1/2. Recurrent acute otitis media associated meningitis in a patient with a contralateral cochlear implant and bilateral cochleovestibular dysplasia.OBJECTIVE: To illustrate that a patient with a cochlear implant may be at increased risk of meningitis secondary to developmental anatomic abnormality associated with the underlying sensorineural hearing loss, as opposed to the implant itself. methods: Case report. RESULTS: Our 12-year-old patient has bilateral cochlear dysplasia, profound sensorineural hearing loss and no prior history of recurrent acute otitis media or meningitis. He underwent a left cochlear implant at 8 years of age and subsequently experienced three episodes of right acute otitis media and meningitis over the next 4 years. Middle ear exploration revealed a cerebrospinal fluid leak. A right radical mastoidectomy with closure of the external auditory canal, removal of the tympanic membrane, malleus, and incus, closure of the eustachian tube, and obliteration of the mastoid and middle ear with abdominal fat has prevented further episodes. CONCLUSION: meningitis in a patient with a cochlear implant is not necessarily related to the implant.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
2/2. fistula of the cochlear labyrinth in noncholesteatomatous chronic otitis media.OBJECTIVE: To discuss the clinical aspects and management of promontory fistula of the cochlear labyrinth. STUDY DESIGN: Case report and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT, INTERVENTION, AND RESULTS: The authors describe an unusual case of cochlear fistula localized to the promontory discovered during tympanoplasty for noncholesteatomatous chronic otitis media in a 59-year-old woman. bone conduction was slightly impaired after operation and hearing improved after a revision myringoplasty performed for reperforation. CONCLUSION: Erosion of the bone of the labyrinth can also be observed in noncholesteatomatous otitis media. The presence of a fistula is not always associated with profound hearing loss. Overlying pathologic tissue can be removed without damaging the membranous labyrinth.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |