1/50. 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 = effusion (Clic here for more details about this article) |
2/50. Spontaneous cerebrospinal fluid otorrhea from a tegmen defect: transmastoid repair with minicraniotomy.Spontaneous cerebrospinal fluid (CSF) otorrhea is a rare condition that presents in 2 clinical categories. In congenital labyrinthine malformations, it leads to bouts of meningitis in a hearing-impaired child. In the adult age group, a spontaneous CSF leak almost always results from a dural and bony defect in the tegmen area. Possible pathogenic mechanisms include progressive sagging and rupture of dura through a congenital tegmen dehiscence and progressive bone erosion by aberrant arachnoid granulations. These patients usually present with a middle ear effusion, resulting in clear discharge after myringotomy with tube insertion. Based on 4 patients with a CSF leak from a tegmen defect, this report reviews the clinical findings and diagnostic approach. The surgical management by a 5-layer closure using a transmastoid approach with minicraniotomy is outlined. This procedure offers a relatively simple and reliable method for repair without the inherent risks of a middle fossa craniotomy.- - - - - - - - - - ranking = 0.16666666666667keywords = effusion (Clic here for more details about this article) |
3/50. Middle ear inflation for diagnosis and treatment of otitis media with effusion.An adult (18 years), healthy, male subject with persistent bilateral middle ear (ME) underpressure and a history of recurrent otitis media into his teen years was identified. The response of his MEs to air inflation was evaluated and showed an immediate pressure increase after a valsalva maneuver followed by a rapid pressure drop to approach the pre-inflation levels. That response is consistent with the presence of ME effusion, which was not diagnosed by otoendoscopy or tympanometry, but was visualized bilaterally within the mastoid regions using magnetic resonance imaging (MRI). The patient was treated for 25 days with ME inflation (3/day) and then re-examined. On each treatment day, he recorded his ME pressure using tympanometry before and after one inflation maneuver. The patient's compliance with the treatment protocol was high, and successful gas transfers were documented on most days. Over the course of treatment, pre-inflation ME pressure became more normal bilaterally. When compared to the pre-treatment test, the post-treatment inflation test showed a similar rate of ME pressure decrease, but significantly higher terminal pressures. On follow-up but not during the pre-treatment period, discrete changes in ME pressure attributable to ET openings were noted during test sessions. MRI documented lesser amounts of effusion in the mastoid, but not complete disease resolution. The significance of these observations to the design of a well controlled clinical trail of ME inflation as a treatment for otitis media is discussed.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
4/50. Organic change of effusion in the mastoid in otitis media with effusion and its relation to attic retraction.To try to solve the pathogenesis of severe attic retraction viewed from mastoid condition, we examined the residual soft tissue density (RSTD) in the mastoid by computed tomography (CT) in 85 patients (107 ears) with otitis media with effusion (OME) 3 months after tympanostomy tube insertion or later. The incidence of RSTD in the mastoid was significantly higher in OME of adults (52.6%) than in children (24.1%). Ears with severe attic retraction had RSTD significantly more frequently (80%) than those with no or mild attic retraction, and many of the mastoids with severe attic retraction were occupied totally by RSTD. The area of the mastoid (mastoid pneumatization) was significantly smaller, and CT density of the mastoid (sclerotic tendency) was significantly higher in ears with RSTD than in those without. RSTD after tympanostomy tube insertion in the mastoid indicating organic change of effusion was considered one of the important factors relating to the pathogenesis of severe attic retraction.- - - - - - - - - - ranking = 1.6666666666667keywords = effusion (Clic here for more details about this article) |
5/50. Nasopharyngeal carcinoma in children.Nasopharyngeal carcinoma (NPC) is rare in children. We report two cases from KK women and Children's Hospital in singapore, who presented with advanced locoregional disease. The various aspects of NPC in children are discussed. It is more common in males and black adolescents. The etiology is probably different from that in adult. Undifferentiated NPC or lymphoepithelioma is the commonest variety. Confusing symptoms like cervical lymphadenopathy and unilateral otitis media with effusion (OME) are among the commonest presentations. When children present with both conditions simultaneously, it is imperative to manage them like adult patients and perform nasendoscopy to rule out NPC. The disease stage at presentation is often more advanced compared with adults. These tumors are, however, associated with a higher cure rate as they are most radiosensitive. radiotherapy with neo-adjuvant chemotherapy is currently the treatment of choice. Both cases achieved satisfactory control of the disease and are presently under close follow-up.- - - - - - - - - - ranking = 0.16666666666667keywords = effusion (Clic here for more details about this article) |
