Otology

Painful rash of the auricle: Herpes zoster oticus

December 19, 2014     Chao-Yin Kuo, MD; Yuan-Yung Lin, MD; Chih-Hung Wang, MD, PhD
article

A PCR assay in addition to conventional serologic testing provides quick confirmation of the diagnosis of herpes zoster oticus infection.

Bezold abscess

June 4, 2015     Yu-Hsuan Lin, MD; Ming-Yee Lin, MD
article

In some circumstances, the only sign or symptom of Bezold abscess is an unnoticed neck lump.

Internal auditory canal osteoma: Case report and review of the literature

June 4, 2015     Sharon Ovnat Tamir, MD; Francoise Cyna-Gorse, MD; Olivier Sterkers, MD
article

Abstract

We report a case of internal auditory canal osteoma and discuss this entity's etiology, natural history, and treatment options. The internal auditory canal osteoma is a rare entity with only a few reports published in the medical literature. Its diagnosis is based on two complementary imaging modalities: thin-slice computed tomography and magnetic resonance imaging. No consensus exists regarding the treatment of this entity, and treatment should be tailored to each patient depending on that patient's initial complaints, as well as his or her medical findings.

Dehiscent high jugular bulb attached to the tympanic membrane

June 4, 2015     Hiroshi Sakaida, MD, PhD; Kazuhiko Takeuchi, MD, PhD
article

The differential diagnosis of high jugular bulb includes cholesterol granuloma, aberrant carotid artery, and tumors such as paraganglioma or schwannoma.

Malignant otitis externa

April 27, 2015     Christina H. Fang, BS; James Sun, BS; Robert W. Jyung, MD
article

The advent of anti-pseudomonal antibiotics has significantly reduced the mortality of malignant otitis externa.

Use of the chorda tympani nerve in reconstruction of the ossicular chain

April 27, 2015     Yi Qiao, MD; Wen-Wen Chen, MD; Ya-Xin Deng, MD; Jun Tong, MD
article

Abstract

We conducted a study to assess the use of the chorda tympani nerve in reconstruction of the ossicular chain. We retrospectively examined the medical records of 141 patients (154 ears) who had undergone middle ear surgery with 12 months of follow-up. The study population was made up of 58 males and 83 females, aged 9 to 83 years (mean: 45). These patients were divided into three groups based on the specific type of surgery they had undergone: in 35 patients, the chorda tympani nerve was used to spring and press the auricular bone prosthesis (CTN group); in 67 patients, the tympanic membrane was used to spring and press the auricular bone prosthesis (TM group); and in 39 patients, a gelatin sponge was used to support the auricular bone prosthesis (GS group). We compared pre- and postoperative air-bone gaps (ABGs) in each group, as well as the differences between these gaps among the three groups. We found significant differences between the pre- and postoperative ABGs in all three groups (all p < 0.01). These differences were also compared between the CTN and TM groups (t = 0.41; p > 0.05), between the CTN and GS groups (t = 2.07; p < 0.05), and between the TM and GS groups (t = 2.51; p < 0.05). In the CTN group, 1 patient experienced temporary postoperative hypogeusia, and another developed a mild case of delayed facial paralysis; both patients recovered within 2 weeks. We conclude that the chorda tympani nerve can be used to repair the ossicular chain to improve hearing without causing taste and facial nerve dysfunction and without the need for a second operation.

Chronic discharging ear and multiple cranial nerve pareses: A sinister liaison

April 27, 2015     Mainak Dutta, MS; Dipankar Mukherjee, MS; Subrata Mukhopadhyay, MS
article

SCC of the temporal bone might well represent the extreme of the “inflammation-metaplasia-dysplasia-carcinoma” sequence, with chronic otitis media representing the inflammation.

Is there a relationship between myeloperoxidase activity and conductive hearing loss in chronic otitis media complicated by cholesteatoma?

