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Grine K, Stephens M. A guide to managing disorders of the ear pinna and canal. J Fam Pract 2020; 69:E1-E6. [PMID: 32724914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This review will help you troubleshoot everything from infections and foreign bodies to trauma and neoplasm.
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Affiliation(s)
- Kristen Grine
- Department of Family and Community Medicine, Penn State College of Medicine, University Park, USA
| | - Mark Stephens
- Department of Family and Community Medicine, Penn State College of Medicine, University Park, USA.
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2
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Willis RG, Kahn SA, Brevard SB. Traumatic Acute External Auditory Canal Stenosis. Am Surg 2017; 83:e386-e388. [PMID: 30454363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- R Grant Willis
- Department of Surgery, University of South Alabama, Mobile, Alabama, USA
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3
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Gravatt L. Ear candling action overdue. N Z Med J 2017; 130:66. [PMID: 28694546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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4
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Bassim MK, Zdanski CJ. Electrode extrusion through the tympanic membrane in a pediatric patient. Otolaryngol Head Neck Surg 2016; 137:680-1. [PMID: 17903593 DOI: 10.1016/j.otohns.2007.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Accepted: 04/26/2007] [Indexed: 11/21/2022]
Affiliation(s)
- Marc K Bassim
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA.
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5
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Wang MK, Ba JB, Wu WB, Xu XL, He J. [Studies on external auditory canal injury in rabbits under simulated 50 mnitrogen-oxygen saturation diving and protective effect of compound aluminium acetate solution]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2016; 32:58-9, 64. [PMID: 27255044 DOI: pmid/27255044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Affiliation(s)
- Victoria Wilmot
- Ear, Nose, and Throat Department, Lauriston Buildings, Edinburgh EH3 9HA, UK
| | - Kim To
- Ear, Nose, and Throat Department, Lauriston Buildings, Edinburgh EH3 9HA, UK
| | - Megan Anderson
- Ear, Nose, and Throat Department, Lauriston Buildings, Edinburgh EH3 9HA, UK
| | - Alex Bennett
- Ear, Nose, and Throat Department, Lauriston Buildings, Edinburgh EH3 9HA, UK
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Rangabashyam M, Poh SS, Low WK. Electrode array extrusion through the posterior canal wall presenting as a delayed post-cochlear implant complication. Cochlear Implants Int 2015; 16:341-4. [PMID: 25831156 DOI: 10.1179/1754762815y.0000000006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
UNLABELLED OBJECTIVES AND IMPORTANCE: Cochlear implantation is an established, reliable, and safe procedure with a low complication rate. Electrode array extrusion through the posterior aspect of external ear canal is a potential major complication of cochlear implant surgery that may result in revision surgery or explantation. Although there have been previous case reports of such extrusions through the tympanic membrane, this is the first well-documented report of an extrusion through the posterior canal wall which was previously intact. CLINICAL PRESENTATION In this case report, we present a case of electrode array extruding through an initially intact posterior canal wall presenting as a delayed post-operative complication in a 13-year old Asian boy. INTERVENTION With reference to existing relevant literature, the case is discussed focusing on its management, possible contributing factors, and prevention strategies. CONCLUSION Excessive thinning of the bony wall should be avoided as it can potentially break down. Abutment on the posterior canal wall by a coiled electrode array in the mastoid cavity exerting undue pressure on the bony wall can further contribute to additional stress. The implant surgeon must be cognizant of mastoid growth patterns in children. Life-long regular follow-up in implanted patients is crucial.
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Adeyi AA, Tonga LN. What health professionals at the Jos University Teaching Hospital insert in their ears. Niger J Med 2013; 22:109-112. [PMID: 23829120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE The aim of this study is to determine if health professionals in our hospital insert objects in their ears and the complications which follow. METHODOLOGY In this prospective cross-sectional study, validated questionnaires were filled by health professionals working in our Teaching Hospital and analyzed. RESULTS One hundred and forty one questionnaires were analyzed involving subjects aged 25 to 59 years with a mean of 42 years (SD = +/- 12.5). There were 94 males and 47 females with a male to female ratio of 2:1. Thirty four (24.1%) nurses participated in the study followed by Resident doctors (n = 22, 15.6%) and Intern doctors (n = 20, 14.2%). One hundred and twenty nine (91.5%) individuals 'clean' their ears with majority of them (n = 48, 37.2%) doing so occasionally. Multiple objects were inserted into the ears by 32 (24.0%) subjects and single objects by 98 (76%). The commonest object inserted into the ears to effect 'cleaning' was cotton buds in 115 cases. Twelve (9.3%) subjects recorded ear injuries in the process. Seven (53.3%) subjects with injuries inserted objects into their ears daily. Seven subjects recorded injuries with the use of match sticks. Sixty three (44.7%) subjects had accumulation of cerumen. Cotton buds (n = 29) were the commonest method for cerumen removal. Complications recorded from the removal of cerumen were otalgia (n = 2) and vertigo (n = 1). CONCLUSION Health professionals in our centre have a practice of inserting various potentially dangerous objects into their ears.
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Affiliation(s)
- A A Adeyi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Jos, PMB 2084, Jos, Plateau State, Nigeria.
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Tao KK, Schwartz DT, Rosh A. Fracture of the external auditory canal mimicking basilar skull fracture. J Emerg Med 2012; 42:e39-e40. [PMID: 19796909 DOI: 10.1016/j.jemermed.2009.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 08/10/2009] [Indexed: 05/28/2023]
Affiliation(s)
- Kevin K Tao
- Department of Emergency Medicine, New York University/Bellevue Hospital Center, New York, New York, USA
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Zivic L, Zivic D. Ear injuries caused by parts of hearing aid. Med Glas (Zenica) 2011; 8:287-289. [PMID: 21849955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 02/18/2011] [Indexed: 05/31/2023]
Abstract
This paper presents two cases of ear injuries caused by parts of hearing aids -a five-year old girl whose tympanic membrane was ruptured by a metal part of the earmold, and a patient with injury and inflammation of outer auditory channel caused by parts of a channel hearing aid. Aid amplifier could serve its purpose only if it is applied and handled with direct coordination with an ORL specialist.
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Affiliation(s)
- Ljubica Zivic
- Otorhynolaringological Clinic of the Clinical Center of Kragujevac, Serbia.
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Robertson MW, Morris DP. Welding injury to the ear: looking beyond the perforation. J Otolaryngol Head Neck Surg 2011; 40:E15-E18. [PMID: 21453642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Mark W Robertson
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS
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12
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Kutz JW, Fayad JN. Ear candling. Ear Nose Throat J 2008; 87:499. [PMID: 18800318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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13
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Rafferty J, Tsikoudas A, Davis BC. Ear candling: should general practitioners recommend it? Can Fam Physician 2007; 53:2121-2122. [PMID: 18077749 PMCID: PMC2231549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- J Rafferty
- c/o Westview, Howe Rd, Kilsyth, Glasgow, Scotland.
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Sabatucci A, Procaccini M, Dabobash F. A rare case of synovial otorrhea of iatrogenic nature in dentistry. Minerva Stomatol 2007; 56:139-44. [PMID: 17327818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The authors describe a unique case of left synovial otorrhea in a masticatory phase, occurring in a 64-year-old patient after a long dental sitting. The otoscopic examination and the transverse CT of the ear revealed the fracture of the anterior wall of left external auditory canal and the presence of a small bone fragment on the external side of the glenoid fossa. This situation, at present, has been judged inoperable by otologists due to the close relationship between this area and the head of the left condyle, probably responsible for the fracture. The therapy used was based on the use of a masticatory bite plate, with the aim of increasing the vertical dimension of the jaws during mastication and, so, to keep the condyle in a forward position. The result obtained was the decrease and then the halting of the liquid exit in the auricle, through an increase of the bite plate height determined by the ex iuvantibus method. This temporary therapy could bring about a spontaneous healing of the fracture, thanks to the masticatory increase of the bite plate; but if this is not possible, a fixed prosthetic solution should then be provided for the patient. Research into the literature revealed no similar observations.
