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Nwosu O, Suresh K, Knoll R, Lee DJ, Crowson MG. A Proof-of-Concept Computer Vision Approach for Measurement of Tympanic Membrane Perforations. Laryngoscope 2024; 134:2906-2911. [PMID: 38214334 DOI: 10.1002/lary.31270] [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: 05/01/2023] [Revised: 11/18/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Size, an important characteristic of a tympanic membrane perforation (TMP), is commonly assessed with gross estimation via visual inspection, a practice which is prone to inaccuracy. Herein, we demonstrate feasibility of a proof-of-concept computer vision model for estimating TMP size in a small set of perforations. METHODS An open-source deep learning architecture was used to train a model to segment and calculate the area of a perforation and the visualized tympanic membrane (TM) in a set of endoscopic images of mostly anterior and relatively small TMPs. The model then computed relative TMP size by calculating the ratio of perforation area to TM area. Model performance on the test dataset was compared to ground-truth manual annotations. In a validation survey, otolaryngologists were tasked with estimating the size of TMPs from the test dataset. The primary outcome was the average absolute error of model size predictions and clinician estimates compared to sizes determined by ground-truth manual annotations. RESULTS The model's average absolute error for size predictions was a 0.8% overestimation for all test perforations. Conversely, among the 38 survey respondents, the average clinician error was a 11.0% overestimation (95% CI, 5.2-16.7%, p = 0.003). CONCLUSIONS In a small sample of TMPs, we demonstrated a computer vision approach for estimating TMP size is feasible. Further validation studies must be done with significantly larger and more heterogenous datasets. LEVEL OF EVIDENCE N/A Laryngoscope, 134:2906-2911, 2024.
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Affiliation(s)
- Obinna Nwosu
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Krish Suresh
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Renata Knoll
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew G Crowson
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Rasheed AM. Does the Location of a Small Tympanic Membrane Perforation Affect the Degree of Hearing Loss in Adult Patients with Inactive Mucosal Chronic Suppurative Otitis Media? Int Tinnitus J 2024; 27:135-140. [PMID: 38507626 DOI: 10.5935/0946-5448.20230021] [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: 03/22/2024]
Abstract
BACKGROUND Tympanic membrane perforation due to inactive mucosal chronic suppurative otitis media is a common problem in otolaryngology, with consequent conductive hearing loss. Still, there is controversy about the relationship between the location of the tympanic membrane perforation and the degree of hearing impairment. AIM OF THE STUDY To assess the correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss in adult patients with inactive mucosal chronic suppurative otitis media. PATIENTS AND METHODS A prospective cross-sectional study enrolled 74 adult patients with small tympanic membrane perforations (perforation involves less than one quadrant of the tympanic membrane) and conductive hearing loss (airbone gap ≥ 20 dB HL) due to inactive mucosal chronic suppurative otitis media for at least 3 months. The locations of the tympanic membrane perforations were classified as anterosuperior, anteroinferior, posterosuperior, and poster inferior perforations. Audiometric analysis and a CT scan of the temporal bone were done for all patients. The means of the air and bone conduction pure tone hearing threshold averages at frequencies 500, 1000, 2000, and 4000 Hz were calculated, and consequently, the air-bone gaps were calculated and presented as means. The ANOVA test was used to compare the means of the air-bone gaps, and the Scheffe test was used to determine if there were statistically significant differences regarding the degree of conductive hearing loss in relation to different locations of the tympanic membrane perforation. RESULTS The ages of the patients ranged from 20 to 43 years (mean = 31.9 ± 6.5 years), of whom 43 (58%) were females and 31 (42%) were males. The means of the air-bone gaps were 32.29 ± 5.41 dB HL, 31.34 ± 4.12 dB HL, 29.87 ± 3.48 dB HL, and 29.30 ± 4.60 dB HL in the posteroinferior, posterosuperior, anteroinferior, and anterosuperior perforations, respectively. Although the air-bone gap's mean was greater in the posteroinferior perforation, statistical analysis showed that it was insignificant (P-value=0.168). CONCLUSION In adult patients with inactive chronic suppurative otitis media, the anteroinferior quadrant is the most common location of the tympanic membrane perforation, and there was an insignificant correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss.
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Affiliation(s)
- Ahmed Muhei Rasheed
- Department of Surgery-Otolaryngology, College of Medicine, University of Baghdad, Baghdad, Iraq
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Sousa LRD, Fraga GA, Costa ISPD, Almeida ACFD, Sassi TSDS, Lourençone LFM. Diagnostic accuracy of the video otoscope in tympanic membrane perforation. Braz J Otorhinolaryngol 2024; 90:101336. [PMID: 37839169 PMCID: PMC10582057 DOI: 10.1016/j.bjorl.2023.101336] [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: 05/03/2023] [Revised: 07/03/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVE The video otoscope has already proven to be useful for the diagnosis of several pathologies, so the objective of this study was to evaluate the diagnostic accuracy of the video otoscope in cases of tympanic membrane perforation. METHODS This is a diagnostic accuracy study performed at the hearing health division of a tertiary-level referral hospital. Patients older than 8 years of age who had any symptom that could be related to perforation (otalgia, otorrhea, tinnitus, and/or hypoacusis) were invited to participate in the study. Participants were evaluated by three different diagnostic methods (otomicroscope, conventional otoscope, and video otoscope) performed by three different evaluators in a blind fashion. The microscope was considered the reference standard. RESULTS 176 patients were evaluated, totaling 352 tympanic membranes. Twenty-seven tympanic membrane perforations were diagnosed by the microscope, a prevalence of 7.7%. The video otoscope showed a sensitivity of 85.2% (95% CI 81.5%‒88.9%), specificity of 98.1% (95% CI 96.7%‒99.5%) and accuracy of 97.1% (95% CI 95.4 %-98.8 %). The conventional otoscope showed a sensitivity of 96.3% (95% CI 94.3-98.3), specificity of 98.8% (95% CI 97.7-99.9) and accuracy of 98.6% (95% CI 97.4-99.8). The Kappa value between the microscope and the video otoscope was 0.8 and between the microscope and the conventional otoscope was 0.9. Regarding the participants' perception, 53.4% (p< 0.001) considered the video otoscope as the best method for understanding the tympanic membrane condition presented by them. CONCLUSIONS The video otoscope showed relevant sensitivity and specificity for clinical practice in the diagnosis of tympanic membrane perforation. Moreover, this is an equipment that can facilitate the patient's understanding of the otologic pathology presented by him/her. In this regard, this method may be important for better patient compliance, requiring further studies to evaluate this hypothesis. LEVEL OF EVIDENCE Is this diagnostic or monitoring test accurate? (Diagnosis)-Level 2 (Individual cross-sectional studies with consistently applied reference standard and blinding).
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Affiliation(s)
| | - Guilherme Adam Fraga
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, SP, Brazil
| | | | | | | | - Luiz Fernando Manzoni Lourençone
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Curso Médico, Bauru, SP, Brazil; Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, SP, Brazil.
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Kim YH, Park HJ, Yoo JH. Effect of eardrum perforation and chronic otitis media on the results of infrared tympanic thermometer in adults: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35932. [PMID: 37960811 PMCID: PMC10637521 DOI: 10.1097/md.0000000000035932] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND This study was conducted to determine whether tympanic membrane perforation or chronic otitis media affects the results of an infrared tympanic membrane thermometer in adults. METHODS A literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar. RESULTS Four nonrandomized studies were included in the analysis. The temperatures of the bilateral eardrums (one eardrum with normal condition [control group] and the other eardrum with perforation or chronic otitis media [experimental group]) were measured for the same subject in the studies. The mean and standard deviation of the bilateral tympanic membrane temperatures were used to calculate the mean difference (MD) with a corresponding 95% confidence interval (CI). The fixed-effect model was utilized based on the results of the heterogeneity measurement using the Chi2 test and I2 statistic. The results of a meta-analysis in the normal eardrum (control group) and perforated eardrum, chronic suppurative otitis media with tympanic membrane perforation, or chronic otitis media with cholesteatoma (experimental group) were 343 subjects (MD = 0.05; 95% CI = -0.00 to 0.11; P = .06). A meta-analysis of the normal eardrum (control group) and perforated eardrum or chronic suppurative otitis media with tympanic membrane perforation except for cholesteatoma (experimental group) found 296 subjects (MD = 0.05; 95% CI = -0.01 to 0.11; P = .10). CONCLUSION When the temperatures of the bilateral eardrums were measured using an infrared tympanic membrane thermometer, no difference was observed between the eardrum with perforation or chronic otitis media and the normal eardrum.
