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OBJECTIVE: This study aims to identify clinical predictors of treatment response to Eustachian Tube Balloon Dilation (ETBD) as measured by changes in Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores. METHODS: One hundred thirteen patients who underwent ETBD at an institution from 2017 to 2021 completed ETDQ-7 pre- and post-operatively. We conducted multivariable regression analyses with ETDQ-7 normalization (<2.1 post-op), minimum clinically important difference (MCID) (>0.5 pre-op - post-op), and quantitative improvement in ETDQ-7 score as outcome variables. Pre-operative ETDQ-7 score, tympanogram type, chronic otitis media, chronic rhinosinusitis (CRS), inferior turbinate hypertrophy, deviated septum, allergic rhinitis, and rhinorrhea were included as covariates. Models controlled for age, sex, ethnicity, prior ear or sinus surgery, and follow-up duration. RESULTS: The mean age was 49 years old. 51% were females, and all patients had pre-operative ETDQ-7 above 2.1. After a mean follow-up period of 13 months, 77% achieved MCID and 37% had normalized. Higher pre-operative ETDQ-7 score was associated with greater ETDQ-7 score improvement (B = 0.60, 95% CI = [0.37, 0.83]) and greater odds of achieving MCID (aOR = 1.65; 95% CI = [1.06, 2.59]). A history of CRS improved chances of achieving MCID (aOR = 4.53; 95% CI = [1.11, 18.55]) and a history of chronic otitis media predicted increased odds of ETDQ-7 normalization (aOR = 2.88; 95% CI = [1.09, 7.58]). CONCLUSIONS: Our findings suggest that ETBD was highly effective among patients with pre-operative ETDQ-7 above 2.1. Furthermore, higher pre-operative ETDQ-7 score, CRS, and chronic otitis media predicted more favorable symptomatic benefit from ETBD. These factors may be important to consider when counseling potential candidates for this procedure.

Auriculocondylar syndrome (ACS) is a rare craniofacial disorder characterized by mandibular hypoplasia and an auricular defect at the junction between the lobe and helix, known as a "Question Mark Ear" (QME). Several additional features, originating from the first and second branchial arches and other tissues, have also been reported. ACS is genetically heterogeneous with autosomal dominant and recessive modes of inheritance. The mutations identified to date are presumed to dysregulate the endothelin 1 signaling pathway. Here we describe 14 novel cases and reassess 25 published cases of ACS through a questionnaire for systematic data collection. All patients harbor mutation(s) in PLCB4, GNAI3, or EDN1. This series of patients contributes to the characterization of additional features occasionally associated with ACS such as respiratory, costal, neurodevelopmental, and genital anomalies, and provides management and monitoring recommendations.

In medicine, a misdiagnosis or the absence of specialists can affect the patients health, leading to unnecessary tests and increasing the costs of healthcare. In particular, the lack of specialists in otolaryngology in third world countries forces patients to seek medical attention from general practitioners, whom might not have enough training and experience for making correct diagnosis in this field. To tackle this problem, we propose and test a computer-aided system based on machine learning models and image processing techniques for otoscopic examination, as a support for a more accurate diagnosis of ear conditions at primary care before specialist referral; in particular, for myringosclerosis, earwax plug, and chronic otitis media. To characterize the tympanic membrane and ear canal for each condition, we implemented three different feature extraction methods: color coherence vector, discrete cosine transform, and filter bank. We also considered three machine learning algorithms: support vector machine (SVM), k-nearest neighbor (k-NN) and decision trees to develop the ear condition predictor model. To conduct the research, our database included 160 images as testing set and 720 images as training and validation sets of 180 patients. We repeatedly trained the learning models using the training dataset and evaluated them using the validation dataset to thus obtain the best feature extraction method and learning model that produce the highest validation accuracy. The results showed that the SVM and k-NN presented the best performance followed by decision trees model. Finally, we performed a classification stage -i.e., diagnosis- using testing data, where the SVM model achieved an average classification accuracy of 93.9%, average sensitivity of 87.8%, average specificity of 95.9%, and average positive predictive value of 87.7%. The results show that this system might be used for general practitioners as a reference to make better decisions in the ear pathologies di

Tophaceous gout of the middle ear is a rare occurrence that presents as a granular white-colored mass. It is frequently misdiagnosed as cholesteatoma or tympanosclerosis in patients who otherwise may not manifest any clinical or biochemical signs of gout. While uncommon, it can lead to clinically significant disease such as conductive hearing loss. The present report describes 2 cases of middle ear gouty tophi initially mistaken for another entity. Both patients underwent surgery, and the diagnosis of gout was revealed after final histopathological analysis. A review of the literature is also presented.

