Emersoncummings0878
Aural atresia is a congenital disease that is characterized by an embryologic developmental defect of the external auditory canal (EAC). There is an erythematous, bulging tympanic membrane by otoscope in physical examination of acute otitis media (AOM). Children with aural atresia experience AOM as children have normal anatomy. However, its diagnosis is hard due to the absence of EAC. Facial paralysis is an intratemporal complication of AOM. If this complication develops in a child with aural atresia and otitis media, it makes the condition even more complicated. A 10-month old child who had such a condition is presented in this paper.Traumatic perilymphatic fistula (PLF) is an uncommon cause of acute vestibular symptoms and hearing loss following head injury in children. We describe the management of 3 pediatric patients with traumatic PLF using an endoscopic ear surgery (EES) approach. Three pediatric patients with traumatic PLF underwent repair via an EES approach between August and October 2018. Patients included a 14-year-old female (oval window), a 13-year-old male (round window), and a 10-month-old male (oval and round window). Ossicular chain injury was identified and repaired in 2 patients. The 10-month-old patient required a second-stage surgery that included lumbar drain placement and a post-auricular, endoscopic-assisted approach due to an especially brisk leak. All patients had complete resolution of vestibular symptoms post-operatively with no recurrence at a mean follow-up of 8.3 months. Traumatic PLF can be safely and effectively diagnosed and managed via an EES approach in children, though an endoscopic-assisted approach may be necessary in select cases due to factors such as patient age and leak severity.We discuss a case of lower lip carcinoma which presented with atypical symptoms; facial paralysis, conductive type hearing loss, and ophthalmoplegia. Due to an earlier resection, no mass was evident on the primary examination. Diagnostic imaging revealed a mass originating from the lower lip, the perineural spread of the tumor along the left inferior alveolar nerve to the left infratemporal fossa and the left foramen ovale. Through a retrograde course from the foramen ovale, the tumor extended the ipsilateral cavernous sinus, Meckel's cave, and cisternal portion of the CN V. This atypical spread pattern of the tumor caused symptoms that may be attributed to a diagnosis related to the ear. The biopsy confirmed squamous cell carcinoma, and the patient was referred for chemotherapy and radiotherapy.Paragangliomas (PGLs) of Head and Neck region account for 0.6% of Head and Neck Tumours. These may originate in paraganglionic tissues in the area of carotid bifurcation, vagus nerve, tympanic plexus and very rarely along vertical Facial nerve canal (FNC). We intend to describe a rare case of primary paraganglioma of FNC associated with hypoxia of submarine environment, its characterization and multidisciplinary approach towards its management.Establish outcomes following cochlear implantation (CI) in patients following temporal bone trauma. Systematic review and narrative synthesis. Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits are placed on language or year of publication. The review conducted in accordance with the PRISMA statement. Searches identified 223 abstracts and 64 full texts. Of these, 23 studies met the inclusion criteria reporting outcomes in 77 patients with at least 96 implants. Hearing outcomes were generally good with most patients demonstrating improved audiological and functional outcomes. Complications were reported in 14 cases with 10 of these being major. The methodological quality of included studies was modest, predominantly consisting of case reports and non-controlled case series with small numbers of patients. All studies were OCEBM grade IV. Hearing outcomes following CI in temporal bone trauma are good with useful functional improvement demonstrated in the majority of patients. It appears to be an effective method of aural rehabilitation and should be considered in selected cases following hearing loss due to temporal bone fracture.It has been revealed that the pure-tone audiometry demonstrates large air-bone gaps at low pitches due to the presence of inner ear fistulae. When a third mobile window resulting from an inner ear fistula is present, in addition to the 2 normally present windows consisting of the oval window and the round window, a portion of the air-conducted waves escape from the scala vestibuli through the inner ear fistula. On the other hand, bone-conducted waves traveling to the scala vestibuli are reduced by an inner ear fistula; however, bone-conducted waves traveling to the scala tympani are not affected by an inner ear fistula. This results in a larger gap than usual in compliance between both perilymphatic spaces and leads to a decrease in the bone conduction threshold. This phenomenon, so-called the third mobile window effects, sometimes may lead otology/neuro-otology surgeons to misunderstand the reason why large air-bone gaps still exist after ossicular reconstruction in tympanoplasty. This review article gives good examples regarding the third mobile window effects in otology/neuro-otology diseases and surgeries.A rare pediatric case report of middle ear neuroendocrine tumor and review of the pediatric cases reported in the literature. A 16-year-old female showed a lesion occupying the posterosuperior part of the medial third of the right external auditory canal confirmed by computed tomography scan, without clear evidence of bone erosion. The patient underwent canal wall tympanoplasty in 1 stage. No residual pathology was present after 1 month, 3-6 months, and after 1 year. There are few known pediatric cases of this disease, there is no statistically significant data for this population regarding the risk of recurrence or metastasis. Middle ear neuroendocrine tumors are rare above all in children. They are slow aggressive tumors but they can recur and rarely give local metástasis. Only 4 pediatric cases have been published. We have completely removed the tumor in our patient, using a conservative surgical treatment in a single stage.