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Affiliation(s)
- A Sabatucci
- School of Orthognathia, Department of Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
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Mustafaev DM, Ashurov ZM, Kopchenko OO, Akhmedov IN. [A foreign body of the external acoustic meatus in a child]. Vestn Otorinolaringol 2007:62-63. [PMID: 18217289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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González-García R, Rodríguez-Campo FJ, Escorial-Hernández V, Muñoz-Guerra MF, Sastre-Pérez J, Naval-Gías L, Gil-Díez Usandizaga JL. Complications of Temporomandibular Joint Arthroscopy: A Retrospective Analytic Study of 670 Arthroscopic Procedures. J Oral Maxillofac Surg 2006; 64:1587-91. [PMID: 17052583 DOI: 10.1016/j.joms.2005.12.058] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Revised: 11/20/2005] [Accepted: 12/20/2005] [Indexed: 11/21/2022]
Abstract
PURPOSE Temporomandibular joint (TMJ) arthroscopy has been considered a safe surgical procedure in the treatment of TMJ derangement. However, it is not exempt from complications. This study evaluates the complications of arthroscopy in patients with internal derangement of TMJ. PATIENTS AND METHODS Five hundred consecutive patients (670 joints) with TMJ derangement who underwent arthroscopy between 1995 and 2004 were retrospectively analyzed. All the patients were classified as II to V in the Wilkes classification. Lysis and lavage, electrocautery of the posterior ligament, injection of corticoids, injection of ethanolamine, myotomy of lateral pterygoid muscle attachments, myotomy and electrocautery, motor debridement, injection of sodium hyaluronate, and meniscal suture were performed in different patients. RESULTS Complications were recognized during or immediately after the surgery. They were observed in 5 of 341 (1.26%) arthroscopies of the right TMJ and 4 of 329 (1.21%) arthroscopies of the left TMJ. A 1.34% complication rate was found in the whole series. No blood clots within the external auditory canal were observed. Bleeding within the superior TMJ space was observed in 57 cases (8.5%), 36 of them in the right TMJ and 21 in the left TMJ, but they were not considered as true complications. Lacerations of the external auditory canal were found in 2 cases (0.3%), with no cases of perforation of the tympanic membrane. Lesion of the auriculotemporal nerve was observed in a case. Paresia of the facial nerve was found in 4 cases (0.6%). Alteration of visual accuracy of the ipsilateral eye was also observed in a patient immediately after the surgery. CONCLUSION Special care must be taken to reduce complications within the upper joint space by means of an adequate instrumentation and by paying attention to essential points of the arthroscopic technique.
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Affiliation(s)
- Raúl González-García
- Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital La Princesa, Madrid, Spain.
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Feilscher T. [Help for the mistreated ear canal]. MMW Fortschr Med 2006; 148:54-5. [PMID: 16669284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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Abstract
OBJECTIVES Case report of a man presenting with spontaneous temporomandibular joint (TMJ) herniation into the external auditory canal (EAC). STUDY DESIGN Case report and literature review. METHODS A case report of a patient with spontaneous TMJ herniation into the EAC is presented. RESULTS The patient was a 41-year-old man complaining of tinnitus in his right ear. Examination revealed that the anterior wall of the bony EAC moved backward when the patient's mouth was closed and forward when opened, causing the resultant discomfort. In this case, surgery was performed, resulting in a good outcome with no complications. Thirteen other cases of spontaneous TMJ herniation into the EAC were found in the literature. CONCLUSION Few cases of spontaneous TMJ herniation into the EAC have been reported; however, if surgical treatment is desired, we should comply with the patient's request.
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Affiliation(s)
- Masaomi Moriyama
- From the Department of Otolaryngology, Faculty of Medicine, Oita University, Oita, Japan
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Abstract
OBJECTIVE To discuss the clinical aspects and management of traumatic cholesteatomas of the temporal bone. STUDY DESIGN Case report. SETTING University hospital, tertiary referral center. PATIENT, INTERVENTION, AND RESULTS The authors describe an uncommon case of otogenic brain abscess resulting from an infected cholesteatoma arising from an old temporal bone fracture line involving the external auditory canal in an otherwise healthy 21-year-old man. The patient was successfully treated with brain abscess drainage, tympanomastoidectomy, and broad-spectrum intravenous antibiotic therapy. CONCLUSIONS The authors recommend long-term follow-up in any patient with a longitudinal or mixed temporal bone fracture with low threshold for obtaining temporal bone computer tomography imaging for any new otologic complaints. Traumatic cholesteatomas complicated by brain abscess should be treated with broad-spectrum intravenous antibiotic therapy and aggressive surgical intervention.
