1/111. Otomastoiditis caused by rhodococcus equi in a patient with AIDS. rhodococcus equi is a well-recognized pathogen in veterinary medicine and a rare but well-documented cause of cavitary pneumonia in immunocompromised patients. Most cases of rhodococcus equi infections in these patients involve the lungs. Otomastoiditis due to rhodococcus equi is rare, and disseminated rhodococcus equi with otomastoiditis has never been reported. We report a case of otomastoiditis with systemic dissemination due to rhodococcus equi in a patient with AIDS. ( info) |
2/111. Salivary gland choristoma of the middle ear: a case report. A choristoma is a nonneoplastic proliferation of histologically normal tissue that forms at an abnormal site. It is extremely uncommon in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. It usually occurs with unilateral conductive hearing loss and requires a differential diagnosis from other mass lesions in the middle ear cavity. This article discusses a case of salivary gland choristoma of the middle ear that we believe to be the 24th case reported on this subject. ( info) |
3/111. Gradenigo's syndrome. Gradenigo's syndrome, which is characterised by the triad of suppurative otitis media, pain in the distribution of the trigeminal nerve, and abducens nerve palsy may give rise to potentially fatal complications. knowledge of the aetiology and appropriate investigations can lead to early diagnosis. A case is reported which illustrates this. ( info) |
4/111. Otitic hydrocephalus of tubercular origin: a rare cause. Otitic hydrocephalus is characterized by increased intra-cranial pressure without focal signs of neurological dysfunction. It usually occurs secondary to lateral sinus thrombosis more commonly on the right side, but it can also occur without lateral sinus thrombosis. With the advent of new antibiotics there has been a spectacular decrease in the complications of otitis media. Otogenic intra-cranial hypertension, always an uncommon condition, is seen only very rarely nowadays. Tubercular otitis media still occurs in india, and due to delays in its diagnosis it usually presents with complications. We present three patients with otitic hydrocephalus of tubercular origin. ( info) |
| INTRODUCTION: We portray and discuss a case of lateral sinus thrombosis following acute otitis media and mastoiditis. CLINICAL PICTURE: The patient presented with otorrhoea, otalgia, neck pain, fever and chills. TREATMENT: Cortical mastoidectomy was performed. Intravenous antibiotics and heparin were administered. OUTCOME: The patient had a complete recovery with no sequelae. CONCLUSIONS: Neurotologic complications of suppurative otitis media like meningitis, cerebral abscess, extradural abscess and dural sinus thrombosis are rare in the antibiotic era. Hence, doctors today have to maintain extra vigilance and a high index of suspicion for such complications. ( info) |
6/111. salmonella senftenberg: ear infection. A case report. A case of otitis media, a rare complication of salmonella senftenberg infection is reported. ( info) |
7/111. Recurrent temporal petrositis. The objective of this paper is to present and discuss the common features of temporal petrositis and the different approaches to its management. petrositis used to be common before the antibiotic era. It can be associated with life-threatening complications. The management of this problem used to be by an aggressive surgical approach. However, recent reports are describing good results with more conservative medical treatment and minimal surgical intervention, with the reservation of more aggressive surgical interventions for chronic or refractory cases. ( info) |
8/111. Otorhinolaringologic manifestation of smith-magenis syndrome. smith-magenis syndrome (SMS) is a multiple congenital anomaly/mental retardation (MCA/MR) syndrome link to a contiguous-gene deletion syndrome, involving chromosome 1 7p 11.2,whose incidence is estimated to be 1:25,000 livebirth. SMS is characterised by a specific physical, behavioural and developmental pattern. The main clinical features consist of a broad flat midface with brachycefaly, broad nasal bridge, brachydactily, speech delay, hoarse deep voice and peripheral neuropathy. Behavioural abnormalities include hypermotility, self-mutilation and sleep disturbance. This report defines the otorhinolaryngological aspects of a new case of SMS, confirmed by cytogenetic-molecular analysis, in a 9 year old girl affected by chronic otitis media, deafness and sinusitis, who presented with typical clinical signs and symptoms. ( info) |
9/111. Labyrinthine fistula detection: the predictive value of vestibular symptoms and computerized tomography. A retrospective case record study of 20 patients in Oslo operated on for chronic otitis media with labyrinthine fistula between 1986 and 1999 was performed in order to estimate the incidence of, and identify predictors for, labyrinthine fistulas. The incidence of fistula was 0.3 per 100 000, with a median age at diagnosis of 37 years. The median duration of chronic otitis media prior to labyrinthine fistula detection was significantly correlated with age at surgery. Subjective hearing loss (90%), otorrhoea (65%) and dizziness (50%) were presenting symptoms. Modified canal-wall-down mastoidectomy was performed in all patients. Preoperative hearing levels could not predict postoperative hearing outcome. Positive signs of fistula were found in only 4 patients (20%). Correspondingly, computerized tomography (CT) diagnosed the fistula in 11 patients (55%). The seven patients presenting without dizziness and with a negative CT scan and fistula test were characterized by lower age, absence of previous middle ear surgery, lower preoperative pure-tone thresholds for bone conduction and better hearing outcome after surgery. In conclusion, the identification of a younger group of patients presenting with fewer symptoms indicates that fistulas should be suspected in all patients undergoing surgery for chronic middle ear and mastoid disease. ( info) |
10/111. Anterior subannular T-tube for prolonged middle ear ventilation during tympanoplasty: evaluation of efficacy and complications. OBJECTIVE: We previously described the use of anterior subannular T-tubes (n = 20) for long-term middle ear ventilation. In the current study, we examine a larger patient population (n = 38) and a longer follow-up interval (average >2 years) to evaluate the efficacy and safety of anterior subannular tympanostomy. STUDY DESIGN: Retrospective nonrandomized case review. SETTING: Tertiary referral hospital. patients: Our series consisted of 38 consecutive patients with a diagnosis of eustachian tube dysfunction, adhesive otitis media, or chronic otitis media with a perforation who underwent a tympanoplasty. INTERVENTION: A subannular T-tube was placed anteriorly at the time of tympanoplasty to provide long-term middle ear ventilation. MAIN OUTCOME MEASURES: The main outcomes of this study are tube position, tube patency, and middle ear ventilation. In addition, hearing was evaluated both preoperatively and postoperatively and any complications were noted. RESULTS: There were 38 patients and 38 ears that received an anterior subannular T-tube at the time of tympanoplasty. The study group consisted of 24 female patients and 14 male patents with a median age of 36 years (range, 10-75 yr). All 38 patients had eustachian tube dysfunction, 22 had adhesive otitis media, 23 had chronic otitis media, 13 had a cholesteatoma, 11 had tympanic membrane perforations, and 3 patients had a cleft palate. All patients underwent tympanoplasty. Eighteen patients had a concomitant ossiculoplasty and 7 had a mastoidectomy. Follow-up ranged from 1 month to 48 months (average, 26 mo). Three tubes had extruded within 2 years, in 1 case resulting in a persistent perforation. postoperative complications included 1 patient with a partially extruded prosthesis, 2 patients with tipped prosthesis and persistent tympanic membrane retraction, and 1 patient with a plugged tube. All other tubes were patent and showed no evidence of migration. Furthermore, there were no cases of anterior canal blunting or ingrowth of epithelium around the tube. CONCLUSION: Anterior subannular tympanostomy is a safe and effective method for long-term middle ear ventilation in patients with chronic eustachian tube dysfunction. ( info) |