Search

To explore the correlation between the width of the bony cochlear nerve canal (CNC) and long-term auditory rehabilitation after unilateral cochlear implantation (CI) in pediatric patients with congenital deafness and bilateral cochlear nerve canal stenosis (CNCS). A retrospective review was performed on 10 patients with bilateral CNCS and bilateral congenital profound hearing loss who each underwent unilateral cochlear implantation. The width of the CNC was determined on computed tomography (CT) imaging and following CI, auditory and speech performance following CI were graded using categories of auditory performance (CAP), speech intelligibility rating (SIR), and the meaningful auditory integration scale (MAIS) at 24 months following implantation. No correlation was noted between CAP score and CNCS at 24 months post CI (P >.05). A positive correlation was noted between SIR score and CNC width (ρ =.81, P <.05). Similarly, a positive correlation was noted between MAIS and CNC width (ρ =.71, P <.05). The width of the CNC in patients with CNCS is positively correlated with some long-term auditory and speech outcomes after CI. [ABSTRACT FROM AUTHOR]

We report a case of cochleovestibular neurovascular compressive syndrome (CVCS)-induced drop attack treated with microvascular decompression (MVD) of the superior vestibular nerve. This report discusses the merits of surgical intervention through a review of related literature. A 58-year-old woman was referred to our clinic with a chief complaint of intermittent, strong, right-sided tinnitus lasting for a few seconds immediately prior to drop attack. Magnetic resonance imaging (MRI) showed bilateral neurovascular contact between the anterior inferior cerebellar artery (AICA) and the vestibulocochlear nerve. Based on MRI findings, history of present illness, and response to anticonvulsants, CVCS was suspected, and surgical decompression on the right side was subsequently performed. The patient became asymptomatic immediately after the surgery, and the vestibular-evoked myogenic potentials were normalized. No recurrence was reported during a 1-year follow-up period. [ABSTRACT FROM AUTHOR]

Background: The Thai Rural ENT foundation has been conducting ear camps in Bhutan for many years to address the shortage of ENT specialists in the kingdom where patients are examined and treated for various ear illnesses. However, there has been no study conducted to assess the outcomes of such camps. This is the first study of its kind to be carried out in Bhutan. Objective: To study the spectrum of ear cases seen during the mobile ear camp, the intervention done and treatment outcomes. Materials and Methods: The study enrolled patients with ear disorders who presented to the mobile ear camp at Monggar Regional Referral Hospital, Bhutan, from January 6, 2020, to January 8, 2020. The following data were recorded: demographic details, preoperative clinical symptoms and otoscopic findings, preoperative audiogram, treatment or surgery done, postoperative middle ear and mastoid infection, wound infection, graft condition, any complications, and postoperative audiogram of operated cases. Patients who underwent surgery were followed up at 1 day, 6 weeks, and 2 months postoperatively. Results: Two hundred ten patients presented with otologic conditions and 43 underwent surgeries. Otitis media was the commonest disease detected, and tympanoplasty was the commonest surgery performed. The tympanic membrane closure rate was 92.1%, and the rate of hearing improvement was 63.2%. Conclusion: The ear camp had beneficial effect and showed good results. [ABSTRACT FROM AUTHOR]

Objective: Microtia is a congenital auricular malformation with a hypoplastic external ear that ranges in severity from a slightly smaller auricle to complete the absence of the auricle. The present study was conducted to identify and analyze the characteristics of microtia-related articles published from 2006 to 2020 by using bibliometric analyses. Method: Microtia-related studies published from 2006 to 2020 were retrieved from the Web of Science Core Collection database. Keywords, first author, citations, date of publication, and publication journal were extracted and quantitatively analyzed using Bibliographic Item Co-Occurrence Matrix Builder software and the Bibliometric (https://bibliometric.com/app). VOSviewer was used to visualize research and form a network map on keywords and citations. Results: A total of 1031 articles from 2006 to 2020 were included. The number of articles showed an overall trend of growth over time. The United States and China are the top 2 countries in terms of the number of microtia-related articles. From the analysis of keyword clustering, keywords could be mainly divided into 4 clusters in the field of microtia research: surgery, tissue engineering, epidemiology, and rehabilitation including hearing-related treatments, evaluation of effects, and quality of life after surgery. The top 10 most frequently cited papers from 2006 to 2020 were also extracted and analyzed. Conclusion: A bibliometric research of microtia-related articles from 2006 to 2020 was conducted. This study may be helpful to understand the current research status of microtia and find the research trends in this field, thus proposing future directions for microtia research. [ABSTRACT FROM AUTHOR]

The article discusses the evolution of the otoscope. Also cited are the study of the gross and microscopic anatomy of the ear in mid-1800s, the works of Anton Freiherr von Troltsch on the state of otoscopy, the invention by German medical officer Friedrich Hofmann of a concave mirror for illumination, and the works of urologist Maximilian Carl-Friedrich Nitze and instrument maker Josef Leiter to develop an illuminated cystoscope.

