A case of salivary gland choristoma presenting with ear discharge in a child having external auditory canal stenosis

Salivary gland choristoma in the middle ear or external ear canal is rare. Generally, it is difficult to differentiate salivary gland choristoma from congenital cholesteatoma or cholesterol granuloma on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). It is challenging to diagnose preoperatively without specific clinical or radiological symptoms or signs. Thus, histopathological examination is required for a definitive diagnosis, and a histopathological sample of the lesion is acquired. We discuss the imaging and histology of salivary gland choristoma with the best recommendation on the management.

Luc's abscess in Down syndrome - A case report

Luc's abscess is an exceedingly rare complication of otitis media, where the middle ear infection spreads extratemporally causing a subperiosteal collection under the temporalis muscle. It is known as a benign complication of otitis media as it is thought not to involve the mastoid bone in comparison to other types of extratemporal abscesses related to otitis media. We describe a challenging case of a 19-year-old male with Down syndrome diagnosed with Luc's abscess involving the mastoid bone. A high-resolution computed tomography scan is important to determine the extent of the abscess, with or without mastoid involvement, and the presence of complications. These findings will then help to determine the surgical options. Drainage of abscesses is a simple, initial, and conservative approach but less effective compared to mastoidectomy. 'Mastoidsparing' approach should only be considered if there is complete resolution after a simple drainage and antibiotic treatment.

Test-retest reliability and responsiveness of a Malay tinnitus questionnaire

INTRODUCTION

Tinnitus is a common complaint among patients with ear diseases and can be serious if not treated. Recently, a Malay tinnitus questionnaire, known as the "Borang Evaluasi Soal selidik Tinnitus" (BEST) had been developed and preliminarily validated among Malayspeaking population. The aims of the present study were to determine the test-retest reliability and responsiveness of the BEST questionnaire.

METHOD

Forty-six Malay adults (aged 23-74 years) with tinnitus were enrolled. They were instructed to fill in the BEST questionnaire accordingly. After one week, 21 of them were asked to fill in the questionnaire again. The other 25 subjects underwent tinnitus intervention for three months and following this; the BEST was administered to them again.

RESULTS

In the test-retest reliability task, the intraclass correlation values obtained were acceptably high (0.70-0.90). After the intervention, significant differences in the BEST result were found in the mind domain, main domain and composite score (p<0.05) with moderate effect sizes (0.61- 0.70).

CONCLUSION

The test-retest reliability of the BEST was found to be good. It also showed good responsiveness to intervention. The clinical usefulness of the BEST in assessing patients with tinnitus was further supported by the present study.

The effectiveness of psychological interventions among tinnitus sufferers: A review

INTRODUCTION

The aim of this article was to review the types of psychological interventions for patients with tinnitus, professionals involved in giving the intervention, the effectiveness of each method of interventions and comparisons with non-psychological approaches in treating tinnitus.

MATERIALS AND METHODS

PubMed database searched.

RESULTS

Twenty one articles that employed randomized controlled trials design were included. Cognitive behavioural therapy (CBT) was the most common intervention conducted by the researchers. Clinical psychologists and trainee psychologists were the most professionals involved in the therapy. The length of therapy ranged from six weeks to three months.

DISCUSSION

Psychological interventions were more effective in reducing psychological impacts of tinnitus than non-psychological interventions such as the use of tinnitus maskers. Nevertheless, the combination of the treatments yielded more superior outcomes.

CONCLUSION

A simplified version of psychological intervention that can be implemented by other clinical professionals should be developed to treat tinnitus holistically to overcome the shortage number of clinical psychologists.