1/44. Sensorineural hearing loss associated with otitis media with effusion in children.Sensorineural hearing loss (SNHL) is known to occur in various types of otitis media. Although the mechanism by which SNHL develops in association with otitis media with effusion (OME) is unknown, several hypotheses have been advocated up to now. We reviewed the clinical records of children with otitis media with effusion (OME) to reveal the association with sensorineural hearing loss. The material consisted of 71 children (119 ears) who were diagnosed as having OME and gave reliable audiograms in our clinic during an 11 month period from February 1997 through January 1998. From these cases those which showed bone conduction loss of 25 dB or higher at any one of the frequencies of 250 through 4 kHz were selected and considered to be cases of SNHL. Eight cases (9%) which had temporary threshold shift (TTS) or permanent threshold shift (PTS) were considered to be etiologically related to OME. The clinical course in each of these cases with SNHL was reviewed and evaluated in detail. We noted that all children with TTS improved completely. The result of this study indicates that we have to be aware of a possible development of SNHL during the course of OME.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
2/44. williams syndrome and the elastin gene in Thai patients.williams syndrome (WS) has long been known as a complex disorder of dysmorphic facial features, described as elfin face, mental retardation or learning disability, loquacious personality, and supravalvular aortic stenosis. The etiology is now known to be due to deletion of the elastin gene (ELN) on long arm of chromosome 7. Thai patients were previously reported by clinical diagnosis. This study reports the first two cases of WS with ELN deletion diagnosed by fluorescent in situ hybridization (FISH) technique. Clinically, hyperacusis is a common finding in WS associated with otitis media. Neither of the patients had hyperacusis, but one of them had bilateral sensorineural hearing loss, which to our knowledge, has never been reported.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
3/44. Wegener's granulomatosis: diagnostic dilemma.Wegener's granulomatosis is a systemic disease characterized by a granulomatous lesion that can affect any organ throughout the body. This case-report illustrates the problem posed by a patient presenting with bilateral serous otitis media with marked sensorineural hearing loss, facial nerve paralysis and an atypical serological picture. The importance of early diagnosis and the protocol for the management of a patient with an uncertain diagnosis is discussed. Due to atypical presentations, only a high index of suspicion will ensure an early diagnosis.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
4/44. facial paralysis in Wegener's granulomatosis of the middle ear.A case of Wegener's granulomatosis, which presented as chronic otitis media with facial nerve palsy, is described. early diagnosis is vital if unnecessary surgical exploration is to be avoided. A false negative cANCA may delay the diagnosis, especially in cases of locoregional disease, and a policy of repeated titres should be adopted, if clinical suspicion is high.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
5/44. Severe audiovestibular loss following ear syringing for wax removal.Syringing of the ear is one of the commonest procedures performed for cleaning cerumen from the external auditory canal. Common complications following syringing are pain, external auditory canal trauma and otitis externa. Hearing and vestibular loss are often mentioned as a complication in descriptions of this technique, but we have not been able to find a reported case of such an occurrence. We report one such a case.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
6/44. Otologic manifestations of Wegener's granulomatosis.OBJECTIVE/HYPOTHESIS: To evaluate the clinical features, treatment, and outcomes of otologic manifestations in Wegener's granulomatosis (WG) treated at Hokkaido University Graduate School of medicine, Sapporo, japan. STUDY DESIGN: We retrospectively reviewed 15 cases of WG with ear involvement. methods: Twenty-five patients with WG were treated at Hokkaido University Graduate School of medicine between 1992 and 2001. Fifteen of these patients had otologic symptoms. We evaluated the clinical course, method of therapy, and outcomes in all cases. Diagnosis of WG was made when the patients had clinical findings and a positive titer of cytoplasmic pattern antineutrophil cytoplasmic antibodies (c-ANCA), or when there were clear histologic findings. We also present three case reports. RESULTS: In 15 cases, the most frequent finding was chronic otitis media. Sensorineural hearing loss was present in 2 patients. In 7 patients whose otologic