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McCarty Walsh E, Hanson MB. Fungal Infections of the External Auditory Canal and Emerging Pathogens. Otolaryngol Clin North Am 2023; 56:909-918. [PMID: 37553272 DOI: 10.1016/j.otc.2023.06.010] [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: 08/10/2023]
Abstract
Fungal infections of the external auditory canal can range from common (otomycosis) to life threatening (necrotizing otitis externa). Proper identification of fungal pathogens is necessary to guide appropriate therapy, and a high index of suspicion for fungal causes of ear canal disease is critical. Fungal pathogens may be an especially important cause of ear canal disease in certain populations, including patients with diabetes, patients recently treated with antibiotics, and immunosuppressed patients. Opportunistic fungal infections of the ear canal are an emerging concern.
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Affiliation(s)
- Erika McCarty Walsh
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Matthew B Hanson
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Aranda-Jiménez F, Martin-Bernal C, Hernández-León D, Fontalba-Navas JL, Calvo I. Short- and long-term outcomes of subtotal ear canal ablation and lateral bulla osteotomy in French bulldogs. Can J Vet Res 2023; 87:277-281. [PMID: 37790263 PMCID: PMC10542946] [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: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 10/05/2023]
Abstract
The objective of this retrospective study was to report the overall peri-operative complications and short- to long-term outcomes of subtotal ear canal ablation and lateral bulla osteotomy in French bulldogs with otitis media. Medical records from 2018 to 2021 were reviewed for preoperative neurological signs, surgical technique, postoperative complications, and long-term outcomes. Postoperative complications, such as a head tilt, nystagmus, ataxia, facial nerve dysfunction, as well as skin or wound infection, were recorded. Eighteen client-owned dogs (20 ears) were included in the study. Postoperative complications were observed in 5/18 dogs (6/20 ears) with 2 of them being considered major complications. Referring veterinarians and owner telephone follow-up (mean: 33 mo, range: 17 to 56 mo) were obtained for all patients. Total recovery was reported in 9/18 dogs (11/20 ears) with a postoperative improvement of the vestibular signs and facial nerve paresis within 8 wk. All dogs maintained the pinnas' natural, erect morphology, and movement.
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Affiliation(s)
| | | | | | | | - Ignacio Calvo
- Hospital Veterinario Anicura Vetsia, C/Galileo 3, 28914, Leganés, Madrid, Spain
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Burton JA, Tarabillo AL, Finnie KR, Shuster KA, Mackey CA, Hackett TA, Ramachandran R. Chronic Otitis Externa Secondary to Tympanic Membrane Electrode Placement in Rhesus Macaques (Macaca mulatta). Comp Med 2022; 72:104-112. [PMID: 35346415 PMCID: PMC9084568 DOI: 10.30802/aalas-cm-21-000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/06/2021] [Revised: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 11/05/2022]
Abstract
Otitis externa (OE) is a condition that involves inflammation of the external ear canal. OE is a commonly reported condition in humans and some veterinary species (for example, dogs, cats), but has not been reported in the literature in macaques. Here, we present a case series of acute and chronic OE likely precipitated by abrasion of the ear canal with a tympanic membrane electrode in 7 adult male rhesus macaques (Macaca mulatta). All animals displayed purulent, mucinous discharge from 1 or both ears with 3 macaques also displaying signs of an upper respiratory tract (URT) infection during the same period. A variety of diagnostic and treatment options were pursued including consultation with an otolaryngologist necessitated by the differences in response to treatment in macaques as compared with other common veterinary species. Due to the nature of the studies in which these macaques were enrolled, standard audiological testing was performed before and after OE, including tympanometry, auditory brainstem responses (ABRs), and distortion product otoacoustic emissions (DPOAEs). After completion of study procedures, relevant tissues were collected for necropsy and histopathology. Impaired hearing was found in all macaques even after apparent resolution of OE signs. Necropsy findings included abnormalities in the tympanic membrane, ossicular chain, and middle ear cavity, suggesting that the hearing impairment was at least partly conductive in nature. We concluded that OE likely resulted from mechanical disruption of the epithelial lining of the ear canal by the ABR electrode, thereby allowing the development of opportunistic infections. OE, while uncommon in macaques, can affect them and should be included as a differential diagnosis of any macaque presenting with otic discharge and/or auricular discomfort.