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Affiliation(s)
- Kshitij Majmundar
- Department of Otolaryngology, Head and Neck Surgery, Virginia Commonwealth University Medical Center, Medical College of Virginia Hospitals and Physicians, Richmond, Virginia 23298, USA.
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Mironov AA, Shaginian GG, Artem'ev ME, Anisimov AZ. [A large foreign body of the internal acoustic meatus penetrating into the retromandibular fossa and nasopharynx]. Vestn Otorinolaringol 2005:55. [PMID: 15700015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Kaftan H, Hosemann W. [Herniation of the soft tissue of the temporomandibular joint into the external auditory canal]. HNO 2004; 52:817-9. [PMID: 15372172 DOI: 10.1007/s00106-003-1020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The bone between the external auditory meatus and temporomandibular joint may be destroyed as a result of canaloplasty or malignant otitis externa. This may lead to herniation of the joint capsule into the external auditory canal. Spontaneous herniation through a foramen of Huschke (bony dehiscence in the anterior wall of the tympanic bone) is rare. We present a case of spontaneous herniation with otorrhea.
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Affiliation(s)
- H Kaftan
- Klinik und Poliklinik für Hals-Nasen-Ohren-Krankheiten, Kopf- und Halschirurgie der Ernst-Moritz-Arndt-Universität Greifswald, Walther-Rathenau-Strasse 43-45, 17487 Greifswald, Germany.
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Abstract
A 5-year-old cat presented with haemorrhagic left aural discharge, 2 days following a road traffic accident. Otoscopic examination identified disruption of the external ear canal at the auricular/annular cartilage junction. This was managed by total ear canal ablation and lateral bulla osteotomy. Left sided facial nerve deficits were present following surgery. Eighteen months postoperatively there were no auricular problems, however facial nerve deficits persisted. There are no previous reports describing management of acute separation at the auricular/annular cartilage junction of the external ear in the cat or dog. This case report describes the presentation, diagnosis and surgical management of an acute ear canal separation at the auricular/annular junction of the external ear canal in a cat.
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Affiliation(s)
- S P Clarke
- East Neuk Veterinary Clinic, St Monans, Fife, UK.
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Kroukamp G. Toy gun injuries. S Afr Med J 2003; 93:726. [PMID: 14652951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
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Abstract
OBJECTIVE The study goal was to determine the relationships between patient management factors and patient outcomes in pediatric patients with external auditory canal foreign bodies. STUDY DESIGN AND SETTING Retrospective analysis was conducted of 698 consecutive cases of pediatric external auditory canal foreign bodies (n = 605 patients) who presented to a tertiary care pediatric referral center during a 6-year period. RESULTS Emergency physicians frequently removed foreign bodies under direct visualization while otolaryngologists primarily used otomicroscopy. Both of these methods had high success rates overall (77% and 86%), but attempts under direct visualization had lower success rates with removing spherical objects, objects touching the tympanic membrane, and objects in the canal for more than 24 hours. Failed removal attempts resulted in higher complication rates. CONCLUSION Certain foreign body and patient characteristics are associated with poor outcomes with removal attempts made under direct visualization. These cases should be referred directly to otolaryngologists for otomicroscopic removal.
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Affiliation(s)
- Stacey L Schulze
- Division of Pediatric Otolaryngology, Department of Otolaryngology and Communication Sciences and Medical College of Wisconson, Children's Hospital of Wisconsin, WI 53202, USA.