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Affiliation(s)
- Yee-Hyuk Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Daegu Catholic University School of Medicine, Daegu, Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Daegu Catholic University Medical Center, Daegu, Korea
| | - Hee-Jun Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Daegu Catholic University Medical Center, Daegu, Korea
| | - Jae-Ho Yoo
- Department of Otorhinolaryngology-Head & Neck Surgery, Daegu Catholic University Medical Center, Daegu, Korea
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Omokanye HK, Dunmade AD, Tunde-Ayinmode MF, Uthman MM, Olawale M, Ologe FE. Hearing loss among inmates of a juvenile correctional facility in Nigeria. Afr Health Sci 2022; 22:695-703. [PMID: 36407407 PMCID: PMC9652660 DOI: 10.4314/ahs.v22i2.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Good hearing is essential to learning and rehabilitation of adolescent and young adults in juvenile correctional facilities. Hearing screening programme is not commonly in place for this incarcerated group. Objective To evaluate hearing threshold among inmates of a juvenile correctional facility in Nigeria and compare pattern of hearing loss with a control group. Methods A total of 135 inmates and equal number of age and sex matched control responded to interviewer-administered questionnaire followed by otoscopy and audiometry. Results Mean age of inmates was 19 years ±2.0, while that of control was 18yrs ± 2.5. (p-value 0.077). Four (3%) inmates had bleeding from the ear; otoscopy revealed traumatic tympanic membrane perforation in 2(1.5%) of them. Prevalence of hearing loss was 19.2% and for disabling hearing loss it was 1.4%. Conductive hearing loss was the most common 33(24.4%). Inmates had consistently worse mean hearing thresholds than controls across all frequencies tested in both ears (p-value <0.001). Conclusion Hearing loss is prevalent among inmates of juvenile correctional facility. Rehabilitation programme should be balanced with detail attention to health needs of inmates; including pre-admission and periodic hearing screening.
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Affiliation(s)
- Habeeb Kayodele Omokanye
- Department of Otorhinolaryngology, College of Health Sciences, University of Ilorin. PMB 1515, Ilorin, 240003, Nigeria
| | - Adekunle David Dunmade
- Department of Otorhinolaryngology, College of Health Sciences, University of Ilorin. PMB 1515, Ilorin, 240003, Nigeria
| | - Mosunmola Florence Tunde-Ayinmode
- Department of Behavioural Sciences. College of Health Sciences, University of Ilorin, University of Ilorin Teaching Hospital. Ilorin, Kwara State, Nigeria
| | - Muhammed Mubashir Uthman
- Department of Epidemiology and Community Health. College of Health Sciences, University of Ilorin, University of Ilorin Teaching Hospital. Ilorin, Kwara State, Nigeria
| | - Musbau Olawale
- Department of Epidemiology and Community Health. College of Health Sciences, University of Ilorin, University of Ilorin Teaching Hospital. Ilorin, Kwara State, Nigeria
| | - Foluwasayo Emmanuel Ologe
- Department of Otorhinolaryngology, College of Health Sciences, University of Ilorin. PMB 1515, Ilorin, 240003, Nigeria
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Tang Y, Lou Z, Lou Z, Jin K, Sun J, Chen Z. Is no de-squamatization of the TM reliable for cartilage over-underlay myringoplasty without external auditory canal packing? Am J Otolaryngol 2021; 42:103064. [PMID: 33892227 DOI: 10.1016/j.amjoto.2021.103064] [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: 02/28/2021] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We evaluated the graft and hearing outcomes of patients with chronic perforations treated via the cartilage-perichondrium over-underlay technique without de-squamatization of the TM and external auditory canal (EAC) packing. MATERIALS AND METHODS Thirty-nine patients with chronic perforations and residual tympanic membranes around the perforation margins were treated using the cartilage-perichondrium over-underlay technique without de-squamatization of the TM and EAC packing. Patients were followed-up for 6 months. RESULTS For all 39 patients with unilateral perforations, the graft success rate was 100% (39/39) at 6 months after surgery. The mean air-bone gap significantly (P < 0.05) improved from 13.41 ± 8.34 dB preoperatively to 7.45 ± 3.81 dB postoperatively in patients with small and medium perforations; the mean air-bone gap significantly improved from 20.57 ± 9.41 dB preoperatively to 9.84 ± 2.41 dB postoperatively in patients with large perforations. The lateral perichondrium gradually became necrotic and crust at postoperative 2-3 months and migrated into the EAC in all patients. CONCLUSIONS The cartilage-perichondrium over-underlay myringoplasty without de-squamatization of the TM and EAC packing is feasible, affording a high graft success rate and good hearing improvement. The lateral perichondrium may gradually become necrotic and crusted, and migrate along the EAC over time.
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Affiliation(s)
- Yongmei Tang
- Department of Pathology, Yiwu Central Hospital, Yiwu City 322000, Zhejiang Provice, China
| | - Zihan Lou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Zhengcai Lou
- Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu City 322000, Zhejiang Provice, China.
| | - Kangfeng Jin
- Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu City 322000, Zhejiang Provice, China
| | - Junzhi Sun
- Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu City 322000, Zhejiang Provice, China
| | - Zhengnong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
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Abstract
BACKGROUND Traumatic eardrum perforation is a common presentation in otorhinolaryngologic practices and emergency clinics. A consistent management strategy (active intervention vs. watchful waiting) is, however, still lacking. OBJECTIVE In the following study, the outcome of watchful waiting is analyzed and presented. MATERIALS AND METHODS A collective of 272 patients presenting at two different specialist ENT practices within days of traumatic tympanic membrane perforation from June 2002 to March 2019 were analyzed. Treatment was non-surgical, with prospective monitoring. Whereas antibiotics were not given at all in one practice, they were given only upon signs of infection in the other practice. The outcome was evaluated retrospectively on the basis of patient files. RESULTS The collective consisted of 185 males and 87 females. Mean age was 30 years (range: 7 months to 82 years). The perforations were most commonly located in the upper anterior and lower posterior quadrants. According to Griffin grading, the size was grade I in 97%. The three most common causes were impact to the ear, barotrauma, and foreign bodies. Under a watchful waiting regimen, 95% of the patients presenting for follow-up checks showed complete closure. CONCLUSION Watchful waiting can be assessed as appropriate in traumatic eardrum perforation, provided otorhinolaryngologic follow-up is ensured. An exception is blast injury, which is now much less common in Central Europe, as this is associated with a risk of secondary cholesteatomas. In these rare cases, active treatment with surgical exploration of the middle ear including relining the perforation is indicated.
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Affiliation(s)
- D Heitmann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Braunschweig, Holwedestraße 16, 38118, Braunschweig, Deutschland
| | | | - J Abrams
- Überregionale HNO-Gemeinschaftspraxis, Hamm, Deutschland
| | - A O H Gerstner
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Braunschweig, Holwedestraße 16, 38118, Braunschweig, Deutschland.
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Zwierz A, Masna K, Burduk P. Middle-ear cholesteatoma co-existing with labyrinthine fistula and vestibular schwannoma. Eur Arch Otorhinolaryngol 2020; 277:999-1003. [PMID: 31974684 PMCID: PMC7072064 DOI: 10.1007/s00405-020-05796-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/15/2019] [Accepted: 01/18/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many conditions, among them vestibular schwannoma and middle ear cholesteatoma with lateral semicircular canal destruction, may be associated with asymmetrical sensorineural hearing loss (SNHL) and vertigo. However, the probability that these two distinct disease entities causing the same symptoms occur in a single patient is very low, approximately 1 per 28 billion per 1 year. METHODS We present the case of a 40-year-old male admitted to our clinic because of chronic middle ear inflammation with concomitant tinnitus vertigo, and deafness in the right ear. The patient was diagnosed with lateral semicircular canal fistula caused by middle-ear cholesteatoma and concomitant vestibular schwannoma. Canal wall-down surgery was carried out to remove the cholesteatoma, followed by gamma knife radiosurgery for the vestibular schwannoma. RESULTS Vertigo and tinnitus resolved within 3 days after the ear surgery, and gamma knife treatment resulted in the complete involution of the vestibular schwannoma. The patient presented with completely dry middle-ear cavity and no recurrence of the cholesteatoma was observed during a 3-year follow-up. CONCLUSION As the hereby reported condition is very rare, the results cannot be compared with any similar report published previously. Nevertheless, based on the outcome, the treatment strategy seems to be both reasonable and effective.
