The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Carrol Gamble - One of the best experts on this subject based on the ideXlab platform.
-
systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
Cochrane Database of Systematic Reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
-
The Cochrane Library - Systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
The Cochrane database of systematic reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
Zhengcai Lou - One of the best experts on this subject based on the ideXlab platform.
-
Assessment and spontaneous healing outcomes of traumatic Eardrum Perforation with bleeding.
American journal of otolaryngology, 2017Co-Authors: Zhong-hai Jin, Zi-han Lou, Zhengcai LouAbstract:Abstract Objective This study investigated the influence of the degree of bleeding from the remnant Eardrum on the spontaneous healing of human traumatic tympanic membrane Perforations (TMPs). Study design A case series with chart review. Setting A tertiary university hospital. Materials and methods The clinical records of traumatic TMP patients who met the case selection criteria were retrieved and categorized into two groups based on the documented degree of bleeding from the remnant Eardrum: with and without bleeding. The demographic data and spontaneous healing outcomes (i.e., healing rate and duration) of these two TMP types were analyzed using the chi-squared test or t -test. Results One-hundred and eighty-eight cases met the inclusion criteria and were analyzed. Of these, 58.5% had Perforations without bleeding and the remaining 41.5% had Perforations with bleeding. The overall closure rate at the end of the 3-month follow-up period was 90.9% for Perforations without bleeding and 96.2% for Perforations with bleeding; the difference was not statistically significant (P > 0.05). However, the average closure time differed significantly between the two groups (P 0.05) between the groups without and with bleeding within 4 weeks, while the closure rate of large-sized Perforations was significantly different between the groups without and with bleeding (27.2 vs. 75%, P = 0.0). Conclusion This study shows that traumatic TMPs with bleeding significantly shortened the closure time compared to TMPs without bleeding. This finding indicates a significant correlation between the prognosis of traumatic TMPs and the degree of Eardrum bleeding: severe bleeding from and a hematoma in the remnant Eardrum appear to be good signs.
-
Natural evolution of an Eardrum bridge in patients with a traumatic Eardrum Perforation.
European Archives of Oto-Rhino-Laryngology, 2013Co-Authors: Zhengcai LouAbstract:Although the “Eardrum bridge” of traumatic tympanic membrane Perforations (TMPs) is very little seen, the underlying natural evolution during the healing process are still unknown.The aim of this retrospective study was to evaluate the natural evolution of the “Eardrum bridge” of TMPs. The data for 36 patients with barotrauma-associated traumatic TMPs with an “Eardrum bridge” between January 2006 and December 2007 were retrieved. The Eardrum bridge was completely liquefied due to infection in one patient. The bridge gradually became necrotic and incorporated into the new Eardrum in four patients, and the healed Eardrum formed a retraction pocket. In nine patients, epithelial hyperplasia occurred on both sides of the Eardrum bridge at the edges, and the bridge became incorporated into the new Eardrum, which became very thin over time. However, in 22 patients, the Eardrum bridge gradually became necrotic, finally forming a yellow crust-like substance and migrating to the external auditory canal (EAC); it was not incorporated into the new Eardrum. The closure of the Perforation depended on stratified epithelial migration at the Perforation edges near the Eardrum bridge, resulting in a normal morphology of the healed Eardrum. The present study shows that the Eardrum bridge has a different natural evolution during the healing process in patients with a TMP. Most Eardrum bridges gradually became necrotic and migrated toward the EAC, and stratified epithelial migration occurred at the Perforation edges near the Eardrum bridge and closed the Perforation. However, a few Eardrum bridges gradually became necrotic or developed epithelial hyperplasia, then became incorporated into the new Eardrum, resulting in the formation of a retraction pocket and the development of atrophy. Thus, long-term follow-up and histological examination of a larger sample is necessary.
-
spontaneous healing of traumatic Eardrum Perforation outward epithelial cell migration and clinical outcome
Otolaryngology-Head and Neck Surgery, 2012Co-Authors: Zhengcai LouAbstract:ObjectiveTo characterize the otoendoscopic features of traumatic tympanic membrane Perforations (TMPs) with outward-migrating epithelium at the Perforation edges and to evaluate the spontaneous hea...
