1
|
Kim H, Han JG, Park HY, Choung YH, Jang JH. Relationship Between Facial Bone Fractures and the Risk of Posttraumatic Complications: A Hypothesis on the Cushion Effect of the Facial Skeletons in Temporal Bone Fractures. J Korean Med Sci 2023; 38:e215. [PMID: 37431543 DOI: 10.3346/jkms.2023.38.e215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/21/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND This study investigated whether concomitant facial bone (FB) fractures reduce temporal bone (TB) injuries, such as posttraumatic facial palsy and vertigo, through an impact absorbing effect, so-called "cushion effect," in severe trauma patients. METHODS A total of 134 patients with a TB fracture were included. They were divided into two groups according to their concomitant facial fractures: group I (no FB fracture) and group II (FB fracture). We compared clinical characteristics, such as brain injury, trauma severity, and complications of TB fracture, between the two groups. RESULTS In group II, immediate facial palsy was more frequent (11.6% vs. 1.5% in group I), and the Injury Severity Score was higher (19.0 ± 5.9 vs. 16.7 ± 7.3, P = 0.020). Delayed facial palsy (12.3% in group I vs. 4.3% in group II) and posttraumatic vertigo (24.6% vs. 7.2%) occurred more often in group I. FB fractures significantly decreased the incidence of posttraumatic vertigo (odds ratio [OR], 0.276; 95% confidence interval [CI], 0.083-0.914). Intraventricular hemorrhage (OR, 20.958; 95% CI, 2.075-211.677), facial nerve canal injury (OR, 12.229; 95% CI, 2.465-60.670), and FB fractures (OR, 16.420; 95% CI, 1.298-207.738) increased the risk of immediate facial palsy. CONCLUSION Concomitant FB fractures reduced the risk of the occurrence of delayed facial palsy and posttraumatic vertigo in injured patients with TB fracture. Particularly, an anterior force may be reduced by the cushion effect of the bony fracture.
Collapse
Affiliation(s)
- Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Jang Gyu Han
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea.
| |
Collapse
|
2
|
Tang R, Zhang Z, Zhao P, Zhao L, Xu N, Yin H, Yang Z, Wang Z. A novel imaging scoring method for identifying facial canal dehiscence: an ultra-high-resolution CT study. Eur Radiol 2023; 33:2830-2839. [PMID: 36376528 PMCID: PMC10017601 DOI: 10.1007/s00330-022-09231-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Facial canal dehiscence (FCD), typically found in the tympanic segment, is a risk factor for facial nerve injury. An imaging scoring method was proposed to identify FCD based on ultra-high-resolution CT. METHODS Forty patients (21 females and 19 males, mean age 44.3 ± 17.4 years), whose tympanic facial canal (FC) was examined during otological surgery, were divided into the FCD group (n = 29) and the control group (n = 11) based on surgical findings. Imaging appearance of tympanic FC was scored 0-3: 0 = no evident bony covering, 1 = discontinuous bony covering with linear deficiency, 2 = discontinuous bony covering with dotted deficiency, and 3 = continuous bony covering. Both lateral and inferior walls were assigned a score as LFCD and IFCD, respectively. An FCD score was calculated as LFCD + IFCD. The diagnostic value of the FCD score was tested using the ROC curve. RESULTS The inter-observer agreement was moderate for the lateral wall (Cohen's κ coefficient 0.416, 95% CI 0.193-0.639), and good for the inferior wall (Cohen's κ coefficient 0.702, 95% CI 0.516-0.888). In the FCD group, the most common appearance for both walls was discontinuous bony covering with linear deficiency (LFCD = 1, 22/29, 75.9%; IFCD = 1, 15/29, 51.7%). An FCD score of less than 4 was associated with high sensitivity (0.82) and specificity (0.93) for identifying FCD, with an AUC of 0.928. CONCLUSIONS Using the proposed scoring method, FCD score < 4 could identify FCD of the tympanic segment with high concordance with surgical findings. KEY POINTS • Imaging appearance of the tympanic facial canal (FC) is divided into four types based on ultra-high-resolution CT images. • The most common appearance of FC with facial canal dehiscence (FCD) is discontinuous bony covering with linear deficiency. • An FCD score, consisting of scores of the lateral and inferior walls, less than 4 is highly indicative of FCD.