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Reiss G, Reiss M. [Otorhinolaryngology--VII: Cotton swabs have no business in ears]. Pflege Z 2002; 55:472-3. [PMID: 12192780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- Gilfe Reiss
- Städtisches Klinikum Görlitz, Hals-Nasen-Ohren-Klinik, James-von-Moltke-Strasse 52, 02826 Görlitz
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Kroon DF, Lawson ML, Derkay CS, Hoffmann K, McCook J. Surfer's ear: external auditory exostoses are more prevalent in cold water surfers. Otolaryngol Head Neck Surg 2002; 126:499-504. [PMID: 12075223 DOI: 10.1067/mhn.2002.124474] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The study goal was to demonstrate the prevalence and severity of external auditory exostoses (EAEs) in a population of surfers and to examine the relationship between these lesions and the length of time surfed as well as water temperature in which the swimmers surfed. It was hypothesized that subjects who predominantly surfed in colder waters had more frequent and more severe exostoses. METHODS Two hundred two avid surfers (91% male and 9% female, median age 17 years) were included in the study. EAEs were graded based on the extent of external auditory canal patency; grades of normal (100% patency), mild (66% to 99% patency), and moderate-severe (<66% patency) were assigned. Otoscopic findings were correlated with data collected via questionnaires that detailed surfing habits. RESULTS There was a 38% overall prevalence of EAEs, with 69% of lesions graded as mild and 31% graded as moderate-severe. Professional surfers (odds ratio 3.8) and those subjects who surfed predominantly in colder waters (odds ratio 5.8) were found to be at a significantly increased risk for the development of EAEs. The number of years surfed was also found to be significant, increasing one's risk for developing an exostosis by 12% per year and for developing more severe lesions by 10% per year. Individuals who had moderate-severe EAEs were significantly more likely to be willing to surf in colder waters than were those who had mild EAEs (odds ratio 4.3). CONCLUSIONS EAEs are more prevalent in cold water surfers, and additional years surfing increase one's risk not only for developing an EAE but also for developing more severe lesions.
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Affiliation(s)
- David F Kroon
- Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA
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Deguine C, Pulec JL. Temporal bone fracture with displacement of bone. Ear Nose Throat J 2001; 80:430. [PMID: 11480294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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Affiliation(s)
- T G Takoudes
- Department of Otorhinolaryngology, Weill College of Medicine of Cornell University, New York, New York, USA
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Abstract
Traumatic ear canal separation is rare in animals, with only eight dogs and one cat reported with the condition in the English language literature. Para-aural abscessation occurred in six of these nine animals. Diagnosis was made on otoscopic observation of a shortened, abruptly ending external ear canal that was free from advanced disease. Radiographs in those cases which have been described showed a disruption of the normal air opacity of the affected ear canal. Drainage, by creating a separate opening for the horizontal ear canal, or total ear canal ablation and lateral bulla osteotomy (TECA/LBO), have led to resolution of the clinical signs. This report adds a further case to the literature in which TECA/LBO was employed successfully.
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Affiliation(s)
- N A Connery
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, University College Dublin, Ireland
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Pausch NC, Reiss G, Reiss M. [Cotton-tipped swabs in the ear canal. Superfluous and dangerous]. Med Monatsschr Pharm 2001; 24:87-9. [PMID: 11284082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- N C Pausch
- HNO-Klinik, Städtisches Klinikum Görlitz, Moltkestr. 52, 02826 Görlitz
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Affiliation(s)
- V F Chong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
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Wong BJ, Cervantes W, Doyle KJ, Karamzadeh AM, Boys P, Brauel G, Mushtaq E. Prevalence of external auditory canal exostoses in surfers. Arch Otolaryngol Head Neck Surg 1999; 125:969-72. [PMID: 10488981 DOI: 10.1001/archotol.125.9.969] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine (1) the prevalence of external auditory exostoses in a population of surfers and (2) the relationship between the length of time spent surfing and the prevalence, severity, and location of the exostoses. DESIGN Cross-sectional epidemiological study. SETTING General community. PATIENTS Three hundred seven avid surfers (93.5% males and 6.5% females; age distributions: 11.2% were < or =20, 67.9% were 21 to 40, 17.5% were 41 to 50, and 3.3% were >50 years). MAIN OUTCOME MEASURES Questionnaires focusing on surfing habits (number of years, geographic region, and number of days per year of surfing) were correlated with otoscopic findings. A simple grading system was devised, based on the degree of external auditory canal stenosis. Grades of normal, mild, moderate, and severe corresponded to 100%, 99% to 66%, 65% to 33%, and less than 33% effective patent surface area, respectively. RESULTS There was a 73.5% overall prevalence of external auditory exostoses and a 19.2% overall prevalence of osteomas in the group studied. Of 441 ears with exostoses, 54.2% were mild, 23.6% were moderate, and 22.2% were severe. Of individuals who had surfed for 10 years or less, 44.7% had normal ear canals and only 6% had severely obstructed auditory canals. In comparison, in the group that had surfed for longer than 20 years, only 9.1% had normal auditory canals and 16.2% were severely affected. Of surfers with no exostoses, 61.1% had surfed for 10 years or less. In contrast, of surfers with severe exostoses, 82.4% had surfed for more than 10 years. Finally, the lesions seemed to affect all external auditory canal quadrants equally. CONCLUSION A positive association exists between the amount of time individuals spend surfing and the presence and severity of exostoses of the external auditory canal.