6/50. Oculopharyngeal muscular dystrophy: clinical and CT findings.A family affected with oculopharygeal muscular dystrophy (OPMD) is reported. This is an uncommon progressive myopathy. The proband presented for evaluation of secretory otitis media with effusion, as a result of tubal dysfunction. CT examination of the father revealed prominent muscular atrophy, and widespread fatty degeneration of the psoas, paraspinal, gluteal and femoral muscles.- - - - - - - - - - ranking = 0.16666666666667keywords = effusion (Clic here for more details about this article) |
7/50. Clinical characteristics of so called eosinophilic otitis media.OBJECTIVE: Although "eosinophilic otitis media" is not as uncommon a condition as was previously believed, its cause and pathogenesis are not yet fully understood. The purpose of this study was to describe the clinical characteristics in patients with "eosinophilic otitis media" to clarify its pathogenesis. methods: Seven adult patients with persistent and intractable otitis media with viscous middle ear effusion containing many eosinophils, who were also under treatment for bronchial asthma, were studied. The following examinations were conducted: nasopharyngeal endoscopy, pure-tone audiometry, eustachian tube function test, temporal bone CT scan, blood analysis, bacterial and fungal culture of middle ear effusion, histological study of the middle ear and nasal specimens, and measurement of eosinophilic cationic protein (ECP) in middle ear effusion. RESULTS: Some patients had persistent perforation with papillomatous granulation tissue arising from the mesotympanic mucosa, and all the patients had nasal polyposis. The pure-tone audiometry showed the mixed-type of hearing loss in all the patients, and the hearing level deteriorated progressively during the course in some patients. The eustachian tube function was not always poor but was patulous in some cases. The most severely diseased areas were in the eustachian tube and mesotympanum by temporal bone CT images. All the seven patients had the high levels of total serum IgE, but the RAST scores were negative in three patients and low grade in three patients. The accumulation of eosinophils was observed in middle ear effusion, middle ear mucosa and nasal polyps, and the eosinophils were highly activated with degranulation. High level of ECP was also recovered from middle ear effusion. CONCLUSIONS: Active eosinophilic inflammation occurs in the entire respiratory tract, including the middle ear in these patients. From our present investigation, we propose the criteria and clinical characteristics of "eosinophilic otitis media".- - - - - - - - - - ranking = 0.83333333333333keywords = effusion (Clic here for more details about this article) |
8/50. Ear involvement in ligneous conjunctivitis: a rarity or an under-diagnosed condition?conjunctivitis lignosa, a rare affliction of the conjunctiva, is sometimes associated with other disturbances. We present two children with concurrent conjunctivitis lignosa and ear involvement. In these two cases, there were histopathologically verified ligneous changes of the middle ears. Routine haematoxylin and eosin, van Gieson, periodic acid-Schiff (PAS) and alcian blue staining of specimens from the eyes and middle ears revealed findings typical for ligneous conjunctivitis. In addition, new histochemical and immunohistochemical studies for glycosaminoglycans on specimens from the eyes and middle ears showed that the accumulations of the amorphous, cell-deficient material stained strongly but heterogeneously for hyaluronic acid and weakly but uniformly for keratin sulphate. The staining for other glycosaminoglycans, e.g. chondroitin-4-sulphate and dermatan sulphate was confined to vessels and areas rich in collagen fibres and fibroblasts. In patients with conjunctivitis lignosa, the ear involvement may remain undiagnosed due to its resemblance to secretory otitis media with effusion. Since isolated ear involvement may occur, we advocate biopsies for routine haematoxylin and eosin, and specific staining for hyaluronic acid and keratin sulphate, also in children with protracted, refractory otitis media with atypical effusion.- - - - - - - - - - ranking = 0.33333333333333keywords = effusion (Clic here for more details about this article) |
9/50. bordetella pertussis causing otitis media: a case report.OBJECTIVE/HYPOTHESIS: is an unusual cause of otitis media with effusion. We report a case in a neonate. STUDY DESIGN: Case report. methods: A case is presented. RESULTS: A 1-month-old infant girl was admitted because of respiratory distress and subsequently was found to have pertussis. On examination she was noted to have a middle ear effusion. Myringotomy was performed for culture. culture confirmed. We were unable to find a previous report of otitis media. CONCLUSION: has been identified in the middle ear effusion of an infant with the pertussis syndrome.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
10/50. hearing loss due to mannosidosis and otitis media with effusion. A case report and review of audiological assessments in children with otitis media with effusion.A case of a child with mannosidosis and bilateral otitis media with effusion (OME) is reported here along with some discussion of relevant literature to emphasize the need for age appropriate audiometric assessment before and after insertion of grommets for glue ear (OME). There is a need for multidisciplinary teamwork in the management of children with hearing loss. If OME is treated surgically, age-appropriate hearing assessment is required before and after insertion of grommets. The need for audiological assessments will be relevant even if children had passed the newborn hearing screening test.- - - - - - - - - - ranking = 1.5keywords = effusion (Clic here for more details about this article) |
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