Otology

Recurrent auricular perichondritis in a child as the initial manifestation of insulin-dependent diabetes mellitus: A case report

February 12, 2014     Andria M. Caruso, MD; Macario Camacho Jr., MD; and Scott Brietzke, MD
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Abstract

An 8-year-old boy presented to our otolaryngology clinic three times in a 3-month period for treatment of acute auricular perichondritis. At each visit he was treated with an antibiotic, and he responded quickly in each case, with a complete resolution of his infection. The results of standard autoimmune laboratory tests were negative. Three months after his initial presentation, the patient developed the classic signs and symptoms of diabetes mellitus, including polydipsia, polyuria, and weight loss. He was diagnosed with and treated for type 1 (insulin-dependent) diabetes, and his recurrent infections ceased. There has been no recurrence over a 4-year follow-up period. This case report serves to illustrate the fact that recurrent infections may be the first sign of diabetes. Since diabetes and perichondritis are known to be associated, we recommend that for patients who present with recurrent episodes of perichondritis, a basic metabolic panel and measurement of the glycosylated hemoglobin level be added to standard autoimmune laboratory testing to possibly identify undiagnosed diabetes.

Unilateral sensorineural hearing loss and facial nerve paralysis associated with low-voltage electrical shock

February 12, 2014     Mahmut Ozkiris;, MD
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Abstract

Electrical injuries can occur as a result of contact with low- or high-voltage electricity. Low-voltage injuries are more common, as they usually occur in the home, but reports in the literature are few. After exposure to electric current, almost every organ system in the body is affected. The severity of an injury depends on many factors, including the type of current, the duration of exposure, and the resistance of the tissue involved. Reported cases of hearing loss and facial nerve paralysis associated with low-voltage electrical shock are rare, and minimal information is available about this circumstance. In this article, the author describes a case of low-voltage electrical shock in a 20-year-old man. To the best of the author's knowledge, this is the first report in the literature of a resolution of unilateral sensorineural hearing loss and facial nerve paralysis caused by a low-voltage electrical shock.

Basaloid squamous cell carcinoma of the pinna: Report of a rare case

January 21, 2014     Anil Jain, MS; Ashish Katarkar, MS; Pankaj Shah, MS; Jignasa Bhalodia, MD; Sanyogita Jain, MD; Sapna Katarkar, DA
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Abstract

Basaloid squamous cell carcinoma (BSCC) is rare. We report a case of BSCC in a 60-year-old woman who presented with a bleeding vascular growth on the left pinna. To the best of our knowledge, no case of BSCC of the pinna has been previously reported in the literature. We present this case to alert physicians that this highly aggressive variant of squamous cell carcinoma can appear on the pinna and therefore it should be considered in the differential diagnosis of lesions in this area.

Temporal bone fracture

January 21, 2014     Danielle M. Blake, BA; Senja Tomovic, MD; Robert W. Jyung, MD
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Transverse fractures account for approximately 20% of temporal bone fractures. They occur secondary to frontal or occipital head trauma, and they run perpendicular to the petrous pyramid.

Case report: Dermal inclusion cyst of the external auditory canal

December 20, 2013     Eric W. Cerrati, MD; Jonathan S. Kulbersh, MD; Paul R. Lambert, MD
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Abstract

Dermal inclusion cysts are benign masses that arise as the result of the entrapment of ectodermal components during embryogenesis. Their presenting symptoms are a direct result of the mass effect of the growing cyst. We describe the case of a 23-month-old girl who presented with a single, large dermal inclusion cyst in the external auditory canal. Our review of the literature revealed that only 2 other cases of a dermal inclusion cyst in this location have been previously reported.

Medial migration of a tympanostomy tube

December 20, 2013     Alejandro Vazquez, MD; Robert W. Jyung, MD
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Vertebral artery dissection: An unusual cause of transient ataxia, vertigo, and sensorineural hearing loss

December 20, 2013     Leila L. Touil, MBChB; Glen James Watson, FRCS, DOHNS; Michael Small, FRCS
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Abstract

We present the case of a 33-year-old man who was admitted with intermittent ataxia, vertigo, and sensorineural hearing loss as a result of a vertebral artery dissection following minor neck trauma. Our aim is to highlight the importance of obtaining magnetic resonance imaging, magnetic resonance angiography, and/or duplex color-flow imaging when presented with a case of fluctuating vertigo and sensorineural hearing loss with side-specific ataxia. Likewise, it is important to obtain the input of neurologists to optimize a patient's prognosis and minimize long-term sequelae.

Bilateral middle cranial fossa encephaloceles presenting as conductive hearing loss

December 20, 2013     Colleen T. Plein, MD; Alexander J. Langerman, MD; Miriam I. Redleaf, MD
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Abstract

We report a case involving a patient with bilateral middle cranial fossa encephaloceles extending into the middle ear and causing conductive hearing loss. An obese, 47-year-old woman with a history of a seizure disorder presented with a slow-onset subjective hearing loss. Examination revealed opaque tympanic membranes, and audiometry showed a mixed hearing loss bilaterally. Myringotomy demonstrated soft tissue behind each tympanic membrane. Biopsy, computed tomography, magnetic resonance imaging, and mastoidectomy confirmed the diagnosis of bilateral middle cranial fossa encephaloceles. Bilateral encephaloceles are uncommon, and the resulting bilateral conductive hearing loss secondary to mechanical obstruction of ossicular vibration is even more rare. This patient's obesity and seizures perhaps contributed to her disease process.

Glial choristoma of the middle ear

December 20, 2013     Karen A. Shemanski, DO; Spencer E. Voth, DO; Lana B. Patitucci, DO; Yuxiang Ma, MD, PhD; Nikolay Popnikolov, MD, PhD; Christos D. Katsetos, MD, PhD; Robert T. Sataloff, MD, DMA, FACS
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Abstract

Glial choristomas are isolated masses of mature brain tissue that are found outside the spinal cord or cranial cavity. These masses are rare, especially in the middle ear. We describe the case of an 81-year-old man who presented with left-sided chronic otitis media, mastoiditis, hearing loss, tinnitus, and aural fullness. He was found to have a glial choristoma of the middle ear on the left. Otologic surgeons should be aware of the possibility of finding such a mass in the middle ear and be familiar with the differences in treatment between glial choristomas and the more common encephaloceles.

Dehiscence of the high jugular bulb

October 23, 2013     Min-Tsan Shu, MD; Yu-Chun Chen, MD; Cheng-Chien Yang, MD; Kang-Chao Wu, MD
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The conservative treatment for a high jugular bulb is regular follow-up with serial imaging studies to detect possible progression, even in asymptomatic cases.

Immunization guidelines for cochlear implant recipients

October 23, 2013     Barry E. Hirsch, MD
article

Patients who have a cochlear implant are considered to be at a higher risk of developing meningitis following otitis media. Whether this occurs along the electrode going from the middle ear into the cochlea or through a blood-borne pathway is unclear.

Extrusion of hydroxyapatite ossicular prosthesis

October 23, 2013     Danielle M. Blake, BA; Senja Tomovic, MD; Robert W. Jyung, MD
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Extrusion of hydroxyapatite prostheses is unfortunately a common complication of middle ear surgery.

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