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Affiliation(s)
- Aleksander Zwierz
- Department of Otolaryngology, Oncology and Oral and Maxillofacial Surgery, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Ujejeskiego Street 75, 85-168, Bydgoszcz, Poland.
- Departament of Phoniatry and Audiology. Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - K Masna
- Department of Otolaryngology, Oncology and Oral and Maxillofacial Surgery, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Ujejeskiego Street 75, 85-168, Bydgoszcz, Poland
| | - P Burduk
- Department of Otolaryngology, Oncology and Oral and Maxillofacial Surgery, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Ujejeskiego Street 75, 85-168, Bydgoszcz, Poland
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Dickinson LJ, Nimmo M, Morton RP, Purdy SC. 'Asymptomatic' South Auckland preschool children have significant hearing loss and middle ear disease. Int J Pediatr Otorhinolaryngol 2018; 114:106-110. [PMID: 30262346 DOI: 10.1016/j.ijporl.2018.08.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Seven hundred children were recalled for hearing screening at age 2-3 years due to a problem with their newborn hearing screen. They had all been well babies with no identified risk factors for hearing loss and hence were not scheduled for targeted follow-up to retest hearing. METHODS There were 485 children (69%) that attended the recall. The average age was 36 months (SD 3.7). Family ethnicity was Pacific Island (36%), Asian (26%), NZ European (13%), and Māori (11%), and there was a high level of deprivation in the study population. Children were screened using distortion product otoacoustic emission (DPOAE) and a parent or caregiver completed a 14-item questionnaire about ear health. The children that did not pass screening were given appointments for audiology testing. Children with hearing loss and/or middle ear problems were referred for otolaryngology review and further hearing assessments. RESULTS About one third (36%; n = 176) of children did not pass DPOAE screening; 82 (17%) had abnormal type B tympanograms and hearing loss; 29 underwent insertion of ventilation tubes, and one had a perforated tympanic membrane. There was a significant association between failed tympanometry and hearing loss (Chi-squared = 16.67, p < .001). Five children had permanent sensorineural hearing loss (SNHL), two of whom required cochlear implants for idiopathic hearing loss, with no specific risk factors. Overall 380 of 485 children screened were deemed to have normal hearing (i.e. 22% failed hearing). From the questionnaire, 15% of the caregivers with no suspicion of hearing problems did have children with significant hearing loss. Regression analysis showed that Pacific/Māori ethnicity was significantly associated with risk of hearing loss, together with questionnaire items identifying hearing problems and breathing problems. CONCLUSIONS There is a high proportion of children in South Auckland with unsuspected hearing loss; a different approach to hearing screening is warranted for this population with high rates of middle ear disease at age 3.
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Affiliation(s)
- Louise J Dickinson
- Counties Manukau Health, Dept of Otorhinolaryngology (ORL), New Zealand.
| | - Moea Nimmo
- Counties Manukau Health, Dept of Otorhinolaryngology (ORL), New Zealand; Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Randall P Morton
- Counties Manukau Health, Dept of Otorhinolaryngology (ORL), New Zealand; Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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Naidoo S, Edkins O, Naran V, Liebenberg S. Tympanoplasty surgery: a retrospective audit of surgical outcomes at a regional hospital. S AFR J SURG 2018; 56:51-54. [PMID: 30264944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Chronic Suppurative Otitis Media (CSOM) is a common condition in our setting, resulting in tympanoplasty surgery being one of the common surgical procedures performed. Little is published regarding outcomes of tympanoplasty surgery in patients living with Human Immunodeficiency Virus (HIV), which has a high prevalence in South Africa. METHODS A retrospective review of all tympanoplasty surgeries performed at our institute. Outcomes of surgery according to patient demographics, documented HIV status, seniority of surgeon, type and techniques of graft placement and hearing outcomes were reviewed. RESULTS Successful closure of perforations was 84.4%. Closure rates in the 10 patients known to be HIV positive were 100%. The number of patients meeting the criteria for The Belfast Rule of Thumb (BROT) increased from 26.3% (n = 20) preoperatively to 68.4% (n = 52) postoperatively. CONCLUSION The results are comparable to both the results obtained at a tertiary hospital and those published internationally. Successful outcomes are obtainable in patients infected with HIV; however, as to the optimal timing of this surgery, this would require further investigation.
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Affiliation(s)
| | | | | | - S Liebenberg
- Sessional Consultant, Department of Otorhinolaryngology, False Bay & New Somerset Hospitals
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Werker CL, van den Aardweg MTA, Coenraad S, Mink van der Molen AB, Breugem CC. Internationally adopted children with cleft lip and/or cleft palate: Middle ear findings and hearing during childhood. Int J Pediatr Otorhinolaryngol 2018; 111:47-53. [PMID: 29958613 DOI: 10.1016/j.ijporl.2018.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Adopted children with cleft lip and/or cleft palate form a diverse group of patients. Due to increased age at palatal repair, adopted children have a higher risk of velopharyngeal insuffiency and poor speech outcome. Delayed palate repair may also lead to longer lasting Eustachian tube dysfunction. Decreased function of the Eustachian tube causes otitis media with effusion and recurrent acute otitis media, which can lead to other middle ear problems and hearing loss. METHODS One-hundred-and-thirty-two adopted children treated by the Cleft palate team in Wilhelmina Children's Hospital during January 1994 and December 2014 were included. Retrospectively, middle ear findings, the need for ventilation tube insertion and hearing during childhood were assessed. Findings were compared with 132 locally born children with cleft lip and/or cleft palate. RESULTS Adopted children had a mean age of 26.5 months old when they arrived in our country. After the age of two the total number of otitis media with effusion episodes and the need for ventilation tube placement did not significantly differ among adopted and non-adopted children. Adopted children had significantly more tympanic membrane perforations. Hearing threshold levels normalized with increasing age. Although within normal range, adopted children showed significantly higher pure tone averages than locally born children when they were eight to ten years old. CONCLUSION In general, adopted patients with cleft lip and/or cleft palate did not have more middle ear problems or ventilation tubes during childhood. However, theyhave more tympanic membrane perforations.
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Affiliation(s)
- C L Werker
- Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
| | - M T A van den Aardweg
- Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - S Coenraad
- Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - A B Mink van der Molen
- Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - C C Breugem
- Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
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Chen F, Yang XP, Liu X, Dong DA, Zhou XR, Fan LH. Retrospective Analysis of 24 Cases of Forensic Medical Identification on Traumatic Tympanic Membrane Perforations. Fa Yi Xue Za Zhi 2018; 34:392-395. [PMID: 30465405 DOI: 10.12116/j.issn.1004-5619.2018.04.010] [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] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To study the case characteristics of forensic medical identification of traumatic tympanic membrane perforations, and to discuss the key points of forensic medical identification and evaluations methods for tympanic membrane perforations. METHODS Twenty-four cases of traumatic tympanic membrane perforations accepted by the Academy of Forensic Science during 2017 were retrospectively analysed. The data of perforation size, form, predilection site, healing time and healing mode were evaluated. RESULTS For the traumatic tympanic membrane perforations, the study showed that the small size of perforation (<1/2 quadrant) with irregular shape was common. The location of perforations was almost on the anterior and inferior quadrant, and centripetal migration healing was common. The healing rate within 6 weeks was up to 90%. CONCLUSIONS In the identification cases of traumatic tympanic membrane perforations, the key is to determine whether it is traumatic and whether it will heal spontaneously within 6 weeks. It is suggested to check the tympanic membrane weekly by an otic endoscope combined with acoustic impedance measurement at the sixth week, which can improve the accuracy, objectivity and scientificity of the identification.
