha média N-S (comprimento da base do crânio anterior), N-S.Ba (ângulo entre as bases anterior e média do crânio, PMax (profundidade maxilar) e N-ENA (altura facial anterior superior).' / There are thousand types of faces and each one is unique. Individual faces are the result from the combination of different kinds of maxillas, mandibles, and orbits. The face proportions, in children, are distinct of adult ones. Craniofacial growth and development depends on a diversity of factors, such as: genetic, metabolic, nasal breathing, teeth development, etc. The auditory tube is part of middle ear and extends from temporal bone to nasopharynx. It has a more horizontal position in children than in adults; therefore otitis media is more frequent in this age group. The type of cranial base and the displacement of the maxilla during craniofacial growth influence the growth of the auditory tube. The lower frequency of otitis media in adults relates to the development of auditory tube during craniofacial growth. So, there should be a correlation between caniofacial morphology and otitis media. The aims of this study are to correlate facial types and cephalometric measurement morphology to otitis media and suggest which measurements can be used as a prediction of the evolution of otitis media. Sixty-four patients, 18 to 40 years old, were selected from the Outpatient Center of the Department of Otolaryngology of the University of São Paulo Medical School. They were divided into two groups: 32 with otitis media and 34 controls. We excluded patients with personal or familiar history of cleft palate, previous buccal, maxillar, pharyngeal, facial or nasal surgery, orthodontic treatment or obstructive process of the auditory tube ostia. All subjects underwent to complete ENT physical examination, videotoscopy, fibernasalendoscopy and lateral cephalograms. Statistical analysis of the cephalometric measurements showed significant differences of cranial base; projection of maxilla and facial height, in patients with otitis media when compared to the control group or to the ideal measures of the harmonic face. There was no predominance of any facial type. The following measures were found to be predictive of the evolution of otitis media: N-S (anterior cranial base), N-S.Ba (angle between anterior and medial cranial base), PMax (projection of the maxilla) and N-ANS(superior anteior facial height).'

Tympanometry is a useful means of evaluating the status of the middle ear. For the pediatric population, tympanometry is particularly valuable for determining the presence of middle ear effusion. The test has been incorporated in many school hearing conservation programs because of its ease of administration, objectivity, and diagnostic value. In a study by deJonge and Cummings (1985), the hourly fluctuation of middle ear pressure was reported in a group of kindergarten-age children. The variability of middle ear pressure for that group of children averaged 150 daPa. In the present study, a maturational effect of this hourly fluctuation was observed between a group of first-grade age students and sixth-grade age students. Results indicated the younger group averaged a range of 145 daPa, correlating well with the deJonge and Cummings study, while the older group averaged a range of 92 daPa. Thus, as a child matures, the hourly fluctuation of middle ear pressure decreases significantly.

Researchers have long been concerned with the effects of otitis media on speech and language acquisition because of the high correlation of a mild to moderate hearing loss during the time period that fluid (effusion) may be in the middle ear. Middle-ear effusion would prevent many of the auditory messages from accurately reaching the nervous system (Zinkus, 1986). Deprived of the ability to discern the subtle acoustic differences that provide information for phonetic contrasts, a child's speech acquisition may differ from children who do not experience such losses.

Otitis media, which is an upper respiratory tract infection that affect the middle ear, is the second most common disease in childhood, outnumbered in prevalence only by the common cold. Diagnosis of middle ear inflammation is often performed in the primary healthcare where the normal procedure involves anamnesis and physical examination of the tympanic membranes (TM) of the patient, usually be means of otoscopy. The general aim of this thesis was to develop optical methods that enable quantification of TM characteristics associated with otitis media. Diffuse reflectance spectroscopy was applied to quantify TM erythema using previously suggested erythema detection algorithms. Healthy TM:s were significantly distinguished from TM:s with induced erythema (p < 0.01) and from TM:s in ears with mucous middle ear effusion (p < 0.05). A new technique for surface shape assessment based on an on-axis dual fibre array incorporated in an otoscope was developed and evaluated in ear models and on tympanic membranes from harvested temporal bones. The technique utilises the combined effects of source-detector fibre separation and fibre-to-sample distance on the detected light intensity. Optical phantoms, both polyacetal plastic solids and latex membranes, were utilised to demonstrate the ability of the surface shape assessment technique to differentiate between convex and concave surfaces – as a bulging tympanic membrane is typically associated with acute otitis media whereas a retracted eardrum is associated with otitis media with effusion. Monte Carlo simulations of the surface shape data were performed in order to validate the experimental results with a theoretical model that are consistent with light transport theory. Retracted and bulging tympanic membranes from harvested temporal bones could be separated with a single measurement, given that variations in measurement distance were accounted for and that measurement from normally positioned tympanic membranes were used for signal normalization. In conclusion, the studies implicate that for individual otitis diagnosis, the hyperaemic tympanic membrane was separated from the healthy by application of erythema indices using diffuse reflectance spectroscopy. Moreover, bulging and retracted positions of the tympanic membrane were separable by means of the source-detector intensity matrix. For further clinical studies it is reasonable to assume that data from both methods are needed for diagnosis.