-
outcome of children with edge everted traumatic tympanic membrane Perforations following spontaneous healing versus fibroblast growth factor containing gelfoam patching with or without edge repair
International Journal of Pediatric Otorhinolaryngology, 2011Co-Authors: Zhengcai Lou, Jian YangAbstract:Abstract Objectives To retrospectively analyze the outcome of children with edge-everted tympanic membrane (TM) Perforations following spontaneous healing and fibroblast growth factor-containing gelfoam patching with or without repair of the edge flaps. Methods Medical records of children with TM Perforations who underwent spontaneous healing ( n = 69) or received fibroblast growth factor (FGF)-containing gelfoam patching treatment ( n = 67) were retrieved from the Records Department of the Wenzhou Medical College-Affiliated Yiwu Hospital in China. The demographic data and outcome measures were analyzed and compared between these two groups of patients. Results Patching with FGF-containing gelfoams significantly improved the healing rate ( P P P > 0.05), despite a slightly reduced healing rate (96.4% versus 100%) and a slightly shorter closure time (10.2 ± 2.6 d versus 10.9 ± 3.3 d) observed as compared with no edge repair. The everted Perforation edge flaps formed scabs during the process of spontaneous healing whereas they underwent retraction and eventually dissolved during the process of gelfoam patching-facilitated healing. Conclusions As compared with spontaneous healing, FGF-containing gelfoam patching had an improved outcome in children with edge-everted traumatic Eardrum Perforation. Repair of everted edge flaps did not affect the healing outcome. Our results suggest that growth factor-containing gelfoam patching without Eardrum flap repair would offer a feasible option to manage traumatic tympanic membrane Perforations in children.
-
relation between Eardrum flap area and healing outcome of traumatic Eardrum Perforation
Chinese journal of traumatology, 2011Co-Authors: Zhengcai Lou, Yong-mei Tang, Jia-hai ChenAbstract:Abstract Objective To retrospectively study the clinical effects of Eardrum flap area on the healing outcome following traumatic Perforation. Methods Totally 291 traumatic Eardrum Perforations with in-/everted edges were included in this study. They were randomly divided into three groups and received conservative treatment, epidermal growth factor (EGF) via Gelfoam patching, or edge-approximation plus Gelfoam patching respectively. Patients in each group were further divided into two subgroups according to the Eardrum flap area ≤1/2 or >1/2 of the Perforation size. The healing rate and mean closure time after tympanic membrane Perforation were evaluated at three months. Results Of the total 291 participants, 281 were included in the final statistical analysis. The area of curled edge did not affect the healing outcome significantly in any groups (P>0.05). The healing rate varied slightly: 90.7% vs 92.3% in spontaneous healing group, 98.2% vs 97.4% in EGF via Gelfoam patching group, and 96.5% vs 100% in edge-approximation plus Gelfoam patching group. In addition, in all groups the area of curled edge did not affect the mean closure time significantly (P>0.05). The closure time was (32.3±2.4) d vs (30.6±3.1) d in sponaneous healing group, (13.4±2.5) d vs (13.1±1.9) d in EGF via Gelfoam patching group, and (11.9±3.1) d vs (12.2±2.1) d in edge-approximation plus Gelfoam patching group. Conclusion The Eardrum flap area of traumatic Eardrum Perforation does not significantly affect the clinical outcomes.
Carolyn Macfadyen - One of the best experts on this subject based on the ideXlab platform.
-
systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
Cochrane Database of Systematic Reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
-
The Cochrane Library - Systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
The Cochrane database of systematic reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
Jose M Acuin - One of the best experts on this subject based on the ideXlab platform.