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Affiliation(s)
- Jane A Burton
- Neuroscience Graduate Program, Vanderbilt University Medical Center, Nashville, Tennessee ; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee;,
| | - Alejandro L Tarabillo
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kelsey R Finnie
- Office of Laboratory Animal Care, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Katherine A Shuster
- Division of Comparative Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Chase A Mackey
- Neuroscience Graduate Program, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Troy A Hackett
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ramnarayan Ramachandran
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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Randrianandraina PM, Randrianirina HH, Fare AT, Andriamahenina AM, Andriambelo RH, Andrianarimanana DK, Rakoto FA. Paralysie faciale périphérique de l'enfant: une manifestation inhabituelle d'un corps étranger de l'oreille. Pan Afr Med J 2020; 36:284. [PMID: 33117478 PMCID: PMC7572671 DOI: 10.11604/pamj.2020.36.284.24308] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/02/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Patrick Maholisoa Randrianandraina
- Service d´Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Professeur Zafisaona Gabriel, Mahajanga, Madagascar
- Corresponding author: Patrick Maholisoa Randrianandraina, Service d´Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Professeur Zafisaona Gabriel, Mahajanga, Madagascar.
| | - Hery Henintsoa Randrianirina
- Service d´Anesthésie-Réanimation, Centre Hospitalier Universitaire Professeur Zafisaona Gabriel, Mahajanga, Madagascar
| | - Avisoa Theodora Fare
- Service d´Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Professeur Zafisaona Gabriel, Mahajanga, Madagascar
| | - Ando Mathieu Andriamahenina
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Professeur Zafisaona Gabriel, Mahajanga, Madagascar
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Mozafari R, Alimoghaddam K, Sotoude H, Asadollahi-Amin A. A Lateral Neck Myeloid Sarcoma Presenting as Acute Otitis Externa. Arch Iran Med 2018; 21:544-546. [PMID: 30551696] [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: 01/06/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
Myeloid sarcoma (MS) is a solid extra-medullary tumor of immature myeloid cells which could occur before, during or after remission of acute leukemia at any site on the body. Owing to variation in differential diagnosis, pathologic evaluation and immunohistochemical staining are essential for definitive diagnosis. Rarely, MS has been shown as an isolated extramedullary relapse (iEMR) after allogeneic stem cell transplantation (allo-SCT), which often does not necessarily result in bone marrow involvement. It seems that despite chemotherapy and graft-versus-leukemia (GVL) effects on bone marrow, leukemic cells could remain alive in the extra-medullary region. However, in order to achieve longer survival, timely diagnosis as well as combined systemic, local, and cellular therapeutic modalities should be considered in any patient with iEMR after allo-SCT. We report a left lateral neck isolated MS presented as acute otitis externa in a patient with prior allo-SCT due to acute myeloid leukemia (AML). Therefore, MS should be considered in patients with any history of acute leukemia even if the patient presents with signs and symptoms of an infectious disease.
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Affiliation(s)
- Rambod Mozafari
- Department of Hematology, Oncology, and Bone Marrow Transplantation, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Alimoghaddam
- Department of Hematology, Oncology, and Bone Marrow Transplantation, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Sotoude
- Department of Emergency Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Asadollahi-Amin
- Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND Otitis externa secondary to irritant or chemical exposure is well documented; however, specifically secondary to jet fuel exposure and its associated toxicology is not. Over 2 million military and civilian personnel per year are occupationally exposed to aviation fuels. CASE REPORT An aircraft maintainer presented with noninfectious acute otitis externa secondary to external ear canal exposure to JP-5 jet fuel. Proper exposure guidelines were followed, but it was not realized that the external ear canal was involved. The first symptoms to emerge were vertigo, dizziness, and disequilibrium; however, on physical exam it appeared that there was no middle ear involvement. DISCUSSION Otitis externa normally does not present with vestibular symptoms as the pathology affects the external ear canal dermal tissue. Upon review of JP-5's toxicology profile, dermal absorption is a route of entry and can cause general neurological symptoms, including loss of coordination. This case highlights potential deficiencies in the standardized safety data sheets that are used after exposure. Without mention of possible auricular exposure one may focus on the logical protection of the eyes, mouth, and visible skin. This is concerning due to potential delayed exposure symptoms, dermal absorption, high level of dermal destruction, and the close proximity to the sensory system. The goal of this case report is to improve the knowledge of providers caring for personnel who may be exposed and to suggest possible revisions to the Safety Data Sheets for jet fuel.Long RJ, Charles RA. Aviation fuel exposure resulting in otitis externa with vertigo. Aerosp Med Hum Perform. 2018; 89(7):661-663.