Tophaceous gout of the middle ear is a rare occurrence that presents as a granular white-colored mass. It is frequently misdiagnosed as cholesteatoma or tympanosclerosis in patients who otherwise may not manifest any clinical or biochemical signs of gout. While uncommon, it can lead to clinically significant disease such as conductive hearing loss. The present report describes 2 cases of middle ear gouty tophi initially mistaken for another entity. Both patients underwent surgery, and the diagnosis of gout was revealed after final histopathological analysis. A review of the literature is also presented.

In this case series, we set out to describe the clinical entity of isolated, prolonged aural fullness (AF) and its relationship with migraine. Patients with isolated, persistent AF for 6 months or more were included with all possible etiologies ruled out. Migraine dietary and lifestyle changes and medical migraine prophylactic therapy were prescribed to all. Eleven patients were included (mean age, 52 years). Six (54%) patients fulfilled International Headache Society criteria for migraine with or without aura. Changes in perceived sensation of AF using the visual analog scale and quality of life questionnaires resulted in a statically significant improvement ( P < .001, 95% confidence interval [CI], 4.7 to 6.72, and P < .001, 95% CI, -5.3 to -2.7, respectively). As such, an improvement of isolated, prolonged AF with migraine lifestyle changes and prophylactic treatment may suggest an etiological association between migraine and prolonged aural fullness.

In this case series, we set out to describe the clinical entity of isolated, prolonged aural fullness (AF) and its relationship with migraine. Patients with isolated, persistent AF for 6 months or more were included with all possible etiologies ruled out. Migraine dietary and lifestyle changes and medical migraine prophylactic therapy were prescribed to all. Eleven patients were included (mean age, 52 years). Six (54%) patients fulfilled International Headache Society criteria for migraine with or without aura. Changes in perceived sensation of AF using the visual analog scale and quality of life questionnaires resulted in a statically significant improvement ( P < .001, 95% confidence interval [CI], 4.7 to 6.72, and P < .001, 95% CI, -5.3 to -2.7, respectively). As such, an improvement of isolated, prolonged AF with migraine lifestyle changes and prophylactic treatment may suggest an etiological association between migraine and prolonged aural fullness.

Objectives: To assess the multiple ear malfomartion that can be found in a patient with type III microtia and to present the demographic findings and the audiological evaluation of a group of patients. Methods: Retrospective study, including all patients with type III microtia referred to the Childhood Hearing Loss Unity of a tertiary hospital during a period of 8 years. Patients’ clinical history, audiologic evaluation and computed tomography (CT) results were collected from individual case files. CT findings were distributed into 5 groups of abnormalities: external ear, middle ear, mastoid, inner ear and fallopian canal. Results: Ten patients with type III microtia were included. The right ear was the most affected. Six patients had associated genetic syndromes. All patients with only one side affected had a conductive hearing loss on the affected ear with normal hearing in the contralateral ear. Regarding the groups of CT findings: the external auditory canal was atresic in nine patients and one patient had a membranous stenosis; in the middle ear, there were malformations of the tympanic membrane, ossicular chain and the tympanic cavity width. The most common ossicular chain anomaly was a malleus-incus fusion. Abnormalities of mastoid size and pneumatization were also observed. The Fallopian canal was abnormal in six patients. No anomalies of tegmen tympani, oval and round window or inner ear were found in our study. Conclusion: This study highlights the anatomic variations of the temporal bone that can be associated with type III microtia. It is a valuable addition to the available knowledge of this rare condition, since it allows us to predict which changes are most expected to be found in these patients and permit an easier reading of the imaging exam., Objetivo: Avaliar as múltiplas malformações do ouvido possíveis nos doentes com microtia tipo III e apresentar os achados demográficos e a avaliação audiométrica de uma amostra destes doentes. Métodos: Estudo retrospetivo, incluindo todos os doentes com microtia tipo III referenciados para o departamento de Surdez Infantil dum hospital terciário durante 8 anos. A avaliação clínica, avaliação audiológica e os resultados da tomografia computorizada (TC) foram obtidos através de consulta dos processos clínicos. Os achados da TC foram distibuídos em 5 grupos de anomalias: ouvido externo, ouvido médio, mastoide, ouvido interno e canal de Falópio. Resultados: Foram incluídos 10 doentes com microtia tipo III. O ouvido direito foi o mais afetado. Seis doentes tinham síndromes genéticas associadas. Todos os doentes com apenas um lado afetado apresentavam hipoacusia de condução ipsilateral com audição normal no ouvido contralateral. Relativamente aos grupos de achados de TC: o canal auditivo externo era atrésico em nove doentes; um doente apresentava estenose membranosa; no ouvido médio, registaram-se malformações da membrana timpânica, da cadeia ossicular e da largura da cavidade timpânica. A malformação da cadeia ossicular mais frequente foi a fusão incudo-maleolar. Na mastoide, observam-se alterações do tamanho e da pneumatização. O canal de falópio estava alterado em seis doentes. Não foram observadas malformações do tégmen timpânico, das janelas oval e redonda ou do ouvido interno. Conclusão: Este estudo realça as alterações anatómicas do osso temporal que podem estar associadas a microtia tipo III. É uma adição importante ao conhecimento atual, uma vez que permite predizer quais as alterações que são expectáveis nestes doentes, assim como possibilita uma leitura mais fácil do exame de imagem