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Affiliation(s)
- F Chen
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - X P Yang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - X Liu
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - D A Dong
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - X R Zhou
- Shanghai Di'an Forensic Science Limited Company, Di'an Institute of Forensic Science, Shanghai 200051, China
| | - L H Fan
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
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Kim SH, Hong HS, Lee JD, Park MK. Tympanometric volume as a useful tool for the evaluation of middle ear status in chronic otitis media. Ear Nose Throat J 2018; 97:E17-E20. [PMID: 30036441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Tympanometric volume is a useful tool for evaluating middle ear status in otitis media. However, its usefulness in chronic otitis media (COM) has not been well evaluated. This study aimed to investigate whether tympanometric volume reflects the status of the middle ear and mastoid or can provide clinical information about patients with COM and subsequent tympanic membrane perforation. A prospective cohort study including 50 adult patients with COM and subsequent tympanic membrane perforation was performed. The volumes of the middle ear and mastoid were preoperatively calculated using tympanometry and three- dimensional computed tomography (CT) reconstruction of the temporal bone, respectively. During surgery for COM, the patency of the middle ear and mastoid antrum was evaluated. The volumes of the middle ear and mastoid measured by tympanometry and CT were compared with the surgical findings. When the mastoid antrum was patent, the volumes of the middle ear and mastoid measured by tympanometry and CT were well correlated. Moreover, the difference in the volumes measured by tympanometry between the affected and unaffected ears was large. However, when the mastoid antrum was poorly aerated, the difference in the volumes measured by tympanometry between the affected and unaffected ears was small. Middle ear status can be evaluated according to the difference in tympanometric volume between the two ears. If the tympanometric volume suggests poor aeration of the middle ear and mastoid, clinicians should consider procedures for mastoid aeration.
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Affiliation(s)
- Shin Hye Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Korea
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Kim SY, Han JJ, Oh SH, Lee JH, Suh MW, Kim MH, Park MK. Differentiating among conductive hearing loss conditions with wideband tympanometry. Auris Nasus Larynx 2018; 46:43-49. [PMID: 29885747 DOI: 10.1016/j.anl.2018.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/07/2018] [Revised: 05/17/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study was aimed to investigate whether wideband tympanometry (WBT) can distinguish among various kinds of conductive hearing loss and provide additional information. METHODS We recruited normal subjects and patients with conductive hearing loss due to the following reasons: tympanic membrane perforation only, ossicular chain problem only, and one or other of those conditions combined with mastoid problems. Wideband absorbance at ambient pressure, peak pressure, resonance frequency, and averaged tympanogram data were measured by WBT and compared between the normal, tympanic membrane perforation only, ossicular chain problem only, and combined with mastoid problems groups. RESULTS The normal subjects showed an average peak pressure of -19.51daPa and an average resonance frequency of 965.94Hz. Tympanic membrane perforation only patients showed a very low peak pressure (-124.93daPa) and resonance frequency (73.12Hz). When patients have ossicular chain problems, they showed slightly low peak pressures (43.08daPa) without changes in the resonance frequency (1024.8Hz). Mastoid problem subjects showed slightly decreased resonance frequencies (787.71Hz). Tympanic membrane perforation subjects showed decreased absorbance at low frequencies and ossicular chain problem subjects showed decreases at high frequencies. When comparing the perforation only and ossicular chain subjects by absorbance at 707Hz, the area under the ROC curve was 0.719 (P<0.022). Mastoid problems subjects showed decreased absorbance at all frequencies. CONCLUSION WBT can help to distinguish tympanic membrane perforation only and ossicular chain problem patients. WBT may provide additional information on "combined with mastoid problems" patients.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, Seoul, South Korea
| | - Jae Joon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Me Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea.
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Saeedi M, Ajalloueian M, Zare E, Taheri A, Yousefi J, Mirlohi SMJ, Aref NM, Saeedi MJ, Khosravi MH. The Effect of PRP-enriched Gelfoam on Chronic Tympanic Membrane Perforation: A Double-blind Randomized Clinical Trial. Int Tinnitus J 2017; 21:108-111. [PMID: 29336128 DOI: 10.5935/0946-5448.20170021] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the effect of PRP-enriched gelfoam on the healing of chronic TM perforation in comparison with gelfoam alone. METHODS In this double-blind randomized clinical trial Patients with chronic tympanic membrane were randomly allocated to two groups; intervention group underwent tympanoplasty with platelet rich plasma (PRP)- enriched gel foams and control group underwent operation with conventional gel foams alone. Patients information was recorded 4 and 12 months after surgery. RESULTS Eventually 24 patients (12 males and 12 females) with a mean age of 43.33 ± 12.34 years in intervention and 41.33 ± 10.02 years in control group underwent analysis (p = 0.667). Complete TM healing was seen in 8 (66.67%) patients in intervention group and 3 (25%) patients in control group three months after intervention (p = 0.031, OR = 5.98). CONCLUSION Addition of PRP to conventional gelfoams used in TM perforation repair increases the complete healing rate of TM perforation with less morbidity and complications.
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Affiliation(s)
- Masoumeh Saeedi
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
- International Otorhinolaryngology Research Association (IORA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Ajalloueian
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Esmaeil Zare
- Student Research Committee, Baqiyatallah University of medical sciences, Tehran, Iran
| | - Abolfazl Taheri
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Jaleh Yousefi
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Mohammadi Aref
- Student Research Committee, Tehran Medical Sciences Branch, Islamic Azad University, Iran
| | - Mohammad Javid Saeedi
- Student Research Committee, Tehran Medical Sciences Branch, Islamic Azad University, Iran
| | - Mohammad Hossein Khosravi
- International Otorhinolaryngology Research Association (IORA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Student Research Committee, Baqiyatallah University of medical sciences, Tehran, Iran
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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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Arndal E, Glad H, Homøe P. Large discrepancies in otomycosis treatment in private ear, nose, and throat clinics in Denmark. Dan Med J 2016; 63:A5231. [PMID: 27127015] [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: 06/05/2023]
Abstract
INTRODUCTION Otomycosis is a fungal infection of the external ear canal that can involve the middle ear in case of tympanic membrane perforation and also extend to the auricle. Fungi cause 7-15% of external otitis. Diagnosing otomycosis is often based entirely on non-specific clinical signs and symptoms. A multitude of antifungal drugs are available. Some are ototoxic in animals, a few are proven safe, but the ototoxicity of many drugs remains unknown. The aim of this study was to describe how otomycosis was diagnosed and treated by private ear, nose, and throat (ENT) consultants in Denmark and to investigate if the patient's immune status and the presence of a tympanic membrane perforation affected the chosen treatment modality. METHOD A questionnaire on the treatment of otomycosis was sent to 147 private ENT consultants. RESULTS In total, 103 (70%) responded. 95% performed intensive aural cleaning using an otomicroscope. The initial diagnosis was based on symptoms as only 20% required to see fungal hypha. 42% sent material for culture and sensitivity (C + S) before starting treatment and 92% sent for C + S if treatment failed. 89% used a variety of topical antifungal drugs as the first line of medical treatment. Antiseptics were used in 5%. The presence of a tympanic membrane perforation did not alter the treatment modality. Only 13% treated immunocompromised patients differently. CONCLUSION The initial diagnosis was based on non-specific symptoms and there were large discrepancies in the chosen antifungal treatment. Topical antifungal drugs were preferred. Additional research is needed. FUNDING Department of Otorhinolaryngolgy and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark. The Danish Association of Research-interested Otorhinolaryngology Consultants: Kim Werther, Peter Tingsgaard, Mads Stougaard, Steen Telmer, Henrik Møller, Liviu Guldfred. TRIAL REGISTRATION No trial registration was necessary as the questionnaire was anonymous and contained no patient data.
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Sugiuchi T, Kodera K, Zusho H, Asano Y, Kanesada K, Hayashida M, Kanaya K, Tokumaru T. [Complications Resulting from Taking Ear Impressions]. ACTA ACUST UNITED AC 2016; 118:1058-67. [PMID: 26548100 DOI: 10.3950/jibiinkoka.118.1058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In 2012, we carried out a study in a large sample to understand the secondary injuries caused during the taking ear impressions for hearing aids. This study is a follow-up of previous research conducted in 1986 (285 medical institutions) and 1999 (98 medical institutions). We posted a questionnaire survey to the otolaryngology departments of 3,257 medical institutions. The response rate to the questionnaire was 62.9% (2,050 of the 3,257 institutions), and the results indicated that 301 of the 2050 institutions (14.7%) had experience with secondary injuries, with a total of 460 cases reported. In 342 of the 460 cases (74.3%), the secondary injuries occurred at hearing-aid dealerships, followed by 67 cases (14.6%) at affiliated medical institutions, and 51 cases (11.1%) in other locations, including other medical institutions, rehabilitation counseling centers, and educational institutions. The most common type of secondary injury (298 cases, 64.8%) was caused by the presence of foreign bodies in the ear, which in turn was a result of complications occurring during the removal of residual ear impression material. Of these 298 cases, 32 required excision of the foreign bodies and surgical intervention under general anesthesia. The remaining 10 cases exhibited isolated tympanic membrane perforation without foreign body-related complications. Furthermore, 146 cases (31.7%) developed bleeding and otitis externa following removal of the ear impression, and there were reports of cases with bleeding that required long-term outpatient care and treatment. Therefore, since retention of a foreign body in the ear and tympanic membrane perforation can occur even in patients without a history of surgery or prior otologic history, adjustment of hearing aids requires prior otorhinolaryngological examination. Furthermore, because of the risk of secondary injury when taking ear impressions, this procedure must be performed with caution under the guidance of an otolaryngologist.