The objective of the study is to compare amplification strategies on tinnitus relief. A repeated measure research design was used to determine the best strategy that provides a significant relief on tinnitus and improvements in speech perception.
We recruited 20 participants in the age range of 30-60 years (mean age = 47.95 years) having mild to moderately severe sloping sensorineural hearing loss with continuous tonal tinnitus. We grouped the participants into mild and severe, based on the scores obtained in the Tinnitus Handicap Inventory. We evaluated tinnitus pitch and loudness using the adaptive method. Besides, we assessed signal to noise ratio 50 (SNR 50) from each of the programs. We carried out a paired comparison method to determine the best strategy among the 3 in which the maximum preference score was obtained on tinnitus relief by a test hearing aid programmed with 3 programs.
Each group of participants significantly preferred the strategy for the gain in hearing aid set at tinnitus pitch on tinnitus. However, there was no significant difference between the SNR 50 scores in the 3 gain settings.
An additional gain set at tinnitus pitch after alleviating hearing loss by the prescriptive method was found to be the best strategy for effective masking of tinnitus and that led to tinnitus relief without compromising speech perception.
An additional gain set at tinnitus pitch after alleviating hearing loss by the prescriptive method was found to be the best strategy for effective masking of tinnitus and that led to tinnitus relief without compromising speech perception.
Anatomical information regarding the eustachian tube (ET) is limited; therefore, more detailed analytical data on ET structure is needed when planning surgical treatments involving the temporal bone.
We examined the bony structure of the middle ear and ET in 30 Japanese donor cadavers (71-97 years old at the time of death) both macroscopically and with cone-beam computed tomography. Each ET was reconstructed in 3 dimensions, and the structure and correlations of ET element measurements, identified via principal component analysis, were analyzed.
Delineation between bony and cartilaginous zones appeared unclear, and the space between ET cartilage and the carotid canal was narrow. We observed stenosis of the ET bony canal in 43.3% of the specimens (n = 30). In 50% of the specimens, the position of the ET bony canal was depressed at the pharyngeal orifice of the auditory side of the tube, and the middle region was a roundish structure. The lateral and central regions of the bony canal were related to the ET bony canal structure.
The close proximity of the ET bony canal to the carotid canal is an important anatomical and morphological finding. Pre-surgical 3D modeling of the middle ear structure, or at a minimum, of the central region of the middle ear canal, may provide useful information for planning procedures that involve the ET.
The close proximity of the ET bony canal to the carotid canal is an important anatomical and morphological finding. Pre-surgical 3D modeling of the middle ear structure, or at a minimum, of the central region of the middle ear canal, may provide useful information for planning procedures that involve the ET.
Compare hearing benefit of incus preservation in primary cholesteatoma surgery versus cartilage-myringostapediopexy.
Prospective cohort study in a tertiary referral center. Tympanoplasty utilizing cartilage or other grafts, with or without intact incus was performed in 195 ears (187 children) with intact stapes. Outcome measures were pre and post-operative four-tone air conduction (AC) threshold (0.5, 1, 2, 4 kHz) and proportion with normal hearing (AC ≤ 30 dB HL) at 12 months.
Ears with intact ossicles had better post-operative AC thresholds than those with incus eroded or removed (median 20 dB HL vs. 30 dB HL, Mann-Whitney P < .001). The normal hearing rate was 81/106 (74%) with intact incus and 46/89 (52%) without (Fisher's exact P = .001). Ears without intact incus and a cartilage-myringostapediopexy had better post-operative thresholds than those with a non-cartilage graft (28.8 dB HL vs. 36.3 dB HL, Mann-Whitney P = .005). Of ears without intact incus, 37/59 (63%) with a cartilage-myringostapediopexy and 9/30 (30%) with a non-cartilage graft had normal hearing post-operatively (Fisher's exact P = .007). find more By preserving the incus in 12 ears, 1 more ear would have normal hearing than with incus removal plus cartilage-myringostapediopexy (NNT = 12 (CI 3.6-); Fisher's exact = 0.1).
Preserving an intact ossicular chain conveys a small but significant hearing benefit in cholesteatoma surgery, the magnitude of which should be considered before deciding to remove the intact incus. Cartilage-myringostapediopexy provides a significant gain in hearing when the incus is absent, even without a partial ossicular replacement prosthesis.
Preserving an intact ossicular chain conveys a small but significant hearing benefit in cholesteatoma surgery, the magnitude of which should be considered before deciding to remove the intact incus. Cartilage-myringostapediopexy provides a significant gain in hearing when the incus is absent, even without a partial ossicular replacement prosthesis.