Objective A smartphone-enabled otoscope (SEO) can capture tympanic membrane (TM) images. We sought to compare a SEO to microscopic otoscopy in the detection and evaluation of TM pathology in an otology/neurotology practice. Study Design Prospective single-site study in adults presenting over a 3-month period. Setting Neurotology clinic within a tertiary care academic medical center. Subjects and Methods Following consent, 57 patients underwent a medical and microscopic ear examination. Afterward, clinicians photographed bilateral TMs using a SEO. A second "blinded" neurotologist received a SEO-acquired image of each TM and a brief patient history. Our primary end point was identification of TM pathology (or lack thereof) and the blinded neurotologists' corresponding diagnosis. Secondary end points included patient-reported SEO comfort levels. Results A single SEO-acquired TM image and brief patient history resulted in correct diagnosis of 96% (23/24) of normal TMs and identification of 100% (33/33) of microscope-confirmed abnormal TMs. When pathology was identified by the "blinded" physician, the diagnosis was identical to that made by the primary treating physician 82% (27/33) of the time. On patient surveys, 93% (53/57) of patients felt "very comfortable" with SEO utilization, and 88% (50/57) reported viewing acquired images was "very useful" in understanding their condition. Conclusion A SEO is 96% specific in identifying normal TMs and 100% sensitive in identifying pathology. Its 97% positive predictive value and small false-positive rate makes it a useful screening tool. Furthermore, patients are receptive to this technology and felt comfortable with its utilization in a health care or possible telemedicine setting.

Objectives/hypothesisTo evaluate the variability and discrepancies among the most commonly prescribed ear drops sold at pharmacies in southern California.Study designProspective study evaluating 11 commonly used ear drops to treat otologic disorders.MethodsRandomly selected drug stores in three major counties in Southern California (Los Angeles, Orange, and San Diego) were included. Mean, range, minimum, and maximum prices for each drug were calculated and analyzed. The median income of pharmacy ZIP code was also cross-referenced.ResultsData were collected from 108 pharmacies. The mean prices are noted for each of the individual drugs: Cortisporin (brand) 10 mL, $82.70; neomycin, polymyxin B sulfates, and hydrocortisone (Cortisporin-generic) 10 mL, $34.70; ofloxacin (generic) 10 mL, $99.95; sulfacetamide (generic) 15 mL, $40.18; Ciprodex (brand) 7.5 mL, $194.44; Cipro HC (brand) 10 mL, $233.32; Vosol (brand) 15 mL, $120.75; acetic acid (Vosol-generic) 10 mL, $116.55; VosolHC (brand) 10 mL, $204.14; acetic acid/aluminum acetate (Domeboro-generic) 60 mL, $22.91; and Tobradex (brand) 5 mL, $166.47.ConclusionsThere is significant variability among the prices of ear drops across Southern Californian pharmacies, which can be a financial burden to patients paying out of pocket or with high deductibles. A state-mandated, publically accessible report of drug prices may help decrease variability and cost by promoting competition among pharmacies. Price negotiations by governmental payers may assist in reducing prices. In the treatment of otologic disorders, clinicians can help reduce costs for patients by prescribing generic ear drop medications and cheaper alternatives when clinically appropriate.Level of evidence4. Laryngoscope, 127:1780-1784, 2017.

