Otitis

Acute suppurative otitis media

April 30, 2008     Eric P. Wilkinson, MD and Rick A. Friedman, MD, PhD
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Clinical evaluation of piezoelectric ear surgery

March 31, 2008     Massimo Dellepiane, MD, Renzo Mora, MD, Francesco A. Salzano, MD, and Angelo Salami, MD
article

Abstract

We evaluated the use of piezoelectric surgery (Piezosurgery; Mectron Medical Technology; Carasco, Genoa, Italy) as a means of avoiding some complications of osteotomy and osteoplasty in otologic surgery, particularly in classic canal-wall-up mastoidectomy. Piezoelectric surgery is a recently developed system for cutting bone with microvibrations created by the piezoelectric effect. This effect occurs when an electric current is passed through certain ceramics and crystals, causing them to oscillate at ultrasonic frequencies. Our study population was made up of 20 adults with unilateral chronic otitis media. In all patients, piezoelectric surgery allowed for effective, precise, safe, easy, and rapid intraoperative management. In particular, the instrument's precision allowed surgeons to make exact, clean, and smooth cuts without causing any injury to adjacent soft tissue. No complications were noted. We conclude that the piezoelectric device is superior to conventionally rotating instruments for performing classic canal-wall-up mastoidectomy.

Correlation between otitis media and craniofacial morphology in adults

December 1, 2007     Renata C. Di Francesco, MD, PhD, Perboyre Lacerda Sampaio, MD, PhD, and Ricardo Ferreira Bento, MD, PhD
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Abstract

We conducted a comparison study to determine if the development of otitis media in adults is correlated with craniofacial morphology. Our study population was made up of 66 adults, aged 18 to 40 years; 32 of these patients had otitis media and 34 did not. All subjects underwent a complete otolaryngologic examination, video-otoscopy, fiberoptic nasal endoscopy, and lateral cephalometry. Statistical analysis of the cephalometric measurements in the otitis media group and the control group revealed significant differences in the angle between the anterior skull base and medial skull base, upper facial height, and anterior facial height. Also, some significant differences were seen between the measurements in the otitis media group and the normal dimensions of the harmonic face as reported in the literature; these differences were seen in the length of the anterior skull base, the angle of cranial deflection, the depth of the maxilla, the angle of the mandibular plane, the angle of facial depth, the angle of the facial cone, and lower facial height. Not all of these significant differences, however, were predictive of the evolution of otitis media. Based on our analysis, we conclude that four cephalometric measurements are predictive of the evolution of otitis media: (1) the length of the anterior skull base, (2) the angle between the anterior skull base and medial skull base, (3) maxillary depth, and (4) upper facial height. No correlations were found between otitis media and nasal blockage or between otitis media and facial type.

Is IV access necessary for myringotomy with tubes?

October 31, 2007     Arthur H. Allen, DO
article

Abstract

A retrospective chart review was conducted at a community-based hospital to determine whether intravenous access is necessary during the performance of myringotomy with tube insertion. The study included 50 pediatric patients divided equally into 2 groups: group 1, who did not have intravenous access established before the procedure, and group 2, who did have intravenous access established. To be enrolled, patients in both groups had to be ≤12 years of age, have an American Society of Anesthesiologists physical status classification of P1 or P2, and had to have undergone no adjunctive procedure with the myringotomy. Induction time was significantly shorter in group 1 (average: 6.96 ± 2.72 minutes) than in group 2 (average: 9.80 ± 3.82 minutes; p = 0.004). Operating time and total operating room time were not significantly different between the two groups. Additionally, 24 of 25 patients in group 1 had their pain managed with acetaminophen or no medication at all, while 9 of 25 group 2 patients received acetaminophen and 13 received intravenous pain medication. Interestingly, no patients in group 1 required antiemetics, whereas 4 patients in group 2, who were given intravenous or intramuscular narcotics, received antiemetic medications. These findings indicate that myringotomy with tube insertion can be safely accomplished without establishing intravenous access. Induction times and time under general anesthesia were significantly increased when intravenous access was obtained. The findings also suggest that acetaminophen provides adequate postoperative pain control in this patient population and that the use of intravenous or intramuscular narcotics increases the risk of postoperative nausea.

Systemic effects of ototopical dexamethasone

October 31, 2007    
article

Impact of biofilms on the treatment of otitis

October 31, 2007    
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Relative value of different fluoroquinolones

October 31, 2007    
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