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宋 忠, 刘 文, 王 宁, 傅 莹, 李 泽, 王 春, 孙 永. [Clinical analysis of 11 cases of otogenic intracranial complications treated by multidisciplinary collaboration]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:819-824;828. [PMID: 37828887 PMCID: PMC10803237 DOI: 10.13201/j.issn.2096-7993.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Indexed: 10/14/2023]
Abstract
Objective:To analyze the clinical diagnosis, treatment ,and surgical timing of otogenic intracranial complications. Methods:The clinical data of 11 patients with intracranial complications with ear symptoms as the first manifestation in Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University(Qingdao) from December 2014 to June 2022 were collected, including 8 males and 3 females, aged from 4 to 69 years. All patients had complete otoendoscopy, audiology, imaging and etiology examination, and the diagnosis and treatment plan was jointly developed through multidisciplinary consultation according to the critical degree of clinical symptoms and imaging changes. Among the 11 patients, 5 cases were treated with intracranial lesions first in neurosurgery department and middle ear lesions later in otolaryngology, 3 cases of meningitis, were treated with middle ear surgery after intracranial infection control, 1 case was treated with middle ear lesions and intracranial infection simultaneously, and 2 cases were treated with sigmoid sinus and transverse sinus thrombosis conservatively. They were followed up for 1-6 years. Descriptive statistical methods were used for analysis. Results:All the 11 patients had ear varying symptoms, including ear pain, pus discharge and hearing loss, etc, and then fever appeared, headache, disturbance of consciousness, facial paralysis and other intracranial complication. Otoendoscopy showed perforation of the relaxation of the tympanic membrane in 5 cases, major perforation of the tension in 3 cases, neoplasia in the ear canal in 1 case, bulging of the tympanic membrane in 1 case, and turbidity of the tympanic membrane in 1 case. There were 4 cases of conductive hearing loss, 4 cases of mixed hearing loss and 3 cases of total deafness. Imaging examination showed cholesteatoma of the middle ear complicated with temporal lobe brain abscess in 4 cases, cerebellar abscess in 2 cases, cholesteatoma of the middle ear complicated with intracranial infection in 3 cases, and sigmoid sinus thrombophlebitis in 2 cases. In the etiological examination, 2 cases of Streptococcus pneumoniae were cultured in the pus of brain abscess and cerebrospinal fluid, and 1 case was cultured in streptococcus vestibularis, Bacteroides uniformis and Proteus mirabilis respectively. During the follow-up, 1 patient died of cardiovascular disease 3 years after discharge, and the remaining 10 patients survived. There was no recurrence of intracranial and middle ear lesions. Sigmoid sinus and transverse sinus thrombosis were significantly improved. Conclusion:Brain abscess, intracranial infection and thrombophlebitis are the most common otogenic intracranial complications, and cholesteatoma of middle ear is the most common primary disease. Timely diagnosis, multidisciplinary collaboration, accurate grasp of the timing in the treatment of primary focal and complications have improved the cure rate of the disease.
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Affiliation(s)
- 忠义 宋
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 文杰 刘
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 宁 王
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 莹 傅
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 泽晶 李
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 春芳 王
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
| | - 永强 孙
- 山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科(山东青岛,266035)Department of Otolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China
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Blanco Pareja M, Liaño Esteso G, Suárez-Vega V, Manrique-Huarte R, Dominguez P, Pérez-Fernández N. Congruence and incongruence on the radiological and functional examination of inner ear hemorrhage. Acta Otolaryngol 2023; 143:845-848. [PMID: 38059470 DOI: 10.1080/00016489.2023.2286494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Inner ear hemorrhage (IEH) is an increasingly recognized cochlear lesion that can cause sensorineural hearing loss (SNHL). Magnetic resonance imaging (MRI) is known to be the best imaging modality for clarifying the causes of SNHL and providing images that point to those causes. AIMS Evaluate the lesional patterns in patients with presumed Inner ear hemorrhage (IEH) from radiological and functional aspects. MATERIAL AND METHODS We retrospectively reviewed 10 patients performed in our institution from 2014 to 2020, with suspected labyrinthine hemorrhage based on radiological and functional examination. RESULTS We included 8 patients with IEH and sensorineural hearing loss (SNHL). The median age was 55 years (range: 3 months - 78 years). The results from the MRI and functional tests were compared for each end-organ. Only three cases (37.5%) showed a correlation between signal abnormalities and dysfunction in the labyrinthine apparatus. CONCLUSIONS In patients with SNHL inner ear hemorrhage needs to be ruled out in the differential diagnosis, so specific MRI sequences should be requested. It represents a way to a better understanding of the disorder and the variety of findings claim for a complete auditory and vestibular testing.