Objective A smartphone-enabled otoscope (SEO) can capture tympanic membrane (TM) images. We sought to compare a SEO to microscopic otoscopy in the detection and evaluation of TM pathology in an otology/neurotology practice. Study Design Prospective single-site study in adults presenting over a 3-month period. Setting Neurotology clinic within a tertiary care academic medical center. Subjects and Methods Following consent, 57 patients underwent a medical and microscopic ear examination. Afterward, clinicians photographed bilateral TMs using a SEO. A second "blinded" neurotologist received a SEO-acquired image of each TM and a brief patient history. Our primary end point was identification of TM pathology (or lack thereof) and the blinded neurotologists' corresponding diagnosis. Secondary end points included patient-reported SEO comfort levels. Results A single SEO-acquired TM image and brief patient history resulted in correct diagnosis of 96% (23/24) of normal TMs and identification of 100% (33/33) of microscope-confirmed abnormal TMs. When pathology was identified by the "blinded" physician, the diagnosis was identical to that made by the primary treating physician 82% (27/33) of the time. On patient surveys, 93% (53/57) of patients felt "very comfortable" with SEO utilization, and 88% (50/57) reported viewing acquired images was "very useful" in understanding their condition. Conclusion A SEO is 96% specific in identifying normal TMs and 100% sensitive in identifying pathology. Its 97% positive predictive value and small false-positive rate makes it a useful screening tool. Furthermore, patients are receptive to this technology and felt comfortable with its utilization in a health care or possible telemedicine setting.

Objectives/hypothesisTo evaluate the variability and discrepancies among the most commonly prescribed ear drops sold at pharmacies in southern California.Study designProspective study evaluating 11 commonly used ear drops to treat otologic disorders.MethodsRandomly selected drug stores in three major counties in Southern California (Los Angeles, Orange, and San Diego) were included. Mean, range, minimum, and maximum prices for each drug were calculated and analyzed. The median income of pharmacy ZIP code was also cross-referenced.ResultsData were collected from 108 pharmacies. The mean prices are noted for each of the individual drugs: Cortisporin (brand) 10 mL, $82.70; neomycin, polymyxin B sulfates, and hydrocortisone (Cortisporin-generic) 10 mL, $34.70; ofloxacin (generic) 10 mL, $99.95; sulfacetamide (generic) 15 mL, $40.18; Ciprodex (brand) 7.5 mL, $194.44; Cipro HC (brand) 10 mL, $233.32; Vosol (brand) 15 mL, $120.75; acetic acid (Vosol-generic) 10 mL, $116.55; VosolHC (brand) 10 mL, $204.14; acetic acid/aluminum acetate (Domeboro-generic) 60 mL, $22.91; and Tobradex (brand) 5 mL, $166.47.ConclusionsThere is significant variability among the prices of ear drops across Southern Californian pharmacies, which can be a financial burden to patients paying out of pocket or with high deductibles. A state-mandated, publically accessible report of drug prices may help decrease variability and cost by promoting competition among pharmacies. Price negotiations by governmental payers may assist in reducing prices. In the treatment of otologic disorders, clinicians can help reduce costs for patients by prescribing generic ear drop medications and cheaper alternatives when clinically appropriate.Level of evidence4. Laryngoscope, 127:1780-1784, 2017.

ObjectiveTo describe a novel approach for excision of exostoses and evaluate the outcomes of transcanal excision of exostoses using ultrasonic serrated knife-assistance versus microosteotomes only.Study designRetrospective analysis.SettingAcademic Tertiary Care Center.Patients/interventionsPatients receiving a transcanal excision of exostoses between 2007 and 2016.Main outcome measuresThe outcomes and postoperative complications of 138 patients who received transcanal microosteotome only technique were compared to 10 patients who received transcanal excision of exostoses using ultrasonic serrated knife-assistance (Stryker Corporation, Kalamazoo, MI).ResultsA total of 175 ears in 128 patients underwent a transcanal microosteotome only technique. Of these, 11 (6.3%) developed an intraoperative tympanic membrane perforation. One developed anterior canal mobilization requiring prolonged (3 wk) packing. One hundred thirty-five ears (77%) were well healed by the 3-week postoperative visit. All but one ear was well healed by the 6-week visit. In comparison, 11 ears in 10 patients were treated for exostoses using a transcanal approach with the use of ultrasonic serrated knife and microosteotomes. One ear canal (the first in the series) was not well healed by the 3-week postoperative visit due to suspected thermal injury. All patients had well-healed ear canals by 6 weeks, and there were no complications.ConclusionThis is the first series to report the use of an ultrasonic serrated knife in the transcanal excision of exostoses. When compared with a transcanal microosteotome only excision of exostoses, the addition of the Sonopet seems to result in a similarly low complication rate. Sonopet can allow for more controlled transcanal excision of broad-based exostoses in patients with severe obstruction.