Collapse
Affiliation(s)
- Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhengyu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Lei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China.
| |
Collapse
|
3
|
Al-Shehri AM, Al-Zomia AS, Alayash AF, M Al Hunaif A, A Mansour A, Alqahtani M, A Asiri O, A Alserhan S. Association Between Acute Otitis Media and Inner Ear Disorders Among Adults in Aseer Region. Cureus 2021; 13:e19556. [PMID: 34926038 PMCID: PMC8671081 DOI: 10.7759/cureus.19556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Acute otitis media (AOM) is an infection of the middle ear that produces pain, fever, and discharge, as well as hearing loss. It is one of the most common problems that pediatricians encounter. Almost 80% of children have had at least one episode of AOM, and between 80% and 90% have had at least one episode of otitis media with effusion before entering school. Methods The cross-sectional study is conducted among male and female patients, adults, and children who visited two of the largest government hospitals in the Aseer region in Southern Saudi Arabia (Aseer Central Hospital and Khamis Mushait General Hospital). The children and adults with AOM who visited the hospitals were traced by searching the medical record system by the keyword "acute otitis media." Two authors extracted data from the medical record and patients. After extracting data, the patient will be called through mobile phone to invite them to participate in the study. If the patient agrees to participate, she/he would be sent through email link containing an encrypted and high-security electronic signature to obtain his/her consent. Conclusion One of the most common pediatric infections is otitis media (inflammation of the middle ear). Children are more often than adults to get otitis media, and the majority of cases are treated with antibiotics. Clinicians commonly miss the acute stage of the disease, especially in children under the age of five. Delay or omission of diagnoses leads to inefficient management and an increased risk of negative effects.
Collapse
Affiliation(s)
| | - Ahmed S Al-Zomia
- Surgery, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Ahmed F Alayash
- Surgery, College of Medicine, King Khalid University (KKU), Abha, SAU
| | | | | | - Mushary Alqahtani
- Medicine, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Omar A Asiri
- ENT, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Saeed A Alserhan
- ENT, College of Medicine, King Khalid University (KKU), Abha, SAU
| |
Collapse
|
4
|
Van Bonn SM, Schraven SP, Schuldt T, Heimesaat MM, Mlynski R, Warnke PC. Chronic otitis media following infection by non-O1/non-O139 Vibrio cholerae: A case report and review of the literature. Eur J Microbiol Immunol (Bp) 2020; 10:186-191. [PMID: 32796134 PMCID: PMC7592514 DOI: 10.1556/1886.2020.00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/08/2020] [Indexed: 12/18/2022] Open
Abstract
We report a case of a chronic mesotympanic otitis media with a smelly purulent secretion from both ears and recurrent otalgia over the last five years in a six-year-old girl after swimming in the German Baltic Sea. Besides Staphylococcus aureus a non-O1/non-O139 Vibrio cholerae strain could be isolated from patient samples. An antibiotic therapy with ciprofloxacin and ceftriaxone was administered followed by atticotomy combined with tympanoplasty. We conclude that V. cholerae should not be overlooked as a differential diagnosis to otitis infections, especially when patients present with extra-intestinal infections after contact with brackish- or saltwater aquatic environments.