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Affiliation(s)
| | | | | | | | - Pablo Dominguez
- Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
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Calvo-Henriquez C, Di Corso E, Alobid I, Cantone E, Di Cesare T, Mullol J. Pathophysiological Link Between Chronic Rhinosinusitis and Ear Disease. Curr Allergy Asthma Rep 2023; 23:389-397. [PMID: 37395977 DOI: 10.1007/s11882-023-01072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE OF REVIEW In the clinical practice, patients affected by chronic rhinosinusitis (CRS) commonly complain of otologic symptoms. This review aims to describe the available literature evidence assessing the relationship between CRS and ear illnesses published in the last 5 years. RECENT FINDINGS Available evidence suggests a higher prevalence of otologic symptoms in patients suffering from CRS, affecting up to 87% of patients. These symptoms may be related to Eustachian tube dysfunction, which improves after treatment for CRS. A few studies suggested a potential but not confirmed role of CRS in cholesteatoma, chronic otitis media, and sensorineural hypoacusis. A special type of otitis media with effusion (OME) may occur in patients with CRS, which seems to respond well to new biologic therapy. Ear symptoms appear to be highly prevalent in patients with CRS. So far, the available evidence is robust only for Eustachian tube dysfunction, which has been shown to be particularly impaired in CRS patients. Additionally, the Eustachian tube function appears to improve after treatment for CRS. Finally, interesting preliminary data were described for eosinophilic otitis media, as it appears to respond well to the treatment with biologics.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Eugenio Di Corso
- Unit of Otorhinolaryngology-Head and Neck Surgery, "A. Gemelli" Hospital Foundation IRCCS, Rome, Italy
| | - Isam Alobid
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elena Cantone
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive and Odontostomatological Sciences, "Federico II" University Hospital, Naples, Italy
| | - Tiziana Di Cesare
- Unit of Otorhinolaryngology-Head and Neck Surgery, "A. Gemelli" Hospital Foundation IRCCS, Rome, Italy
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
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Yang M, Margaretten M. Recurrent Eye and Ear Pain in an Older Patient. JAMA 2022; 327:2348-2349. [PMID: 35622372 PMCID: PMC9327438 DOI: 10.1001/jama.2022.8313] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Monica Yang
- Department of Medicine, Division of Rheumatology, University of California, San Francisco
| | - Mary Margaretten
- Department of Medicine, Division of Rheumatology, University of California, San Francisco
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Merkulova EP, Baranaeva EA, Mikulchik NV, Bolshakova ES. [Approaches to the correction of auditory tube dysfunction in children with allergic rhinitis]. Vestn Otorinolaringol 2022; 87:57-62. [PMID: 36404692 DOI: 10.17116/otorino20228705157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
UNLABELLED Allergic diseases are a global public health problem. One of the most common among them is allergic rhinitis (AR), which affects up to 40% of adults and 2-25% of children. OBJECTIVE To assess the state of ventilation of the middle ear in various forms of AR in children and the effectiveness of drug correction. MATERIAL AND METHODS We conducted a comprehensive examination of 100 children with various forms of AR. The examination complex included the analysis of anamnestic data, the clinical picture of the disease, subjective otological symptoms, data from otoscopy, acoustic impedansometry and tonal threshold audiometry. UNLABELLED There are 3 groups of children. UNLABELLED Group 1 - 40 children suffering from intermittent allergic rhinitis with pollen sensitization. UNLABELLED Group 2 - 20 children with persistent allergic rhinitis with household sensitization. UNLABELLED Group 3 - 40 children suffering from persistent allergic rhinitis in combination with an allergic form of bronchial asthma. CONCLUSIONS 1. Regardless of the form of AR, every third patient has auditory tube dysfunction, which develops mainly on both sides, is asymptomatic and is not accompanied by otoscopic changes. UNLABELLED 2. As a result of combination therapy, including irrigation agents, montelukast and cetirizine, an improvement in the ventilation of the tympanic cavity was noted with a decrease in the number of recording tympanograms of type «B» and «C» from 30.5 to 22.0%.
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Affiliation(s)
- E P Merkulova
- Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
| | - E A Baranaeva
- Belarusian State Medical University, Minsk, Republic of Belarus
| | - N V Mikulchik
- Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
| | - E S Bolshakova
- Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
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Itoh T, Kojimoto A, Kojima K, Mikawa K, Shii H. Surgical creation of multiple drainage holes versus local injection of corticosteroids for treatment of aural hematomas in dogs: 51 dogs with 71 aural hematomas (2000-2017). J Am Vet Med Assoc 2021; 260:S15-S23. [PMID: 34914622 DOI: 10.2460/javma.20.12.0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the outcome of surgical creation of multiple drainage holes (MDHs) versus local corticosteroid injection (LCI) for treatment of aural hematomas (AHs) in dogs and identify risk factors for recurrence and development of new AHs. ANIMALS 51 dogs with 71 AHs. PROCEDURES Medical records were reviewed, and information on signalment, clinical findings, and outcome was recorded. Recurrence was defined as development of an AH at the primary site after the first month of treatment. Development of a new AH was defined as an AH occurring at a site different from the treated site. RESULTS The recurrence rate after the first month of treatment was significantly higher following the LCI procedure (17/48 AHs [33%]) than after the MDH procedure (1/24 AHs [4%]). The odds of recurrence increased as the numbers of LCI in the first month increased (OR, 2.414). Recurrent AHs after LCI resolved with additional LCIs; only 1 AH (2%) required a change to MDHs. No recurrence was observed after the eighth month, and the cosmetic results were good. Sixteen of 51 (31%) dogs had multiple or new AHs. The risk of new AHs was higher in Golden Retrievers and Labrador Retrievers and in dogs with allergic dermatitis. CONCLUSIONS AND CLINICAL RELEVANCE Long-term outcomes suggested that both creation of MDHs and LCI can be therapeutic options for dogs with AHs. However, the risk of new AH development should be considered, especially in retriever breeds and dogs with allergic dermatitis.
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Hernández-Nuño de la Rosa MF, Keith DA, Siegel NS, Moreno-Hay I. Is there an association between otologic symptoms and temporomandibular disorders?: An evidence-based review. J Am Dent Assoc 2021; 153:1096-1103. [PMID: 34799013 DOI: 10.1016/j.adaj.2021.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The aim of this article is to discuss the scientific evidence available on the the pathophysiology and management of otologic complaints in patients with temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED The authors conducted an electronic search in MEDLINE, Web of Science and ScienceDirect and retrieved all the relevant peer-reviewed journal articles available in English on the topic. No time restriction was applied. RESULTS No consensus exists on the management of otologic symptoms in patients with concomitant TMD. The scientific evidence suggests that conservative or reversible TMD therapy might provide relief. However, this evidence is scarce and low, thus further studies with larger sample sizes and better designed methodological frameworks are needed. Until such evidence is available, dentists and orofacial pain specialists should treat TMD patients using current guidelines and refer those with otologic symptoms to an otolaryngologist. PRACTICAL IMPLICATIONS Given the wide range of potential pathophysiologies and treatments for each otologic symptom described in the TMD patient, close collaboration with otolaryngologists is essential to achieve the best patient care.
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Lengane N, Nacanabo R, Goueta A, Maiga S, Nao E, Gyebre Y, Ouattara M, Ouoba K. [Tropical otitis]. Med Trop Sante Int 2021; 1:KQZA-2C12. [PMID: 35685400 PMCID: PMC9128460 DOI: 10.48327/kqza-2c12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 68-year-old patient presents with chronic right-sided otorrhea associated with hypoacousis and chronic cough. Otoscopy showed multiple perforations of the right eardrum. The search of acid-fast bacilli was positive for direct examination of sputum and negative for the examination of ear pus. A antituberculosis treatment has been initiated.
