摘要:

Chronic stenosing external otitis is an indolent condition that is difficult to treat. Twelve cases that were operated on during a 3-year period were reviewed. The results of treatment are presented and the surgical methods are discussed. This involves excision of all fibrous tissue and if necessary the drum, a wide canalplasty, a meatoplasty, and then reconstruction with a fascial graft if necessary followed by split skin grafts, with emphasis on maintaining the anterior tympanomeatal angle.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We all encounter them: difficult chronic ears that seem to confound management efforts and that constitute an unrelenting imposition to the patient. Typically these ears have undergone multiple surgeries and are chronically infected. Such cases are commonly associated with residual or recurrent cholesteatoma. Those rare ears that temporarily respond to therapy promptly recur once treatment is withdrawn. Even the most aggressive nonsurgical protocols fail these patients, who exhibit lifelong social and professional incapacity. They seem to ultimately defy resolution. The purpose of this article is to present a surgical solution to the difficult chronic ear dilemma that emphasizes disease control. Treatment outcome is reviewed in 541 cases. Management pitfalls are analyzed with follow-up, in some cases 20 years.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Labyrinthine fistula in chronic otitis media with cholesteatoma most commonly involves the horizontal semicircular canal. We report three cases of cochlear fistula in chronic otitis media with cholesteatoma. All of them had a long history of otorrhea. One patient had total hearing loss of the affected side. The other two patients had conductive hearing loss. Radical mastoidectomy had been done in all cases. Cholesteatoma in the tympanic cavity destroyed the basal turn of the cochlea. These fistulas were sealed with muscle or Gelfoam with streptomycin. We found no fistula in the semicircular canal in any of the three cases. We report three cases of cochlear fistula in chronic otitis media with cholesteatoma, and review the literature.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A modification of an ossiculoplasty technique, in which a hole is drilled through an ossicular or cortical bone graft so that it can encircle the malleus handle, has been evaluated during a 4-year period. During this time, 26 operations have been carried out. The 1-year hearing results obtained have been compared with those for conventional operations in ears with the same ossicular defect by creating matched pairs whose preoperative air-bone gaps differed by no more than 5 dB. There is no difference between the hearing results for the two groups. Revision operations have been carried out in five cases. In two of these the cause of failure was iatrogenic cholesteatoma. This probably occurred because the technique demands the separation of the malleus handle from the tympanic membrane. This can be easily achieved except at the lower end, where the attachment is much firmer. The incidence of cholesteatoma in the study group is higher than that found in the author's patients who have undergone conventional ossiculoplasty operations. The “Jigsaw” technique has no advantage over conventional ossiculoplasty techniques and, in view of the risk of cholesteatoma formation, cannot be recommended.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

An organism must maintain a fairly constant balance of pH to survive. Most bacteria grow the best in a narrow range of pH from 6.5 to 7.5. Ninety-six patients with chronic suppurative otitis media were selected. Two weeks before the treatment they were instructed to stop taking any antibiotics; then a sterile swab culture was taken from auditory canal secretions and at the same time the pH of the secretions were measured. Otomicroscopic examination of the ear with cleaning of purulent debris was done. All patients received ear irrigation with 2% acetic acid solution three times per week for the maximum of 3 weeks without antibiotic therapy. Any patients with cholesteatoma, polyp, granulation and otomycosis were excluded. Patients were followed for up to 3 years. Fifty-five patients (57%) had resolution of their original otorrhea, whereas 19 patients (20%) developed healed ear drum perforation. The remaining 14 patients (15%) showed recurrence and 8 of them (8%) had no response to the treatment.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

There are several hyperostosis diseases of the skull that are accompanied by hearing impairment. In this article a case of Engelmann disease is presented. Currently > 130 cases of Engelmann disease are reported in literature. About 18% of these cases reported hearing impairment, but it is possible that this figure may be higher, because many of the authors concentrated on other aspects of the disease and made no reference to hearing loss in their reports. The etiology of deafness is the narrowing of the internal auditory canals caused by bony encroachment on nerves and vessels. This leads to progressive perceptive hearing loss and narrowing of the tympanic cavities. The result is fixation or adhesion of ossicles to tympanic walls, and narrowing of the bony part of auditory tubes, which causes serous otitis media.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The electroretinogram (ERG) is the only test currently available that has the potential to identify patients with Usher syndrome before onset of fundoscopic and visual abnormalities. The ERG is a noninvasive technique that can diagnose retinitis pigmentosa via measurement of corneal-retinal potentials. Forty-seven children with bilateral severe to profound sensorineural hearing loss were evaluated. Usher syndrome was diagnosed in five children, all of whom subsequently underwent cochlear implantation. We have found that accurate diagnosis of Usher syndrome in infants and young children is possible via ERG. Benefits of early diagnosis include timely counseling regarding genetic issues, educational and vocational placement, and cochlear implantation. For this reason we recommend that all newly identified children with bilateral severe to profound sensorineural hearing loss undergo ERG testing.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The supratubal recess (STR), located superior to the bony eustachian tube and anterior to the attic and often the site of disease, is clearly separated from the attic by the presence of a bony partition. Its anatomic development in childhood, however, remains unclear. We reviewed serial horizontal sections of fetal and children's temporal bones from the collection of the Otopathology Laboratory, University of Minnesota. Apparently, upward expansion of the bony eustachian tube begins at a late fetal stage and continues throughout childhood, thus forming the STR. Our finding that the STR had already developed in temporal bones without pneumatization of petrous bone suggests that its formation is independent of the air-cell system. Absorption of mesenchymal tissue in the STR tends to be slower than elsewhere in the temporal bone. Surrounded solely by petrous bone, the STR seems, both developmentally and anatomically, a distinctive compartment of the middle ear.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Patients with acquired immunodeficiency syndrome (AIDS) were investigated to determine the sites, nature, and severity of any otologic abnormalities. Tinnitus, “muffled” or “echoing” hearing, and vertigo were frequent complaints. Eight percent of the 155 patients studied showed evidence of chronic otitis media, usually with effusion. Mostly mild, but occasionally severe sensorineural hearing loss was found in many, affecting more severely the higher and lower frequencies than the middle range. Almost all patients showed diminished otoacoustic emissions, suggesting cochlear dysfunction resulting from infection or ototoxicity as the basis for the hearing loss. Impairment of the otoacoustic emissions by a subclinical otitis media with effusion cannot, however, be excluded. On the basis of this study it is suggested that the provision of otologic care to patients with AIDS may enhance their quality of life and, by the early detection and treatment of severe otitis media, may even prolong life.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We report a case of hearing preservation after removal of the semicircular canals and discuss the possible explanations for the mechanisms of preservation of hearing after removal of the labyrinth. We hope to promote the perspectives and possibilities of functional surgery of the inner ear and for tumors of the cerebellopontine angle.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID