Hearing Loss

Bilateral hemotympanum secondary to septoplasty

September 7, 2012     Jae Hoon Lee, MD
article

Hemotympanum can be caused by temporal bone fractures, barotrauma, administration of anticoagulants, hematologic disorders, and chronic otitis media secondary to the formation of granulation tissue or a cholesterol granuloma. It can also occur secondary to nasal packing or spontaneous epistaxis, as well as eustachian tube dysfunction.

Intradermal melanocytic nevus of the external auditory canal

August 10, 2012     Kai-Chieh Chan, MD; Chi-Ju Yeh, MD; Wan-Ling Ho, MD
article

Intradermal melanocytic nevi are usually asymptomatic, but a patient with such a lesion in the external auditory canal can present with aural obstruction and conductive deafness.

Prediction of stapes footplate thickness based on the level of hearing loss in otosclerosis

August 10, 2012     Hadi Samimi-Ardestani, MD; Mohammadtaghi Khorsandi-Ashtiani, MD; Elmira Ghoujeghi, MD; Mohsen Rajati, MD; Mahtab Rabbani-Anari, MD; Aman Ghoujeghi, MD
article

Abstract

During surgical treatment of a patient with otosclerosis, the probability of success depends in large part on the extent of the surgeon’s experience. Therefore, predicting the preoperative severity of disease may help determine the choice of surgeon based on how experienced the surgeon should be. We conducted a study to evaluate the relationship between hearing thresholds and footplate thickness in otosclerosis patients who underwent stapes surgery. We used a qualitative method for measuring footplate thickness that was based on the simplicity or difficulty of opening the footplate. Our study population was divided into two groups; group 1 was made up of 66 patients whose footplates were easily opened with low pressure or with repeated motions by hand, and group 2 was made up of 14 patients whose footplate was either opened by drilling or not opened because it had been obliterated. We found that the patients in group 2, who had more severe disease, had significantly higher air- and bone-conduction thresholds than did the patients in group 1. According to our findings, otosclerotic patients with high air- and bone-conduction thresholds generally have more severe disease and thus require a more experienced surgeon.

Primary acquired cholesteatoma

April 30, 2012     Joseph A. Ursick, MD; Jose N. Fayad, MD
article

Cholesteatomas are believed to form as the result of poor eustachian tube function with resultant tympanic membrane retraction and a lack of normal epithelial migration.

Idiopathic bilateral auricular petrification

March 31, 2012     Karl J. Alsey, MbChB, MRCS, Simon R. Freeman, MBChB, FRCS, and Ajay Nigam, MBBS, FRCS
article

Abstract

Auricular petrification is a rare diagnosis and presents an interesting therapeutic challenge. Fewer than 160 cases have been reported in the literature since the first description by Bochdalek in 1866. The most common etiology is ectopic calcification. It may also result from injurious processes including frostbite, physical trauma, inflammatory conditions, and various endocrinopathies. We report an incidental finding of idiopathic bilateral auricular petrification in a 40-year-old man presenting with idiopathic unilateral sensorineural deafness.

Otoscopic findings in otosclerosis

March 31, 2012     John C. Goddard, MD and Jose N. Fayad, MD
article

Only 10% of patients with otosclerosis exhibit the reddish hue of the Schwartze sign. It is believed to appear because of increased vascularity over the promontory in the middle ear.

The burden of hearing loss in Kaduna, Nigeria: A 4-year study at the National Ear Care Centre

March 31, 2012     Aliyu M. Kodiya, FWACS, Olushola A. Afolabi, FWACS, and Babagana M. Ahmad, FWACS, FICS
article

Abstract

Hearing loss among people in developing countries has been recognized as a major source of disability. Many of its causes are preventable, and others are curable. We reviewed the records of 5,485 patients who had presented during a 4-year period to the National Ear Care Centre in Kaduna, Nigeria. Of these, we identified 1,435 patients-812 males and 623 females, aged 9 months to 90 years (mean: 29.2 yr)-who had been diagnosed with hearing loss (26.2%). In addition to demographic data, we compiled information on each patient's type and degree of hearing loss, the affected side, and the predisposing factors. Sex and age cross-tabulations revealed that the greatest proportion of hearing loss according to sex occurred between the ages of 11 and 20 years for males and 21 and 30 years for females. The most common type of hearing loss was sensorineural, which was seen in 78.9% of patients; conductive hearing loss was seen in 17.7% and mixed in 3.4%. More than three-quarters of hearing losses were either moderate, moderately severe, or severe. Bilateral losses were far more common than unilateral losses; among the latter, the left side was affected slightly more often than the right. Predisposing factors were not documented in the vast majority of cases (87.6%), but when they were, the most common were chronic suppurative otitis media, meningitis, febrile convulsion, measles, and trauma. We present these findings to highlight the burden of hearing loss in our part of the world.

