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Nowak C, Tanaka L, Bobin S, Nevoux J. [The infections of the ear]. Presse Med 2017; 46:1071-1078. [PMID: 29097032 DOI: 10.1016/j.lpm.2017.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 11/26/2022] Open
Abstract
In front of external otitis in spite of a well-conducted treatment, especially in immunodeficient patient, it is always necessary to look for an osteomyelitis of the skull base that requires an urgent parenteral antibiotic treatment of several weeks. Acute otitis media (AOM) is the most common bacterial infection of the child. In children under 2 years with purulent AOM, antibiotic therapy with amoxicilline is systematic for a period of 8-10 days. After 2 years of age and with mild symptoms of AOM, symptomatic treatment may be justified as first-line treatment. Chronic otitis media is frequent after an episode of AOM and becomes chronic only after 3 months of evolution. Grommets reduce the frequency of AOM episodes. All AOM complicated with meningitis requires monitoring by audiogram and MRI of the ear.
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Affiliation(s)
- Catherine Nowak
- AP-HP, hôpital Bicêtre, service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 94270 Le Kremlin-Bicêtre, France.
| | - Lei Tanaka
- AP-HP, hôpital Bicêtre, service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 94270 Le Kremlin-Bicêtre, France
| | - Serge Bobin
- AP-HP, hôpital Bicêtre, service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 94270 Le Kremlin-Bicêtre, France; Université Paris-Saclay, faculté de médecine, 94275 Le Kremlin-Bicêtre, France
| | - Jérôme Nevoux
- AP-HP, hôpital Bicêtre, service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 94270 Le Kremlin-Bicêtre, France; Université Paris-Saclay, faculté de médecine, 94275 Le Kremlin-Bicêtre, France; Inserm U1185, 94275 Le Kremlin-Bicêtre, France
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Chahed H, Dhaouadi A, Mediouni A, Kedous S, Bachraoui R, Zainine R, Ben Amor M, Beltaief N, Besbes G. [Facial nerve paralysis secondary to acute otitis media]. Presse Med 2014; 43:e135-9. [PMID: 24791653 DOI: 10.1016/j.lpm.2013.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/11/2013] [Accepted: 11/18/2013] [Indexed: 11/16/2022] Open
Abstract
OBJECTS To discuss clinical presentation and therapeutic approaches of facial paralysis in acute otitis media. METHODS We present five cases of facial palsy in children with acute otitis media managed in our ENT department during a period of 12 years (2001-2012). RESULTS The mean age was 14.2 years; sex ratio was 0.66. All patients presented with a facial asymmetry, but only 3 of them had otalgia before the onset of facial asymmetry. The facial palsy delay was 3.3 days. The ear examination showed that the tympanic membrane was congestive in 4 patients, associated with a bulging in 2 patients, and a small perforation in one patient. Our patients presented grade III to IV initial facial palsy according to House and Brackmann staging. Computed tomography scan revealed a dehiscence of the bony facial canal in one patient. Antibiotic therapy associated with intravenous corticosteroids was administered in all patients. All patients underwent a facial kinesis therapy. A progressive improvement of facial palsy was observed in 4 patients and complete recovery of facial function in one case. DISCUSSION Conservative treatment associating intravenous antibiotic and corticosteroids with or without myringotomy is the standard approach.
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Affiliation(s)
- Houda Chahed
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie.
| | - Afef Dhaouadi
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Azza Mediouni
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Skander Kedous
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Rim Bachraoui
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Rim Zainine
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Mohamed Ben Amor
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Najeh Beltaief
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
| | - Ghazi Besbes
- Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie
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