Objectives: The neurotropic and neuroinvasive properties of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been described. It remains unknown how SARS-CoV-2 affects the audiovestibular system when it causes mild or severe disease. In this study, the sequelae effect of SARS-CoV-2 on the audiovestibular systems of different patient groups was investigated using objective and subjective test batteries. Methods: In this present study, we evaluated vestibulocochlear functions of patients who previously had Coronavirus Disease-2019 (COVID-19) with pure tone audiometry, ocular vestibular-evoked myogenic potential (o-VEMP), and cervical vestibular-evoked myogenic potential (c-VEMP) tests to identify possible sequelae by comparing them with the control group. Results: We found that the amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the results of the left ear c-VEMP, the amplitude of p13-n23 was statistically different between the outpatient, inpatient, and control groups. The amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the evaluation of the o-VEMP in the left ear, we observed a statistically significant difference in the latency of n10 (p = 0.006) and the amplitude of n10-p15 (p < 0.001) between the groups. The n10 latency was prolonged in both groups of patients compared to the control group and there was no statistically significant difference between groups of patients. Furthermore, the amplitude of n10-p15 was lower in both groups of patients compared to the control group and there were no statistically demonstrable differences between the groups of patients. Conclusions: In conclusion, our results suggest that SARS-CoV-2 may affect the vestibulocochlear system. But we could not find a direct relationship according to the severity of the disease. [ABSTRACT FROM AUTHOR]

Objectives: This study compared the rate of graft success, as well as hearing improvement and dry ear time between dry ears and wet ears with otomycosis or without otomycosis in patients with chronic suppurative otitis media (CSOM) after endoscopic cartilage myringoplasty. Methods: This retrospective study was conducted in a tertiary hospital in Shanghai. In total, 83 patients with CSOM (43 with dry ears and 40 with wet ears) were included. Among the 40 patients with CSOM and wet ears, 25 exhibited otomycosis. All patients underwent endoscopic myringoplasty, and perforations were repaired using tragal cartilage with a singlesided perichondrium. Patients were followed up for at least 6 months. Pure-tone hearing was examined preoperatively and at 3 months postoperatively. The graft uptake rate, hearing improvement, and dry ear time were compared between the groups. Results: The graft success rate did not differ significantly between the dry-ear and wet-ear groups (95.35% and 90.00%, respectively). Furthermore, the graft success rate also did not differ significantly between patients with wet ears and otomycosis and those with wet ears without otomycosis (92.00% and 86.67%, respectively). Hearing gain did not differ significantly between the dry-ear and wet-ear groups. No significant difference in hearing gain was also found in patients with wet ears with or without otomycosis. However, the time to dry ear was significantly longer in the wet-ear group than in the dry-ear group. Conclusion: Patients with CSOM and wet ears required more time to achieve a completely healthy status. However, the graft success rate and hearing improvement were not affected by a wet middle ear and otomycosis. Thus, endoscopic myringoplasty using tragus cartilage is an effective treatment for refractory CSOM in patients with wet ears and otomycosis. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) may lead to many otolaryngological disorders such as loss of smell and taste, sudden sensorineural hearing loss (SSNHL), facial palsy, and parotitis. The involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vestibular neuritis (VN) has been reported in 2 adult patients but not really confirmed through objective testings. We present a case of a 13-year-old girl with left superior vestibular neuritis confirmed by Video Head Impulse Test during a proven COVID-19 infection. To the best of our knowledge, this is the first case associating VN and COVID-19 that was demonstrated with an objective peripheral assessment. Physicians may be aware about the occurrence of VN in patients with COVID-19, keeping in mind that this condition may develop not only in adults. Early detection of SARS-CoV-2 in this pandemic is required to prevent its spread. [ABSTRACT FROM AUTHOR]

Objectives: Eustachian tube dysfunction (ETD) is frequent in children with adenoid hypertrophy (AH). Although the most common treatment of AH is surgical removal of adenoid tissue, numerous studies have reported the efficacy of intranasal steroids. The effects of the intranasal steroid and azelastine combination on AH and ETD have not been reported before. In this study, we tried to determine the effects of 3-month intranasal Azelastine-Fluticasone dipropionate combination (Aze-Flu) treatment in children with ETD and AH. Materials and Methods: 100 children who had open mouth sleep, snoring, and sleep apnea and were diagnosed with AH and ETD participated in this study. The mean age was 7.73 ± 2.37 (4–14 years). The rates of adenoid tissue hypertrophy and choanal occlusion were evaluated using a rigid pediatric nasal endoscope and reassessed after 3 months of Aze-Flu nasal spray treatment. The function of the Eustachian tube (ET) was evaluated before and after medical treatment using the Eustachian tube score, the Eustachian dysfunction test-7 (ETS-7) and tubomanometry (TMM). Results: The results were evaluated in 100 patients with AH and ETD. The adenoid tissue to choana rate was 82% before treatment and decreased to 37% after treatment. The ETS-7 test score was 6.36 before treatment and increased to 9.72 at the end of 3 months. Both the regression of the adenoid tissue and the improvement in the Eustachian function scores were statistically significant (p < 0.05). Conclusions: AH significantly increases the frequency of ETD. In this study, it was observed that Aze-Flu treatment was significantly effective in both regression of the adenoid tissue and Eustachian tube dysfunction. We believe that it can be applied as an initial therapy in children with AH and associated ETD. [ABSTRACT FROM AUTHOR]

Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory disease involving multiple organs. Some studies have reported otological manifestations of IgG4-RD, although most studies describe involvement of the middle ear, and reports on inner ear manifestations are limited. Here, we describe a case of a 30-year-old man with IgG4-RD involving the inner ear. This case demonstrated that IgG4-RD affected the inner ear and caused cochlear ossification. Cochlear implants may be considered for milder cases, and hormone and immunosuppressive therapy may control disease progression. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the effects of laryngopharyngeal reflux disease (LPRD) and proton pump inhibitor (PPI) treatment on Eustachian tube function in patients with obstructive sleep apnea (OSA). Methods: The Eustachian tube score-7 (ETS-7) was observed before and after PPI treatment in the control group, OSA only group, and OSA + LPRD group. Results: Age, sex, smoking history, and drinking history showed no differences among 3 groups (P >.05). The body mass index (BMI) in the control group was lower than that in other groups (P <.017). Before PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group statistically differed from that in the control group and the OSA only group (P <.017). After PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group exhibited no significant differences compared with that in the control group and the OSA only group (P >.017), and it declined remarkably compared with that before PPI treatment (75% vs 35%, χ2 = 13.334, P =.001). Moreover, the multivariate analysis revealed that only LPRD had an independent correlation with the abnormality of ETS-7 (OR = 1.245, 95% CI: 1.759–6.861, P =.000). Conclusion: In view of its high incidence in OSA patients, LPRD may be a considerable factor for the high incidence of abnormality rate of ETS-7 in OSA patients, and PPI therapy is of significant value in improving Eustachian tube function in OSA patients with LPRD. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a clinical score to predict the risk of tympanosclerosis before surgery. Methods: A sample of 404 patients who underwent middle ear microsurgery for otitis media was enrolled. These patients were randomly divided into 2 cohorts: the training cohort (n = 243, 60%) and the validation cohort (n = 161, 40%). The preoperative predictors of tympanosclerosis were determined by multivariate logistic regression analysis and implemented using a clinical score tool. The predictive accuracy and discriminative ability of the clinical score were determined by the area under the curve (AUC) and the calibration curve. Results: The multivariate analysis in the training cohort (n = 243, 60%) identified independent factors for tympanosclerosis as the female sex (odds ratio [OR]: 3.83; 95% CI: 1.66-9.37), the frequency-specific air-bone gap at 250 Hz ≥ 45 dB HL (OR: 3.68; 95% CI: 1.68-8.57), aditus ad antrum blockage (OR: 3.29; 95% CI: 1.38-8.43), type I eardrum calcification (OR: 25.37; 95% CI: 8.41-88.91) or type II eardrum calcification (OR: 18.86; 95% CI: 6.89-58.77), and a history of otitis media ≥ 10 years (OR: 4.10; 95% CI: 1.58-11.83), which were all included in the clinical score tool. The AUC of the clinical score for predicting tympanosclerosis was 0.89 (95% CI: 0.85-0.93) in the training cohort and 0.89 (95% CI: 0.84-0.95) in the validation cohort. The calibration curve also showed good agreement between the predicted and observed probability. Conclusions: The clinical score achieved an optimal prediction of tympanosclerosis before surgery. The presence of calcification pearls on the promontorium tympani is a strong predictor of tympanosclerosis with stapes fixation. [ABSTRACT FROM AUTHOR]

The article describes the clinical diagnosis of an asymptomatic case of posterior helicine type and marginal helicine type of preauricular fistula. Topics mentioned include the symptoms of posterior and marginal helicine type of preauricular fistula, the pathogesn that caused infection, the formation of epithelial-lined subcutaneous cyst, and the use of fistulectomy.

Objective: The purpose of the present study was to assess the rate of tympanic membrane perforation in patients with otomycosis and to discuss the literature regarding the difficulties in managing this condition. Data Sources: Literature review from 1999 to 2019, Web of Science, PubMed, and Medline. Study Selection: We searched for eligible articles concerning the clinical entity of tympanic membrane perforation secondary to otomycosis. Case series and clinical trials were the types of articles included for this review. Data Extraction: All the articles described in the study selection were used for this review. Data Synthesis: Statistical techniques were not used. Conclusion: Based on the available literature, it seems that tympanic membrane perforation secondary to otomycosis is not uncommon. The presence of this complication is associated with 2 problems: Antimycotic solutions are irritant to middle ear and may be ototoxic to the cochlea. Although most cases of fungus caused tympanic membrane (TM) perforation resolve with proper medical treatment, in a few patients a tympanoplasty may be required. [ABSTRACT FROM AUTHOR]

Objective: The main aim is to discuss the effect of nasal septal deviation on the postoperative hearing results of patients with tympanosclerosis. Material and Methods: We analyzed the hearing results of patients with tympanosclerosis who were operated on in a tertiary center. Pure tone audiometric results were compared according to the existence of nasal septal deviation. Results: This study included 48 patients with unilateral tympanosclerosis disease. Moderate or severe septal deviation had no significant effect on postoperative hearing results. Conclusion: The nasal septal deviation as the only pathologic factor in patients with tympanosclerosis did not have a deteriorating effect after surgery. [ABSTRACT FROM AUTHOR]