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Abstract
CONCLUSION Based on the results of this study, it is believed that, in appropriate patients with tympanic membrane perforation, the endoscopic butterfly cartilage myringoplasty can be applied, with a shorter operation time, high graft success rate, and low risk of complications. OBJECTIVE The aim of this study was to evaluate the results of the endoscopic butterfly cartilage myringoplasty in terms of the graft success rate and hearing gain. METHODS Forty-five ears of the 42 patients who were subjected to endoscopic butterfly cartilage myringoplasty surgery between January 2013 and December 2014 were included in this study. The archival records of the patients were reviewed retrospectively, evaluating the pre-operative and post-operative hearing results and post-operative graft success rates in the early and late periods. RESULTS The graft success rates were 97.8% (44/45 ears) and 95.6% (43/45 ears) at the post-operative 1- and 6-month follow-ups, respectively. When the post-operative air conduction hearing thresholds were compared, significant improvement was seen at post-operative 1- and 6-month follow-ups in the hearing thresholds, when compared to the pre-operative levels (p < 0.001).
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Affiliation(s)
- Abdulkadir Özgür
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Engin Dursun
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Suat Terzi
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Özlem Çelebi Erdivanlı
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Zerrin Özergin Coşkun
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Mahmut Oğurlu
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
| | - Münir Demirci
- a Department of Otorhinolaryngology, Medical Faculty , Recep Tayyip Erdogan University , Rize , Turkey
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Kryukov AI, Garov EV, Ivoilov AY, Shadrin GB, Sidorina NG, Lavrova AS. [The clinical manifestations and diagnostics of otitis media caused by tuberculosis]. Vestn Otorinolaringol 2015; 80:28-34. [PMID: 26288206 DOI: 10.17116/otorino201580328-34] [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] [Indexed: 06/04/2023]
Abstract
The objective of the present study was to clarify the characteristic pathognomonic features of middle ear lesions associated with tuberculosis and the approaches to their diagnostics under the present-day conditions. The study included 11 cases (18 ears) of tuberculosis otitis media and the related lesions of the mastoid process diagnosed with the use of clinical, roentgenological, cytological, bacteriological, pathomorphological, and molecular-genetic methods (including PCR diagnostics). The primary localization of tuberculosis in the middle ear was documented in 6 patients; in 5 patients, it was associated with pulmonary involvement. Five patients presented with smoldering exudative otitis media and the remaining six ones with suppurative perforating otitis media. The tuberculous process was diagnosed with the use of various methods including clinical examination, bacteriological (9%), cytological (27.3%), pathomorphological (18%) studies, and PCR diagnostics (55%). Diagnosis was made within a period from 1 month to 1.5 years after the application of the patients for medical assistance which suggests the difficulty of verification of tuberculous etiology of the disease of the middle ear. It is concluded that the high index of suspicion in the case of smoldering middle ear pathology facilitates its early diagnostics and successful treatment.
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Affiliation(s)
- A I Kryukov
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - E V Garov
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A Yu Ivoilov
- 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
| | - N G Sidorina
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A S Lavrova
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Marin KC, Berdich-Kun KN, Gentil F, Parente M, Natal RJ, Marin HA, Poenaru M, Popa DR. Application of a finite element model in the diagnosis process of middle ear pathologies. Rom J Morphol Embryol 2014; 55:1511-1514. [PMID: 25611290] [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: 06/04/2023]
Abstract
The ear is a complex organ that can be affected by various pathologies that are still fairly misunderstood. This work tests the possibilities of studying the ear and its pathologies using a virtual environment and thus bypassing expensive and time-consuming clinical trial. A previous validated finite element model of the middle ear was employed to study two pathological states of the middle ear. It was shown that the model obtained results very close to the clinical evaluation thus proving of being a proper tool for further investigations of middle ear pathologies.
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Affiliation(s)
- Karina Cristina Marin
- Department of Otorhinolaryngology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania;
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Yamamoto Y, Takahashi K, Morita Y, Takahashi S. Clinical behavior and pathogenesis of secondary acquired cholesteatoma with a tympanic membrane perforation. Acta Otolaryngol 2013; 133:1035-9. [PMID: 23848236 DOI: 10.3109/00016489.2013.814924] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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
CONCLUSION The pathogenesis of secondary acquired cholesteatoma with a tympanic membrane (TM) perforation is very different from that of other types of cholesteatoma. This disease should be clearly categorized as a different type of cholesteatoma. OBJECTIVE Primary cholesteatoma generally arises from retraction of the squamous epithelium of the TM. However, in rare cases, epithelial invasion occurs from the edge of the TM perforation and migrates to the medial surface of the TM and middle ear cavity. The aim of this study was to evaluate the clinical features of secondary acquired cholesteatoma with a TM perforation. METHODS We investigated 13 ears that underwent surgical treatment after the diagnosis of secondary acquired cholesteatoma with a TM perforation. Patient backgrounds, the preoperative appearances of TM, intraoperative findings, and histopathological findings were investigated. RESULTS The average age was much higher than that of patients with other types of cholesteatoma, suggesting that it must require long periods of time to establish the disease. The common area of the epithelial invasion was on the superior part of the TM perforation around the tip of the malleus handle. The tendon of the tensor tympani muscle plays an important role as an extension route for this disease.
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Affiliation(s)
- Yutaka Yamamoto
- Department of Otolaryngology Head and Neck Surgery, Niigata University Faculty of Medicine , Niigata , Japan
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Abstract
Although the "eardrum bridge" of traumatic tympanic membrane perforations (TMPs) is very little seen, the underlying natural evolution during the healing process are still unknown.The aim of this retrospective study was to evaluate the natural evolution of the "eardrum bridge" of TMPs. The data for 36 patients with barotrauma-associated traumatic TMPs with an "eardrum bridge" between January 2006 and December 2007 were retrieved. The eardrum bridge was completely liquefied due to infection in one patient. The bridge gradually became necrotic and incorporated into the new eardrum in four patients, and the healed eardrum formed a retraction pocket. In nine patients, epithelial hyperplasia occurred on both sides of the eardrum bridge at the edges, and the bridge became incorporated into the new eardrum, which became very thin over time. However, in 22 patients, the eardrum bridge gradually became necrotic, finally forming a yellow crust-like substance and migrating to the external auditory canal (EAC); it was not incorporated into the new eardrum. The closure of the perforation depended on stratified epithelial migration at the perforation edges near the eardrum bridge, resulting in a normal morphology of the healed eardrum. The present study shows that the eardrum bridge has a different natural evolution during the healing process in patients with a TMP. Most eardrum bridges gradually became necrotic and migrated toward the EAC, and stratified epithelial migration occurred at the perforation edges near the eardrum bridge and closed the perforation. However, a few eardrum bridges gradually became necrotic or developed epithelial hyperplasia, then became incorporated into the new eardrum, resulting in the formation of a retraction pocket and the development of atrophy. Thus, long-term follow-up and histological examination of a larger sample is necessary.