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Affiliation(s)
- B J Wong
- Department of Otolaryngology-Head and Neck Surgery and the Beckman Laser Institute and Medical Clinic, University of California at Irvine, Orange 92868, USA.
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Abstract
The leaking labyrinthine lesion is treated by conservative methods or surgical procedures. With respect to the stapes, the surgical treatment is controversial. Five cases of middle ear injuries accompanying oval window rupture are reported herein. In each case, direct force through the auditory canal damaged not only the ossicular chain but also the oval window. Initial symptoms were sudden hearing loss with significant conductive disturbance and various degrees of unsteadiness. Spontaneous horizontal nystagmus directed toward the uninvolved ear was observed in each case. Tympanic cavities were promptly explored under general anesthesia and oval window injuries were confirmed. In each case, the damaged stapes was temporally removed from the oval window. Perilymphatic leakage was recognized in each case. Two patients had subluxation of the stapes with a paucity leakage. Three had complete luxation of the stapes with a relatively huge oval window fistula. Disrupted oval windows were repaired with temporalis muscle fascial grafts that were inserted under the middle ear mucosae surrounding the oval windows. The stapes were replaced in the repaired oval windows, and the ossicular chains were reconstructed without artificial grafts. Vestibular dysfunctions disappeared within 7 days, and satisfactory audiologic results were obtained in each case.
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Affiliation(s)
- M Suzuki
- Department of Otolaryngology, Oita Medical University, Japan
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Affiliation(s)
- R P Hogg
- Department of Otolaryngology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
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Blake P, Matthews R, Hornibrook J. When not to syringe an ear. N Z Med J 1998; 111:422-4. [PMID: 9861921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This article reviews the potential hazards of ear syringing and the Accident Compensation Corporation Medical Misadventure Unit's experience of alleged iatrogenic injury over a 17-month period. Syringing claims account for about 25% of the total claims received by the ACC ENT Medical Misadventure Committee. Forty-seven claims were accepted as either mishap or error, and 63 claims were declined. Perforation of the drum was by far the commonest injury resulting in significant disability. Severe iatrogenic otitis externa accounted for most of the remainder. Practice nurses had syringed the ears of approximately two-thirds of the claimants with significant disability. The contraindications to ear syringing are listed and discussed. The correct technique, with a few "do and don't" pointers, is briefly reviewed. Management of the unintentional injury is discussed.
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Affiliation(s)
- P Blake
- Wellington Hospital, Wellington School of Medicine
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Abstract
We report an unusual case of malocclusion following a history of apparently blunt trauma. No maxillary or mandibular fractures were identified. The malocclusion persisted for several days. Finally computed tomography was performed, which revealed a foreign body in the infratemporal fossa. A 4-cm pencil was extracted from the patient's right temporomandibular joint.
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Affiliation(s)
- C Tang
- Division of Plastic Surgery, University of Toronto, Ontario, Canada
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38
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Abstract
OBJECTIVE To review the presentation, symptoms and management associated with low velocity gunshot injuries to the temporal bone. METHODS A retrospective analysis of 26 patients treated for low velocity gunshot injuries to the temporal bone. RESULTS Initial presentation included otorrhoea (69 per cent), facial nerve injury (27 per cent), hearing loss (65 per cent), intracranial injuries (50 per cent), and cranial neuropathies (58 per cent). Nine patients (35 per cent) underwent angiography, which showed vascular injury in five of them. Four patients died. CONCLUSIONS Low velocity gunshot injuries can be devastating and may result in functional sequelae. Low velocity missiles crush and lacerate surrounding structures, while high velocity missiles cause extensive wound cavity formation. Early aggressive management for intracranial, vascular and facial nerve injury can improve outcome.
