Hearing Loss

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
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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.

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.

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.

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.

Otomastoiditis with acute left facial nerve paralysis caused by Mycobacterium chelonae

December 15, 2011     Kang-Chao Wu, MD, Min-Tsan Shu, MD, and Bo-Nien Chen, MD
article

Abstract

Mycobacterium chelonae usually causes soft-tissue and skin infection. It is a rare cause of otomastoiditis. The clinical presentation and operative findings are similar to those of other nontuberculous mycobacterial infections. We describe a case of left-sided otomastoiditis with acute facial nerve paralysis caused by this organism in a previously well middle-aged woman. Her facial palsy totally resolved after tympanomastoidectomy plus a 7-week regimen of clarithromycin and moxifloxacin. To our knowledge, a case of otomastoiditis with acute facial nerve paralysis caused by M chelonae has not been reported previously.

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.

A purely intracanalicular cochlear schwannoma presenting with progressive hearing loss

October 26, 2011     Hüseyin I&scedil;&inodot;ldak, MD, Metin Ibrahimov, MD, Mehmet Yilmaz, MD, Ozgun Enver, MD, and Sait Albayram, MD
article

Abstract

Schwannomas arising from the cochlear nerve and confined to the internal auditory canal are rare. Clinically, a cochlear schwannoma can cause a progressive hearing loss. We report the case of a 56-year-old woman with a cochlear schwannoma that manifested as a slowly progressive hearing loss. The lesion was diagnosed by gadolinium-enhanced 3-Tesla magnetic resonance imaging.

Meningioma mimicking vestibular schwannoma

July 13, 2011     Sung Won Chae, MD and Moo Kyun Park, MD
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