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Wingelaar TT, van Ooij PJA, van Hulst RA. Otitis externa in military divers: more frequent and less harmful than reported. Diving Hyperb Med 2017; 47:4-8. [PMID: 28357818 PMCID: PMC6147244 DOI: 10.28920/dhm47.1.4-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Although otitis externa (OE) is a common disease, data related to (military) divers are limited. This study aimed to determine the incidence of OE in military divers during their initial training. We also wished to consider seasonal influences on incidence and whether early detection increases completion of the diving course. METHODS From January 2011 to October 2016 the Royal Netherlands Navy Diving School trained 189 divers. Up to December 2015 we used the training records for the analyses. From January 2016 onward all divers were prospectively screened. Pearson's chi-squared 2 and Fisher's exact tests were used to analyse the data. RESULTS In the 162 included divers, 30 cases of OE were identified. The incidence in 2016 was significantly higher than in 2011-2015 (17/35 (49%) versus 13/127 (10%), P < 0.001). Almost all cases developed after three weeks of diving. No influence of season was found (P = 0.354). Early diagnosis and treatment of OE does not seem to affect completion of diving courses (P = 0.28). Only in three cases did a diver have to discontinue the course due to OE. DISCUSSION This study suggests that OE is more frequent among military divers than earlier reported, most likely caused by prolonged water exposure. Diving activities can often be continued with standard topical treatment.
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Affiliation(s)
- Thijs T Wingelaar
- Royal Netherlands Navy Diving Medical Center, Rijkszee en marinehaven, 1780 CA Den Helder, The Netherlands
- Department of Anesthesiology, Academic Medical Center, University of Amsterdam
| | | | - Rob A van Hulst
- Department of Anesthesiology, Academic Medical Center, University of Amsterdam
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BAUMANN ES, CARR CD, SENTURIA BH. LXXVI Studies of Factors Considered Responsible for Diseases of the External Auditory Canal. Ann Otol Rhinol Laryngol 2016; 70:1055-61. [PMID: 13865916 DOI: 10.1177/000348946107000410] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
The objective of the present study was to evaluate the clinical effectiveness and safety of the local application of triderm for the treatment of diffuse external otitis. The study included 68 patients presenting with bacterial and fungal diffuse external otitis. The treatment in the form of local empiric therapy was continued till the results of microbiological treatment became apparent. The beneficial outcome achieved in 91.2% of the patients was clinically manifest as the regression of the inflammatory process in the external auditory meatus. No complications, such as ototoxic events, either local or systemic allergic reactions, were documented. The authors substantiate the possibility of the application of the medication under consideration for the treatment of diffuse external otitis based on the knowledge of the mechanism of the actin of its constituent components, viz. betamethasone, dipropionate, gentamicin sulfate, and clotrimazole, taking into account the occurrence of the most common causative agents of diffuse external otitis. It is concluded that triderm is a safe medication for the local application and, probably, for the initial empiric therapy of diffuse external otitis to be continued till the results of the microbiological treatment become apparent.
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Affiliation(s)
- O V Fedorova
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - G B Shadrin
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Moriarty ME, Vickers TW, Clifford DL, Garcelon DK, Gaffney PM, Lee KW, King JL, Duncan CL, Boyce WM. Ear Mite Removal in the Santa Catalina Island Fox (Urocyon littoralis catalinae): Controlling Risk Factors for Cancer Development. PLoS One 2015; 10:e0144271. [PMID: 26641820 PMCID: PMC4671584 DOI: 10.1371/journal.pone.0144271] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 11/16/2015] [Indexed: 11/18/2022] Open
Abstract
Ear mites (Otodectes cynotis) and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae) living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas) were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation.
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Affiliation(s)
- Megan E. Moriarty
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
| | - T. Winston Vickers
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- Institute for Wildlife Studies, Arcata, California, United States of America
| | - Deana L. Clifford
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- Wildlife Investigations Laboratory, California Department of Fish and Wildlife, Rancho Cordova, California, United States of America
| | - David K. Garcelon
- Institute for Wildlife Studies, Arcata, California, United States of America
| | - Patricia M. Gaffney
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- Departments of Pathology and Medicine, University of California San Diego, San Diego, California, United States of America
| | - Kenneth W. Lee
- Greer Laboratory, Lenoir, North Carolina, United States of America
| | - Julie L. King
- Catalina Island Conservancy, Avalon, California, United States of America
| | - Calvin L. Duncan
- Catalina Island Conservancy, Avalon, California, United States of America
| | - Walter M. Boyce
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
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Schlimpert V. [Earache after bathing. Acute otitis externa: first treat locally]. MMW Fortschr Med 2014; 156:24. [PMID: 25195391 DOI: 10.1007/s15006-014-3324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Weber CS, Kleinjung T. [Common infections of the ear, nose, and throat]. Praxis (Bern 1994) 2014; 103:1001-1007. [PMID: 25146944 DOI: 10.1024/1661-8157/a001755] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Infectious diseases of the ear, nose and throat are common reasons why patients visit their family physician. Therefore, the aim of this mini-review is to give an overview of the most important and frequent infectious diseases of the ear, nose and throat, the appropriate diagnostic measurements and therapy with relevance for the family physician. Most of these infectious diseases can be treated by the family physician and do not necessarily need to be seen by an ENT-specialist.
