Auditory Canal

An evaluation of auditory exostoses in 621 prehistoric human skulls from coastal Brazil

July 31, 2007     Maria Mercedes M. Okumura, PhD; Célia Helena C. Boyadjian, BA; Sabine Eggers, PhD
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Abstract
Auditory exostoses are bone anomalies located on the floor of the external auditory canal. They frequently develop in individuals who participate in water sports and other aquatic activities. Their etiology is probably multifactorial; development seems to be triggered by regular exposure to cold water, as well as to low air temperatures and/or cold winds. The presence of auditory exostoses has been recorded in human skull fossils that date back approximately 250,000 years. We conducted a study of auditory exostoses in 621 skulls of adult humans who had been part of a marine-dependent population that lived on the Brazilian coast between 5,400 and 800 years ago. The overall frequency of exostoses was 22%, but there was a great variance among different subgroups (0 to 56%). In this article, we propose some possible explanations for this variance. We also hope that our study will stimulate multidisciplinary research aimed at deciphering the intricate bony messages contained in cryptic archaeologic remains.

Bilateral cerebellopontine angle metastatic melanoma: A case report

June 30, 2007     Abraham Jacob, MD; Rebecca P. Brightman, MD; D. Bradley Welling MD, PhD
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Abstract
Although melanoma accounts for approximately 1% of all malignancies, melanoma metastases to the cerebello-pontine angles (CPAs) are exceedingly rare. Here we describe a patient with melanoma metastases to the internal auditory canals and CPAs who presented with a remote history of cutaneous melanoma. This patient had a rapidly progressive hearing loss, vestibulopathy, and facial nerve dysfunction. Magnetic resonance imaging demonstrated bilateral, enhancing CPA lesions but was otherwise nonspecific. The diagnosis required a careful history, unilateral surgical resection for tissue acquisition, and histopathologic confirmation. A search for primary cutaneous melanoma at the time of presentation was negative. However, the history of cutaneous melanoma 8 years earlier distinguishes this patient's metastatic disease from solitary primary intracranial melanoma, an equally rare disease. Treatment consists of surgical excision, radiation, chemotherapy, and immunotherapy. The prognosis for patients with melanoma metastases is generally poor, but isolated reports of long-term survival have been described. Metastatic disease to the CPAs must be included in the differential diagnosis for any patient presenting with rapid-onset VIIth or VIIIth cranial nerve symptoms.

Epidermolysis bullosa

March 31, 2007     James Lin, MD; Jose N. Fayad, MD
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Amyloidosis of the external auditory canal and middle ear: Unusual ear tumor

February 1, 2007     Heitham Gheriani, FRCSI, FRCSEd; Rajesh Tewary, MD, FRCSEd; Timothy J. O'Sullivan, FRCS(C)
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Multiple angiomas of the external auditory canal in a patient with Sturge-Weber syndrome

January 1, 2007     Matthew E. Dahl, MD; Marcella Bothwell, MD; Scot D. Hirschi, MD
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Cholesteatoma of the external auditory canal in an immunocompromised patient

September 30, 2006     Arun K. Gadre, MD; Jennifer Davies, MD
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Role of impacted cerumen in hearing loss

September 30, 2006     Sethu T. Subha, MS (ORL); Rajagopalan Raman, MS (ORL)
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Abstract
We performed a study to determine if cerumen in the ear canal causes significant hearing loss and to ascertain if there is any correlation between the amount of cerumen and the degree of hearing loss. Our study was conducted on 109 ears in 80 patients. The results indicated that impacted cerumen does cause a significant degree of conductive hearing loss. We found no significant correlation between the length of the cerumen plug and the severity of hearing loss. Nor did we find any significant correlation between the presence of impacted cerumen and variables such as age, sex, ethnicity, or affected side.

Primary B cell lymphoma of the external auditory canal

August 31, 2006     Sheldon P. Hersh, MD; Winston G. Harrison, MD; David J. Hersh, MD
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Abstract
Temporal bone lymphomas are rare and typically metastatic neoplasms. We describe a case of primary B cell lymphoma that originated in the external auditory canal of an elderly woman. The diagnosis was based on histopathologic examination supplemented by immunophenotypic analysis. The patient was treated with external-beam radiation and remained disease-free throughout 9 years of follow-up. We also point out that the presence of non-Hodgkin's lymphoma in an unusual site may be an indication that the patient has an acquired immunodeficiency syndrome.

An unusual 'disappearing mass' in the ear canal

June 30, 2006     Eu Chin Ho, MRCS, DOHNS; Naeem Siddiqui, DLO, FRCS (ORL-HNS)
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Reconstruction of the conchal bowl and external auditory canal

June 30, 2006     Suma Susan Mathews, DLO, MS; Shiby Ninan, MS, Mch
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Exostosis of the external auditory canal

March 1, 2006     J. Walter Kutz, Jr., MD; Jose N. Fayad, MD
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An unusual site of a CSF leak following resection of a retrosigmoid acoustic neuroma

March 1, 2006     Michael P. Ondik, MD; Aaron G. Benson, MD; Hamid Djalilian, MD
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Abstract
Cerebrospinal fluid (CSF) leaks may occur after acoustic neuroma resection. These leaks are usually the result of an iatrogenic injury during removal. The retrosigmoid approach is commonly associated with leaks that occur through the lateral end of the internal auditory canal, through the perilabyrinthine cells extending to the region of the internal auditory canal, or through the retrosigmoid air cells. We describe a case of an infracochlear CSF leak that developed following the retrosigmoid resection of an acoustic neuroma. To the best of our knowledge, this leak was unique for both its location and etiology.
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