• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.1
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• pp.42-56
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• 2024

Objectives : The purpose of this literature review is to analyze herbal medicine's efficacy in pediatric otitis media. Methods : Six databases(Pubmed, CNKI, RISS, KISS, KCI, OASIS) were used to search randomized controlled trials related to pediatric otitis media until October 2023. Total nine studies written in Korean, English, Chinese, and German were selected and analyzed. Results : Recurrent otitis media was treated with Kami-hyunggyeyungyo-tang, Echinacea purpurea, and Sipjeondaebo-tang. For acute otitis media, Otovowen and Sopunghaedok capsule were administered, while Oryung-san, Chongyi-tang, and Changyija-san were used for otitis media with effusion. Glycyrrhizae Radix(甘草) and Cnidii Rhizome(川芎) were the most frequently used. Objective measures showed superior effects in the herbal medicine group for otoscopic examination, impedance test, audiometry, and fever. Sipjeondaebo-tang exhibited significant efficacy in recurrent otitis media treatment, possibly related to warming-interior medicine(溫裏藥) or blood-invigorating medicine(血分藥). Conclusion : Analyzing studies revealed herbal medicine's superiority for pediatric otitis media over conventional approaches.

• The Journal of Pediatrics of Korean Medicine
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• v.13 no.1
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• pp.205-226
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• 1999

Background: Pediatric chronic sinusitis and otitis media were often recurred, so patients are increased. But there are a few reports on the herbal medicine therapy treating pediatric chronic sinusitis and otitis media, this report was studied. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis before and after treatment using computed tomograpy(CT). To compared before and after treatment of otitis media using earscope. Materials and methods: Eighteen patients (10 mail and 8 femail) treated in our hospital between April 1998 and June 1999 were studied. Ages ranged from 4 to 11 years (mean age :6.6 years). All patients had a underlying family history (allergy or sinusitis of parents or brothers). In the past history, 56% patients atopic dermatitis. Illness period was from 2 to 48 months (mean period: 13.9 month). Mean duration of treatment were 95.6 days. To ascertain the efficacy of treatment, CT were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms. Results: The symptoms of otitis media were hearing loss and edemation. The symptoms of chronic sinusitis were nasal obstruction(78%), purulunt or mucosal discharge(67%), cough(61%), postnasal dripping (44%) and nose bleeding(28%). Before the oriental treatment in the our hospital, all patients have been antibiotic therapy at the pediatrics or during the three months and recurrent otitis media from twice to tenth Correlation illness period and. treatment period were not significant statistically. Conclusion: The treatment period of the otitis media was more short than chronic sinusitis because the otitis media had been not recurrent on the 30 percent improvement of the chronic sinusitis. We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis and otitis media using earscope and CT.

• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.39-49
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• 2002

The author measured IL-8 and $TGF-{\beta}1$ levels of 84 ears - 48 ears of them had treated by antibiotics, 36 of them by Kamihyunggyeyungyotang(KHY) - of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IL-8 in KHY group was significantly lower than that in antibiotics group(p<0.05). 2. The level of $TGF-{\beta}1$ in KHY group was lower than that in antibiotics group. According to above results, KHY is considered to be used for treating recurrent otitis media with effusion by controlling the production of interleukin-8 and transforming $growthfactor-{\beta}1$.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.87-100
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• 2001

Otitis media with effusion(OME) is the second most common disease in childhood after upper respiratory tract infection. Antibiotic treatment and ventilation tube insertion are the common treatment. The emergence of drug-resistant streptococcus pneumoniae (DRSP) has implications for the primary care provider who treats acute otitis media(AOM) in children. OME need not be treated with antibiotics unless the effusion has been present for 3 to 4 months. Tympanostomy tubes are an effective treatment for both chronic OME and recurrent AOM. But the complications of tympanostomy tubes are serious Kamihyunggyeyungyotang is known to have antiinflmmatory and antiallergic effect. In this study, we investigated the clinical efficacy of the Kamihyunggyeyungyotang on recurrent otitis media with effusion prospectively by using pneumatoscopy, tympanogram, pure tone audiometry, and radiologic study. The patients who had treated by antibiotics was used as control. The statistical analysis was done by Mann-Whitney test and the significance was considered when the p value was less than 0.05. The general outcome was significantly higher in Kamihyunggyeyungyotang group than in antibiotic group. The recovery rate from grade 3 to 0 in pneumatoscopy was 42.5% but the control was 6%. Hearing gain was improved 71% and pnuematization was returned 70%.

• Journal of Mycology and Infection
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• v.23 no.4
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• pp.105-110
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• 2018

Background: Otomycosis is a fungal infection that comprises 7~10% of outer ear infections. Although the occurrence is higher in humid climates, relatively few studies have investigated otomycosis occurrences in humid environments. While recurrent chronic otitis media discharge in the ear creates a milieu in which otomycosis is likely to occur, investigations of otomycosis co-occurring with chronic otitis media have been rare. Objective: To examine the characteristics of patients with otomycosis co-occurring with chronic otitis media and identify causative fungi. Methods: The study included 60 patients with chronic otitis media who presented typical otomycosis findings in the outer ear canal and the presence of fungi. Patients were treated in the department of otolaryngology, Daegu Catholic University Medical Center, between July 2011 and June 2018. Results: The mean patient age was 57.77 years, and our study included 20 men and 40 women (p=0.010). The lesion was on the right in 39 patients and on the left in 21 (p=0.020). Ear discharge was the most common chief complaint at diagnosis. Of the 54 patients over age 19, 10 had diabetes (18.5%). Aspergillus was causative in 29 patients and Candida in 31. Aspergillus niger was identified in 15 patients, Aspergillus sp. in 14, Candida parapsilosis in 12, Candida sp. in six, and Candida albicans in five. Conclusion: Otomycosis and chronic otitis media co-occurrences increase with age. The Aspergillus and Candida genera were similar in proportion. A. niger was the most common Aspergillus species, while C. parapsilosis was the most common Candida.