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Affiliation(s)
- Claudia Sandra Weber
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
| | - Tobias Kleinjung
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
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[Swimmer's ear is in season. Summer, sun, pain in the ear]. MMW Fortschr Med 2013; 155:20. [PMID: 24006582] [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: 06/02/2023]
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Bruins MJ, Wijshake D, de Vries-van Rossum SV, Klein Overmeen RGJ, Ruijs GJHM. Otitis externa following aural irrigation linked to instruments contaminated with Pseudomonas aeruginosa. J Hosp Infect 2013; 84:222-6. [PMID: 23764317 DOI: 10.1016/j.jhin.2013.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 01/03/2013] [Accepted: 04/21/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The incidence of acute otitis externa, an infection of the external auditory canal, in general practitioners' (GP) practices in The Netherlands is about 14 per 1000 patients per year. In early 2010, one of the authors noted that some of the otitis externa patients in his GP practice had undergone cerumen removal by ear syringing a few weeks earlier. Bacterial cultures of samples taken from the instruments used showed contamination of an ear syringe by Pseudomonas aeruginosa. From then on, P. aeruginosa isolates from patients' ears were stored in the laboratory. AIM It was assessed whether cross-contamination with P. aeruginosa between patients in the same GP practice could occur through the use of contaminated ear lavage instruments. METHODS From 17 GP practices, the otolaryngology Outpatient Department and the Out-of-Hours GP Service, instruments used for examining and cleaning the outer ear were swabbed. Strains of P. aeruginosa cultured from the instruments were genotyped together with isolates of patients registered in the same practice. FINDINGS In four practices where contaminated instruments were found, genotyping showed similarity between P. aeruginosa strains isolated from a patient and the ear syringe, and/or between strains of different patients in the same practice. CONCLUSIONS Transmission of P. aeruginosa from ear lavage instruments to patients appears to occur with otitis externa as a result. Together with the Infection Control Unit of our hospital we have formulated recommendations for the appropriate cleaning, disinfection and storage of re-usable ear lavage instruments for the GP practices to implement.
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Affiliation(s)
- M J Bruins
- Laboratory of Clinical Microbiology and Infectious Diseases, Isala Klinieken, Zwolle, The Netherlands.
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Kotimäki J, Bazia P. [When external otitis does not heal]. Duodecim 2012; 128:598-601. [PMID: 22506322] [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: 05/31/2023]
Abstract
An illness initially started as external otitis in a healthy and physically fit middle-aged person turned out to be a difficult-to-manage Langerhans cell histiocytosis. The disease occurs mostly in children, and international clinical guidelines have accordingly been devised mainly for juvenile patients. Treatment of adult patients is thus essentially empirical. The disease may affect several organs, as in our case report, in which the disease after progression to a multisystemic disease led to secondary leukemia and death of the patient.
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Khon EM, Dzhenzhera GE, Ovchinnikov AI. [Local antibacterial therapy for the inflammatory diseases of the external and middle ear]. Vestn Otorinolaringol 2012:92-94. [PMID: 22951697] [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: 06/01/2023]
Abstract
The objective of the present study was to estimate the efficacy and safety of candibioic designed for the treatment of the patients presenting with diffuse otitis externa and chronic otitis media. The open randomized trial included 40 patients with diffuse otitis externa and 40 ones with chronic otitis media who had undergone a surgical sanitation procedure. Their standard clinical and otorhinolaryngological examination was supplemented by the characteristic of clinical symptoms and personal complaints using the 10-score scale. The composite preparation candibiotic was found to be equally effective for the treatment of both diffuse otitis externa and chronic otitis media. The results of the study give reason to recommend the use of candibiotic as an efficacious and safe drug for the treatment of these conditions.