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Affiliation(s)
- S L Sabin
- State University of New York-Health Science Center at Brooklyn, USA
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39
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Abstract
BACKGROUND Foreign bodies in the external ear canal present a frequent situation in pediatric practice. It is generally benign, but infectious complications may occur. POPULATION Between January 1996 and March 1997, 35 children with a foreign body in the ear canal were treated in the ENT department of Robert-Debré hospital. RESULTS Age ranged from 15 months to 14 years, with a mean of 6.5 years. The sex ratio was 1.2 (19 boys/16 girls). Five children had bilateral foreign bodies. The most frequent foreign bodies were pearls (8/40) and cockroaches (7/40). Eleven children had complications: ear canal laceration in five cases, otitis externa in five cases, cervical adenitis in three cases, general septic syndrome with fever in one case, and drum perforation in one case. CONCLUSION The methods of extraction and the management of the complications are discussed.
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Affiliation(s)
- M Dubois
- Service ORL, hôpital Robert-Debré, Paris, France
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Nishizaki K, Akagi H, Ogawa T, Yuen K, Masuda Y. Post-traumatic guitar-shaped deformity of the tympanic membrane. Int J Pediatr Otorhinolaryngol 1998; 44:11-3. [PMID: 9720674 DOI: 10.1016/s0165-5876(98)00025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report a unique case of post-traumatic guitar-shaped deformity of the tympanic membrane in an 8-year-old boy. After a traffic accident, he exhibited bleeding from the ear, incomplete facial palsy and a conductive hearing loss on the left side. Although his symptoms gradually improved, the deformity of the tympanic membrane and external auditory canal persisted. The tympanic membrane appeared to be duplicated. Careful examination using an otoscope was required for accurate diagnosis. Without knowledge of the deformity, the physician could easily misinterpret the appearance of the tympanic membrane. Formation of cholesteatoma was not observed and the normal migration of the epithelium in the external auditory canal seemed to be maintained. However, we were concerned that tubal dysfunction could eventually induce the retraction and atrophy of the tympanic membrane to ultimately form a cholesteatoma. We therefore recommend patients such as this to be evaluated periodically because of the risk of tubal dysfunction and cholesteatoma.
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Affiliation(s)
- K Nishizaki
- Department of Otolaryngology, Okayama University Medical School, Japan.
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41
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Wasala W, Adamiak G, Kantor I. [A rare case of injury of the external auditory meatus]. Otolaryngol Pol 1998; 49 Suppl 23:217-8. [PMID: 9499901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The authors present difficulties in the diagnosis and the treatment of rare case of external ear injury. 41-year-old woman with acute inflammation of external ear was observed in our Department. The cause of this inflammation was a foreign body which obliterated the external auditory meatus.
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Affiliation(s)
- W Wasala
- Kliniki Otolaryngologicznej Centralnego Szpitala Klinicznego WAM w Warszawie
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42
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Avrahami E, Katz R. An association between imaging and acute posttraumatic ear bleeding with trismus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85:244-7. [PMID: 9540077 DOI: 10.1016/s1079-2104(98)90002-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Computed tomography findings for each of 94 patients with unilateral ear bleeding and trismus correlated with either comminuted temporal bone fracture (26 cases) or bilateral temporomandibular joint fracture (68 cases). STUDY DESIGN Ninety-four patients with post-traumatic unilateral ear bleeding and 10 asymptomatic adults underwent coronal computed tomography examinations of their temporomandibular joints. Of these, 26 patients with intact temporomandibular joints underwent axial computed tomography of the temporal bones. For 23 of the 94 symptomatic patients, computed tomography was the final imaging procedure; for the other 71 symptomatic patients, it was the first imaging procedure. Quantifications of the radiation dose and the per-patient cost of imaging were performed. Measurement of the maximal mandibular movements in vertical and horizontal directions was performed clinically in the 10 asymptomatic adult control subjects and in the 94 patients with trismus and ear bleeding. RESULTS Ten control subjects had maximal opening values of 40 mm or more, and horizontal movement exceeded 24 mm. In 68 symptomatic patients, coronal computed tomography demonstrated bilateral fracture: there was bilateral high condylar fracture in 35 patients, and there was ipsilateral to the bleeding high condylar fracture with contralateral subcondylar fracture dislocation in 33 patients. Axial computed tomography scans in 26 symptomatic patients with intact temporomandibular joints demonstrated comminuted petrous bone fracture ipsilateral to the ear bleeding. CONCLUSIONS Patients with post-traumatic ear bleeding associated with trismus should first be evaluated by computed tomography. Any other initial procedure doubles the radiation dose as well as the cost of the imaging.