Collapse
Affiliation(s)
- Sara M Van Bonn
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner Rostock University Medical Center, Rostock, Germany
| | - Sebastian P Schraven
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner Rostock University Medical Center, Rostock, Germany
| | - Tobias Schuldt
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner Rostock University Medical Center, Rostock, Germany
| | - Markus M Heimesaat
- 3Institute of Microbiology, Infectious Diseases and Immunology Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Robert Mlynski
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner Rostock University Medical Center, Rostock, Germany
| | - Philipp C Warnke
- 2Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medicical Center, Rostock, Germany
| |
Collapse
|
5
|
An intact bony tympanic facial canal does not protect from secondary facial paresis in adult acute otitis media. The Journal of Laryngology & Otology 2020; 134:409-414. [PMID: 32425144 DOI: 10.1017/s0022215120000973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis. METHOD A retrospective case-control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography. RESULTS Forty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6-55.6). CONCLUSION Prevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.
Collapse
|
6
|
Posa M, Nestor K, Coleman R, Rajderkar D, Kelly MN. An 11-Month-Old Male With Acute-Onset Left-Sided Facial Paralysis. Clin Pediatr (Phila) 2019; 58:594-598. [PMID: 30897949 DOI: 10.1177/0009922819837354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Molly Posa
- 1 University of Florida, Gainesville, FL, USA
| | | | | | | | | |
Collapse
|
7
|
Kechker P, Senderovich Y, Ken-Dror S, Laviad-Shitrit S, Arakawa E, Halpern M. Otitis Media Caused by V. cholerae O100: A Case Report and Review of the Literature. Front Microbiol 2017; 8:1619. [PMID: 28894440 PMCID: PMC5581382 DOI: 10.3389/fmicb.2017.01619] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/09/2017] [Indexed: 12/20/2022] Open
Abstract
Infections due to Vibrio cholerae are rarely documented in Israel. Here we report a case of recurrent otitis media in a young male, caused by V. cholerae non-O1/O139. This extra-intestinal infection was caused by V. cholerae O100 and has been associated with freshwater exposure and travel. Symptoms of chronic periodic earaches along with purulent exudate began about one week after the patient suffered a water skiing accident on a river in Australia. The condition lasted for three years, until his ear exudate was examined in a clinical laboratory, diagnosed and treated. Five bacterial isolates were identified as V. cholerae O100. The isolates were screened for genetic characteristics and were found positive for the presence of hapA, hlyA, and ompU virulence genes. All isolates were negative for the presence of ctxA. Based on antibiogram susceptibility testing, ciprofloxacin ear drops were used until the patient’s symptoms disappeared. This case demonstrates that exposure to freshwater can cause otitis media by V. cholerae non-O1/O139 in young and otherwise healthy humans.
Collapse
Affiliation(s)
- Peter Kechker
- W. Hirsch Regional Microbiology Laboratory, Clalit Health ServicesHaifa, Israel
| | - Yigal Senderovich
- W. Hirsch Regional Microbiology Laboratory, Clalit Health ServicesHaifa, Israel
| | - Shifra Ken-Dror
- W. Hirsch Regional Microbiology Laboratory, Clalit Health ServicesHaifa, Israel
| | - Sivan Laviad-Shitrit
- Department of Evolutionary and Environmental Biology, Faculty of Natural Sciences, University of HaifaHaifa, Israel
| | - Eiji Arakawa
- National Institute of Infectious DiseasesToyama, Japan
| | - Malka Halpern
- Department of Evolutionary and Environmental Biology, Faculty of Natural Sciences, University of HaifaHaifa, Israel.,Department of Biology and Environment, Faculty of Natural Sciences, University of Haifa at OranimTivon, Israel
| |
Collapse
|
8
|
Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children. Curr Allergy Asthma Rep 2017; 16:72. [PMID: 27613655 DOI: 10.1007/s11882-016-0654-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.