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Affiliation(s)
- N.I. Lengane
- Service d’ORL et chirurgie cervico-faciale, CHUR de Ouahigouya, BP 16, Ouahigouya, Burkina Faso
| | - R. Nacanabo
- Service de pneumologie, CHUR de Ouahigouya, BP 16, Ouahigouya, Burkina Faso
| | - A. Goueta
- Service d’ORL et chirurgie cervico-faciale, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - S. Maiga
- Service de pneumologie, CHUR de Ouahigouya, BP 16, Ouahigouya, Burkina Faso
| | - E.E.M. Nao
- Service d’ORL et chirurgie cervico-faciale, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - Y.M.C. Gyebre
- Service d’ORL et chirurgie cervico-faciale, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - M. Ouattara
- Service d’ORL et chirurgie cervico-faciale, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - K. Ouoba
- Service d’ORL et chirurgie cervico-faciale, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
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Chen KW, Chen HC. Keratosis Obturans of the External Auditory Canal With the Complication of Acute Taste Loss. Ear Nose Throat J 2020; 101:148-149. [PMID: 32791900 DOI: 10.1177/0145561320947271] [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] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kuan-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, 63452Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck Surgery, 63452Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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D'Arco F, Youssef A, Ioannidou E, Bisdas S, Pinelli L, Caro-Dominguez P, Nash R, Siddiqui A, Talenti G. Temporal bone and intracranial abnormalities in syndromic causes of hearing loss: an updated guide. Eur J Radiol 2019; 123:108803. [PMID: 31891841 DOI: 10.1016/j.ejrad.2019.108803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/11/2019] [Accepted: 12/15/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe in detail the temporal bone and brain findings in both common and rare syndromic causes of hearing loss, with the purpose of broadening among radiologists and enhance the current understanding of distinct imaging features in paediatric patients with syndromic hearing loss. METHODS A detailed search of electronic databases has been conducted, including PubMed, Ovid Medline, Scopus, Cochrane Library, Google Scholar, National Institute for Health and Care Excellence (NICE), Embase, and PsycINFO. RESULTS Syndromic causes of hearing loss are characterised by different and sometimes specific abnormalities in the temporal bone. CONCLUSION A complete knowledge of the image findings in the temporal bones, brain, skull and other body regions is critical for the optimal assessment and management of these patients.
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Affiliation(s)
- Felice D'Arco
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Adam Youssef
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | | | - Sotirios Bisdas
- Department of Neuroradiology, University College of London, London, UK
| | - Lorenzo Pinelli
- Neuroradiology Unit, Spedali Civili Di Brescia, Brescia, Italy
| | | | - Robert Nash
- Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital for Children, London, UK
| | - Ata Siddiqui
- Department of Neuroradiology,Guy's and St.Thomas Hospital, London, UK
| | - Giacomo Talenti
- Neuroradiology Unit, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Caton MT, Malone F. Auricular calcification in a patient with traumatic brain injury and adrenal insufficiency: clinico-radiographic correlation with 3D cinematic rendering. Endocrine 2019; 64:422-423. [PMID: 30693435 DOI: 10.1007/s12020-019-01853-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
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Sebothoma B, Khoza-Shangase K. A comparison between video otoscopy and standard tympanometry findings in adults living with human immunodeficiency virus (HIV) in South Africa. S Afr J Commun Disord 2018; 65:e1-e7. [PMID: 30035605 PMCID: PMC6111599 DOI: 10.4102/sajcd.v65i1.591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/04/2018] [Accepted: 05/12/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Literature suggests that there is a correlation between video otoscopy and standard tympanometry findings. However, there is limited evidence on whether these two measures are comparable in the identification of middle ear pathologies in adults living with human immunodeficiency virus (HIV). Objective: This study aimed to determine the correlation between video otoscopy and standard tympanometry with 226 Hz probe tone in the identification of middle ear pathologies in adults living with HIV in Limpopo, South Africa. Method: A prospective, non-experimental, comparative design was employed on HIV-positive adults aged 18 years and older. All participants underwent basic audiological assessment including case history interviews, video otoscopy, tympanometry with a 226 Hz probe tone and pure tone audiometry. Two ear, nose and throat (ENT) specialists independently analysed video otoscopic images and provided their reports to the researcher, and these were compared to the tympanometry results. The IBM SPSS v.24 was used for data analysis, including the use of Cohen's kappa to determine the agreement between the two procedures. Pearson's correlation coefficient was used to determine the strength of the correlation between tympanometry and video otoscopy. Results: A total of 87 adults (N = 161 ears) took part in the study. Middle ear pathology was observed in 8% (n = 13) of the sample when tympanometry was used, and this increased to 10.6% (n = 17) when video otoscopy was utilised. Kappa statistics found a good agreement (k = 0.7) between the diagnoses made by two ENTs. However, there was poor agreement (k = 0.2) between the diagnoses by video otoscopy and tympanometry. Pearson's correlation coefficient indicated weak correlation between video otoscopy and tympanometry (r = 0.195). Conclusion: Findings from this study suggest that video otoscopy may be more accurate in the identification of middle ear pathologies in adults living with HIV when compared to tympanometry. These findings have training implications in the use of video otoscopy to ensure accuracy and reliability. Clinical implications of current findings include the use of both video otoscopy and tympanometry in a complementary manner for more sensitive identification of middle ear pathologies in this population. Lastly, tele-audiologic implications of the use of video otoscopy to increase access in resource-constrained contexts are raised.
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Affiliation(s)
- Ben Sebothoma
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand.