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Neher A, Lumassegger M, Scholtz A. [Otitis externa]. MMW Fortschr Med 2011; 153:43-48. [PMID: 21688495] [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]
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Mösges R, Baues CM, Schröder T, Sahin K. Acute bacterial otitis externa: efficacy and safety of topical treatment with an antibiotic ear drop formulation in comparison to glycerol treatment. Curr Med Res Opin 2011; 27:871-8. [PMID: 21332272 DOI: 10.1185/03007995.2011.557719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 11/23/2022]
Abstract
OBJECTIVES To demonstrate the efficacy and safety of an antibiotic ear drop formulation combining polymyxin B sulfate, neomycin sulfate and gramicidin (PS) in patients with acute bacterial otitis externa (AOE). The combination was compared to glycerol ear drops, a non-pharmacologic treatment of AOE. METHODS An active controlled, double-blind, randomized, parallel group, multicenter clinical trial study design was performed in ear, nose and throat (ENT) practices with a planned interim analysis for sample size adaptation. In total, 244 patients aged 19-84 with no previous episode of otitis externa within the last year were randomized to receive either PS or glycerol ear drops thrice daily for 10 ± 2 days. OUTCOME MEASURES Absolute change in the clinical symptom score (CSS) (with subscores redness, swelling, pain, and secretion) from Day 1 to 4 was measured. As second endpoints, absolute change in CSS, individual subscores, pain perception measured on a visual analog scale (VAS) and intake of paracetamol 500 mg tablets were noted. Moreover, patient's assessment of efficacy at Day 10 and the frequency and type of adverse events were noted. RESULTS On Day 4, the CSS showed a clear advantage for the PS group over the glycerol group, being lower by 0.6 (p < 0.03); the clinical outcome was even more pronounced after 10 days (p = 0.006). The swelling subscore showed a statistically significant difference favoring the PS treatment group in Days 1-4 (p = 0.01) and Days 1-10 (p = 0.003). More PS- than glycerol-receiving patients rated the efficacy as good (glycerol: 32%; PS: 36%) or very good (glycerol: 38%; PS: 48%). Males, patients with AOE for >2 days and those with positive microbiologic findings profited most from PS therapy. CONCLUSION This study proves that PS is an effective and well-tolerated drug, showing results superior to glycerol, especially in patients with a longer pre-existing condition before therapy. The absence of a group treated with another established antibiotic is a limitation of this trial.
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Affiliation(s)
- R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Faculty of Medicine, University of Cologne, Germany.
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Linek M. [Otitis externa and media in the dog and cat]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2011; 39:451-463. [PMID: 22167173] [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] [Received: 08/30/2011] [Accepted: 02/18/2011] [Indexed: 05/31/2023]
Affiliation(s)
- M Linek
- Tierärztliche Spezialisten, Rodigallee 85/Holstenhofweg, 22043 Hamburg.
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Azizi MH. Ear disorders in scuba divers. Int J Occup Environ Med 2011; 2:20-26. [PMID: 23022815] [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: 06/01/2023]
Abstract
History of underwater diving dates back to antiquity. Breath-hold technique in diving was known to the ancient nations. However, deep diving progressed only in the early decades of the 19th century as the result of advancements in efficient underwater technologies which subsequently led to invention of sophisticated sets of scuba diving in the 20th century. Currently, diving is performed for various purposes including commercial, recreational, military, underwater construction, oil industry, underwater archeology and scientific assessment of marine life. By increasing popularity of underwater diving, dive-related medical conditions gradually became more evident and created a new challenge for the health care professionals, so that eventually, a specialty the so-called "diving medicine" was established. Most of the diving-associated disorders appear in the head and neck. The most common of all occupational disorders associated with diving are otologic diseases. External otitis has been reported as the most common otolaryngologic problem in underwater divers. Exostosis of the external ear canal may be formed in divers as the result of prolonged diving in cold waters. Other disorders of the ear and paranasal sinuses in underwater divers are caused by barometric pressure change (i.e., barotraumas), and to a lesser extent by decompression sickness. Barotrauma of the middle ear is the most prevalent barotrauma in divers. The inner ear barotraumas, though important, is less common. The present paper is a brief overview of diving-related ear disorders particularly in scuba divers.
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Affiliation(s)
- M H Azizi
- Academy of Medical Sciences of the IR Iran, Tehran, Iran.