ObjectiveTo describe a novel approach for excision of exostoses and evaluate the outcomes of transcanal excision of exostoses using ultrasonic serrated knife-assistance versus microosteotomes only.Study designRetrospective analysis.SettingAcademic Tertiary Care Center.Patients/interventionsPatients receiving a transcanal excision of exostoses between 2007 and 2016.Main outcome measuresThe outcomes and postoperative complications of 138 patients who received transcanal microosteotome only technique were compared to 10 patients who received transcanal excision of exostoses using ultrasonic serrated knife-assistance (Stryker Corporation, Kalamazoo, MI).ResultsA total of 175 ears in 128 patients underwent a transcanal microosteotome only technique. Of these, 11 (6.3%) developed an intraoperative tympanic membrane perforation. One developed anterior canal mobilization requiring prolonged (3 wk) packing. One hundred thirty-five ears (77%) were well healed by the 3-week postoperative visit. All but one ear was well healed by the 6-week visit. In comparison, 11 ears in 10 patients were treated for exostoses using a transcanal approach with the use of ultrasonic serrated knife and microosteotomes. One ear canal (the first in the series) was not well healed by the 3-week postoperative visit due to suspected thermal injury. All patients had well-healed ear canals by 6 weeks, and there were no complications.ConclusionThis is the first series to report the use of an ultrasonic serrated knife in the transcanal excision of exostoses. When compared with a transcanal microosteotome only excision of exostoses, the addition of the Sonopet seems to result in a similarly low complication rate. Sonopet can allow for more controlled transcanal excision of broad-based exostoses in patients with severe obstruction.

ObjectivesTo evaluate the outcomes and complications of transcanal excision of exostoses using micro-osteotomes, without a postauricular incision or the use of the drill.Study designA retrospective chart review of patients undergoing exostoses excision.SettingTertiary Care Medical Center.Subjects and methodsAll of the patients underwent surgical removal of the exostoses using only a 1 or 2 mm micro-osteotomes. Patients were followed postoperatively and associated complications were evaluated.ResultsOne-hundred thirty-eight ears in 106 patients were treated for obstructive exostosis. The average age of patients was 43 ± 16 years. Of these, 99 were man (93%) and 7 were woman (7%). A majority of the patients (84%, n = 89) had 90 to 100% obstruction of the ear canal. Complete ear canal healing was observed in 80% of patients by 3 weeks. All but one patient had healed by 6 weeks postoperatively. There were 9 (6.5%) slit tympanic membrane perforations that healed with intraoperative gelfoam or fascia myringoplasty. One patient had an anterior canal mobilization which required Xeroform packing for 3 weeks for stabilization. There were no postoperative vertigo, facial paresis, conductive/sensorineural hearing loss, soft tissue stenoses, and no skin grafting required.ConclusionsThis is the first study to report a series of patients performing solely a transcanal approach using micro-osteotomes for removing exostoses. Results indicate that it is a safe procedure with low complication rate and expeditious healing. Patients with 100% obstruction can have this procedure performed with no significant increase in morbidity.