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Affiliation(s)
- Zhengcai Lou
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical College, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China,
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Pankey PA. You're the flight surgeon: tympanic membrane rupture. Aviat Space Environ Med 2013; 84:266-268. [PMID: 23513292 DOI: 10.3357/asem.3530.2013] [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: 06/01/2023]
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Boissevain I. [Cause and consequence]. Tijdschr Diergeneeskd 2012; 137:789. [PMID: 23327073] [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: 06/01/2023]
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Abstract
OBJECTIVE Reflectance measured in the ear canal offers a noninvasive method to monitor the acoustic properties of the middle ear, and few systematic measurements exist on the effects of various middle-ear disorders on the reflectance. This work uses a human cadaver-ear preparation and a mathematical middle-ear model to both measure and predict how power reflectance R is affected by the middle-ear disorders of static middle-ear pressures, middle-ear fluid, fixed stapes, disarticulated incudostapedial joint, and tympanic-membrane perforations. DESIGN R was calculated from ear-canal pressure measurements made on human-cadaver ears in the normal condition and five states: (1) positive and negative pressure in the middle-ear cavity, (2) fluid-filled middle ear, (3) stapes fixed with dental cement, (4) incudostapedial joint disarticulated, and (5) tympanic-membrane perforations. The middle-ear model of Kringlebotn (1988) was modified to represent the middle-ear disorders. Model predictions are compared with measurements. RESULTS For a given disorder, the general trends of the measurements and model were similar. The changes from normal in R, induced by the simulated disorder, generally depend on frequency and the extent of the disorder (except for the disarticulation). Systematic changes in middle-ear static pressure (up to 6300 daPa) resulted in systematic increases in R. These affects were most pronounced for frequencies up to 1000 to 2000 Hz. Above about 2000 Hz there were some asymmetries in behavior between negative and positive pressures. Results with fluid in the middle-ear air space were highly dependent on the percentage of the air space that was filled. Changes in R were minimal when a smaller fraction of the air space was filled with fluid, and as the air space was filled with more saline, R increased at most frequencies. Fixation of the stapes generally resulted in a relatively small low-frequency increase in R. Disarticulation of the incus with the stapes led to a consistent low-frequency decrease in R with a distinctive minimum below 1000 Hz. Perforations of the tympanic membrane resulted in a decrease in R for frequencies up to about 2000 Hz; at these lower frequencies, smaller perforations led to larger changes from normal when compared with larger perforations. CONCLUSIONS These preliminary measurements help assess the utility of power reflectance as a diagnostic tool for middle-ear disorders. In particular, the measurements document (1) the frequency ranges for which the changes are largest and (2) the extent of the changes from normal for a spectrum of middle-ear disorders.
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Affiliation(s)
- Susan E. Voss
- Picker Engineering Program, Ford Hall Smith College, Northampton, MA, USA, phone: 413 585-7008
| | | | - Nicholas J. Horton
- Department of Mathematics and Statistics Smith College, Northampton, MA, USA
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Ageenko IV. [Transmeatal aerodynamical otoendoscopy for otitis media]. Vestn Otorinolaringol 2012:31-33. [PMID: 23250522] [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
This study was designed to compare the efficacy of various methods of transmeatal aerodynamical otoendoscopy based on the examination of 60 patients presenting with acute suppurative otitis media (CSOM), chronic suppurative otitis media (CSOM), exudative and adhesive otitis media. Transmeatal aerodynamical otoendoscopy was performed with the use of otobarohydroendoscope. The results of the study demonstrate the advantages of the transmeatal aerodynamical otoendoscopic technique for the examination of the patients presenting with different clinical forms of otitis media.
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Gindesgaard CB, Møller TR. [Perforation of the eardrum caused by child abuse]. Ugeskr Laeger 2011; 173:2419-2420. [PMID: 21958485] [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]
Abstract
Munchausen syndrome by proxy (MSBP) is a complex, multifaceted form of child abuse that presents a challenge to all health-care providers. Diagnosis is difficult in cases of MSBP, and it is imperative to recognise the clinical features of MSBP in both the child and the perpetrator. All members of the health-care team must stay objective in the interactions with families where MSBP is suspected and make referrals to the proper agencies. A case is presented to explain the medical and social complexities associated with nursing and diagnosing MSBP. This article also provides a brief review of the definition of MSBP.
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Ikezono T, Shindo S, Sekine K, Shiiba K, Matsuda H, Kusama K, Koizumi Y, Sugizaki K, Sekiguchi S, Kataoka R, Pawankar R, Baba S, Yagi T, Okubo K. Cochlin-tomoprotein (CTP) detection test identifies traumatic perilymphatic fistula due to penetrating middle ear injury. Acta Otolaryngol 2011; 131:937-44. [PMID: 21696257 DOI: 10.3109/00016489.2011.575795] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONCLUSIONS The cochlin-tomoprotein (CTP) detection test can be used to make a definite, objective diagnosis of traumatic perilymphatic fistula (PLF), and therefore offers valuable information on patient selection for surgical treatment. OBJECTIVES Penetrating middle ear injury can cause traumatic PLF, which is a surgically treatable otologic emergency. Recently, we have reported on CTP, a novel perilymph-specific protein. The purpose of this study was to determine if the CTP detection test is useful for the diagnosis of traumatic PLF. METHODS This was a prospective study of CTP detection in penetrating middle ear injury cases with tympanic membrane perforation and hearing loss. RESULTS A total of seven individuals were included in this study. CTP was detected in three of four cases with posterosuperior quadrant perforation of the tympanic membrane. In one of these three cases, even though the high resolution CT scan was not suggestive of PLF and the perilymph leakage could not be visualized intraoperatively, the CTP detection test was able to detect PLF. In two cases, the preoperative positive test results enabled us to make a diagnosis of PLF and a decision for surgical treatment. CTP was not detected in the cases with anterior or inferior tympanic membrane perforation.
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Affiliation(s)
- Tetsuo Ikezono
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
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Kaffel N, Jlassi N, Selmi Z, Boulakbeche R, Lahiani R, Nejah D, Ben Saleh M, Hajri H, Ferjaoui M. [Traumatic perilymphatic fistulae : about 13 cases]. Tunis Med 2011; 89:471-475. [PMID: 21557186] [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: 05/30/2023]
Abstract
BACKGROUND Post-traumatic peri-lymphatic fistulas have been described following ear and temporal bone injury, particularly in the setting of temporal bone fractures. The symptoms and signs of perilymphatic fistulae (PLF) are very varied and frequently misleading. The diagnosis can be suspected on the bases of the clinical and the audiometrial findings. Indications for exploratory surgery in cases of trauma are vague and not well described. AIM To assess the principal clinical and radiologic signs of PLF. METHOD Study of 13 patients with different symptoms of posttraumatic peri-lymphatic fistulae. RESULTS Ten patients had vertigo, and 2 presented otoliquorreha. Two patients had tympanic perforation. Nine patients presented neurosensorinal hearing loss and 5 were completely deaf. A CT Scann was realized in 12 cases and showed the fracture in 10 cases (91%) with a pneumolabyrinth in 4 cases. Medical and postural treatment was indicated for all the patients then a surgery was indicated in all of them in an average wait of 4 months realizing an ear exclusion in one case and a filling-up for 12 patients. Vertigo improved in 10 cases and the hearing loss in 2 cases. CONCLUSION The diagnostic of perilymphatic fistulae is not easy. The trauma and the clinical signs can help but the confirmation is surgical. The indication of surgery and its timing are still discussed.
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31
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Strieth S. [Diagnosis and treatment of otitis media]. MMW Fortschr Med 2011; 153:35-37. [PMID: 21644357 DOI: 10.1007/bf03367950] [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: 05/30/2023]
Affiliation(s)
- Sebastian Strieth
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main.
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32
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Mironov AA. [Chronic purulent otitis media]. Vestn Otorinolaringol 2011:72-76. [PMID: 22334933] [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
This lecture reviews up-to-date information on the classification, etiology, pathogenesis, clinical features, diagnostics, surgical and conservative treatment of chronic purulent otitis media. It is maintained that surgical intervention including sanative and reconstructive procedures as well as hearing improvement measures is currently the preferred approach to the treatment of the disease in question. Special attention is given to different variants of sanative surgery in combination with tympanoplasty. The author emphasizes that the conservative therapy of chronic otitis media has the objective to eliminate exacerbation of the chronic process and does not substitute the surgical treatment.
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33
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Kriukov AI, Garov EV, Antonian RG, Azarov PV, Gutieva TK. [Differential atticoanthrotomy with type 1 tympanoplasty as the method of choice for the treatment of chronic perforating otitis media with expressed mucositis]. Vestn Otorinolaringol 2011:32-34. [PMID: 22334921] [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
The authors report the results of surgical treatment of 37 patients (42 ears) presenting with chronic perforating otitis media and grade I-III mucositis. All the patients were treated by differential atticoanthrotomy with type 1 tympanoplasty. Most of them suffered seriously disturbed ventilation and drainage functions of the Eustachian tube. Mean bone conduction and air conduction audibility thresholds for the voice frequency (0.5-2 kHz) prior to surgery were 12.5 +/- 6.7 and 12.0 +/- 4.2, 14.2 +/- 4.6 and 45.1 +/- 11.7 dB, 46.2 +/- 8.4 and 58.4 +/- 8.6 dB, respectively. Large defects of the tympanic membrane necessitated the use of a composite flap (autofascia and autocartilage) as the tympanic membrane autograft. Excellent survival of the tympanic autograft was documented in 33 (78.6%) patients. The remaining 9 patients had perforations in the neotympanic membrane of different size. Mean bone conduction and air conduction audibility thresholds for the voice frequency upon discharge from the clinic were 14.3 +/- 4.2, 14.0 +/- 4.4, 16.2 +/- 4.2 and 35.9 +/- 12.4 dB, 36.2 +/- 10.4, 46.6 +/- 8.2 dB, respectively. The functional outcome of the surgical treatment further improved in half a year due to the fact that the sound-conducting system acquired a higher rigidity (mean audibility thresholds for air conduction became 32.6 +/- 8.4, 34.0 +/- 6.8, and 42.2 +/- 8.4 dB. Audibility thresholds for bone conduction remained practically unaltered compared with their vales upon discharge from the clinic.
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34
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Poliakova SD, Bateneva NN, Popova EA. [Combined approaches to diagnostics and treatment of traumatic otitis]. Vestn Otorinolaringol 2010:23-25. [PMID: 21191346] [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: 05/30/2023]
Abstract
A total of 216 patients with the injured tympanic membrane were examined and treated during the last 5 years. 198 (91.6%) patients presenting with traumatic otitis were found to have pathological changes in the nose and paranasal sinuses. In patients who applied for medical aid soon (within 1-2 weeks) after injury to the tympanic membrane, the resulting perforation was closed with the use of hen's egg amniotic membrane. Audiological examination demonstrated that 84.7% of traumatic tympanic membrane ruptures were associated with acute sensorinerual loss of hearing.
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35
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Wright D, Safranek S. Treatment of otitis media with perforated tympanic membrane. Am Fam Physician 2009; 79:650-654. [PMID: 19405408] [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]
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36
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Rutt AL, Sataloff RT. Aspergillus otomycosis in an immunocompromised patient. Ear Nose Throat J 2008; 87:622-623. [PMID: 19006061] [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: 05/27/2023] Open
Abstract
Aspergillus niger, an opportunistic filamentous fungus, was identified as the cause of chronic unilateral otomycosis in a 55-year old, immunocompromised man who had been unresponsive to a variety of treatment regimens. The patient presented with intermittent otalgia and otorrhea and with a perforation of his left tympanic membrane. A niger was identified in a culture specimen obtained from the patient's left ear canal. In immunocompromised patients, it is important that the treatment of otomycosis be prompt and vigorous, to minimize the likelihood of hearing loss and invasive temporal bone infection.
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Affiliation(s)
- Amy L Rutt
- Department of Otolaryngology-Head and Neck Surgery, Huron Valley-Sinai Hospital, Detroit Medical Center, Detroit, Michigan, USA
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37
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Nepal A, Bhandary S, Mishra SC, Singh I, Kumar P. The morphology of central tympanic membrane perforations. Nepal Med Coll J 2007; 9:239-244. [PMID: 18298012] [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: 05/26/2023]
Abstract
The objective of this study was to assess the extent of conductive hearing loss in relation to different sizes and sites of simple central tympanic membrane perforations. Total 100 cases attending ENT OPD, BPKIHS during period of April 2003 to Mar 2004 without any discrimination of sex, race and religion were taken for the cross sectional prospective study. Dry, clean central tympanic membrane perforations due to various causes like chronic suppurative otitis media-tubotympanic, post acute suppurative otitis media residual perforations or simple traumatic perforations with conductive hearing loss and without preexisting hearing loss were clinicoaudiologically evaluated and analyzed. Hearing loss was found to be directly proportional to the size of perforation irrespective of their cause, which was statistically significant. Hearing loss in the study was found to range from negligible to 53dB. Overall, perforations involving posterioinferior quadrant were found to have maximum hearing loss.
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Affiliation(s)
- A Nepal
- Department of Otolaryngology and Head and Neck Surgery, B.P.Koirala Institute of Health Sciences, Dharan, Nepal.
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38
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Abstract
In tympanoplasty fascia of the temporal muscle, perichondrium and cartilage of the tragus are most commonly used as a transplant for covering tympanic membrane defects. In this study the autors investigated the use of autologous nasal mucosa as a transplant for covering small and middle sized tympanic membrane defects. The authors treated 12 patients between 5 and 75 years of age with an endomeatal tympanoplasty technique using autologous nasal mucosa as a transplant. In 11 patients the tympanic membrane defect could be sealed completely and permanently. Under certain circumstances autologous nasal mucosa which is prepared very easily can be used among other tissues as a transplant for covering tympanic membrane defects.
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Affiliation(s)
- G M Strasser
- HNO-Abteilung, Klinik am Pferdemarkt, Deggendorf
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39
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Rahmat O. Beyond a tympanic membrane perforation: a superb view of normal middle ear structures. Ear Nose Throat J 2007; 86:375. [PMID: 17702308] [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: 05/16/2023] Open
Affiliation(s)
- Omar Rahmat
- Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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40
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Abstract
BACKGROUND The goal of this study was to evaluate the prevalence of chronic tympanic membrane perforation in the adult population. MATERIALS AND METHOD The study population included 1,000 subjects (453 males, 547 females) aged 18-93 years. In addition to interview data, ear examinations were performed. RESULTS There were eight subjects with unilateral chronic tympanic membrane perforation and a single subject with a bilateral perforation. The age adjusted prevalence of chronic tympanic membrane perforation was 0.45% (95% confidence interval: 0.03-0.87). Eight out of nine subjects disliked tympanoplasty. CONCLUSION The high proportion of subjects with chronic tympanic membrane perforations who do not want to be operated suggests that there is a considerable need for novel therapeutic procedures.
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Affiliation(s)
- H Kaftan
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, Kopf- und Hals-Chirurgie, Ernst-Moritz-Arndt-Universität Greifswald, Walther-Rathenau-Str. 43-45, 17475 Greifswald.
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41
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Cho KJ, Lee DH, Jung SH, Kim JH. A case of an inflammatory myofibroblastic tumor of the mastoid presenting with chronic suppurative otitis media. Auris Nasus Larynx 2007; 34:523-6. [PMID: 17467217 DOI: 10.1016/j.anl.2007.03.005] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Revised: 02/22/2007] [Accepted: 03/02/2007] [Indexed: 10/23/2022]
Abstract
Inflammatory myofibroblastic tumors, also known as inflammatory pseudotumors, include a diverse group of lesions characterized by inflammatory cell infiltration and variable fibrotic responses. Their occurrence in the temporal bone is unusual. We present a case of an inflammatory myofibroblastic tumor of the mastoid bone in a 55-year-old female who complained of repeated otorrhea and a hearing impairment. On an otoscopic exam, her tympanic membrane was perforated. The computed tomographic imaging revealed a soft-tissue density-filled middle ear and mastoid with sclerotic bony change. The initial clinical diagnosis was chronic suppurative otitis media and mastoiditis, and the patient underwent a canal-wall down tympanomastoidectomy through a retroauricular approach. A histopathologic examination showed the presence of myofibroblastic spindle cells with mixed inflammatory infiltrates, and the pathologic diagnosis was inflammatory myofibroblastic tumor.
