Middle Ear

Eustachian tube foreign body undetected for 30 years: Case report

March 31, 2009     David M. Filsoof, MD and Steven Y. Park, MD
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Abstract

This case report describes the unexpected finding of a eustachian tube prosthesis placed 30 years earlier, after the patient had experienced years of chronic rhinorrhea.

Facial nerve hemangioma of the middle ear

March 1, 2009     Issam Saliba, MD and Jose N. Fayad, MD
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From the Department of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center (Dr. Saliba), and the House Ear Clinic, Los Angeles (Dr. Fayad)

Middle ear barotrauma with hyperbaric oxygen therapy: Incidence and the predictive value of the nine-step inflation/deflation test and otoscopy

December 1, 2008     Serdar Karahatay, MD, Yavuz Fuat Yilmaz, MD, Hakan Birkent, MD, Hakan Ay, MD, and Bulent Satar, MD
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Abstract

We conducted a prospective study to determine the incidence of middle ear barotrauma in patients who were undergoing hyperbaric oxygen therapy (HBOT). We also investigated the value of the nine-step inflation/deflation test and otoscopic findings before and immediately after the initial HBOT session in predicting barotrauma in an attempt to establish some criteria for prophylaxis. The study was conducted on 36 ears of 18 adults who had no history of eustachian tube dysfunction. Patients were being treated with HBOT for sudden hearing loss, wound-healing complications, or complications of diabetes. After 7 days of HBOT, barotrauma was seen in 12 of the 18 patients (66.7%) and in 18 of the 36 ears (50.0%). The nine-step inflation/deflation tests, which were performed before and immediately after the initial HBOT session, were not predictive of barotrauma (p = 0.095 before and p = 0.099 after). However, otoscopic findings obtained immediately after the first session of HBOT were predictive of barotrauma, with a sensitivity and specificity of 83 and 100%, respectively. We conclude that patients with even minor positive pathologic findings on otoscopy immediately following HBOT are at increased risk of middle ear barotrauma if HBOT is to be continued without prophylaxis.

White mass in the middle ear

October 31, 2008     Maroun T. Semaan, MD and Jose N. Fayad, MD
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Migration of T-tubes to the middle ear

July 31, 2008    
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Aggressive papillary tumor of the middle ear: A true entity or an endolymphatic sac neoplasm?

June 30, 2008     James R. Tysome, MA, MRCS, Jonny Harcourt, MA, FRCS, Manish C. Patel, FRCR, Ann Sandison, FRCPath, and Leslie Michaels, MD, FRCPath
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Abstract

Aggressive papillary tumors of the middle ear are rare, and their true origin is not clear. We describe the clinical, radiologic, genetic, and histopathologic features of a papillary epithelial tumor filling the middle ear of a 68-year-old woman. Imaging revealed no evidence of petrous temporal bone apex involvement, nor did genetic studies demonstrate the von Hippel-Lindau mutation. A literature search revealed 24 previously reported cases of such a papillary epithelial tumor of the middle ear. All except 2 cases demonstrated apical petrous temporal bone invasion on imaging, and it has been suggested that they arose from a primary endolymphatic sac tumor, which has a similar papillary epithelial histology. Substantial numbers of cases of papillary epithelial tumors involving the middle ear are reported to be associated with von Hippel-Lindau disease, as are known cases of endolymphatic sac tumor. This is the third reported case of papillary epithelial tumor of the middle ear that does not show apical petrous temporal bone invasion on imaging, suggesting that such neoplasms do not always arise from a primary in the endolymphatic sac.

Hemotympanum

June 30, 2008     Marc K. Bassim, MD and Jose N. Fayad, MD
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Acute suppurative otitis media

April 30, 2008     Eric P. Wilkinson, MD and Rick A. Friedman, MD, PhD
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Aberrant ectatic internal carotid artery in the middle ear

March 31, 2008     Adnan Safdar, FRCS, Joseph P. Hughes, FRCS, and Rory McConn Walsh, FRCS
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Abstract

We report the case of a 34-year-old man with pulsatile tinnitus and a reddish mass in the anteroinferior quadrant of the middle ear. Physical examination and imaging were unable to establish a diagnosis, so an exploratory tympanotomy was performed. Exploration revealed the presence of an ectatic aberrant internal carotid artery in the middle ear. Aberrations of the internal carotid artery in the middle ear are rare. Even so, our case is unusual in that all initial investigations had failed to establish the diagnosis. This case highlights the limitations of modern imaging techniques in certain situations.

Spontaneous cerebrospinal fluid leak presenting as unilateral (left-sided) middle ear effusion

February 1, 2008     Kavadi T. Rajkumar, MBBS, DLO, Ahmed A. Orabi, FRCS, MSc, and Michael S. Timms, FRCS
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Abstract

Spontaneous leak of cerebrospinal fluid (CSF) into the middle ear occurs rarely and can easily be missed, especially in adults. Although the presenting symptoms can be subtle, early suspicion and confirmatory imaging can establish the diagnosis. Most previously reported cases of spontaneous CSF leak into the middle ear occurred on the right side. We report a case of left-sided single-defect spontaneous leak.

Migration of T-tubes to the middle ear

January 1, 2008     Thabet Abbarah, MD, FACS and M. Aiman Abbarah, MD
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