Collapse
|
9
|
Xiang Y, Jin C, Wang W, Wang Z, Huang Y, Fan F, Ma Y, Zhang X, Xu W, Yin Y, He Y. The critical role of myeloperoxidase in Streptococcus pneumoniae clearance and tissue damage during mouse acute otitis media. Innate Immun 2017; 23:296-306. [PMID: 28359218 DOI: 10.1177/1753425917693907] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We have recently reported that neutrophils play a pivotal role in innate defense against Streptococcus pneumoniae ( Spn) during mouse acute otitis media (AOM). However, the underlying mechanism remains unclear. By constructing models of pneumococcal AOM in C57BL/6 mice and using a specific inhibitor in vivo, we investigated the role of myeloperoxidase (MPO), one of the most important protein components of neutrophils. Experiment results showed a significant increase in MPO production of the recruited neutrophils in Spn-infected mice. Neutrophils killed Spn in a MPO-dependent manner. MPO facilitated the generation of reactive oxygen species (ROS), and consequently promoted Spn clearance at an early stage and exacerbated tissue damage. Moreover, MPO induced neutrophil apoptosis and necrosis, which, in turn, worsened tissue damage. In summary, our study demonstrates that neutrophil MPO plays a paradoxical role in bacterial clearance and tissue damage in pneumococcal AOM.
Collapse
Affiliation(s)
- Yun Xiang
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Chunfang Jin
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China.,2 Department of Laboratory Medicine, Chongqing Traditional Chinese Medicine Hospital, Chongqing, People's Republic of China
| | - Wei Wang
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China.,3 The Sixth People's Hospital of Chongqing City, Chongqing, People's Republic of China
| | - Zimeng Wang
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Yifei Huang
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Fangmei Fan
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Yurong Ma
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Xuemei Zhang
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Wenchun Xu
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Yibing Yin
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| | - Yujuan He
- 1 Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, People's Republic of China
| |
Collapse
|
10
|
Acute Ataxia in Children: A Review of the Differential Diagnosis and Evaluation in the Emergency Department. Pediatr Neurol 2016; 65:14-30. [PMID: 27789117 DOI: 10.1016/j.pediatrneurol.2016.08.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 08/26/2016] [Indexed: 11/21/2022]
Abstract
Acute ataxia in a pediatric patient poses a diagnostic dilemma for any physician. While the most common etiologies are benign, occasional individuals require urgent intervention. Children with stroke, toxic ingestion, infection, and neuro-inflammatory disorders frequently exhibit ataxia as an essential-if not the only-presenting feature. The available retrospective research utilize inconsistent definitions of acute ataxia, precluding the ability to pool data from these studies. No prospective data exist that report on patients presenting to the emergency department with ataxia. This review examines the reported causes of ataxia and attempts to group them into distinct categories: post-infectious and inflammatory central and peripheral phenomena, toxic ingestion, neurovascular, infectious and miscellaneous. From there, we synthesize the existing literature to understand which aspects of the history, physical exam, and ancillary testing might aid in narrowing the differential diagnosis. MRI is superior to CT in detecting inflammatory or vascular insults in the posterior fossa, though CT may be necessary in emergent situations. Lumbar puncture may be deferred until after admission in most instances, with suspicion for meningitis being the major exception. There is insufficient evidence to guide laboratory evaluation of serum, testing should be ordered based on clinical judgement-recommended studies include metabolic profiles and screening labs for metabolic disorders (lactate and ammonia). All patients should be reflexively screened for toxic ingestions.
Collapse
|
11
|
Kim CH, Yang YS, Im D, Shin JE. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis. Acta Otolaryngol 2016; 136:559-63. [PMID: 26797398 DOI: 10.3109/00016489.2015.1132845] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conclusion The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. Objective This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. Methods From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. Results The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment.
