October 31, 2012 Min-Tsan Shu, MD; Kang-Chao Wu, MD; Yu-Chun Chen, MD
article
Tympanic membrane retraction caused by long-term eustachian tube dysfunction may lead to erosion of the ossicles and cholesteatoma.
October 31, 2012 Moshe Hain, MD; Edit Feldberg, MD; and Doron Halperin, MD
article
Abstract
We report the case of a 73-year-old man who developed metastatic small-cell lung cancer to the bony external auditory canal (EAC). The patient had only recently been diagnosed with his primary carcinoma. The metastasis presented as a bulky, fleshy, bleeding mass in the right EAC. Biopsy of the metastasis revealed that its histologic characteristics were identical to those of the primary. This case is of interest because this was a unique type of metastasis to the EAC. Although there are reports in the literature of lung cancer and even small-cell cancer metastasizing to the temporal bone, we could find no previously published report of a small-cell lung carcinoma metastasizing to the EAC.
October 31, 2012 Lester D.R. Thompson, MD
article
An uncommon entity, otic polyp arises in response to a long-standing inflammatory or infectious process of the middle ear, most often in young boys.
October 8, 2012 Joseph A. Ursick, MD; Derald E. Brackmann, MD
article
Cholesterol granulomas can cause bony expansion and typically become symptomatic when they encroach upon adjacent cranial nerves.
October 4, 2012 Yok Kuan Chew, MS; Jack Pein Cheong, MBBS; Abdullah Khir, MS; Sushil Brito-Mutunayagam, MS; Narayanan Prepageran, FRCS
article
Abstract
Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that caused a left temporal lobe abscess and a right mastoid fistula.
September 7, 2012 John C. Goddard, MD; Eric R. Oliver, MD; Ted A. Meyer, MD, PhD
article
Abstract
Hallermann-Streiff syndrome, also known as oculomandibulofacial syndrome, is a rare congenital disorder affecting growth and cranial, dental, ocular, pilocutaneous, and mental development. In addition to routine audiologic testing in patients with this syndrome, high-resolution computed tomography of the temporal bones should be performed in those with documented or suspected sensorineural hearing loss. Cochlear implantation may be considered, as in other children with syndromic hearing loss and certain inner ear abnormalities, if the appropriate audiologic, psychosocial, and medical criteria are met. The current case report radiographically and clinically characterizes inner ear dysplasia in an 8-year-old patient with Hallermann-Streiff syndrome. High-resolution computed tomography of the temporal bones revealed a hypoplastic bony island between the vestibule and horizontal semicircular canals, as well as incomplete bony coverage of the posterior semicircular canal crura bilaterally. To our knowledge, this is the first report of a pediatric patient demonstrating bilateral posterior semicircular canal dehiscence.
September 7, 2012 Jae Hoon Lee, MD
article
Hemotympanum can be caused by temporal bone fractures, barotrauma, administration of anticoagulants, hematologic disorders, and chronic otitis media secondary to the formation of granulation tissue or a cholesterol granuloma. It can also occur secondary to nasal packing or spontaneous epistaxis, as well as eustachian tube dysfunction.
August 10, 2012 Kai-Chieh Chan, MD; Chi-Ju Yeh, MD; Wan-Ling Ho, MD
article
Intradermal melanocytic nevi are usually asymptomatic, but a patient with such a lesion in the external auditory canal can present with aural obstruction and conductive deafness.
August 10, 2012 Borlingegowda Viswanatha, MS, DLO
article
Abstract
A 14-year-old girl who had been experiencing ear discharge for the previous 3 years was referred to a tertiary care center for management of a 3-day history of severe headache and vomiting. Otolaryngologic examination revealed the presence of an atticoantral type of ear disease on the left side. Computed tomography detected an interhemispheric subdural abscess that had originated on the left side. The patient was initially treated with antibiotics, and she later underwent a mastoidectomy to clear the ear disease. She recovered without complications. Subdural empyema is the rarest complication of otitis media, and it is very rarely seen in an interhemispheric setting.
August 10, 2012 Ahmed Hesham, MD; Ayman Hussien, MD; Ahmed Hussein, MD
article
Abstract
Previous animal studies have shown that the topical application of mitomycin C is safe and effective in prolonging the patency of myringotomy openings in ears that have not received a ventilation tube. We conducted a randomized, controlled study in humans to determine if this treatment would make a difference in outcomes when a ventilation tube is inserted. To that end, we prospectively studied a group of patients with resistant otitis media with effusion who underwent bilateral myringotomy and ventilation tube insertion. Our original study population was made up of 55 children aged 2 to 12 years; 15 of these patients were lost to follow-up, leaving us with 40 patients and 80 ears. Each patient served as his or her own control, as mitomycin C was applied to the tympanic membrane on one side just prior to myringotomy creation and normal saline was applied to the other side. Our main outcomes measures were the duration of tube placement (i.e., the length of time before extrusion of the tube) and the incidence of other early and late postoperative complications. We found no statistically significant difference between the mitomycin C-treated ears and the control ears in any of these parameters. We conclude that the use of mitomycin C prior to myringotomy and ventilation tube insertion is not worthwhile.
August 10, 2012 Hadi Samimi-Ardestani, MD; Mohammadtaghi Khorsandi-Ashtiani, MD; Elmira Ghoujeghi, MD; Mohsen Rajati, MD; Mahtab Rabbani-Anari, MD; Aman Ghoujeghi, MD
article
Abstract
During surgical treatment of a patient with otosclerosis, the probability of success depends in large part on the extent of the surgeon’s experience. Therefore, predicting the preoperative severity of disease may help determine the choice of surgeon based on how experienced the surgeon should be. We conducted a study to evaluate the relationship between hearing thresholds and footplate thickness in otosclerosis patients who underwent stapes surgery. We used a qualitative method for measuring footplate thickness that was based on the simplicity or difficulty of opening the footplate. Our study population was divided into two groups; group 1 was made up of 66 patients whose footplates were easily opened with low pressure or with repeated motions by hand, and group 2 was made up of 14 patients whose footplate was either opened by drilling or not opened because it had been obliterated. We found that the patients in group 2, who had more severe disease, had significantly higher air- and bone-conduction thresholds than did the patients in group 1. According to our findings, otosclerotic patients with high air- and bone-conduction thresholds generally have more severe disease and thus require a more experienced surgeon.
August 10, 2012 Levent Gurbuzler, MD; Kursat Yelken, MD; Ibrahim Aladag, MD; Ahmet Eyibilen, MD; Sema Koc, MD
article
Abstract
We conducted a study to examine cochlear activity in women with a naturally occurring menstrual cycle by measuring transient otoacoustic emissions (TOAEs) and distortion-product otoacoustic emissions (DPOAEs). Our study population was made up of 11 women aged 20 to 40 years (mean: 35.6) who were not taking a contraceptive medication or hormone therapy. Measurements of TOAEs and DPOAEs were made during both the follicular phase and the luteal phase of the menstrual cycle. We found no statistically significant difference in any of the TOAE amplitude values between the two phases. Although a sharp decrease at the 0.75 kHz frequency was seen in DPOAEs during both phases, none of the amplitude values in the tested frequencies were significantly different between the two phases. The absence of TOAE and DPOAE amplitude changes suggests that it is unnecessary to take into account the phase of the menstrual cycle when interpreting the results of otoacoustic emissions testing.
