January 1, 2006 S. Arif Ulubil, MD; Adrien A. Eshraghi, MD
January 1, 2006 Frank O. Agada, FRCS; Ravi Sharma, FRCS; Zvoru G.G. Makura, FRCS
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Abstract
A 70-year-old Asian man with noninsulin-dependent diabetes presented with a 4-month history of left-sided otitis externa and right-sided facial palsy. Physical examination of the left ear revealed a punched-out ulcerative lesion on the tragus, an edematous and inflamed external auditory canal, and a purulent nonmucoid discharge. Computed tomography of the brain and neck demonstrated a large retropharyngeal abscess, an abscess in the left parapharyngeal space, and a small collection adjacent to the right carotid sheath at the level of C4; the cervical vertebrae and lungs were normal. Microscopy of drained pus and histology of left ear and neck node biopsies identified tuberculosis. The patient was started on antituberculosis drug therapy, but he died within 2 weeks of treatment. We discuss the characteristics of this unusual presentation of tuberculosis infection.
December 1, 2005 Saba Battelino, MD, MSc; Irena Hocevar-Boltezar, MD, PhD; Miha Zargi, MD, PhD
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Abstract
The ability of mitomycin C to inhibit fibroblasts in vitro has prompted its use during standard surgical procedures as a means of preventing the development of adhesions and stenosis. We conducted a prospective study to evaluate the effectiveness of topical mitomycin C in maintaining an open external auditory canal in 6 ears of 4 patients with aural fibrotic atresia who were undergoing meatoplasty. During the procedure, we applied 1 ml of mitomycin C (0.4 mg/ml) for 4 minutes to the external auditory canal (in 1 case, mitomycin C was reapplied to an ear 1 month later). Between 3 and 14 months postoperatively, the patency of the ear canal was assessed visually and hearing was evaluated audiometrically. Adequate patency was achieved in 5 of the 6 ears (83.3%), and the air-bone gap in these 5 ears had improved to 10 dB or less. No postoperative complications or sensorineural hearing loss was observed. In this very limited number of cases, we found that the intraoperative use of mitomycin C appeared to have been helpful in preventing scarring in both congenital and secondary fibrotic atresias of the external auditory canal. These preliminary results are encouraging, and a prospective, placebo-controlled study appears to be warranted.
April 1, 2005 Yakubu G. Karagama, MRCS, DLO; Lindsey R. Bridges, FRCPath; Philip T. van Hille, FRCS
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Abstract
We describe a case of angioleiomyoma of the internal auditory meatus. A finding of this tumor at this site is very unusual. In fact, our review of the literature revealed that only 1 case has been previously reported. In our patient, the tumor was clinically and radiologically difficult to distinguish from an acoustic neuroma. It would be important to recognize this rare small tumor preoperatively because it may be appropriate to manage it conservatively.
March 1, 2005 John W. House, MD; Jose N. Fayad, MD
January 1, 2005 Henry J. Carson, MD; Jeffrey S. Krivit, MD; Stanley G. Eilers, MD
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Abstract
We report on a patient who developed far-ranging metas-tases of adenocarcinoma of the colon that followed a gradual cephalad progression, including the right external ear canal, and led to hearing loss. The patient was a 63-year-old white male with stage III adenocarcinoma of the colon. After 2 years with metastases elsewhere, he developed hearing loss on the right side. Physical examination of the head and neck showed a mass in the external ear canal, and biopsy confirmed adenocarcinoma. After removal, the patient's hearing improved. This case is interesting not only because of the unusual metastasis to the external ear canal, but also because of the patient's previous history of metastasis over the course of more than 2 years. The significance of such wide-ranging metastases is that metastasis of adenocarcinoma to the ear did not signal imminent death, and relief of the hearing loss it caused was possible.