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Affiliation(s)
- E Avrahami
- Department of Radiology, Wolfson Medical Center, Holon, Israel
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43
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Blaugrund JE, Rocco JW, Niparko JK. Imaging quiz case 2. Complex temporal bone fracture. Arch Otolaryngol Head Neck Surg 1997; 123:1237, 1239-40. [PMID: 9366705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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44
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Smeak DD. Traumatic separation of the annular cartilage from the external auditory meatus in a cat. J Am Vet Med Assoc 1997; 211:448-50. [PMID: 9267506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 13-year-old cat was evaluated because of anorexia and otic discharge of 1 week's duration. A left head tilt and left facial nerve deficit were evident. Pink fleshy tissue was seen in the area where the tympanic membrane was expected during otoscopic examination. The left ear canal was laterally displaced from the skull on a rostrocaudal (open mouth) radiographic view, suggesting ear canal separation. During surgery, the annular cartilage was found to be separated from the external auditory meatus, and total ear canal ablation was performed. Complications did not develop, and facial nerve function returned 6 weeks after surgery. In previous reports, traumatic ear canal separation was diagnosed after trapped otic secretions formed abscesses or para-aural fistulas.
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Affiliation(s)
- D D Smeak
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210-1089, USA
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45
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Tselishchev VA. [A foreign body of the parapharyngeal space]. Vestn Otorinolaringol 1997:60. [PMID: 9092182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- V A Tselishchev
- Department of Pediatric Otorhinolaryngology, GIDUV, Novokuznetsk
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46
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Raghuram J, Ong YY, Wong SY. Tetanus in Singapore: report of three cases. Ann Acad Med Singap 1995; 24:869-73. [PMID: 8838999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Three cases of tetanus in Singapore are presented. One local resident had cephalic tetanus most likely secondary to otitis media and the other two, residents from surrounding Asean countries, had generalised tetanus. The portal of entry was a puncture wound on the foot in one patient and the ear in another. No portal of entry was identified in one patient. All three patients required tracheostomy, ventilatory support and intensive care management for periods ranging from 11 to 22 days. One patient died from complications of nosocomial septicaemia and one patient required prolonged rehabilitation. There was a questionable history of tetanus immunization in the Singapore resident whereas the other two patients who were foreigners had never received any immunization. Tetanus is an uncommon but important disease in Singapore. In spite of the availability of intensive care management, it continues to be a disease with significant morbidity and mortality. Early recognition and treatment of the disease are critical factors in determining the prognosis. This is a disease that may be largely prevented by adequate immunization.
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Affiliation(s)
- J Raghuram
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital
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47
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Abstract
Although lightning injuries are common, neuro-otologic sequelae are infrequently reported. The most common otologic injury encountered in the lightning strike victim is tympanic membrane rupture; the most common vestibular disturbance documented is transient vertigo. A variety of other clinical findings have been described in this population of patients. They include sensorineural hearing loss, conductive deafness, tinnitus, basilar skull fracture, avulsion of the mastoid bone, burns to the external auditory canal, and peripheral facial nerve palsy. The initial treatment of the lightning strike victim consists of basic life support measures. Once stabilized, the patient should undergo a complete otologic and vestibular evaluation. The majority of otolaryngologic problems encountered can be managed expectantly, with periodic re-evaluation. Tympanoplasty should be delayed for 6 to 12 months because of the frequent delay in spontaneous healing.
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Affiliation(s)
- F P Ogren
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha 68198-1225, USA
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48
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Abstract
Three dogs were presented for para-aural abscessation. Ear canal separations were suspected preoperatively, based on histories of trauma, physical examination findings of minimally inflamed external ear canals with abrupt endings, and radiographic evidence of discontinuity of the ear canals. Concurrent otitis media, based on radiographic findings, was diagnosed in all three dogs. Disruptions of the external ear canals were confirmed at surgery, and the dogs each responded to total ear canal ablation and lateral bulla osteotomy.
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Affiliation(s)
- P E McCarthy
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803-8410, USA
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49
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Deguine C, Pulec JL. Temporal bone fracture with facial palsy and total deafness. Ear Nose Throat J 1995; 74:78. [PMID: 7705236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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