• IMMUNE NETWORK
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• v.7 no.2
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• pp.75-79
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• 2007

Background: Defective or immature antibody responses to pathogens in children may explain the increased susceptibility to acute otitis media. However, there is no study in Korea patients whether a correlation exists between otitis media with effusion and the levels of serum immunoglobulins, IgG subclasses, IgA, IgM and IgE. Methods: 45 children with otitis media with effusion more than 4 episodes in 12 months or 3 episodes in 6 months, 62 children with otitis media with effusion less than 3 episodes in 12 months and 102 children for control group took part in the study at the Department of Otorhinolaryngology of the KyungHee University from May 2004 to Feburary 2007. Serum immunoglobulin levels were determined by nephelometry. And then the relationship between otitis media with effusion and serum immunoglobulin level was evaluated. Results: In otitis media prone group, serum IgG1, IgG2, IgG4, and IgA level was lower than those level of control group, it was significantly decreased (p<0.05). In otitis media group, serum IgA, IgE, and IgG4 level was lower than those level of control. But it was not statistically significant (p>0.05). Conclusion: Lower immunoglobulins in children with otitis media with effusion suggest a generalized decreased antibody responses. Lower levels of serum IgG1, IgG2, IgG4, and IgA may be related with chronicity or intractability of otitis media with effusion.

• IMMUNE NETWORK
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• v.8 no.2
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• pp.59-65
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• 2008

Background: Toll-like receptors (TLRs) detect microbial infection and can directly induce innate host defense responses, which are thought to play critical roles in protecting the tubotympanum from infection. However, little is known about the relationship between TLRs, which are related to innate immunity, and immunoglobulins, which are related to adaptive immunity, in recurrent otitis media with effusion (OME). We therefore investigated the expression of TLR2 and TLR4 and immunoglobulin in children with OME. Methods: The study population consisted of 72 children with OME, 31 with more than 4 episodes in 12 months or more than 3 episodes in 6 months (otitis-prone group), and 41 with fewer than 3 episodes in 12 months (non-otitis prone group). The expression in middle ear effusion of TLR2 and TLR4 mRNA, as determined by Real time- -polymerase chain reaction (RT-PCR), and the concentrations of IgG, IgA, and IgM, as determined by Enzyme-linked immunosorbent assay(ELISA), were compared between the two groups. Results: Expression of TLR2 and TLR4 mRNA was lower in the otitis prone than in the non-otitis prone group, but the difference was not statistically significant (p>0.05). Between group differences in the concentrations of IgG, IgA and IgM in effusion fluid were not significant (p>0.05), and there were no correlations between immunoglobulin concentration and the expression of TLR2 and TLR4. Conclusion: Although there was a trend toward lower expression of TLR2 and TLR4 in the otitis-prone group, the differences, and those in immunoglobulin concentration, did not differ significantly between the otitis-prone and non-prone groups.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.131-153
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• 2001

The author measured IgG1, IgG2, IgG3 and IgG4 levels of 22 ears-11 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang-of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IgG1 in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P=0.002). 2. The level of IgG2 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.178). 3. The level of IgG3 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.215). 4. The level of IgG4 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.198). According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by controlling the production of immunoglobulins.

• The Journal of Pediatrics of Korean Medicine
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• v.13 no.2
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• pp.149-170
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• 1999

The author measured IL-2, IL-4, IL-6, TNF-${\alpha}$ and total protein(TP) level of middle ear effusion(MEE) of 24 ears - 13 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang - of pediatric recurrent otitis media with effusion(PROME) using ELISA assay, and compared the level of cytokines(pg/ml)/TP(mg/dl). And investigated the clinical finding in those children. The results were obtained as follows: 1. The level of IL-2／TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.05). 2. The level of IL-4/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.0l). 3. The level of IL-6/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.05). 4. The level of TNF-${\alpha}$/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.01) 5. 79.1% of children with recurrent otitis media with effusion(ROME) were also complicated to chronic sinusitis. The children's t-test was used to make a statistical comparison between the groups. According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by control produce of cytokines which are connected with inflammatory reaction.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.308-311
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• 2003

Clinical outcomes of dogs treated for end-stage otitis extema with total ear canal ablation (TECA) combining lateral bullar osteotomy (LBO) at Veterinary medical teaching hospital of Seoul National University from 2001 to 2003 were evaluated. In 14 dogs, 23 ears, the operation was successful in alleviating all clinical signs of otitis externa and media. The main complication after TECA combining LBO were facial nerve paralysis and the others were recurrent infection and the formation of fistula and cyst. Two cases were tumors. One was ceruminous gland adenoma and the other was squamous cell carcinoma. The operation successfully resolved the original problems in 100% (23 of 23) of the surgically treated ears of these dogs.