The purpose of this study is to categorize anomalous tympanic facial nerve (FN) on high-resolution computed tomography (HRCT) and to determinate the significance of associated temporal bone anomalies and congenital syndromes without microtia in patients with hearing loss. A retrospective analysis of HRCT findings in 30 temporal bones in 18 patients with anomalous FN was performed. Abnormalities of the tympanic FN were categorized as follows: category 1: FN medially positioned, but above the oval window; category 2: FN in the oval window niche; and category 3: FN below the oval window. Potential associated findings that were assessed included stapes abnormalities, oval window atresia, and inner ear anomalies, as well as the presence of a known congenital syndrome with hearing loss. The most common type of anomalous tympanic FN was category 1 (67%, n = 20), following by group 2 (20%, n = 6) and group 3 (13%, n = 4). Stapes anomalies were detected in 77% of temporal bones (n = 23), oval window atresia was detected in 43% of temporal bones (n = 13), and inner ear anomalies were detected in 70% of temporal bones (n = 21). Anomalous tympanic facial nerves in temporal bone with conductive hearing loss were often (60%) not associated with oval window atresia. The combination of aberrant tympanic FN and inner ear anomalies was significantly (P =.038) associated with a known congenital syndrome (6 patients), including CHARGE syndrome, oculo-auriculo-vertebral spectrum, Pierre-Robin sequences, and Down syndrome. Therefore, an anomalous tympanic FN in conjunction with inner ear anomalies appears to be a biomarker for certain congenital syndromes with hearing loss in the absence of microtia. [ABSTRACT FROM AUTHOR]

The "Clinical Practice Guideline: Tympanostomy Tubes in Children" published in 2013 by the American Academy of Otolaryngology—Head and Neck Surgery Foundation encourages that an "educational video, or other teaching aid, should be developed to illustrate how parents/caregivers" may manage postoperative complications such as tube otorrhea; however, the current literature is devoid of such patient safety and quality improvement measures. Our objective was to develop an effective educational model to assist parents and caregivers in understanding the signs and symptoms of tympanostomy tube (TT) otorrhea and how to independently institute the appropriate otologic treatment. A 3.5 × 2-inch instructional card was designed to illustrate TT otorrhea and describe the subsequent steps necessary to obtain and institute the appropriate medical therapy. This was distributed to caregivers of all patients undergoing TT placement in September 2016; patients undergoing TT placement in May 2016 served as the preintervention control cohort. Group comparisons were made before and after implementation of the educational model by number of telephone calls our clinic triaged regarding untreated TT otorrhea, as documented within the electronic medical record. A total of 30 sets of TT were placed in September 2016, compared to 27 sets of TT in May 2016. Postoperatively, a run chart revealed a significant shift (ie, 7 consecutive points) in the number of telephone calls received (16-5 calls) after establishment of the proposed educational model. This clinical experience demonstrates the utility of patient-driven management of TT otorrhea through ancillary educational material. Given the superiority of topical otic therapy, continued translation efforts are needed for continued focus on practice implementation and dissemination. [ABSTRACT FROM AUTHOR]

The article describes the case of a 46-year-old man diagnosed with a facial nerve schwannoma (FNS) presenting as an external auditory canal mass. Facial nerve tumor was excised using a transmastoid approach. Nuclear palisading with Verocay body formation was shown by the pathology. There are said to be no accepted guidelines for the management of FNS.

The article describes the case of a 28-year-old woman with keratosis obturans (KO) of the external auditory canal (EAC) with the complication of acute taste loss. Topics covered include the findings of physical examination and high-resolution compute tomography of the temporal bone, the etiology of KO and the common symptoms of KO in EAC.

The author talks about the current state of management of patients with Eustachian tube dysfunction (ETD). Topics include the prevalence of ETD among adults and children in the U.S., the difficulty in clarifying the diagnosis of ETD faced by otolaryngologists and primary care providers, some of the symptoms presented by patients with acute dilatory or obstructive ETD, and the use of short-term ventilating tubes (VT) as the gold standard for treating ETD.

We conducted a retrospective observational chart review to characterize otorrhea in patients with cleft palate (CP) after tympanostomy tube placement in terms of the bacteria profile, treatment effectiveness, and overall disease burden. A total of 157 patients over 6 years were reviewed. Fifty of the 157 patients (31.8%) experienced postoperative otorrhea. Of the 50 patients with otorrhea, all received topical antibiotics, 30 received oral antibiotics, and 12 received povidone-iodine irrigations. The average duration of otorrhea was 5.2 months for patients with povidone-iodine irrigations and 8.5 months for those without povidone-iodine irrigations. Methicillin-resistant Staphylococcus aureus was the most commonly cultured microorganism. The average number of total healthcare visits over a 12-month period was 13.6 per patient. We conclude that postoperative otorrhea is a common problem after tympanostomy tube placement in children with CP and places a significant burden on these patients and the healthcare system. he bacteriologic profile may be different in this population compared with the non-CP population with otorrhea after tympanostomy, and a search for more effective treatment options is warranted, including further investigation into povidone-iodine irrigations. [ABSTRACT FROM AUTHOR]