April 27, 2015     Ozlem Celebi Erdivanli, MD; Arif Sanli, MD
article

Abstract

We conducted a prospective, controlled study of patients with chronic otitis media and cholesteatoma (1) to examine the expression of myeloperoxidase (MPO) using immunohistochemical staining techniques and (2) to investigate the relationship between MPO activity and the degree of conductive hearing loss in these patients. Our study population included 51 adults-26 men and 25 women, aged 18 to 58 years (mean: 37.5)-who had been diagnosed with chronic otitis media and cholesteatoma by physical examination and computed tomography (study group). Another 30 patients-13 men and 17 women, aged 18 to 52 years (mean: 32.7)-who had chronic otitis media without cholesteatoma served as the control group. Following audiometric evaluations, all patients underwent appropriate surgery. Postoperatively, cholesteatoma samples were analyzed by immunostaining for MPO positivity as a marker for acute inflammation. We found that MPO activity was present in all 51 study patients (100%) but in only 10 controls (33.3%); the difference was statistically significant (p< 0.01). In the study group, the degree of MPO activity was slight in 6 patients (11.8%), moderate in 24 patients (47.1%), and intense in 21 patients (41.2%), while in the control group, all 10 MPO-positive cases showed only a slight degree of activity. We also found a statistically significant association in the study group between the degree of MPO activity and the degree of conductive hearing loss (χ2 = 13.518; p < 0.001). We encourage further study of all steps in the process of cholesteatoma formation.

Cochlear implantation leading to successful stapedectomy in the contralateral only-hearing ear

March 2, 2015     Samantha J. Mikals, MD; Gerald I. Schuchman, PhD; Joshua G.W. Bernstein, PhD; Arnaldo L. Rivera, MD
article

Abstract

Cochlear implants have recently begun to be offered to patients with single-sided deafness (SSD). Implantation in these patients has led to good results in suppressing ipsilateral tinnitus and in providing audiologic benefits in terms of speech perception in noise and localization. One previously unreported benefit of cochlear implantation in patients with SSD is the restoration of functional hearing in the previously deaf ear, which may allow for surgical opportunities in the contralateral hearing ear. We report a case in which cochlear implantation in the deaf left ear of a 50-year-old man allowed for surgical intervention in the previously only-hearing right ear, which in turn led to the restoration of normal middle ear function. Further studies may be warranted to consider the surgical candidacy of the contralateral only-hearing ear as another potential indication for cochlear implantation in patients with SSD.

Progression of autoimmune inner ear disease to labyrinthitis ossificans: Clinical and radiologic correlation

March 2, 2015     Jenn Nee Khoo, FRCR; Tiong Yong Tan, FRCR
article

Abstract

We report the case of a 42-year-old man who presented with fluctuating bilateral sensorineural hearing loss that subsequently progressed to a complete hearing loss, and we describe the correlation between the clinical and radiologic features of this case. To the best of our knowledge, this is the first report to demonstrate imaging evidence of progression from autoimmune inner ear disease to labyrinthitis ossificans. This is also the first reported case of a reversal of a loss of labyrinthine CISS (constructive interference in a steady state) signal, suggesting that T2-weighted hyposignal may be attributable to an alteration in labyrinthine fluid content and not to fibrosis only.

Streamlined bilateral otologic surgery: How I do it

March 2, 2015     Tara E. Brennan, MD; Miriam I. Redleaf, MD
article

Abstract

Bilateral simultaneous otologic surgery is being performed more commonly among otologists. The benefits of performing bilateral simultaneous cochlear implants in the pediatric population, in particular, have become increasingly recognized as the safety and efficacy of this operation have been recognized in the literature. Here we present a streamlined method of performing bilateral simultaneous otologic surgery that emphasizes midline placement of facial nerve electrodes and a method of sterile preparation and draping that affords direct exposure to both ears at one time, without the need to turn the head or adjust the drapes multiple times throughout the operation. Our approach facilitates frequent and efficient alternation between ears throughout the operation, optimizing efficiency of motion and instrumentation for the surgeon, and reducing overall operative and general anesthesia time for the patient.

Septic arthritis of the temporomandibular joint caused by Aspergillus flavus infection as a complication of otitis externa

March 2, 2015     Lalee Varghese, MS, DLO, DNB; Rabin Chacko, MDS, FDS, FCPS; George M. Varghese, MD, DNB, DTMH; Anand Job, MS, DLO, MNAMS
article

Abstract

Septic arthritis of the temporomandibular joint (TMJ) is a very rare complication of otitis externa that can lead to ankylosis and destruction of the joint. We report the case of a 74-year-old man who developed aspergillosis of the TMJ following otitis externa. To the best of our knowledge, this is the first reported case of TMJ septic arthritis secondary to otitis externa caused by Aspergillus flavus. The patient was successfully managed with condylectomy, debridement, and drug treatment with voriconazole.

Page
of 37Next