manifestations were the primary involvement of WG, all were confirmed positive for c-ANCA and were treated with glucocorticoids and immunosuppressive drugs. Three patients who could be treated within 1 month of symptom onset showed marked improvement. CONCLUSIONS: In localized cases, biopsy specimens are often small, and it is frequently difficult to make a histologic diagnosis. The prognosis for hearing was poor when appropriate treatment was not given in the early stages of the disease. Therefore, WG should be included in the differential diagnosis in cases of atypical inflammatory states of the ear. early diagnosis and appropriate treatment are important to prevent irreversible changes in the middle ear and inner ear.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
7/44. Neuroepithelial cysts of the middle ear.Neuroepithelial cysts are lesions of the central nervous system that have previously been reported in cerebral parenchyma, in the spinal cord, and within the ventricles in association with the choroid plexus. We describe 2 cases of neuroepithelial cysts of the middle ear. One was diagnosed after surgery for a retraction pocket and chronic otitis media complicated by an intraoperative cerebrospinal fluid (CSF) leak. The other produced bilateral spontaneous CSF otorrhea and mimicked the presentation of arachnoid granulations. Both cases were verified with immunohistochemical stains. Neuroepithelial cysts, although rare, should be considered in the differential diagnosis of spontaneous CSF otorrhea or an epitympanic mass.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
8/44. Is it necessary to screen for hearing loss in the paediatric population with osteogenesis imperfecta?The aim of the study was to assess the necessity of a screening service to detect early hearing loss in the paediatric population with osteogenesis imperfecta. Twenty-two children were assessed over a 5-year period. Five children (22.7%) had normal hearing. Fourteen (63.6%) had conductive hearing loss, with 12 children in this group having otitis media with effusion (OME); all had resolution of hearing loss with appropriate therapy. Two children had persistent conductive losses unrelated to OME. Three children (13.6%) had sensorineural hearing loss, with one being detected at the age of 1 year. Existing evidence suggests that hearing loss associated with osteogenesis imperfecta has its onset in the second to third decade of life. Contrary to this, hearing loss was detected in 77.3% (17) of this population with a median and mean age of 9 years. This study would suggest that routine screening is worthwhile in children with osteogenesis imperfecta.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
9/44. External auditory canal closure in cochlear implant surgery.OBJECTIVE: To evaluate surgical techniques and complications associated with external auditory canal (EAC) closure in cochlear implant surgery. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center with a large cochlear implant program. patients: Twenty-eight patients (8 adults and 20 children) underwent multichannel cochlear implantation with EAC closure. The follow-up periods ranged between 1 and 10 years. Closure of the EAC was performed in conjunction with implantation of ears with chronic suppurative otitis media or cochlear drill-out procedures for ossification, or for access to the cochlea in patients with abnormal temporal bone anatomy. A modified Rambo technique was used for EAC closure in all but one case. INTERVENTIONS: cochlear implantation with EAC closure and subsequent clinical and radiologic follow-up. MAIN OUTCOME MEASURES: postoperative complications or the development of cholesteatoma in the implanted ear. RESULTS: cholesteatoma developed in the implanted ear in two patients. Breakdown of EAC closure occurred in one of these patients. The details of these patients are reviewed. CONCLUSION: Closure of EAC can be done with relatively low risk. Close and careful follow-up is required for early detection of a developing cholesteatoma.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
10/44. Five children--vignettes of language disorders.The pediatric otolaryngologist cares for children who have abnormal language as a primary or secondary deficiency. Five children, each with a different form of language disorder, are presented. These are children with specific language impairment (SLI) expressive, pervasive developmental delay (autism), expressive language delay associated with severe to profound hearing loss early in life, language delay secondary to a moderate to severe hearing loss diagnosed late and not cared for, and language delay secondary delay secondary to social deprivation and otitis media with effusion.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
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