We conducted a retrospective study to reexamine the value of single-photon emission computed tomography (SPECT) in the evaluation of patients with neurotologic complaints, and to assess the intra- and inter-radiologist variability of SPECT readings. Our study population was made up of 63 patients--23 men and 40 women, aged 34 to 91 years (mean: 59)--who had presented to a tertiary care otolaryngology practice and university hospital for evaluation of head trauma, sensorineural hearing loss, tinnitus, and/or vertigo. All patients had undergone brain scanning with SPECT during their evaluation, and almost all had also undergone magnetic resonance imaging (MRI) and standard computed tomography (CT). We compared the findings of all three imaging modalities in terms of their ability to detect neurotologic abnormalities. We found that detection rates were very similar among the three modalities; abnormalities were found in 24% of SPECT scans, 26% of MRIs, and 23% of CTs. Nevertheless, we did find that among 60 patients who underwent all three types of imaging, 13 (22%) exhibited areas of cerebral hypoperfusion on SPECT while their MRIs and CTs were read as either normal or nonspecific. In all, 18 of these 60 patients (30%) exhibited normal or nonspecific findings on all three types of imaging. In addition, when SPECT scans were read by the same radiologist at different times, different results were reported for 17 of the 63 scans (27%). Likewise, when SPECT scans were read by different radiologists, different results were reported for 21 of 63 scans (33%). We conclude that SPECT may be a valuable complementary diagnostic modality for making a comprehensive neurotologic evaluation and that it may detect abnormalities in some patients whose other imaging is read as normal. However, we did not find that SPECT was the most sensitive of the three modalities in neurotologic evaluation, as we had previously found in a preliminary study that the senior author (R.T.S.) published in 1996. In addition, with respect to our radiologists, both their intra- and inter-reader reliability was low, and we recommend additional study on this matter. [ABSTRACT FROM AUTHOR]

We conducted a prospective crossover study to assess the safety and efficacy of 70% isopropyl alcohol delivered from a squeezable bottle with a specially designed tip as a weekly irrigant to reduce cerumen accumulation. Twenty patients were divided into 2 groups of 10 (20 ears in each group). The patients in group 1 instilled 70% isopropyl alcohol once a week for 2 months; this was followed by 2 months of no ear cleaning. The patients in group 2 performed the opposite routine. At each visit (0, 2, and 4 mo), cerumen accumulation was graded on a scale of 0 to 4, indicating 0, 25, 50, 75, and 100% occlusion, respectively. After the accumulation was graded, a cerumenectomy was performed. At the initial evaluation, the mean occlusion scores were 3.1 for group 1 and 3.3 for group 2-not a statistically significant difference. After the first 2 months of the study, there was a significant difference in occlusion scores between groups 1 and 2 (0.75 and 1.55, respectively; p < 0.0002). At 4 months, after the crossover, the occlusion scores were 1.15 and 0.95, respectively, not a significant difference (p = 0.38). At study's end, there were also significant differences within each group between occlusion scores obtained during the treatment and nontreatment periods (group 1: p < 0.02; group 2: p < 0.01). All patients tolerated the alcohol rinse well, and there were no cases of external otitis or other complications. We conclude that weekly irrigation with 70% isopropyl alcohol is safe and reduces the accumulation of cerumen in the external auditory canal. Routine use should decrease the number of office visits for cerumen removal and hearing aid cleaning. [ABSTRACT FROM AUTHOR]

Gun-shooting deafness is the common terminology applied to sensorineural hearing loss caused by shooting firearms. Many characteristics of gun-shooting hearing loss have been proposed, but they have not been defined clearly or established conclusively. We studied 37 users of recreational firearms to obtain pilot data to help determine if it is true that right-handed gun shooters develop more hearing loss in the left ear and vice versa, whether everyone who frequently shoots guns develops sensorineural hearing loss, and whether significant hearing loss is typically prevented by wearing commercially available ear protectors while shooting. [ABSTRACT FROM AUTHOR]

The article focuses on the clinical case of a 49-year-old scuba diver who experiences vestibular symptoms. It recalls the first episode of the patient that occurred following a routine dive in which he experienced symptoms such as hearing loss, rotary vertigo and vomiting. It explores the results of several tests done on the patient which include electronystagmography, computed tomography and metabolic examination. It is concluded that diving did not cause reversible inner ear dysfunction in the patient.