Collapse
Affiliation(s)
- Chang-Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young Soo Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Donghyuk Im
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
12
|
Urík M, Machač J, Šlapák I, Hošnová D. Pott's puffy tumor: a rare complication of acute otitis media in child: a case report. Int J Pediatr Otorhinolaryngol 2015; 79:1589-91. [PMID: 26148429 DOI: 10.1016/j.ijporl.2015.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 06/19/2015] [Indexed: 11/18/2022]
Abstract
To describe a rare case of Potts' puffy tumor (PPT) in the zygomatic area, which developed as a complication of acute otitis media in a 6-year-old child. To date, only one case of PPT has been described in the literature as a complication of latent mastoiditis in an adult, and one case of PPT as a complication of acute mastoiditis in a 10-year-old child. Urgent surgical intervention, including evacuation of the purulent lesion, removal of inflamed soft tissue and osteolysis of the involved bone, and antromastoidectomy, intravenous treatment with broad-spectrum antibiotics, including G+, G-, anaerobes and fungi, and local therapy.
Collapse
Affiliation(s)
- Milan Urík
- Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno, Černopolní 9, 61300, Czech Republic.
| | - Josef Machač
- Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno, Černopolní 9, 61300, Czech Republic
| | - Ivo Šlapák
- Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno, Černopolní 9, 61300, Czech Republic
| | - Dagmar Hošnová
- Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno, Černopolní 9, 61300, Czech Republic
| |
Collapse
|
13
|
Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis? Int J Pediatr Otorhinolaryngol 2015; 79:1429-35. [PMID: 26141864 DOI: 10.1016/j.ijporl.2015.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 06/12/2015] [Accepted: 06/16/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis. METHODS A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time. RESULTS The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis. CONCLUSIONS Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media resembled more the bacteriology of acute mastoiditis than that of out-patient acute otitis media. The children hospitalized due to acute otitis media needed less surgical treatment and a shorter hospitalization than those hospitalized due to acute mastoiditis.
Collapse
|
14
|
Mattos JL, Colman KL, Casselbrant ML, Chi DH. Intratemporal and intracranial complications of acute otitis media in a pediatric population. Int J Pediatr Otorhinolaryngol 2014; 78:2161-4. [PMID: 25447953 DOI: 10.1016/j.ijporl.2014.09.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/23/2014] [Accepted: 09/25/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To review all cases intratemporal and intracranial complications of acute otitis media (AOM) in infants and children from 1998 to 2013. METHODS Retrospective chart review of 109 consecutive patients admitted for complications of AOM during a 15-year period at a tertiary-care children's hospital. The main outcomes are: (1) complications of AOM, (2) bacteriology, (3) management strategies. RESULTS In our population, complications included mastoiditis (86.1%), subperiosteal abscess (38%), facial nerve palsy (16.7%), sigmoid sinus thrombosis (8.3%) and epidural abscess (7.4%). Other complications included post-auricular cellulitis, otic hydrocephalus and elevated intracranial pressure, internal jugular thrombosis, cranial nerve VI palsy and Gradenigo's syndrome, labyrinthine fistula, sensorineural hearing loss, and cerebellar infarct. Sixty-one patients (56%) received antibiotics prior to presentation. Cultures revealed Streptococcus pneumoniae in 36 patients (33.3%), other bacteria in 30 patients (27.8%), and "no growth" in 33 patients (30.5%). Nine patients (8.3%) did not undergo culture. Of the patients with S. pneumoniae, 20 cultures (55%) were found to be multidrug-resistant. Eleven patients (10.2%) were treated non-surgically, 31 (31%) were treated with myringotomy and intravenous antibiotics. Forty patients (97.5%) presenting with subperiosteal abscess required mastoid surgery. Thirteen of 18 (72.2%) patients with facial paralysis had full recovery. Eight of 10 (80%) patients with epidural abscess empyema required mastoid surgery and incision and drainage of the abscess. CONCLUSION Complications of AOM are uncommon, yet continue to have potentially serious consequences. The bacteriology in this population reveals an increasing trend of multi-drug resistant S. pneumoniae as the causative organism.