It was assessed in genetically modified (GM) maize with Agrisure ® Viptera TM 3111, the incidence and severity of ear rot by Fusarium sp., in two locations from Culiacan, Sinaloa. In El Camalote, the hybrid showed incidence and severity of 47.2 and 22.5% respectively; compared to conventional hybrid with pest control showed 54.7 and 27.1% of incidence and severity of rot and conventional hybrid (control), had further damage with an incidence of 59.4 and severity of 35.2%. In assessing Oso Viejo, the hybrid Agrisure ® Viptera TM 3111 showed less damage with 25.7 and 7.6% incidence and severity of the disease respectively; the conventional hybrid with pest control had an incidence of 67.5% and severity of 38.7%, and control had the highest damage 80.8 and 53.5% of incidence and severity. Agrisure ® Viptera TM 3111 corn was not developed for disease management, however; the findings show that the genetically modified maize confers an indirect additional benefit to pest resistance, preventing the formation of entry points for pathogens that develop in susceptible tissue, causing ear rot., Se evaluó en maíz genéticamente modificado (GM) con el evento Agrisure ® Viptera TM 3111, la incidencia y severidad de pudrición de mazorca por Fusarium sp., en dos localidades de Culiacán, Sinaloa. En El Camalote, el híbrido observó una incidencia y severidad de 47.2 y 22.5% respectivamente; comparado con el híbrido convencional con control de plagas que presentó 54.7 y 27.1% de incidencia y severidad de pudrición y el híbrido convencional (testigo absoluto), tuvo un mayor daño con una incidencia de 59.4 y 35.2% de severidad. En la evaluación de Oso Viejo, el hibrido Agrisure ® Viptera TM 3111 presentó menor daño con 25.7 y 7.6% de incidencia y severidad de la enfermedad respectivamente; el híbrido convencional con control de plagas tuvo una incidencia de 67.5% y una severidad de 38.7%, y el testigo absoluto tuvo el mayor daño 80.8 y 53.5% de incidencia y severidad. El maíz Agrisure ® Viptera TM 3111 no fue desarrollado para el manejo de enfermedades, no obstante; el resultado encontrado demuestra que el maíz genéticamente modificado confiere un beneficio adicional indirecto al de resistencia a insectos plaga, previniendo la formación de puntos de entrada para fitopatógenos que se desarrollan en el tejido susceptible, provocando la pudrición de mazorca

Ear mites (Otodectes cynotis) and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae) living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas) were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation.

Ear mites (Otodectes cynotis) and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae) living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas) were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation.

BACKGROUND There is some evidence of a relationship between psychosocial health and the incidence of ear infections and hearing problems in young children. There is however little longitudinal evidence investigating this relationship. This paper used 6-year prospective longitudinal data to examine the impact of ear infection and hearing problems on psychosocial outcomes in two cohorts of children (one cohort recruited at 0/1 years and the other at 4/5 years). METHODS Data from the Longitudinal Study of Australian Children (LSAC) were analysed to address the research aim. The LSAC follows two cohorts of children (infants aged 0/1 years - B cohort, n = 4242; and children aged 4/5 years - K cohort, n = 4169) collecting data in 2004, 2006, 2008 and 2010. In B cohort at baseline 3.7% (n = 189) of the sample were reported by their parent to have had an ear infection (excluding hearing problems) and 0.5% (n = 26) were reported by their parent to have hearing problems (excluding ear infections). 6.7% (n = 323) of the K cohort were identified as having had an ear infection and 2.0% (n = 93) to have hearing problems. Psychosocial outcomes were measured using the Strengths and Difficulties Questionnaire. Data were analysed using multivariate analysis of variance and logistic regression, reporting adjusted odds ratio and 95% confidence intervals of the association between reported ear infections (excluding hearing problems)/or hearing problems (excluding ear infections) and psychosocial outcomes. RESULTS Children were more likely to have abnormal/borderline psychosocial outcomes at 10/11 years of age if they had been reported to have ongoing ear infections or hearing problems when they were 4/5 years old. When looking at the younger cohort however, poorer psychosocial outcomes were only documented at 6/7 years for children reported to have hearing problems at 0/1 years, not for those who were reported to have ongoing ear infections. CONCLUSION This study adds further evidence t

Door hangende oren bij 2 erg zieke kalveren dacht de dierenarts meteen aan een infectie met Mycoplasma bovis, een ziekte die bij jongvee longproblemen teweeg kan brengen, maar ook oorontsteking.

Behavioral inhibition (BI) is an important early childhood marker of risk for later psychiatric problems. The current 20-year prospective, longitudinal study focused on individual differences in this early temperament and adolescent brain function. As adolescents, 83 participants initially identified in infancy with the temperament of BI were assessed using functional imaging to examine striatal responses to incentives. Five years later, as young adults, these participants provided self-report of their substance use. Our findings show that children's early temperament interacts with their striatal sensitivity to incentives in adolescence to predict their level of substance use in young adulthood. Those young adults who, as children, showed the highest levels of BI reported the greatest substance use if, as adolescents, they also exhibited striatal hypersensitivity to incentives. These longitudinal data delineate one developmental pathway involving early biology and brain mechanisms for substance use in young adulthood.