Objectives: To explore the effect of gastroesophageal reflux disease (GERD) on Eustachian tube function in patients with obstructive sleep apnea (OSA). Methods: This was a cross-sectional study. The patients were divided into 4 groups according to OSA and GERD: OSA+GERD group; OSA-only group; GERD-only group; and normal control group. Results: There were no differences among the 4 groups regarding age, sex, smoking history, and alcohol history (all P >.05). The patients in the OSA and OSA+GERD groups had a significantly larger body mass index than those in the control and GERD-only groups (all P <.05). The proportions of patients with abnormal ETS-7 and ETD-Q results were higher in the GERD and OSA+GERD groups compared to the control group (P <.008). There were no significant differences in ETS-7 and ETD-Q between the control and the OSA-only groups (P >.008). The multivariable analysis showed that only GERD was independently associated with abnormal ETS-7 results (odds ratio = 3.090, 95% CI: 1.332-7.169, P =.009). Conclusion: Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA. [ABSTRACT FROM AUTHOR]

The article details a treatment approach to the case of a 46-year-old man who presented with a four-month history of tinnitus. The patient was placed on risedronate 30 milligrams (mg) twice weekly plus daily supplementation with calcium/vitamin D, vitamin D3 and fluoride. At follow up three months later, etidronate 400 mg daily for two of every six weeks was added to the continued medical regimen and risedronate was discontinued. Treatment was then changed at another follow up so that etidronate was taken for two of every eight weeks.

The excessive, indiscriminate use of masking during measurements of pure-tone bone-conduction thresholds can reduce or eliminate air-bone gaps. This may result in an abnormal, audiometrically induced bone-conduction threshold shift and suggest to the otologist the need for auditory brainstem response testing and/or magnetic resonance imaging. A case is presented in which the inappropriate use of the masking plateau method resulted in a reduction of the air-bone gap in an ear with a mild conductive hearing loss. The audiometric Weber test should be used in these cases, and nonmasked bone thresholds should be used to determine the actual level of the cochlear reserve. [ABSTRACT FROM AUTHOR]

Auditory exostoses are bone anomalies located on the floor of the external auditory canal. They frequently develop in individuals who participate in water sports and other aquatic activities. Their etiology is probably multifactorial; development seems to be triggered by regular exposure to cold water, as well as to low air temperatures and/or cold winds. The presence of auditory exostoses has been recorded in human skull fossils that date back approximately 250,000 years. We conducted a study of auditory exostoses in 621 skulls of adult humans who had been part of a marine-dependent population that lived on the Brazilian coast between 5,400 and 800 years ago. The overall frequency of exostoses was 22%, but there was a great variance among different subgroups (0 to 56%). In this article, we propose some possible explanations for this variance. We also hope that our study will stimulate multidisciplinary research aimed at deciphering the intricate bony messages contained in cryptic archaeologic remains. [ABSTRACT FROM AUTHOR]

This report on unilateral hearing loss is based on the findings of a national survey on hearing loss and blindness in Oman. The survey of randomly selected households was conducted by trained healthcare personnel between Oct. 1, 1996, and Feb. 28, 1997. A total of 11,402 subjects of all ages were screened for hearing loss. Those who reported hearing impairment in either ear were subsequently reexamined by otologists in hospitals to confirm the findings and to determine the cause of the hearing loss. Based on these findings, we calculated that the prevalence of unilateral hearing impairment throughout Oman was 30.06 per 1,000 population (95% confidence interval [CI]: 29.80 to 30.31). Males had a significantly higher rate (36.67/1,000 [95% CI: 34.55 to 38. 79]) than females (23.88/1,000 [95% CI: 21.82 to 25.94]). The causes of unilateral hearing loss were different from the reported causes of bilateral hearing loss. Impacted earwax (16.0% of cases) and otitis media with effusion (13.1%) were the most common identifiable causes of unilateral hearing loss; genetic causes were responsible for less than 2% of cases. Just over one-half of the hearing-impaired patients had only a mild hearing loss. Impairment rates varied in different regions of the country. [ABSTRACT FROM AUTHOR]

The article focuses on the management of post-tympanostomy tube otorrhea (PTTO) in children. Causes of PTTO in children are viral illness, acute otitis media and swimming. Pathogenic microorganisms associated with PTTO are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis but may be changed as drainage continues. Topical quinolones are effective treatment for PTTO.

Management of earlobe keloids is still controversial. Many different treatment modalities have been employed: however, no single approach has been completely successful. We used combination therapy that included compression therapy, laser excision, and serial steroid injection, which has improved our therapeutic outcomes for earlobe keloids. [ABSTRACT FROM AUTHOR]

The article describes the case of a 53-year-old female with immunoglobulin G4-related disease and with a year of progressive right hearing loss refractory to high-dose steroid treatment. Highlights include bilateral vestibular weakness according to electronystagmography, and headaches experienced by the patient 18 months after onset of initial symptoms, and left temporal craniotomy underwent by the patient for dural biopsy.