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Sakaida H, Usui S, Matsuda Y, Masuda S, Takeuchi K. Sonographic diagnosis of acute mastoiditis and subsequent retroauricular abscess in a pediatric cochlear implant recipient: A case report. J Clin Ultrasound 2017; 45:515-519. [PMID: 28369924 DOI: 10.1002/jcu.22442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/15/2016] [Accepted: 12/04/2016] [Indexed: 06/07/2023]
Abstract
When acute mastoiditis occurs in cochlear implant recipients, it can progress to subsequent retroauricular abscess due to the absence of the external mastoid cortex resulting from mastoidectomy performed for cochlear implantation. The management goal is to control infection while preserving the implanted device. A 2-year-old boy with cochlear implants developed acute mastoiditis and a subsequent retroauricular abscess. The patient underwent a surgical intervention based on the diagnosis made utilizing gray-scale and power Doppler sonography. This case illustrates the diagnostic usefulness of sonography in this rare situation. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:515-519, 2017.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Satoko Usui
- Department of Otorhinolaryngology, National Mie Hospital, Tsu, Mie, Japan
| | - Yasunori Matsuda
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Sawako Masuda
- Department of Otorhinolaryngology, National Mie Hospital, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Shukla R, Easto R, Williams R. Conditions of the external and middle ear: an overview of presentation, management and associated complications. J R Nav Med Serv 2017; 103:49-55. [PMID: 30088741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ear, nose and throat (ENT) presentations to primary care are common and frequently affect military patients. Many patients can be managed in primary care with appropriate treatment, but some presentations require appropriate, timely, and occasionally emergency onward referral for hospital management. This paper discusses the management of common otological presentations including otitis externa (OE), acute otitis media, chronic suppurative otitis media (including cholesteatoma), tympanic membrane (TM) perforations and pinna haematoma.
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Li Y, Choi WJ, Qin W, Baran U, Habenicht LM, Wang RK. Optical coherence tomography based microangiography provides an ability to longitudinally image arteriogenesis in vivo. J Neurosci Methods 2016; 274:164-171. [PMID: 27751893 DOI: 10.1016/j.jneumeth.2016.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Arteriogenesis describes the active growth of the pre-existing collateral arterioles, which is a crucial tissue-saving process in occlusive vascular diseases. NEW METHOD We propose to use optical coherence tomography (OCT)-based microangiography (OMAG) to monitor arteriogenesis following artery transection in mouse ear and focal stroke in mouse brain. RESULTS Our longitudinal mouse ear study shows that the growth phase of arteriogenesis, indicated by changes in collateral vessel diameter and velocity, occurs between 12 and 24h after vessel transection. Additionally, the magnitude of local inflammation is consistent with the time course of arteriogenesis, judging by the tissue thickness measurement and lymphatic vessel signals in OCT. In the mouse brain study, collateral vessel morphology, blood flow velocity and directionality are identified, and an activation of the collateral flow at the arteriolo-arteriolar anastomoses (AAA) is observed during stroke. COMPARISON WITH EXISTING METHODS In comparison with histology and fluorescence imaging, OCT/OMAG is completely non-invasive and capable of producing consistent results of longitudinal changes in collateral vessel morphology and vasodynamics. CONCLUSION OCT/OMAG is a promising imaging tool for longitudinal study of collateral vessel remodeling in small animals. This technique can be applied in guiding the in vivo experiments of arteriogenesis stimulation to treat occlusive vascular diseases, including stroke.
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Affiliation(s)
- Yuandong Li
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Woo June Choi
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Wan Qin
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Utku Baran
- Department of Bioengineering, University of Washington, Seattle, WA, USA; Department of Electrical Engineering, University of Washington, Seattle, WA, USA
| | - Lauren M Habenicht
- Department of Comparative Medicine, University of Washington, Seattle, WA, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA.
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16
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Zinn Z, Kurian S, Burch D. Bilateral Pruritic Auricular Papules and Plaques. Am Fam Physician 2016; 94:486-489. [PMID: 27637126] [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: 06/06/2023]
Affiliation(s)
- Zachary Zinn
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sara Kurian
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - David Burch
- West Virginia University School of Medicine, Morgantown, WV, USA
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17
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Abstract
Approximately 57 patients with red ear syndrome have been reported in the literature since it was initially described in 1994. The clinical phenotype therefore continues to be defined and no consistent treatment response has been described. We report three new cases of red ear syndrome and suggest that the disorder may exist as a primary trigeminal or cervical autonomic cephalalgia, coexist with other rare trigeminal autonomic cephalalgias, or may be secondary. The pathogenesis in these different circumstances may be distinct, the triggers specific and, when secondary, the disorder may be more resistant to treatment.
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Affiliation(s)
- P Boulton
- Mayo Clinic College of Medicine, Scottsdale, AZ 85259, USA
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Manche SK, Madhavi J, Meganadh KR, Jyothy A. Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population. Braz J Otorhinolaryngol 2016; 82:643-649. [PMID: 26923827 PMCID: PMC9444790 DOI: 10.1016/j.bjorl.2015.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/14/2015] [Accepted: 11/10/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. OBJECTIVE The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. METHODS A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT) specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ2 test and binary logistic regression. RESULTS Tinnitus was observed in 29.3% (956) of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR=1.79, 95% CI=1.02-3.16) and inner (OR=3.00, 95% CI=1.65-5.45) inner ear diseases. It was noted that 96.9% (n=927) of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%), presbycusis (16.6%) and otosclerosis (14.3%) are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM) subjects. CONCLUSION The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.
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Affiliation(s)
- Santoshi Kumari Manche
- MAA ENT Hospitals, Speech and Hearing Center, Somajiguda, Hyderabad, Telangana State, India; Osmania University, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, Telangana State, India
| | - Jangala Madhavi
- MAA ENT Hospitals, Speech and Hearing Center, Somajiguda, Hyderabad, Telangana State, India; Osmania University, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, Telangana State, India
| | - Koralla Raja Meganadh
- MAA ENT Hospitals, Speech and Hearing Center, Somajiguda, Hyderabad, Telangana State, India
| | - Akka Jyothy
- Osmania University, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, Telangana State, India.
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19
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Krivopalov AA, Yanov YK, Korneenkov AA, Shcherbuk AY, Artyushkin SA, Vakhrushev SG. EPIDEMIOLOGIC AND DEMOGRAPHIC FEATURES OF INTRACRANIAL OTO- AND RHINOSINUSOGENIC PYOINFLAMMATORY COMPLICATIONS IN RUSSIAN FEDERATION. Vestn Khir Im I I Grek 2016; 175:36-42. [PMID: 30427146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An analysis of demographic and epidemiologic situation was made in cases of otogenic and rhinosinusogenic intracranial complications on the area of 32 regions of Russian Federation at the period from 2009 to 2014. The state of ENT-service of examined subject is characterized by reduction of provision of during ENT-beds and lower level of hospitalization of population over indicated period. There was revealed a reliable correlated dependence of the main medical statistical indices from the intracranial complications with climatic and demographic factors, the rate of morbidity and activities of ENT-service in the area of this region.