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[External otitis in children: etiology and principles of therapy]. Vestn Otorinolaringol 2011;:113-6. [PMID: 22433710] [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: 05/31/2023]
Abstract
External otitis accounts for 21 to 25% of all inflammatory ear diseases. This paper presents the original data providing a deeper insight into etiology of this disease taking into consideration the great variety of its pathogenic agents, the possibility of development of mixed forms, and changes of whether conditions at the peak of morbidity. In addition, the results of assessment of the efficacy of Pimafucort designed for both mono- and combined therapy of the disease of interest are reported.
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Affiliation(s)
- John Roberts
- Department of Internal Medicine, University of Alabama-Birmingham, Huntsville Regional Medical Campus, Huntsville, Alabama, USA
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Kim JK, Cho JH. Change of external auditory canal pH in acute otitis externa. Ann Otol Rhinol Laryngol 2009; 118:769-772. [PMID: 19999361] [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: 05/28/2023]
Abstract
OBJECTIVES We investigated (1) the correlation between the degree of acute otitis externa (AOE) and a change of pH and (2) the recovery of pH after acidification compared to an antibiotic otic solution in AOE. A change of pH in the external auditory canal (EAC) is very important for the pathogenesis of otitis externa. Therefore, not only an antibiotic otic solution, but also acidification, is known to be a good treatment for AOE. However, pH has only been investigated in chronic otitis externa, and not in AOE. METHODS This was a prospective randomized control study. Forty adult patients (56 ears) with AOE and 40 normal control subjects (80 ears) participated in this study. The severity of disease was graded as mild, moderate, or severe. The pH of each EAC was then measured. The patients were randomly assigned into 2 groups: one for vinegar irrigation and the other for topical antibiotics. The pH of the diseased ears was measured at 1 and 2 weeks after the treatment. RESULTS The mean (+/-SD) pH for the normal control subjects was 5.4 +/- 0.48, and the EAC lost its acidity proportionately to the degree of disease (p < 0.05). For both the vinegar irrigation and topical antibiotic groups, the acidity was restored dramatically (p < 0.05) at 1 and 2 weeks for the moderate and severe grades of otitis, but not for the mild grade. There was no difference in recovery between the 2 groups. CONCLUSIONS The EAC lost its acidity proportionately to the degree of disease in AOE. Vinegar irrigation and topical antibiotics were equally effective for restoration of pH.
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Affiliation(s)
- Jin Kook Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University, Seoul, Korea
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26
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Canis M, Siedek V. [Infections of the external ear canal]. MMW Fortschr Med 2009; 151:38-39. [PMID: 19728681] [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: 05/28/2023]
Affiliation(s)
- Martin Canis
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum Grosshadern, Universität München.
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JONES EH, NORMAN TD. Preliminary report on the pathogenesis of dermatoses of the external auditory canal. Twenty cases of acute diffuse external otitis, due to deep infections. Laryngoscope 2009; 68:839-54. [PMID: 13551124 DOI: 10.1288/lary.1958.4970680503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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28
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Wilkinson EP, House JW. Extruding stapes prosthesis. Ear Nose Throat J 2009; 88:718. [PMID: 19172562] [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
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29
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Arnheim K. [Otitis and sinusitis. Only risk patients need antibiotics]. MMW Fortschr Med 2008; 150:18-20. [PMID: 18986115] [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: 05/27/2023]
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30
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Siddiq MA, Samra MJ. [Otalgia]. Praxis (Bern 1994) 2008; 97:785-786. [PMID: 18717461 DOI: 10.1024/1661-8157.97.14.785] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- M A Siddiq
- Department of Otorhinolaryngology, Head and Neck Surgery, New Cross Hospital, Wolverhampton.
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31
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Schroeder CJ. Outer limits. An overview of otomycosis. Adv Nurse Pract 2007; 15:60-61. [PMID: 20014678] [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: 05/28/2023]
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32
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Neumaier J. [To whom diving should be permitted]. MMW Fortschr Med 2007; 149:10-3. [PMID: 17855841 DOI: 10.1007/bf03365112] [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: 10/21/2022]
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Bizindavyi F, Guyot JP, Kos MI. [Otitis externa, a self-inflicted disease?]. Rev Med Suisse 2007; 3:2200-2203. [PMID: 17970152] [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: 05/25/2023]
Abstract
Otitis externa, an inflammation of the external auditory canal is the most frequent cause of ENT consultation all over the world. It can be caused by viral, bacterial or fungal infections. In most of the cases it is provoked by anatomical causes and, even more frequently inadvertently, by the patient himself. Typically, otitis externa is an isolated episode of short duration, easily treated with topical medication. It evolves rarely to the atypical forms of chronic otitis externa and malignant otitis externa. It is important to search for an allergy, eczema or immunodepression in cases of chronic otitis externa and for diabetes in cases of malignant otitis externa.