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MESH Headings
- Chronic Disease
- Diagnosis, Differential
- Ear Neoplasms/diagnosis
- Ear Neoplasms/pathology
- Ear Neoplasms/surgery
- Ear, Middle/pathology
- Ear, Middle/surgery
- Female
- Granuloma, Plasma Cell/diagnosis
- Granuloma, Plasma Cell/pathology
- Granuloma, Plasma Cell/surgery
- Humans
- Mastoid/pathology
- Mastoid/surgery
- Mastoiditis/diagnosis
- Mastoiditis/pathology
- Mastoiditis/surgery
- Middle Aged
- Myofibroma/diagnosis
- Myofibroma/pathology
- Myofibroma/surgery
- Otitis Media, Suppurative/diagnosis
- Otitis Media, Suppurative/pathology
- Otitis Media, Suppurative/surgery
- Otoscopy
- Skull Neoplasms/diagnosis
- Skull Neoplasms/pathology
- Skull Neoplasms/surgery
- Tomography, X-Ray Computed
- Tympanic Membrane Perforation/diagnosis
- Tympanic Membrane Perforation/etiology
- Tympanic Membrane Perforation/surgery
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Affiliation(s)
- Kwang-Jae Cho
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Secho-gu, Seoul 137-701, Republic of Korea
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42
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Ageenko IV. [Transmeatal controlled barohydrodynamic diagnosis of otitis media with perforation of the tympanic membrane]. Vestn Otorinolaringol 2007:36-39. [PMID: 18163091] [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: 05/25/2023]
Abstract
The article presents a novel method of topical diagnosis and treatment of acute and chronic otitis media purulenta with perforation in the tympanic membrane; describes indications and contraindications for the method application, its technique with use of two devices: otobarohydroscope and transmeatal catheter. The treatment was performed in a group of patients with acute otitis media purulenta at the stage of tympanic membrane perforation complicated with exudative serous mastoiditis. Transmeatal controlled barohydrodynamic therapy proved its high efficacy in topical diagnosis and therapy of patients with the above condition.
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43
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Kubilay U, Sezen OS, Ozkiriş M, Haytoğlu S, Unver S. Incudostapedial rebridging ossiculoplasty with glass ionomer cement: a case report. Kulak Burun Bogaz Ihtis Derg 2007; 17:183-6. [PMID: 17873512] [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: 05/17/2023]
Abstract
A 31-year-old woman presented with a complaint of hearing loss of a two-year history. Otoscopic examination revealed a central ear drum perforation without discharge. The air-bone gap was 35 dB at 0.5, 1, 2, and 3 kHz. Under general anesthesia, the patient underwent tympanoplasty for chronic otitis media. At surgery, the ossicular chain was intact except for discontinuity by a 2-mm gap between the long process of the incus and the head of the stapes. The gap was reconstructed with the use of a fluoroplastic prosthesis. Myringoplasty was successful, but the patient complained of hearing loss at the end of six months. Transcanal posterior tympanotomy was performed under local anesthesia for decreased conductive hearing. The prosthesis was still in place, but was not conducting the movements of the malleus to the stapes. It was removed and glass ionomer cement (Ketac-Cem) was applied for rebridging. The average air-bone gap measured in the postoperative sixth month was less than 10 dB.
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Affiliation(s)
- Utku Kubilay
- Department of Otolaryngology, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
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44
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Abstract
BACKGROUND The goal of this study was to evaluate the effects of a fibrin gel on the healing of tympanic membrane perforation in rats. METHODS Prolonged tympanic membrane perforations in 12 rats were created by application of mitomycin C to the intact tympanic membranes followed by bilateral myringotomy. Repeated applications of a fibrin gel to the perforation site of one tympanic membrane were performed in each animal. Tympanic membranes were observed for a total of 8 weeks. RESULTS One perforation in each group was already patent at the end of the observation period. The mean healing period of the remaining tympanic membranes was found to be 16.7 days in the fibrin gel group and 19.6 days in the control group. CONCLUSION A fibrin sheet does not seem to promote the wound healing process of tympanic membranes. However, the sheet might serve as a drug-delivery system for growth factors in the treatment of tympanic membrane perforations, because of its biocompatibility.
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Affiliation(s)
- H Kaftan
- Klinik und Poliklinik für Hals-Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, Ernst-Moritz-Arndt-Universität, Walther-Rathenau-Str. 43-45, 17475, Greifswald.
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45
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Abstract
CONCLUSIONS This study revealed two characteristic findings of the feeling of ear fullness (FEF) in acute sensorineural hearing loss (ASNHL). First, that the appearance of FEF was not associated with the auditory function on audiograms; and second, that the disappearance of FEF is clearly associated with the hearing prognosis. OBJECTIVE FEF appears frequently in patients with ASNHL. However, there are few reports on this symptom and its mechanism has yet to be clarified. So we tried to investigate the character of FEF in ASNHL. PATIENTS AND METHODS In this study, observations were made during the period from the first medical examination to 2 months after obtaining a steady audiogram on 227 ears from unilateral ASNHL cases, and the relationship between FEF and the audiograms was analyzed. RESULTS The FEF prevalence at the first medical examination was about 80% for any audiogram shape or hearing threshold. Moreover, the better the hearing prognosis, the higher the improvement rate of FEF.
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Affiliation(s)
- Toshifumi Sakata
- Department of Otorhinolaryngology, University of Fukuoka, School of Medicine, Fukuoka, Japan.
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46
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Teschner M, Buhr T, Donnerstag F, Lenarz T, Majdani O. [Expansion of an ceruminous adenoma into the middle ear]. Laryngorhinootologie 2006; 85:444-7. [PMID: 16770841 DOI: 10.1055/s-2005-870514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 37-year-old female presented for surgery with central perforation of the eardrum with granulation. Mastoidectomy had been performed 18 years ago following chronic mastoiditis. As the clinical picture now suggested a suspected cholesteatoma, radiological imaging was performed. The CT scan revealed specification of the mastoid and the tympanic cavity. In addition, MRI scan showed signal enhancement in the same areas. However, the suspected cholesteatoma could not be confirmed intraoperatively. Pathohistology revealed a ceruminal gland adenoma. They are a rare phenomenon and should be distinguished from middle ear adenomas, pleomorph ceruminal gland adenomas, ceruminal gland adenocarcinomas and cylindromas of the ceruminal glands. Owing to a high recurrence rate, complete surgical removal is necessary. Despite its rare occurrence, a ceruminal gland adenoma must be taken into consideration in the differential diagnosis of individual cholesteatoma cases.
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MESH Headings
- Adenoma/diagnosis
- Adenoma/pathology
- Adenoma/surgery
- Adult
- Apocrine Glands/pathology
- Apocrine Glands/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Cerumen
- Connective Tissue/pathology
- Connective Tissue/surgery
- Diagnosis, Differential
- Ear Canal/pathology
- Ear Canal/surgery
- Ear Neoplasms/diagnosis
- Ear Neoplasms/pathology
- Ear Neoplasms/surgery
- Ear, Middle/pathology
- Ear, Middle/surgery
- Female
- Hearing Loss, Mixed Conductive-Sensorineural/diagnosis
- Hearing Loss, Mixed Conductive-Sensorineural/surgery
- Humans
- Image Enhancement
- Image Processing, Computer-Assisted
- Imaging, Three-Dimensional
- Magnetic Resonance Imaging
- Mastoid/pathology
- Mastoid/surgery
- Neoplasm Invasiveness
- Sweat Gland Neoplasms/diagnosis
- Sweat Gland Neoplasms/pathology
- Sweat Gland Neoplasms/surgery
- Tomography, X-Ray Computed
- Tympanic Membrane Perforation/diagnosis
- Tympanic Membrane Perforation/surgery
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Affiliation(s)
- M Teschner
- Medizinische Hochschule Hannover, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, 30625 Hannover.
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47
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Affiliation(s)
- G Dumas
- Service d'oto-rhino-laryngologie, CHRU, 38043 Grenoble Cedex 09.
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48
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Day RS. You're the flight surgeon. Aviator with perforated tympanic membrane. Aviat Space Environ Med 2006; 77:462-3. [PMID: 16676662] [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: 05/09/2023]
Affiliation(s)
- R Shane Day
- Department of Graduate Medical Eduation, USAF School of Aerospace Medicine, Brooks City-Base, TX 78235-5130, USA
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49
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Kemmer A, Welslau W, Muth CM. [Injuries caused by pressure differences while diving]. MMW Fortschr Med 2005; 147:33-4. [PMID: 16041937] [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
Barotraumas are caused by pressure differences. As described by Boyle's Law, barotraumas develop during the descent phase of diving (and much more rarely during the ascent). The most frequently affected are the ears and paranasal sinuses, in addition to the facial skin and eyes. The most important preventive measure is performing pressure compensation in the affected body cavities. Barotrauma is treated symptomatically.
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Affiliation(s)
- A Kemmer
- Abteilung für Anästhesie, BG-Unfallklinik Murnau, Gesellschaft für Tauch- und Uberdruckmedizin GTUEM e.V
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50
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Fayad JN, House JW. Traumatic posterior tympanic membrane perforation. Ear Nose Throat J 2005; 84:396. [PMID: 16813021] [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: 05/10/2023] Open
Affiliation(s)
- Jose N Fayad
- House Ear Clinic and the Keck School of Medicine, University of Southern California, Los Angeles, USA
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