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20
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Rubin AN, Shcherbuk YA, Krivopalov AA, Yanov YK, Vakhrushev SG. COOPERATIVE MANAGEMENT OF NEUROSURGEON AND OTOLARYNGOLOGIST IN TREATMENT OF CHILDREN WITH OTORHINOGENIC SUPPURATIVE-INFAMMATORY BRAIN DISEASES. Vestn Khir Im I I Grek 2016; 175:53-58. [PMID: 30427148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This work analyzed 47 cases of oto- and rhinosinusogenic suppurative meningoencephalitis, abscesses and empyemas of the brain in children at the age from 3 months to 17 years old. The article presents the treatment strategy, results and the volume of diagnostic measures. On the basis of this research, the authors came to conclusion, that care of the children with otogenic and rhinosinusogenic suppurative diseases of the brain required an interdisciplinary approach and effective cooperation of a neurosurgeon, otolaryngologist, pediatrician, resuscitation specialist, infectionist and a clinical pharmacologist.
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21
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Piskunov IS, Shcherbuk YA, Krivopalov AA, Rubin AN, Glaz’ev IE, Nekhaeva EA. URGENT X-RAY DIAGNOSTICS OF INTRACRANIAL PYOINFLAMMATORY OTORHINOSINUSOGENIC COMPLICATIONS. Vestn Khir Im I I Grek 2016; 175:54-63. [PMID: 30444095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An analysis of the results of X-ray CT and MR-imaging was made in 46 patients aged from 13 to 78 years old. The patients were admitted to multifield hospitals in Kursk at the period from 2005 to 2015. The research included the nasal cavity, paranasal sinuses, mastoid and pyramid of the temporal bones and the brain. The study could be repeated with bolus contrast medium infusion. The condition of the patients was evaluated in dynamics at intervals of 5-7 days and these data was associated with clinical picture. The authors presents a complex of symptoms and an algorithm of differentiated X-ray diagnostics of diseases of the ENT organs and the main nosological forms of pyoinflammatory diseases of arachnoid membrane and substances of the brain.
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22
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Bosatra A. On the wall-down tympanoplasty. Adv Otorhinolaryngol 2015; 37:117-21. [PMID: 3673800 DOI: 10.1159/000414123] [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] [Indexed: 01/06/2023]
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23
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Yamashita K, Wang ZQ. Observation of the eustachian tube in pediatric cases with acquired cholesteatoma. Adv Otorhinolaryngol 2015; 37:39-46. [PMID: 3673818 DOI: 10.1159/000414107] [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] [Indexed: 01/06/2023]
Affiliation(s)
- K Yamashita
- Department of Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
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24
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25
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Iino Y. [Clinical aspect of ear pain]. Nihon Jibiinkoka Gakkai Kaiho 2014; 117:1431-1437. [PMID: 26298877] [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: 06/04/2023]
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26
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Xie SM, Liu W, Xiang YY, Xiao ZA, Ren HM, Peng AQ, Wu WJ, Yang XM, Xie DH, Yin TF, Ren JH. A rare disorder mimics otitis media: Langerhans cell histiocytosis of the temporal bone in a child with interstitial pulmonary fibrosis. Am J Otolaryngol 2014; 35:816-21. [PMID: 25139821 DOI: 10.1016/j.amjoto.2014.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 05/25/2014] [Revised: 06/25/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease ranging from a benign to a rapidly fatal condition affecting young children predominantly, and is characterized by an abnormal clonal proliferation of Langerhans cells. We report a case of a 3-year-old child presenting with a 1-year history of otorrhea and otorrhagia followed by a 6-month history of postauricular swelling in the right ear. Imaging demonstrated a large mass of organized tissue. A biopsy was conducted, and the diagnosis of LCH was confirmed by histopathological and immunohistochemical examination. The child was treated with a 12-month course of vinblastine chemotherapy with prednisolone. No clinical evidence of recurrence was noticed after 3 years of follow-up. This rare case highlights the importance for otolaryngologists to keep LCH in mind for differential diagnosis in very young patients with symptoms and signs suggestive of acute mastoiditis or chronic otitis media.
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Affiliation(s)
- S M Xie
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - W Liu
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Y Y Xiang
- Department of Human Anatomy, University of South China, Hengyang, PR China
| | - Z A Xiao
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - H M Ren
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - A Q Peng
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - W J Wu
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - X M Yang
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - D H Xie
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - T F Yin
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - J H Ren
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China.
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Abstract
We report a 76-year-old man, a retired farmer, presenting with bilateral external auditory canal obstruction. Skin examination revealed multiple pruritic nodules and periorbital purpura. Ear canal opening surgery was performed. Skin and ear canal biopsy revealed extensive amyloid depositions. Immunoelectrophoresis for urinary Bence-Jones protein was positive, and bone marrow examination showed plasma cell dyscrasia. He received chemotherapy for amyloid light-chain amyloidosis secondary to light-chain multiple myeloma but died from myeloma progression. This case demonstrated how infiltrative conditions such as amyloidosis can lead to bilateral auditory canal obstruction and that the diagnosis of amyloidosis can be missed if a clinician focuses solely on a single organ.
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Affiliation(s)
| | | | - Yasuharu Tokuda
- General Internal Medicine, Tsukuba University, Mito, Ibaraki, Japan
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28
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Blake DM, Vazquez A, Jyung RW. Bilateral external auditory canal cholesteatomas. Ear Nose Throat J 2014; 93:92-96. [PMID: 24652554] [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: 06/03/2023] Open
Affiliation(s)
- Danielle M Blake
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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29
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Kosiakov SI, Nosulia EV, Perich B. [Otogenic intracranial disorders: topical problems of diagnostics and treatment]. Vestn Otorinolaringol 2014:64-69. [PMID: 24724201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The present paper summarized the recently published data on the prevalence, etiology, pathogenesis, diagnostics, and treatment of otogenic intracranial complications. The results of statistical analysis of the prevalence of otogenic intracranial complications are presented in conjunction with the data on their structure and the frequency of selected nosological forms. The authors emphasize the importance of the problems concerning the choice of the therapeutic strategy for the management of otogenic intracranial complications. Special attention is given to the peculiarities of antibacterial treatment of various forms of otogenic intracranial infection.