ObjectiveTo determine postoperative hearing outcomes after surgical plugging via middle cranial fossa approach for superior semicircular canal dehiscence syndrome (SCDS).Study designClinical review.SettingTertiary care medical center.PatientsForty-three cases of SCDS based on history, physical examination, vestibular function testing, and computed tomography imaging confirming the presence of a dehiscence. All patients underwent surgical plugging of the superior semicircular canal via middle cranial fossa approach.InterventionPure tone audiometry was performed preoperatively and at 7 days and at least 1 month postoperatively.Main outcome measuresChange in air-bone gap (ABG) and pure tone average (PTA).ResultsPreoperative average ABG across 0.25, 0.5, 1, and 2 kHz was 16.0 dB (standard deviation [SD], 7.5 dB). At 7 days postoperatively, average ABG was 16.5 dB (SD, 11.1; p = 0.42), and at greater than 1 month was 8.1 dB (SD, 8.4; p < 0.001). 53% (95% confidence interval, 33-69) of affected ears had greater than 10 dB increase in their 4-frequency (0.5, 1, 2, and 4 kHz) PTA measured by bone-conduction (BC) threshold 7 days postoperatively and 25% (95% confidence interval, 8-39) at greater than 1 month postoperatively. Mean BC PTA of affected ears was 8.4 dB hearing loss (HL) (SD, 10.4) preoperatively. Compared with baseline, this declined to 19.2 dB HL (SD, 12.6; p < 0.001) at 7 days postoperatively and 16.4 dB HL (SD, 18.8; p = 0.01) at greater than 1 month. No significant differences in speech discrimination score were noted (F = 0.17).ConclusionLow-frequency air-bone gap decreases after surgical plugging and seems to be due to both increased BC thresholds and decreased AC thresholds. Surgical plugging via a middle cranial fossa approach in SCDS is associated with mild high-frequency sensorineural hearing loss that persists in 25% but no change in speech discrimination.

Behavioral inhibition (BI) is an important early childhood marker of risk for later psychiatric problems. The current 20-year prospective, longitudinal study focused on individual differences in this early temperament and adolescent brain function. As adolescents, 83 participants initially identified in infancy with the temperament of BI were assessed using functional imaging to examine striatal responses to incentives. Five years later, as young adults, these participants provided self-report of their substance use. Our findings show that children's early temperament interacts with their striatal sensitivity to incentives in adolescence to predict their level of substance use in young adulthood. Those young adults who, as children, showed the highest levels of BI reported the greatest substance use if, as adolescents, they also exhibited striatal hypersensitivity to incentives. These longitudinal data delineate one developmental pathway involving early biology and brain mechanisms for substance use in young adulthood.

Vooral bij honden met hangende oren of veel haar in de oorschelp, kan opgehoopt vuil, oorsmeer en vocht een broedplaats van bacteriën of andere ziekteverwekkers worden.

Enkele jaren geleden bezocht ik een klein schapenbedrijfje voor een zieke ooi met uierziekte. Het was ergens in februari en de lente leek nog lang niet in zicht. De lammeren van de ooi hadden kleine plekjes op hun lippen.

Bij een kalf waren waarschijnlijk bij het inbrengen van het oormerk wat vuil en bacteriën mee naar binnen gekomen en waren op die ma- nier het oorkraakbeen en de oorschelp ontstoken geraakt

Thèse de doctorat en sciences biomédicales (immunologie) (SBIM 3)--UCL, 2001

It has been shown that sera from patients with autoimmune inner ear disease contain antibodies to several inner ear antigens. We report here the characterization of the 42-43 kDa protein against which a significant number of patients' sera react strongly. After separation of inner ear proteins from guinea-pig cochleas by SDS-PAGE, the band corresponding to the 42-43 kDa protein was digested with trypsin and the peptide fragments were separated by high-performance liquid chromatography. Two fractions were then subjected to amino acid sequencing by the classical automated Edman degradation. The sequence of a stretch of 15 amino acids of the first fragment was identical to that of amino acids 148-162 of beta-actin. The sequence of the 10 amino acids of the second fragment was also identical to beta-actin. On Western blots, monoclonal antibody directed against beta-actin reacted with the inner ear 42-43 kDa proteins. The serum samples from the patients and the monoclonal antibody reacted with the non-muscle actin used as antigen in Western blotting. Immunoblot analysis of inner ear proteins after two-dimensional gel electrophoresis showed a spot, corresponding to the region of the 43 kDa as compared to the protein standards. On the basis of these data it is concluded that the target 42-43 kDa protein for antibodies in sera of patients with autoimmune inner ear disease is beta-actin, a molecule, which has important and numerous functions inside cells. This is the first report to identify the cytoskeletal protein beta-actin as a candidate autoantigen in autoimmune inner ear disease.