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Affiliation(s)
- F Bizindavyi
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale HUG, 1211 Genève
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34
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Affiliation(s)
- C Plummer
- Centre for Neuroscience and Neurological Research, St Vincent's Hospital, Melbourne, Victoria, Australia
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35
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Colombo S, Hill PB, Shaw DJ, Thoday KL. Requirement for additional treatment for dogs with atopic dermatitis undergoing allergen-specific immunotherapy. Vet Rec 2007; 160:861-4. [PMID: 17586789 DOI: 10.1136/vr.160.25.861] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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: 11/04/2022]
Abstract
Allergen-specific immunotherapy (ASIT) is one of the main treatments for atopic dermatitis in dogs, but it often requires additional treatments such as antibacterial and antifungal therapy for secondary bacterial and yeast infections, or antipruritic drugs to control the clinical signs or treat the adverse effects of the immunotherapy. Twenty-seven dogs enrolled in a study of ASIT were clinically assessed four times over a period of nine months; their requirement for treatment for secondary bacterial and yeast infections, for the administration of glucocorticoids as additional antipruritic therapy, and for the treatment of any adverse effects of the ASIT were evaluated. Twenty (74 per cent) of the dogs were treated for superficial bacterial pyoderma, 18 (66.6 per cent) required treatment for Malassezia species dermatitis on one or more occasions, eight (29.6 per cent) required treatment for otitis externa due to Malassezia species or bacteria, and eight required glucocorticoids to control their clinical signs. Five (18.5 per cent) of the dogs experienced adverse effects due to the ASIT and two required treatment with antihistamines (H1 receptor antagonists) in order to continue with the ASIT.
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Affiliation(s)
- S Colombo
- Dermatology Unit, Division of Veterinary Clinical Sciences, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
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37
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Carlson L. Inside and out. A review of otitis in children. Adv Nurse Pract 2007; 15:51-58. [PMID: 20000213] [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: 05/28/2023]
Affiliation(s)
- Linda Carlson
- Adjunct Nurse Practitioner Program Faculty at Georgia Southern University, Statesboro, Ga, USA
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38
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Affiliation(s)
- David R Waterhouse
- Department of Otolaryngology - Head and Neck Surgery, Whangarei Hospital, Whangarei, New Zealand.
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39
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De Rotalier P, Faye M, Sissokho B, Fall D. [Allergies in ENT]. Dakar Med 2007; 52:2-6. [PMID: 19102083] [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
Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Questioning remains the most important part of the enquiry for clinical examination is usually poor if notdesapointing. Biological testings detailed in this paper may be of some help; In Africa, test-treatements using cheap and unharmfull drugs give often the best evidence of allergy. Seldom, ENT allergy may be or become life-threatening. Its detection and appropiate actions are briefly mentioned.
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Abstract
Malignant external otitis or skull base osteomyelitis and osteoradionecrosis of the skull base and the skull are potentially life-threatening conditions. The standard methods of treatment involve the use of antibiotics, local treatment and, where necessary, surgical excision of necrotic tissue. These approaches do not provide a complete cure in many cases. Severe functional deficits and even death can occur in advanced stages. We conducted a long-term retrospective follow-up study and report on a multimodal approach that we have been using with great success since 1987. The four cornerstones of this treatment are surgical debridement, combinations of antibiotics, specific immunoglobulins, and adjunctive hyperbaric oxygen therapy. This multimodal treatment approach has proved to be highly effective in improving the survival and quality of life of the patients concerned. These excellent outcomes justify the high costs that this therapy admittedly involves.
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Affiliation(s)
- M Tisch
- Bundeswehrkrankenhaus Ulm, Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Chirurgie, Oberer Eselsberg 40, 89081 Ulm.
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Iwasaki S, Takebayashi S, Watanabe T. Tick bites in the external auditory canal. Auris Nasus Larynx 2006; 34:375-7. [PMID: 17052878 DOI: 10.1016/j.anl.2006.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 08/08/2006] [Revised: 09/06/2006] [Accepted: 09/21/2006] [Indexed: 10/24/2022]
Abstract
We report a case of Ixodes ovatus tick in the external auditory canal. Chief complaints of earfullness and pruritus appeared after the contact with dog. Using a removal method consisting of excising the abdomen of the tick and suctioning its body fluids, followed by removal of the tick body 3 days later, the patient was successfully treated without the development of complications.