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Abstract
OBJECTIVE To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy. METHODS A retrospective single institution review of CI users with either superior semicircular canal dehiscence syndrome or asymptomatic superior semicircular canal dehiscence identified eight post-lingually deafened adults with unilateral or bilateral cochlear implantation between 2006 and 2010. Preoperative and postoperative speech perception scores as well as medical and epidemiological data were recorded and analyzed. RESULTS One patient with superior canal dehiscence syndrome and seven patients with asymptomatic superior semicircular canal dehiscence were identified, representing 7% or 8/113 of CI patients that fulfilled selection criteria. Average dehiscence length was 3.3 mm ± 0.79 SEM. Three patients received bilateral implants and five patients received a unilateral implant. Among asymptomatic superior semicircular canal dehiscence patients, subjective rates of post-operative dizziness were similar to those seen in patients with normal temporal bone anatomy (12.5 % vs. 15.9%, respectively). Speech perception abilities after surgery were poorer in SCD patients compared to the non-SCD cohort (Consonant Nucleus Consonant 33.7 ± 7.78 SEM vs. 56.7 ± 2.15 SEM P = 0.011), although both groups improved substantially relative to pre-operative performance. We also completed detailed analyses of auditory and vestibular outcomes in one patient with SCDS who underwent CI surgery in the symptomatic ear, which demonstrated preservation of vestibular function post-operatively, improved quality-of-life measures, and reduced dizziness symptomatology. CONCLUSIONS Our data suggest that patients with asymptomatic superior canal dehiscence at the time of CI surgery have similar albeit decreased speech perception scores compared to non-SCD adult CI users. Subjective rate of dizziness or vertigo following CI surgery was similar in both asymptomatic SCD and non-SCD cohorts, with detailed analyses of a single symptomatic SCD patient revealing improved vestibular function and reduced SCD symptoms following CI.
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CALIFANO L, VASSALLO A, MELILLO M, MAZZONE S, SALAFIA F. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis. Acta Otorhinolaryngol Ital 2013; 33:254-60. [PMID: 24043913 PMCID: PMC3773965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/06/2013] [Indexed: 11/29/2022]
Abstract
Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position). In the geotropic variant, which is more frequent, the fast phase of the nystagmus is directed towards the lowermost ear, when the patient lies on the affected side or on the healthy side; in the apogeotropic variant, which is less frequent, the fast phase is directed always toward the uppermost ear, regardless of which side the patient lies on. Paroxysmal nystagmus is more intense on the affected side in the geotropic form, and more intense on the healthy side in the apogeotropic form. The authors describe five cases of another primitive and rare form of lateral BPPV, defined as "direction-fixed paroxysmal nystagmus lateral canal BPPV", which has previously been described by other authors as a transitory step observed during the transformation from an apogeotropic into a geotropic form. It is characterized by typical BPPV symptoms and diagnosed by the presence of a paroxysmal horizontal unidirectional positioning nystagmus, evoked through Pagnini-McClure's test, which is apogeotropic on the affected side and geotropic on the healthy side. In the reported cases, direction-fixed horizontal paroxysmal nystagmus was always transformed into a typical geotropic form. The clinical features and pathophysiology of direction-fixed nystagmus lateral canal BPPV are discussed.
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Affiliation(s)
- L. CALIFANO
- Departmental Unit of Audiology and Phoniatrics, Surgical Sciences Department, "G. Rummo" Hospital, Benevento, Italy
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32
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Abstract
Pain of the ear, nose, sinuses, and throat is commonly encountered in clinical practice. For the most part, the pathologic process responsible for the patient's symptoms is easily identifiable after the physician performs a targeted history and physical examination. Unfortunately, the nature of this anatomic region makes it possible for the most thorough physician to miss pathologic factors that may ultimately harm the patient. For this reason, the following rules for the treatment of ear, nose, sinus, and throat pain serve both the patient and the clinician well: (1) take a targeted history; (2) perform a careful, targeted physical examination; (3) heed the warning signs of serious disease, such as fever, constitutional symptoms, or weight loss; (4) image early and frequently if the diagnosis remains elusive; (5) perform laboratory tests that help identify "sick from well," such as erythrocyte sedimentation rate, hematology, and blood tests; (6) avoid attributing the patient's pain to idiopathic or psychogenic causes; and (7) always assume that you have missed the diagnosis.
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Affiliation(s)
- Steven D Waldman
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
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33
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Talyshinskiĭ AM, Talyshinskiĭ AA, Abbasova AA. [Multichamber otogenic brain abscess in the patients presenting with the congenital defect of external and middle ears]. Vestn Otorinolaringol 2013:91-94. [PMID: 24429869] [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: 06/03/2023]
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YU DZ, QIU JX, HU XP. [Diagnosis and treatment of cerebellum abscess in 2 cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47:334-335. [PMID: 22800356] [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: 06/01/2023]
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35
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Wu JL, Chen WW, Luo Y. [Sudden deafness caused by inner ear bleeding: one case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:1044-1045. [PMID: 22336022] [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: 05/31/2023]
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36
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Badel T, Savić-Pavicin I, Zadravec D, Marotti M, Krolo I, Grbesa D. Temporomandibular joint development and functional disorders related to clinical otologic symptomatology. Acta Clin Croat 2011; 50:51-60. [PMID: 22034784] [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: 05/31/2023] Open
Abstract
Temporomandibular disorders (TMDs) are a form of musculoskeletal pain of the temporomandibular joint (TMJ) and/or masticatory muscles of nonspecific etiology. In this study, the relationship between embryonic and anatomic-topographic similarities of the TMJ and the ear was analyzed, i.e. secondary otologic symptoms that can be closely connected to TMJ disorder. Nonspecific otologic symptoms are not primary diagnostic symptoms of TMD, but may cause diagnostic confusion due to patients' inability to correctly locate the origin of pain. The most common otologic symptoms that can be related to TMDs are otalgia, tinnitus and vertigo. Otorhinolaryngologists have to differentiate between primary otologic symptoms and those caused by TMJ disorders. In TMD diagnosis, manual techniques are used to determine the arthrogenic or myogenic form, whereas in the diagnosis of arthrogenic disorders magnetic resonance imaging is indicated as the highly specific imaging method ofjoint disk and osteoarthritic changes. Symptomatic treatments for TMD as well as the etiologic diagnosis of the pain require multidisciplinary cooperation between dentists and medical specialists.