-
systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
Cochrane Database of Systematic Reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
-
The Cochrane Library - Systemic antibiotics versus topical treatments for chronically discharging ears with underlying Eardrum Perforations
The Cochrane database of systematic reviews, 2006Co-Authors: Carolyn Macfadyen, Jose M Acuin, Carrol GambleAbstract:Background Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. Objectives To compare systemic antibiotics and topical antiseptics or antibiotics (excluding steroids) for treating chronically discharging ears with an underlying Eardrum Perforation (CSOM). Search methods The Cochrane ENT Disorders Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2005), MEDLINE (January 1951 to March 2005), EMBASE (January 1974 to March 2005), LILACS (January 1982 to March 2005), AMED (1985 to March 2005), CINAHL (January 1982 to March 2005), OLDMEDLINE (January 1958 to December 1965) PREMEDLINE, Metadatabase of registers of ongoing trials (mRCT), and article references. Selection criteria Randomised controlled trials; any systemic versus topical treatment (excluding steroids); participants with CSOM. Data collection and analysis One author assessed eligibility and quality, extracted data, entered data into RevMan; two authors provided a second assessment of titles and abstracts, and inputted where there was ambiguity. We contacted investigators for clarifications. Main results Nine trials (833 randomised participants; 842 analysed participants or ears). CSOM definitions and severity varied; some included mastoid cavity infections, other diagnoses, or complications. Methodological quality varied; generally poorly reported, follow-up short, handling of bilateral disease inconsistent. Topical quinolone antibiotics were better than systemic antibiotics at clearing discharge at 1-2 weeks: relative risks (RR) were, 3.21 (95% confidence interval (CI) 1.88 to 5.49) using systemic non-quinolone antibiotics (2 trials, N = 116), and 3.18 (1.87 to 5.43) using systemic quinolone (3 trials, N = 175); or 2.75 (1.38 to 5.46) in favour of systemic plus topical quinolone over systemic quinolone alone (2 trials, N = 90). No statistically significant benefit was seen at 2-4 weeks for topical non-quinolone antibiotic (without steroids) or topical antiseptic over systemic antibiotics (mostly non-quinolones), but numbers were small: one trial tested topical non-quinolones (N = 31); two tested antiseptics (N = 152). No benefit of adding systemic to topical treatment at 1-2 weeks was detected either, although evidence was limited (three trials, N = 204). Evidence regarding safety was generally weak. Adverse events reported were generally mild, although hearing worsened by ototoxicity (damaging auditory hair cells) was seen with chloramphenicol drops (non-quinolone antibiotic). Authors' conclusions Topical quinolone antibiotics can clear aural discharge better than systemic antibiotics; topical non-quinolone antibiotic (without steroids) or antiseptic results are less clear. Evidence regarding safety was weak. Further studies should clarify topical non-quinolones and antiseptic effectiveness, assess longer-term outcomes (for resolution, healing, hearing, or complications), and include further safety assessments, particularly to clarify the risks of ototoxicity and whether there may be fewer adverse events with topical quinolones than other topical or systemic treatments.
Berthold Langguth - One of the best experts on this subject based on the ideXlab platform.
-
Trauma-Associated Tinnitus
The Journal of head trauma rehabilitation, 2014Co-Authors: Peter M. Kreuzer, Michael Landgrebe, Veronika Vielsmeier, Tobias Kleinjung, Dirk De Ridder, Berthold LangguthAbstract:Up to 53% of individuals suffering from traumatic brain injuries develop tinnitus. To review the current literature on trauma-associated tinnitus in order to provide orientation for the clinical management of patients with trauma-associated tinnitus. A systematic literature search has been conducted in PubMed database applying the search terms posttraumatic tinnitus and trauma-associated tinnitus. Results have been complemented by related studies, book chapters, and the authors' clinical experience. Not only mechanical, pressure-related, or noise-related head traumata but also neck injuries and emotional trauma can cause tinnitus. Exact diagnosis is essential. Disorders such as ossicular chain disruption, traumatic Eardrum Perforation, or perilymphatic fistula can be surgically treated. It should also be considered that pulsatile tinnitus can be a sign of life-threatening disorders such as carotid cavernous fistulas, arteriovenous malformations, and carotid dissections. Also, posttraumatic stress disorder should be taken into consideration as a potential contributing factor. There is an evident mismatch between the high incidence of trauma-associated tinnitus and scarce literature on the topic. A consistent and-at best-standardized assessment of tinnitus- and hearing-related sequelae of trauma is recommended both for the improvement of clinical care and for a deeper understanding of the various pathophysiological mechanisms of trauma-associated tinnitus.