This study examined the extent to which mothers of children with and without otitis-media histories differ in their perceptions of children's social behavior. Twenty-three mothers, each with two children aged 2 1/2 to 9 (30 boys, 16 girls) participated. Mothers' average age was 34. Two-thirds were full-time homemakers. Most belonged to middle-class Anglo socioeconomic status. Early recurrent otitis media (EROM) children (n = 27) had had four or more episodes before age 2 and a first episode before age 1. Mild or no otitis media (MNOM) children (n = 19) had had either fewer than four episodes before age 2 or none before age 1. Mothers rated children's social behaviors on the two-part Eyberg Child Behavior Inventory. Its intensity scale score represented frequencies with which a child showed any of 36 behaviors. Its problem scale score was the number of behaviors a mother perceived as a problem for her. Intensity scale score means did not differ significantly for EROM and MNOM children [F(1, 44) = 1.56, p ≥ .05], suggesting no differences in the frequency of occurrence of problem behaviors for the two groups. Problem scale score means differed significantly [F(1, 44) = 5.46, p < .05], suggesting that mothers perceived more behavioral problems in EROM than in MNOM children. Thirteen EROM children had conduct problems (scores above either scale's cutoff), versus two MNOM children. A significant relationship between otitis-media history and conduct problems was shown by a chi-square test [χ² (df=1)= 5.57, p < .05 . Children's age, sex, and birth order did not influence mothers' ratings. Mothers' general anxiety, measured by the Anxiety Scale Questionnaire, influenced their ratings of children's social behaviors on each individual ECBI scale, but did not have an effect after children were described as having conduct-problem or normal behavior. EROM children were rated as having conduct problems significantly more often than were MNOM children. The findings have restricted generalizability, but suggest that psychologists, pediatricians, and speech/hearing pathologists and clinicians may need to help mothers reduce children's conduct problems related to early otitis media.

M. Tech. Pharmaceutical Sciences / Bacteria are present in natural environments and can develop into biofilms. Mucus-like extracellular matrix produced by biofilms provides protection to biofilm formers by inhibiting antimicrobial penetration and de-activating antimicrobial molecules, while allowing strong attachment onto surfaces. Biofilm development is associated with otitis media and cystic fibrosis. In this study, selected biofilm-formers implicated in otitis media and cystic fibrosis, Pseudomonas aeruginosa and Moraxella catarrhalis, were used to evaluate the effect of combinations of mucoactive substances and antibiotics against their biofilms. Microtiter-plate assay and optical density measurements were used to evaluate antimicrobial and antibiofilm activities. Confocal scanning laser microscopy was used to visualise the effect of selected treatments against biofilms.

Children have difficulty with reading for a number of reasons. One of these reasons may be temporary conductive hearing loss (TCHL) in preschool, which can be caused by otitis media (persistent fluid build-up in the middle ear), one of the most frequent medical issues in preschool children (Burt & Schappert, 2004). While otitis media can be treated medically, the duration of hearing loss and the age at which the hearing loss occurred may contribute to future reading difficulties (Easterbrooks, Lederberg, Miller, Bergeron & Connor, 2008). The literature surrounding the connection between otitis media, TCHL, and reading development is inconclusive. In addition, the nature of interdisciplinary communication to discuss the potential future challenges for children who have had TCHL is unclear. Little is known about how professionals communicate with parents about these challenges, and about how parents can best support their children. This research focused on providing detailed descriptions of how medical and educational professionals reported they communicated with each other and with parents about the potential reading risks associated with TCHL. This study followed standard qualitative research methods to conduct in-depth interviews with six medical and educational professionals and with two parents of children with TCHL. Results from this study have revealed important aspects that characterize what, when, and how professionals inform parents of children with TCHL about potential future reading problems. The knowledge gained through this research can guide future research and have practical implications for medical and educational professionals and provides recommendations for how parents are informed about potential future reading difficulties. / Thesis (Master, Education) -- Queen's University, 2011-09-27 11:48:59.805

Background: There is a need for more well-controlled research on the relationship between vision and hearing limitations and emergent literacy to inform early literacy intervention. Two highly prevalent difficulties of early childhood, poor distance visual acuity and otitis media with effusion (OME), have been shown to be associated with literacy achievement. There is little research, however, on the relationship between these conditions and emergent literacy. Objective: The objective of this study was to assess the relationships between (1) distance visual acuity and emergent letter name knowledge, and (2) OME status and emergent letter name knowledge in children at school entry. Method: A prospective cohort of children (N=298) was recruited at school entry. Participants were aged 5, did not require special education for high needs and spoke a nationally recognized language of New Zealand. Distance vision and tympanometry testing was performed and a parent report of OME was obtained. The Wechsler Individual Test of Letter Name Knowledge and the Vocabulary and Block Design sub-tests of the Wechsler Intelligence Scale for Children were administered. Covariates of reading achievement were also measured. Results: Twenty three percent of children knew fewer than 4 letters at school entry, 31.9% had marginal distance visual acuity of 6/9 in one or both eyes and 37.2% had a history of ear infections and/or a B tympanometry test at school entry. Logistic regression tests demonstrated that both 6/9 vision (OR= 2.069, CI0.95=0.999-4.227) and OME status 10 (OR=1.846, CI0.95=1.034-3.297) were significantly associated with low letter name knowledge at school entry, controlling for covariates of emergent literacy. Another analysis showed that children with 6/9 vision and/or OME at school entry were also at greater risk for low letter knowledge (OR=2.187, CI0.95=1.067 – 4.484) than children with 6/6 vision and no OME at school entry. Conclusions: The results of the current study indicate that 6/9 distance vision and OME are risk factors for low letter name knowledge at school entry. These factors warrant greater consideration with regard to early literacy intervention, classroom teaching practices and future research.