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Affiliation(s)
- Tomislav Badel
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
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37
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Topdag M, Can E. External ear canal cholesteatoma. Ear Nose Throat J 2010; 89:416-417. [PMID: 20859865] [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: 05/29/2023] Open
Affiliation(s)
- Murat Topdag
- Department of Otolaryngology, Kocaeli University Faculty of Medicine, Istanbul, Turkey
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38
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Zhang Q, Xu M, Zhang X, Ren T, Anniko M, Duan M. A case of Meniere's disease in the left ear and Lermoyez syndrome in the right ear--a 32-month longitudinal observation and literature review. Acta Otolaryngol 2010; 130:1084-8. [PMID: 20148752 DOI: 10.3109/00016480903582139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/13/2022]
Abstract
We here present a 32-month follow-up of a case of Lermoyez syndrome combined with Meniere's disease. The patient was a 49-year-old male, with a stabilized severe hearing loss in the left ear for about 15 years after Meniere's disease. He started to show typical symptoms of Lermoyez syndrome in the right ear about 32 months ago. Audiologic data were obtained and imaging examinations were performed 0, 9, 15, 28, and 32 months after the onset of the Lermoyez syndrome. Pure tone threshold data obtained 5 months before the onset are also reported. The results show that the hearing thresholds, mainly at low frequencies, elevated rapidly during the first months shortly after the onset of the disease and slowly in later months. The glycerol test resulted in a remarkable hearing improvement at the beginning of the disease, but showed no detectable improvements as the disease advanced. Electrocochleogram revealed a -SP/AP value with click stimulus 0.65 at the 9th month and > 1.0 at the 28th month after the onset. Clinical manifestations of this patient fit well with a pathological endolymphatic hydrops.
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Affiliation(s)
- Qing Zhang
- Department of Otorhinolaryngology and Head Neck Surgery, 2nd Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
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Hamilton ST, Gadre SA, Gadre AK. Cholesterol granuloma and recurrent cholesteatoma after canal-wall-down mastoidectomy. Ear Nose Throat J 2010; 89:298-300. [PMID: 20628984] [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: 05/29/2023] Open
Affiliation(s)
- S Todd Hamilton
- Division of Otolaryngology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
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Than P, Abumasmah R. Floppy ear, premature myocardial infarctions, and severe arthritis. are they related? Med Health R I 2010; 93:94. [PMID: 20415118] [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: 05/29/2023]
Affiliation(s)
- Peter Than
- Warren Alpert Medical School of Brown University, USA.
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Ekburanawat W, Ekpanyaskul C, Brennan P, Kanka C, Tepsuwan K, Temiyastith S, Klinvimol T, Pongnikorn S, Sangrajrang S. Evaluation of non-viral risk factors for nasopharyngeal carcinoma in Thailand: results from a case-control study. Asian Pac J Cancer Prev 2010; 11:929-932. [PMID: 21133603] [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: 05/30/2023] Open
Abstract
Nasopharyngeal cancer (NPC) is rare in most populations but common in Southern China and Southeast Asia. To understand the role of environmental exposures on risk of NPC, a case-control study was conducted among 327 newly diagnosed case of NPC and 327 controls matched to case on sex, age and geographic residence. Information was collected by interviewer about demographic variables, cigarette smoking, alcohol drinking, eating habits, past history of disease, family history of cancer and a lifetime history of every job that was held for one year or longer. The result indicates that cigarette smoking was associated with an increased risk of NPC (OR=2.41, 95% CI 1.61-3.6). There was indication of increased risk with a history chronic ear or nose disease (OR=2.71, 95% CI 1.45-5.06). Occupational exposure to wood dust was also associated with a higher risk (OR=1.63, 95% CI 1.02-2.61). Furthermore, lower education was found to be positively associated with NPC (OR=2.71, 95% CI 1.45-5.06). There was no association between NPC and salted fish intake (OR=1.38, 95% CI 0.84-2.25) or alcohol consumption (OR=0.88, 95% CI 0.58-1.33). Our results suggest that cigarette smoking, past history of ear or nose disease and occupational exposure to wood dust may play a role in the development of NPC in the Thai population.
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Affiliation(s)
- Wiwat Ekburanawat
- Occupational and Environmental Medicine Center, Nopparat Rajthanee Hospital, and Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
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Keilmann A, Hajioff D, Ramaswami U. Ear symptoms in children with Fabry disease: data from the Fabry Outcome Survey. J Inherit Metab Dis 2009; 32:739. [PMID: 19876760 DOI: 10.1007/s10545-009-1290-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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] [Received: 07/09/2009] [Revised: 09/04/2009] [Accepted: 09/08/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hearing loss and tinnitus are common symptoms in Fabry disease and increase in prevalence with age. This study aimed to provide an epidemiological description of hearing impairment and tinnitus in children with Fabry disease in the Fabry Outcome Survey (FOS), an international database to assess the natural history of Fabry disease and the efficacy of enzyme replacement therapy with agalsidase alpha. METHODS Signs and symptoms questionnaires were completed for 543 children with Fabry disease. Pure-tone audiograms were obtained from 101 children (53 girls, 48 boys). RESULTS On questioning, 33% of the children (n = 179) reported subjective hearing impairment. However, when assessed by age-appropriate audiometry, only 19 of 101 patients (19%) had a persistent hearing loss at least one frequency. Of these, 14 had a high-frequency hearing loss, 4 a pan-frequency hearing loss, and 1 a pattern typical of noise-induced loss. Of the 101 children with audiometry, 44 complained of tinnitus. Only 2 children reported sudden hearing loss, which was not verified by audiometry. Children with tinnitus had greater disease severity scores. CONCLUSIONS Hearing loss is a well-known clinical manifestation in patients with Fabry disease. It was reported in significant numbers of children in the FOS signs and symptoms questionnaire, but confirmed in only 19% by formal audiometry. The subjective hearing impairment may have been due to middle-ear effusions in many cases. Tinnitus is a well-recognized symptom in Fabry disease and can present in childhood. The presence of tinnitus correlated with overall disease severity.
