Tympanum

Aspergillus otomycosis in an immunocompromised patient

October 31, 2008     Amy L. Rutt, DO and Robert T. Sataloff, MD, DMA
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Abstract

Aspergillus niger, an opportunistic filamentous fungus, was identified as the cause of chronic unilateral otomycosis in a 55-year old, immunocompromised man who had been unresponsive to a variety of treatment regimens. The patient presented with intermittent otalgia and otorrhea and with a perforation of his left tympanic membrane. A niger was identified in a culture specimen obtained from the patient's left ear canal. In immunocompromised patients, it is important that the treatment of otomycosis be prompt and vigorous, to minimize the likelihood of hearing loss and invasive temporal bone infection.

Assessments of the size of tympanic membrane perforations: A comparison of clinical estimations with video-otoscopic calculations

September 25, 2008     Titus S. Ibekwe, FWACS, Onyekwere G.B. Nwaorgu, FWACS, Aderemi A. Adeosun, FWACS, Daniel D. Kokong, MBBS, Hakeem O. Lawal, MBBS, Patrick O. Okundia, MBBS, and Paul A. Onakoya, FWACS (Ib)
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Abstract

We conducted a study to determine how accurate various ENT specialists were in estimating the size of 100 tympanic membrane (TM) perforations with standard otoscopy. The specialists included, in descending order of rank, 2 Consultant Surgeons, 2 Senior Registrars, and 2 Registrars, all of whom had confirmed good vision. We compared their estimates, which were made independently and expressed as a percentage of the total area of the TM, with exact measurements calculated with computer-based video-otoscopy. We found that the video-otoscopic calculations were far superior to the estimates of the specialists, even the most experienced Consultants (p < 0.01). We recommend that video-otoscopy be used whenever possible.

Monitoring reimbursement for unit charges

September 25, 2008     Steven F. Isenberg, MD
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Results of exploratory tympanotomy following sudden unilateral deafness and its effects on hearing restoration

July 31, 2008     Wolfgang Maier, MD, Milo Fradis, MD, Susanne Kimpel, MD, Jörg Schipper, MD, and Roland Laszig, MD
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Abstract

In cases of acute unilateral deafness, no consensus exists as to whether tympanotomy and sealing of the round window should be performed routinely. To further address this issue, we conducted a retrospective study of pre-, intra-, and postoperative findings in 97 patients who had undergone exploratory tympanotomy (EXT) after the onset of sudden and severe unilateral deafness. Our goal was to ascertain, if we could, whether the benefits of EXT outweigh the risks. We also took into account the effects of perilymph fistula (PLF) on the etiology of sudden hearing loss and postoperative outcomes. We found that routine EXT was indeed beneficial for these patients. It was associated with a very low surgical complication rate, and its effects on hearing as assessed by objective measures were beneficial. The greatest benefits were seen in patients who underwent EXT within 7 days after the onset of their hearing loss. With respect to PLF, we found that the presence or absence of the “typical history” of PLF (i.e., a sudden unilateral hearing loss within 48 hours after a precipitating trauma or physical exertion) had no bearing on whether a PLF was actually present in our group; nor was vertigo a reliable predictor of PLF. We recommend that EXT be performed on all patients with new-onset acute unilateral deafness, barring any contraindications, of course. The absence of a typical history of PLF should not dissuade the surgeon from proceeding with EXT.

Hemotympanum

June 30, 2008     Marc K. Bassim, MD and Jose N. Fayad, MD
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Recurrent tympanic membrane perforation following medial graft tympanoplasty

December 1, 2007     Arun K. Gadre, MD and Adam C. Augenstein, MD
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Myringostapediopexy after tympanomastoidectomy

August 31, 2007     Matthew Taljebini, MD; Eric P. Wilkinson, MD; Jose N. Fayad, MD
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A 53-year-old man presented with chronic otitis media in the right ear and a cholesteatoma in the right ear. Audiometric testing revealed a high-frequency sensorineural hearing loss in both ears and a mixed hearing loss in the right ear.

Encephalocele

July 31, 2007     James Lin, MD; Jose N. Fayad, MD
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Glomus tympanicum tumor

March 31, 2007     Troy Hutchins, MD; Enrique Palacios, MD
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