A classification of tympanic retraction pockets is indispensable in order to standardise their evaluation. In this manner, the evolution of the pathology can be carefully followed and the most appropriate therapy chosen. The authors propose adapting their classification to endoscopy which permits the inspection of the depths of certain pockets, otherwise invisible to examination under microscope, thus ensuring a better follow-up.

by P.J. Wormald., Thesis (M.D.)--Chinese University of Hong Kong, 1998., Includes bibliographical references (p. 195-217)., Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Mode of access: World Wide Web., s in English and Chinese., http://library.cuhk.edu.hk/record=b6073077, Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

by P.J. Wormald., Thesis (M.D.)--Chinese University of Hong Kong, 1998., Includes bibliographical references (p. 195-217)., Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Mode of access: World Wide Web., s in English and Chinese., http://library.cuhk.edu.hk/record=b6073077, Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

A cholesteatoma originating in the external auditory canal is a rare finding. We report 2 cases illustrating its typical localization in the inferior part of the auditory canal and its marked osteolytic character. The extension of such a cholesteatoma in the depth of the temporal bone is often larger than suggested by clinical examination. Since the purpose of treatment is to achieve the complete eradication of the epidermic matrix, surgical treatment is required in most cases. We discuss herein the follow-up strategies, keeping in mind that local recurrence and bilateral disease are not uncommon.

We have previously shown that a 30,000 Mr protein extracted from guinea pig inner ear tissue is recognized by autoantibodies present in the serum of patients suffering from autoimmune inner ear disease. This protein was localized in the modiolus and in the organ of Corti. We have now identified this protein by a combination of microsequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry of its tryptic peptides. A partial sequence of the protein was thereby determined. These data and 2-dimensional gel electrophoresis followed by immunoblotting experiments showed that the 30,000 Mr inner ear antigen is the major peripheral myelin protein Po. This suggests that protein Po may be an important autoantigen in autoimmune inner ear disease.

In this study, the authors attempted to develop a method of extracting guinea pig inner ear antigens for otoimmunological research, and to investigate the distribution of the antigens in the various structures of the inner ear. The antigens were extracted either from the entire or from various parts of the guinea pig inner ear. These antigens were separated on sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gels. Western blot techniques were used to test sera from patients with inner ear disease against guinea pig inner ear protein extracts. It found that the various molecular weight antigens in the inner ear were associated with the different structures of the inner ear. The sera of 37.5% (N = 80) of patients reacted with two bands (30 and 58 kd) of the guinea pig inner ear immunoblots. The 58 kd band was not specific to the inner ear, but instead was also found in the immunoblots of other guinea pig tissues (brain, lung, and liver). This study suggests that the various antigens of interest could be further extracted and purified from the corresponding locations of the inner ear.

The authors have studied 11 series of results following cholesteatoma surgery by closed or open technique. The closed technique was performed in 77%. The notion of surgical revision is not accepted by all surgeons; it is practised with an average of 59% for the whole series. Residual cholesteatoma and/or recurrences are observed in 34% of the cases of which 20% have been discovered at the time of revision surgery. Surgical revision appears mandatory to the authors.

A summary of the Kiev Scientific Research Institute of Otolaryngology Conference held May, 1972 is presented., Edited machine trans. Zhurnal Ushnykh, Nosovykh i Gorlovykh Boleznei (USSR) n1 p118-122 1973, by Joseph E. Pearson.

Five cases of spectacle-frame acanthoma are reported; four were retro-auricular (three unilateral; one bilateral) and one was present on the left side of the nose. Clinical aspects of the lesions are described by the light of all the other cases that have been previously reported in the literature. Histopathological features are compared to those encountered in chondrodermatitis nodularis helicis for which a frictional origin may also be suspected. In the vast majority of cases, spontaneous resolution is obtained when responsible spectacle frames are removed whereas a few lesions persist indefinitely despite of the fact that corrective measures are applied, on the contrary to what has been reported in previous papers. Apart from removing spectacles, these few cases needed surgical excision for a complete cure. Anatomo-clinical confrontations seem to indicate that those persistent lesions are completely fissured acanthomas.