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Affiliation(s)
- A Keilmann
- Department for ENT and Communication Disorders, University Hospital, Langenbeckstr. 1, 55101, Mainz, Germany.
| | - D Hajioff
- Department of Otolaryngology, Southmead Hospital, Bristol, UK
| | - U Ramaswami
- Department of Paediatric Endocrinology, Diabetes and Metabolism, Addenbrooke's University Teaching Hospital, Cambridge, UK
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Roberts RA, Gans RE, Kastner AH, Listert JJ. Prevalence of vestibulopathy in benign paroxysmal positional vertigo patients with and without prior otologic history Prevalencia de vestibulopatía en pacientes con vértigo postural paroxístico benigno (BPPV), con y sin historia previa de patología otológica. Int J Audiol 2009; 44:191-6. [PMID: 16011047 DOI: 10.1080/14992020500057715] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [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: 10/23/2022]
Abstract
The purpose of this study was to determine the prevalence of reduced or absent labyrinthine reactivity (vestibulopathy) in two groups of participants with posterior canal BPPV. One group had prior diagnosis of otologic disease (positive history group). No one in the second group had ever been diagnosed with otologic disease (negative history group). Caloric responses were retrospectively analyzed for the two groups. Patients with a positive history exhibited a greater prevalence of vestibulopathy than patients with a negative history. The positive history group, on average, also exhibited a larger unilateral weakness than those patients in the negative history group. We conclude that patients with BPPV and a history of otologic disease are more likely to present with vestibulopathy, than patients with BPPV and no history of otologic disease. This finding supports the benefit of complete vestibular evaluation in patients with BPPV to ensure comprehensive and successful treatment outcome.
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Affiliation(s)
- Xenia L Stalpers
- Canisius-Wilhelmina Hospital, Department of Neurology, Nijmegen, Netherlands.
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Paparella MM. Sudden deafness secondary to a middle ear/inner ear interaction: The implications of finding an "adhesive tent" during tympanotomy. Ear Nose Throat J 2009; 88:776-777. [PMID: 19224477] [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: 05/27/2023] Open
Affiliation(s)
- Michael M Paparella
- Department of Otolaryngology, University of Minnesota Medical School, Minneapolis, MN, USA
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Klockars T, Kentala E, Hurmerinta K, Jero J, Ala-Mello S, Suutarla S, Rautio J. [Microtia--not just an ear problem]. Duodecim 2009; 125:975-982. [PMID: 19517866] [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: 05/27/2023]
Abstract
Microtia can be defined as a malformation of the auricle with varying severity. In the majority of patients it is combined with atresia or stenosis of the external auditory canal. The prevalence of microtia in Finland is approx. 4 out of 10000. Associated anomalies should be actively seeked and excluded. Approximately 70% of the patients seem to be non-syndromatic. Patients with microtia are known to more than usual have other structural abnormalities. With the exception of the mildest cases, the development of facial structure and dental occlusion should be monitored in all microtia patients, attempting to actively exclude any associated diseases.
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Svistushkin VM, Ovchinnikov IM, Nikiforova GN, Bankhaeva ZB, Rudenko MV, Detochka IV. [Experience with the use of surgical lasers for the treatment of patients with upper respiratory tract and ear diseases]. Vestn Otorinolaringol 2009:36-39. [PMID: 19738589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The objective of this study was to analyse the efficiency and safety of the use of a holmium- YAG laser (wave length 2.09 mcm) and an erbium-activated glass-based fiber laser scalpel (wave length 1.56 mcm) in ENT-surgery. Priority methods for the surgical intervention in the nasal cavity, paranasal sinuses, and middle ear were developed to treat patients with distorted nasal septa, vasomotor rhinitis, polypous rhinosinusitis, Eustachian tube dysfunction, and various forms of chronic suppurative otitis media. Long-term observations demonstrated fairly good stability of beneficial outcomes of the treatment with the above methods in the majority of the patients. It is concluded that surgical technologies with the use of modern medical lasers provide extensive possibilities for a great variety of interventions in patients with upper respiratory tract and ear diseases.
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Yang H, Chen XW, Gao ZQ, Ni DF, Jiang H, Xu CX, Liu ZY, Zhou BT, Yang DH. [Clinical analysis of otogenic intracranial complications]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008; 43:801-805. [PMID: 19267967] [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: 05/27/2023]
Abstract
OBJECTIVE To analyze the clinical features and treatment protocols of otogenic intracranial complications in Peking Union Medical College Hospital. METHODS Retrospective study of 14 patients (10 males and 4 females, aged between 12 - 62 years, mean age 32.1 years) hospitalized from 1982 - 2006. Twelve cases were otitis media (OM) with cholesteatoma, the other 2 cases were non-cholesteatomatous OM. All the otogenic intracranial complications located at the same sides as otologic disorders. Brain abscess was the most common type of otogenic complications and Proteus was the most common microorganism detected. Suppurative ear discharge, headache, high fever and nausea with vomiting were the most common clinical manifestations with very high incidences. All the patients received combined protocols of mastoid surgeries and antibiotics treatment. RESULTS All the 14 patients recovered clinically. For patients discharged before 1987, there were 4 patients followed up for 22.5 - 24.4 years with a mean time of 23.8 without recurrence, 1 patient died of cardiovascular disease 19.2 years later after discharge, 4 patients lost follow-up. For the 5 patients discharged after 1997, brain abscess recurred in one patient with pseudo-recovery after 24 days and he fully recovered after re-hospitalization and treatment. All the five patients were followed up for 1.5 years to 10.6 years with a mean time of 6.5 years without recurrence. CONCLUSIONS Youngsters and males seemed to be more vulnerable. Brain abscess was the most common intracranial complication and Proteus was the most common pyogenic microorganism. Combination of mastoid surgery and antibiotics were essential for effectively controlling the intracranial complications and improving the recovery. CT and MRI were essential for correct diagnosis bedtimes and MRI seemed to have a better performance.
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Affiliation(s)
- Hua Yang
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
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Bassim MK, Fayad JN. Hemotympanum. Ear Nose Throat J 2008; 87:366. [PMID: 18633923] [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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