Perilymph gusher (PG) is a very rare occurrence that can lead to an adverse outcome during inner ear surgery. In the absence of a family history of X-linked mixed deafness syndrome, surgeons may have difficulty determining if a patient is at risk preoperatively. Radiographic imaging is often performed in an attempt to identify such a possibility, but there are few data to support the value of negative studies. We conducted a retrospective study of 3 cases of PG in which findings on preoperative high-resolution computed tomography (CT) of the temporal bone had been interpreted as normal. We reviewed these CTs to discern if they did in fact demonstrate any abnormalities that might have indicated a risk of PG, and we found that the original radiologist had missed a dilated internal auditory canal and a deformity of the cochlear modiolus in the affected ear of 1 of these patients. No abnormality was detected on review of the CTs of the other 2 patients. Therefore, we conclude that negative CT findings do not necessarily rule out a risk of PG. [ABSTRACT FROM AUTHOR]

We conducted a prospective, randomized, controlled, double-blind study of 33 patients to compare the efficacy and tolerability of a new glycerin formulation of ototopical 0.3% ciprofloxacin with that of a conventional aqueous formulation of ciprofloxacin for the treatment of acute external otitis. Outcomes measures were resolution of discharge, swelling, pain, and redness and the incidence of adverse side effects. Patients were examined on three occasions: on the day of enrollment (visit 1), 48 to 72 hours later (visit 2), and 7 days after enrollment (visit 3). At visit 2, the patients in the glycerin group showed a significantly greater resolution of discharge. We observed the same pattern with respect to swelling, pain, and redness, which resolved more quickly in the glycerin group, although not significantly so. All patients were cured by visit 3, and the two treatments were equally well tolerated. On the basis of our findings, we conclude that the glycerin formulation of ototopical 0.3% ciprofloxacin appears to be at least as effective as the aqueous form in the treatment of acute external otitis--and in the case of otorrhea, more so. [ABSTRACT FROM AUTHOR]

Focuses on the formation and management of middle ear granulation tissue in chronic ear disease. Phases of granulation tissue formation; Origins of tympanostomy-tube-related granulation tissue; Information on chronic ear diseases with granulation tissue; Methods used to control and manage granulation tissue.

Presents a discussion on the use of steroids in treating ear diseases. Conclusions of human and animal experiments on the outcomes of ototopical steroids in pharmacokinetics, sensorineural hearing loss and refractory otitis externa; Effects of steroids on patients with external otitis; Results of the intake of steroid-containing drops by children.

Presents an update on methods of assessing microbiologic outcomes in patients with otic disease. Information on the use of polymerase chain reaction (PCR) methods with DNA-based technology in detecting bacteria such as Corynform bacteria and Rhizobium radiobacter; Impact of antibiotic resistance on clinical trials; Discussion on the use of DNA-based technology in PCR.

Presents a discussion on alternatives to the use of potentially ototoxic antibiotic drops in ears that have an open tympanic membrane. Comparison between quinolones and ototoxic topical antibiotics; Reason for the use of ototoxic agents; Instructions on the use of drugs for patients with otorrhea.

The repair of surgical wounds of the external ear--whether it be a primary skin closure, a skin flap, or a skin graft--presents several challenges with respect to healing. One of these challenges is that it is not easy to fashion a wound dressing that has a smooth, moisture-containing surface, conforms to the shape of the auricle, and adheres to it while providing light pressure. An ear dressing that features these characteristics--the malleable ear dressing--is expected to become commercially available soon. In this article, the author describes his use of this dressing in 48 patients and reviews the results of follow-up questioning of 20 of these patients. Based on these findings, the author concludes that this dressing is effective, comfortable, aesthetically acceptable, and can be worn continuously for 7 consecutive days without complications. [ABSTRACT FROM AUTHOR]

In order to discern trends in surgical procedures used to treat Ménière's disease in the United States during the 1990s, we mailed a questionnaire to 700 members of the American Otological Society and the American Neurotology Society. These physicians were asked about the frequency, results, and complications of surgical procedures for Ménière's disease that they had performed between Jan. 1, 1990, and Dec. 31, 1999. Questionnaires were returned by 137 surgeons (19.6%). Their responses indicated that the number of vestibular neurectomies, labyrinthectomies, and endolymphatic sac surgeries all decreased during 1999. Meanwhile, the use of office-administered intratympanic gentamicin therapy increased rapidly throughout the entire 10-year period, and by 1999 it had become the most frequently used invasive treatment for Ménière's disease. Surgeons now seem to reserve inpatient procedures for cases where intratympanic gentamicin fails to control vertigo. [ABSTRACT FROM AUTHOR]

G-induced vestibular dysfunction (GIVD) is a condition well known to aircraft pilots who experience high positive and negative G loads during unlimited-aerobatic competitions and air-show demonstrations. After landing and walking from their aircraft, pilots with GIVD manifest an extremely unstable gait, which they call the wobblies. This article includes a report of one such case of GIVD, which to the author's knowledge is the first published case report of this condition in the medical literature. The author also discusses what is known and theorized about the pathogenesis of GIVD, and he reviews its diagnosis, treatment, and prevention. [ABSTRACT FROM AUTHOR]

Chronic external otitis is probably a disease of mixed etiology; infection and hypersensitivity both play an important role. As such, these two components must be recognized and respected. Steroids are the mainstay of medical management. Antibiotics should be used cautiously and probably on an intermittent basis. The disease appears to be exacerbated by any manipulation of the canal, including aggressive cleansing. Medical therapy will slow the development of fibrosis in some cases, but it does not always prevent it. Once stenosis has progressed to the point that conductive hearing loss develops, surgery will restore hearing and prevent restenosis in at least 80% of cases. [ABSTRACT FROM AUTHOR]

