Wilkinsonmcguire8712

Preoperative audiometry revealed total hearing loss in 4 (44.4%) patients. Further, five patients with residual hearing before surgery had stage I fistulas, and the bone conduction thresholds remained stable after surgery. CONCLUSION Cochlear fistulas were often detected in patients with (1) a history of chronic otitis media (exceeding 10 years), (2) frequently recurring otorrhea, and (3) pars tensa cholesteatomas that extended to the posterior mesotympanum and filled the sinus tympani. Such patients can suffer from potentially severe and irreparable sensorineural hearing loss.OBJECTIVES To endoscopically evaluate the patency of the isthmus tympanicum and integrity of the tensor tympani fold as routes of ventilation of the attic and mastoid in chronic otitis media (COM) and to assess their effects on mastoid pneumatization. MATERIALS AND METHODS Sixty patients with COM were categorized into two groups (1) Group A 36 patients with tympanic membrane perforation (2) Group B 24 patients with limited attic disease of whom 14 patients had attic retraction pockets and 10 with limited attic cholesteatoma. A multislice computed tomography scan of the temporal bone was performed for each patient to assess the degree of mastoid pneumatization. Notably, either myringoplasty or tympanomastoid surgery was performed in all patients. An endoscope was inserted into the middle ear for evaluation of the isthmus tympanicum and tensor fold area. RESULTS The isthmus tympanicum was patent in most ears (83.3%) of group A, whereas it was blocked in most ears (83.3%) of group B. The tensor fold was complete in 77.8% of ears in group A and 83.3% of ears in group B. It was observed that 94.1% of ears with patent isthmus in both groups had normal mastoid pneumatization and 5.9% of ears had poorly pneumatized mastoid. By contrast, 7.7% of ears with blocked isthmus tympanicum had normal mastoid pneumatization and 92.3% had poor mastoid pneumatization. Normal mastoid pneumatization was observed in 50% of ears in both groups with complete tensor fold, and 83.3% of ears with an incomplete tensor fold. CONCLUSION A significant correlation was observed between COM with limited attic disease and obstruction of the isthmus tympanicum. Obstruction of isthmus tympanicum was associated with poor mastoid pneumatization. Furthermore, an incomplete tensor fold was associated with well pneumatized mastoid.OBJECTIVES Malignant (necrotizing) otitis externa (MOE) is an aggressive form of skin inflammation of the external ear with a tendency to spread infection to the temporal bone. The study aimed to evaluate a causal relationship between treatment responses and clinical features in patients with MOE. MATERIALS AND METHODS In a retrospective, descriptive section study, the database was analyzed between January 2008 and December 2018 in our department, all patients with diagnosed MOE were identified. RESULTS A total of 30 patients were evaluated, of which 27 men and 3 women. The youngest patient was 52 years old while he was eldest 88 years, (mean-71 years old). As the most common comorbidity, diabetes mellitus was found in 23 (76%) subjects. Median duration of symptoms was about 3 months. The most common isolated pathogen was Pseudomonas aeruginosa (47%). Patients with facial nerve palsy and erosion of temporal bone find on computerized tomography affect prolonged stationary treatment (Mean, SD 29.2±8.5 and 26,7±11.6 days), while 80% of patients with facial nerve palsy had recurrence of disease (p=0.005) with mean duration of clinical remission of 60±17.3 days. Overall length of treatment is also increased in the presence of comorbidities as well as in patients with cranial nerve involvement. Proxalutamide ic50 CONCLUSION Patients with cranial nerve involvement, erosion of temporal bone and presence of comorbidities affect prolonged treatment and adverse prognosis. Early diagnosis and initiation of aggressive therapy are essential for stopping the further spread of the disease and prevention of serious complications.OBJECTIVES To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. MATERIALS AND METHODS Nine individuals (ages 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. RESULTS In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase in the summating potential/action potential (SP/AP) ratio in both ears. CONCLUSION Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus.OBJECTIVES The ideal outcome of cochlear implant surgery involves the insertion of the array inside the scala tympani of the cochlea with the least mechanical trauma. Recently, round window insertion and the direction in which the cochlea is approached have gained attention in this respect. The Angles of Cochlear Approach (ACA) can be defined with a plane in the plane of the basal turn, termed the in-plane angle, and the plane orthogonal to this plane, termed the out-plane angle. The aim of this study was to compare the trajectory angles for different surgical techniques of Veria, suprameatal, pericanal, and multiple posterior tympanotomy (PT) approaches, including an optimal trajectory that is simulated for robotic surgery. MATERIALS AND METHODS The trajectories of these surgical techniques were simulated on the same high-resolution computed tomography scan. The simulated trajectory angles were analyzed with dedicated software for medical images, defining the ACA and distances to critical otological structures.