Collapse
Affiliation(s)
- Jose L Mattos
- Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Ave., Pittsburgh, PA 15224, United States
| | - Kathryn L Colman
- Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Ave., Pittsburgh, PA 15224, United States
| | - Margaretha L Casselbrant
- Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Ave., Pittsburgh, PA 15224, United States
| | - David H Chi
- Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Ave., Pittsburgh, PA 15224, United States.
| |
Collapse
|
15
|
Abstract
Ataxia refers to motor incoordination that is usually most prominent during movement or when a child is attempting to maintain a sitting posture. The first part of the review focuses on the anatomic localization of ataxia--both within the nervous system and without--using a combination of historical features and physical findings. The remainder of the review discusses etiological considerations that vary depending on the age group under consideration. In infancy, certain specific diseases, such as opsoclonus myoclonus ataxia syndrome, must receive special mention because the underlying disease process may be amenable to surgical intervention. In the toddler- and school-age groups, certain conditions (such as stroke and acute cerebellitis) require immediate recognition and imaging, whereas others (such as post-infectious ataxia and concussion) require close follow-up. Finally, mention must be made of diseases outside of the central nervous system that can present with ataxia, such as Guillain-Barré syndrome.
Collapse
|
16
|
Barr JS, Katz KA, Hazen A. Surgical management of facial nerve paralysis in the pediatric population. J Pediatr Surg 2011; 46:2168-76. [PMID: 22075352 DOI: 10.1016/j.jpedsurg.2011.06.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND In the pediatric patient population, both the pathology and the surgical managements of seventh cranial nerve palsy are complicated by the small size of the patients. Adding to the technical difficulty is the relative infrequency of the diagnosis, thus making it harder to become proficient in the management of the condition. The magnitude of the functional and aesthetic deficits these children manifest is significantly troubling to both the patient and the parents, which makes immediate attention, treatment, and functional restoration essential. METHODS A literature search using PubMed (http://www.pubmed.org) was undertaken to identify the current state of surgical management of pediatric facial paralysis. RESULTS Although a multitude of techniques have been used, the ideal reconstructive procedure that addresses all of the functional and cosmetic needs of these children has yet to be described. Certainly, future research and innovative thinking will yield progressively better techniques that may, one day, emulate the native facial musculature with remarkable precision. CONCLUSION The necessity for surgical intervention in children with facial nerve paralysis differs depending on many factors including the acute/chronic nature of the defect as well as the extent of functional and cosmetic damage. In this article, we review the surgical procedures that have been used to treat pediatric facial nerve paralysis and provide therapeutic facial reanimation.
Collapse
Affiliation(s)
- Jason S Barr
- Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, NY 10016, USA
| | | | | |
Collapse
|
17
|
Fusobacterium otitis causes a case of hydrocephalus and fatal meningitis. JAAPA 2011; 24:57-9. [DOI: 10.1097/01720610-201111000-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Skatvedt O, Mjøen S, Sealy A. [A ten-year-old girl with dizziness]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2009; 129:634-5. [PMID: 19337333 DOI: 10.4045/tidsskr.09.33787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Childhood dizziness may take many forms; most often it presents as acute short-lived spinning attacks associated with headaches and nausea and less frequently as long-lasting symptoms with unsteadiness. Migrainous vertigo and middle ear infections are considered to be the most common causes of childhood dizziness, while head injury and pathology of the central nervous system are less common causes. We present a case history of a 10-year-old girl with acute positional vertigo attacks. Investigations and treatment demonstrated that this patient had canalithiasis variant Benign Paroxysmal Positional Vertigo (BPPV) in the lateral canal of the inner ear. The conventional view among many vestibular specialists is that childhood BPPV does not exist. We have demonstrated the opposite, and propose that childhood BPPV is more widespread than previously thought. We believe that children often spontaneously reposition dislodged otoconia through normal childhood play activities (e. g. tumbling, running, jumping, rolling etc.) thus avoiding the need to present for treatment with Epley and/ or Barbecue manoeuvres.
Collapse
|