An 83-year-old man with a lifelong history of intermittent otorrhea and hearing loss was referred for management of a facial paralysis of 3 weeks' duration. Computed tomography (CT) of the head detected a neoplasm of the nasopharynx along with chronic otomastoiditis. A followup CT suggested the development of a nasopharyngeal abscess, which was confirmed by needle aspiration. A later coronal-projection CT showed definite bone destruction in the anterior petrous apex, confirming suspicions that a petrous apicitis was responsible for the facial paralysis and abscess. This article describes the management of this patient and reviews the historical, medical, and surgical aspects of petrous apicitis. [ABSTRACT FROM AUTHOR]

Objective: To emphasize the benefits of tele-otology in community screening of patients with ear diseases. Methods: A retrospective study of all patients screened and treated under the Shruti tele-otology program between 2013 and 2019 was conducted. It involved screening, diagnosis, medical management, surgical intervention, and rehabilitation using hearing aid. The study focused on underprivileged and underserved community of rural and urban slums across 12 states of India. The study was conducted using a telemedicine device called ENTraview, that is, a camera-enabled android phone integrated with an otoscope and audiometry screening. Result: A total of 810 746 people were screened, and incidence of various ear diseases was recorded. Ear problems were found in 265 615 (33%) patients, of which 151 067 (57%) had impacted wax, 46 792(18%) had chronic suppurative otitis media, 27 875 (10%) had diminished hearing, 12 729 (5%) had acute otitis media and acute suppurative otitis media (ASOM), and 27 152 (10%) had problems of foreign body, otomycosis, and so on. Of the total 265 615 referred patients, 20 986 (8%) reported for treatment and received treatment at a significantly reduced cost through Shruti program partners. The conversion rate of nonsurgical and surgical procedure was also compared, and it was found that, while 9% of the patients opted for nonsurgical treatment, only 3% opted for surgery in the intervention group giving a significant P value of.00001. Conclusion: The potential for telemedicine to reduce inequalities in health care is immense but remains underutilized. Shruti has largely been able to bridge this gap as it is an innovative, fast, and effective programs that address the ear ailment in the community. [ABSTRACT FROM AUTHOR]

Otophyma is a rare condition that can result in conductive hearing loss. Current otophyma literature does not examine validated treatment outcomes for patients. Utilizing a medical and surgical approach to maintain a patent canal can lead to significant objective improvements. The aim of this case series is to describe a combined successful approach in 3 cases from an academic, multidisciplinary center. The main outcomes analyzed were pre and post air-bone gap audiogram analysis and disimpaction frequency. The results showed that post-management, patient 1 had substantial improvement in hearing, recovering 49 dB in his right ear and 25 dB in his left ear, demonstrating near complete air-bone gap closure. Patient 2 showed a similar dermatologic and functional improvement, although objective audiometric assessment related to otophyma could not be performed due to coexisting chronic otitis media and cholesteatoma. Patient 3, in the 12 months prior to comanagement, had 8 bilateral disimpactions, and following comanagement had 2 disimpactions in 23 months. All 3 patients were pleased with the resultant functional and physical appearance following comanagement. By presenting this approach and objective measures of treatment, we hope to improve future clinical decision-making in a rare condition. [ABSTRACT FROM AUTHOR]

Discusses audiological changes associated with HIV infections. Manifestations as a response to viral complications; Symptoms; Auditory changes indirectly associated with HIV infections; Direct effects of HIV viruses; Abnormalities in the auditory brainstem response (ABR) in symptomatic and asymptomatic patients.

The article describes the case of advanced aural myiasis with external ear destruction on a 61-year-old male with schizophrenia from Bolivia. Highlights include tissue specimen obtained during debridement that was sent for culture and pathology review, additional debridement done two weeks later that showed exposure of the left condyle without bony destruction, and the use of ivermectin medication for complicated cases before and/or after extraction.

The article describes the case of a 36-year-old female diagnosed with Red ear syndrome secondary to an anticancer drug known as Ara-C. The patient started on induction chemotherapy for newly diagnosed acute myeloid leukemia. Her blood counts suggested chemotherapy-induced myelosuppression. Lack of steroid prophylaxis and younger age are considered risk factors for Ara-C-induced skin toxicity.

We describe the case of a 22-year-old woman who presented with a slowly growing osseous lesion of the mastoid cortex. On computed tomography, the lesion was found to involve the mastoid cortex, with which it demonstrated similar attenuation. The indications for treatment in this case were the patient's sensation of a mass effect, the encroachment of the mass onto the external auditory meatus, and a cosmetic deformity. The tumor was removed in its entirety via a postauricular approach. Findings on histopathologic examination were consistent with a compact osteoma. Mastoid osteomas are rare, benign tumors. If their growth significantly occludes the meatus, they may cause cosmetic deformities, conductive hearing loss, and recurrent external ear infections. Several other osseous lesions of the temporal bone should be considered in the differential diagnosis. The etiology of mastoid osteomas is poorly understood. Surgical management can be undertaken with minimal postoperative morbidity. [ABSTRACT FROM AUTHOR]