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Affiliation(s)
- Satoshi Iwasaki
- Department of Otolaryngology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Hamamatsu City 431-3192, Japan.
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Paukstadt W. [Ear infections are now in seasons--when otalgia spoils swimming fun]. MMW Fortschr Med 2006; 148:12-3. [PMID: 16886483] [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: 05/11/2023]
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44
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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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45
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García de Hombre AM, Varillas Solano F. [Diagnostic difficulty and Medicine Based on Evidence]. An Med Interna 2006; 23:200. [PMID: 16900605 DOI: 10.4321/s0212-71992006000400019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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46
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Schwarzkopf S, Lautenschlager S. [What is your diagnosis? Relapsing polychondritis]. Praxis (Bern 1994) 2005; 94:1427-8. [PMID: 16193904 DOI: 10.1024/0369-8394.94.37.1427] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- St Schwarzkopf
- Dermatologisches Ambulatorium des Stadtspitals Triemli, Zürich.
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Abstract
Acute diffuse otitis externa (swimmer's ear), otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.
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Affiliation(s)
- Mao-Che Wang
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan
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48
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Zoltan TB, Taylor KS, Achar SA. Health issues for surfers. Am Fam Physician 2005; 71:2313-7. [PMID: 15999868] [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: 05/03/2023]
Abstract
Surfers are prone to acute injuries as well as conditions resulting from chronic environmental exposure. Sprains, lacerations, strains, and fractures are the most common types of trauma. Injury from the rider's own surfboard may be the prevailing mechanism. Minor wound infections can be treated on an outpatient basis with ciprofloxacin or trimethoprim-sulfamethoxazole. Jellyfish stings are common and may be treated with heat application. Other treatment regimens have had mixed results. Seabather's eruption is a pruritic skin reaction caused by exposure to nematocyst-containing coelenterate larvae. Additional surfing hazards include stingrays, coral reefs, and, occasionally, sharks. Otologic sequelae of surfing include auditory exostoses, tympanic membrane rupture, and otitis externa. Sun exposure and skin cancer risk are inherent dangers of this sport.
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Westhofen M. [Main symptom otorrhea: diagnosis and therapy]. MMW Fortschr Med 2005; 147:36-7, 39. [PMID: 15977632] [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: 05/03/2023]
Abstract
Otorrhea is an ambiguous symptom that underlies diverse clinical pictures. Fundamentally, the treatment of uncomplicated acute otitis externa and media can be carried out by the family physician. An ENT specialist should be definitely consulted in cases of complications or development of a chronic condition.
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Affiliation(s)
- M Westhofen
- Klinik für Hals-Nasen-Ohrenheilkunde und Plastische Kopf- und Halschirurgie am Universitätsklinikum Aachen
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Lu JJ, Shakespeare TP, Thiagarajan A, Zhang X, Liang L, Tan S. Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma: an evaluation of response and toxicity. Laryngoscope 2005; 115:806-10. [PMID: 15867644 DOI: 10.1097/01.mlg.0000157283.73284.a1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Stage II nasopharyngeal carcinoma (NPC) treated with conventionally fractionated radiotherapy results in loco-regional control of around 80%. This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost (C-Boost) schedule. METHODS AND MATERIALS Twenty-five 1997 AJCC Stage II NPC patients were enrolled and analyzed in this preliminary report. The primary tumor and clinically involved nodes received a total dose of 72 Gy in 42 fractions. C-Boost for gross disease consisted of 18 Gy in 12 fractions commencing on day 19 and was delivered at least 6 hours after the first dose. Patients were assessed for response, survival, and toxicity. RESULTS With a median follow-up of 24 months, only one patient had pathologically confirmed local recurrence, necessitating IMRT. Two developed distant metastases for which they received chemotherapy. One died from systemic disease after refusing treatment for persistent neck lymphadenopathy. Two-year loco-regional control rates, overall survival and disease-free survival rates were 96%, 96%, and 88%, respectively. All patients experienced some degree of acute and/or late toxicity. However, the toxicity profile was comparable to that seen following standard fractionation. Acute or late toxicities directly attributable to C-Boost were not observed. CONCLUSION This C-Boost radiotherapy regimen administers a substantially higher biologically effective dose compared with conventional radiation schedules. Preliminary locoregional control and survival rates are promising with no significant acute and/or late toxicities.
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Affiliation(s)
- Jiade Jay Lu
- Department of Radiation Oncology, National University Hospital, Singapore
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