Is there a need for audiologic evaluation in patients with Behçet disease?

March 1, 2012     Saniye Cinar, MD, Fikret Cinar, MD, and Sibel Kiran, MD, PhD
article

Abstract. Behçet disease is known to be a multisystem condition. We conducted a study to determine the prevalence of hearing loss in patients with Behçet disease and to identify any associations between audiologic findings and other clinical manifestations and treatment. Our study group was made up of 41 adults with Behçet disease and 41 healthy sex- and age-matched controls. All patients and controls underwent a complete clinical otolaryngologic examination, which included pure-tone audiometry, acoustic impedance testing, and otoacoustic emissions testing. Audiology revealed that the prevalence of sensorineural hearing loss (SNHL) was significantly higher in the Behçet patients than in the controls-68.3 vs. 22.0% (p < 0.002). The duration of Behçet disease had no significant impact on whether patients did or did not experience hearing loss. Hearing loss was the fourth most common clinical finding in the Behçet group, after oral ulcers, genital ulcers, and skin lesions. We conclude that SNHL is present in a significant number of Behçet patients, and we suggest the need for an adequate investigation of hearing in the routine follow-up of these patients.

Ectodermal dysplasia: Otolaryngologic evaluation of 23 cases

February 18, 2012     Muzeyyen Yildirim, MD, Ediz Yorgancilar, MD, Ramazan Gun, MD, and Ismail Topcu, MD
article

Abstract

The aim of this prospective study was to improve the quality of life of and reduce morbidity for patients with ectodermal dysplasia by assessing their actual and potential ENT pathologies, and offering methods of prevention and treatment. The study was conducted between 2006 and 2008 and included 23 patients diagnosed with ectodermal dysplasia. The major symptoms of ectodermal dysplasia were evaluated. Patient histories were obtained in all cases, and a complete head and neck examination was carried out. Of the 23 patients (11 males and 12 females, aged 5 to 45 years) diagnosed with ectodermal dysplasia, 22 had hypohidrotic ectodermal dysplasia and 1 had ectrodactyly-ectodermal dysplasia-clefting syndrome. In all patients diagnosed with hypohidrotic ectodermal dysplasia, the salivary glands were examined by ultrasonography and, when necessary, by scintigraphy. Hearing defects in patients with otologic problems were determined by audiometric examination: 39.1% of the patients had hearing loss, 43.5% had otitis media, and 39.1% had impacted cerumen. The most common rhinologic findings were saddle nose deformity in 56.5%, nasal obstruction and nasal dryness (52.2% each), and chronic rhinitis/rhinosinusitis (34.8%). The most common oral and oropharyngeal findings were difficulty chewing in 82.6% and dry mouth in 78.3%. All 23 patients had required dental work. Because this disorder affects several aspects of the body, its treatment requires a multidisciplinary approach, with the otolaryngologist being a vital part of the management team.

Folliculosebaceous cystic hamartoma of the external auditory canal in an adult

February 18, 2012     Fabiana Pirani Carneiro, MD, Leonora Maciel de Souza Vianna, MD, Aline Marques dos Santos, MD, Igor Teixeira Raymundo, MD, and Ana Emília Borges de Azevedo, MD
article

Abstract

Folliculosebaceous cystic hamartoma (FSCH) is a cutaneous hamartoma of pilosebaceous origin that usually occurs on the face. We present what we believe is only the second reported case of FSCH of the external auditory canal, and the first in an adult. The patient was a 59-year-old woman who presented with a 4-year history of a firm nodule on the left external auditory canal that had caused hearing loss, pruritus, and pain. The lesion was excised, and histopathologic examination identified infundibular cysts, hyperplasia of the sebaceous lobules, and a large amount of mucin, features that are consistent with FSCH. One year postoperatively, the patient was asymptomatic, and no evidence of recurrence was noted.

Hearing loss: Economic impact

January 25, 2012     Robert T. Sataloff, MD, DMA, FACS, Editor-in-Chief
article

More and more of us are living long enough to experience hearing loss.

Was that my doctor?

December 15, 2011     Robert T. Sataloff, MD, DMA, FACS, Editor-in-Chief
article

Confusion among patients about what kind of healthcare provider they have seen is pervasive. While reputable professionals in all disciplines are responsible about avoiding confusion and potential adverse health consequences, problems still exist.

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