Cases reported "Labyrinthitis"

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1/9. Unilateral sensorineural hearing loss and its aetiology in childhood: the contribution of computerised tomography in aetiological diagnosis and management.

    OBJECTIVES: The objective of this study was to identify factors correlated with the CT outcome and to examine the contribution of the CT scan in the aetiological diagnosis and management of unilateral sensorineural hearing loss in childhood. methods: The records of 35 consecutively investigated patients by the audiology Department of Great Ormond Street Hospital between January 1996 and June 1998 were reviewed. The CT results, population sample characteristics, initiation of further investigations after the CT results and management decisions based on the CT results were tabulated and analysed. RESULTS: In a series of 35 consecutively investigated children with unilateral sensorineural hearing loss, 11 CT scans were identified as abnormal. The CT findings were: labyrinthitis ossificans (3), unilaterally dilated vestibular aqueduct (2), bilaterally dilated vestibular aqueduct (2), unilateral deformity of the cochlea ('Mondini') (1), unilateral severe labyrinthine dysplasia (1), unilateral markedly narrow internal acoustic meatus (1), bilaterally dilated lateral semicircular canals (1). The presence of progressive hearing loss was a significant predictor of abnormal CT outcome, while the severity of hearing loss was not. The CT scans offered valuable information regarding the aetiological diagnosis in all cases and, in addition, prompted the appropriate vestibular rehabilitation in three cases, further investigations in four (with dilated vestibular aqueduct) and hearing preservation counselling in two (bilateral DVA) (seven out of 35 = 20%). CONCLUSION: All children with unilateral sensorineural hearing loss should have a CT scan of the petrous pyramids/IAMs performed at some stage, as not only aetiology but also prognosis and management of these cases may be significantly influenced by the CT outcome.
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2/9. Histopathological findings in the inner ear caused by measles.

    An otopathological analysis of three cases of viral labyrinthitis was performed. Six temporal bones cut in serial sections were available for this study. According to the degree of degenerative changes in various parts of the inner ear two types of morphologically distinct labyrinthitis after measles are presented: the first one with the port of entrance through the internal auditory meatus and characterized by, first and most significantly, changes in the spiral ganglion cells; and the second, as described previously by Lindsay, with the port of entrance of the virus in the inner ear through the stria vascularis, with degenerative changes in various structures within the endolymphatic duct.
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3/9. Histopathological features of the spiral ganglion and cochlear nerve in temporal bones from three patients with profound hearing loss.

    In the following study the condition of the spiral ganglion and the cochlear nerve of ears from patients suffering from profound hearing loss is described. The number of spiral ganglion cells has been related to the clinical diagnosis. The number of spiral ganglion cells in the two temporal bones of a patient with neomycin ototoxicity was almost normal. A reduction of less than one-third of spiral ganglion cells has been observed in the temporal bones of a child who died after a bacterial labyrinthitis. The temporal bone with a Mondini dysplasia revealed a pronounced reduction of ganglion cells of more than two-thirds. The cochlear nerve trunk in the internal auditory canal appeared normal in all three cases. The present findings are discussed in respect to the degenerative behaviour of the cochlear neural elements in human being compared to animals.
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4/9. Treatable sensorineural hearing loss.

    Sensorineural hearing loss is generally felt to be an untreatable medical condition. However, in some cases, prompt diagnosis and treatment of the underlying condition may reverse the deafness. This article summarizes various treatable forms of sensorineural hearing loss and provides illustrative cases histories of patients who have had sensorineural hearing losses that were improved by medical or surgical intervention. patients with reversible sensorineural deafness due to inadvertent aminoglycoside over-dosage, congenital cholesteatoma, Meniere's syndrome, blood coagulopathy, and perilymphatic fistula all had improvements in auditory function after medical or surgical intervention. Recent experimental studies on animals may explain the basic mechanisms behind hearing loss and recovery. Aminoglycoside ototoxicity appears to have an initial reversible step, followed by a permanent process. Early endolymphatic hydrops and fistulas may cause mechanical effects in the cochlea which can be corrected. Coagulopathy may cause hypoxia which reverses after anticoagulation. These observations reveal that animal experiments can be useful in explaining human auditory dysfunction of the reversible type.
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ranking = 3288.4495403903
keywords = perilymphatic
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5/9. labyrinthitis ossificans.

    Three cases with postinflammatory inner ear sequelae are presented to illustrate unusual histopathologic changes. endolymphatic hydrops without changes in the perilymphatic system was present in one ear following "influenza" meningitis and labyrinthitis ossificans in the contralateral ear. The characteristic histopathological changes of the temporal bones with hematogenic bacterial infection were an extensive labyrinthine ossification associated with a generalized sclerotic change of the whole periotic bone. Bony fixation of the stapedial footplate occurred with the generalized inflammatory process of the otic capsule. Severe and diffuse labyrinthitis ossificans occurred in one case due to tympanogenic inflammation spreading through the round window membrane in the course of suppurative otitis media. A general immunosuppression leading to fatal termination was the apparent factor predisposing to the inner ear complication.
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keywords = perilymphatic
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6/9. Meniere's syndrome and otitis media.

    We here present a clinical study of 37 patients with Meniere's syndrome. Meniere's syndrome can occur subsequent to and in some cases simultaneously with chronic otitis media. When otitis media which has occurred many years earlier in childhood becomes inactive, leading to sequelae of Meniere's later in life, full-blown Meniere's symptom-complex with vertigo tends to occur; whereas when active chronic otitis media accompanies Meniere's, cochlear Meniere's syndrome tends to predominate. endolymphatic hydrops is described in pathological cases of labyrinthitis and in 11 human temporal bone cases where there is evidence of chronic otitis media in the absence of visible labyrinthitis. A discussion of pathogenic factors includes considerations of quantity of endolymph due to hypodevelopment of the endolymphatic duct and sac related to mastoid hypocellularity and otomastoiditis in childhood and to other endolymphatic malabsorptions and also considerations of endolymph quality which can influence endolymph production as well as absorption.
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7/9. Autonomic dysfunction on the affected side in Meniere's disease.

    For ascertaining the existence of autonomic dysfunction on the affected side as being the cause of Meniere's disease, the mecholyl tests were conducted by means of conjunctival instillation in normal subjects as well as in patients with Meniere's disease, labyrinthitis and vestibular neuritis. The rate at which significant miosis (more than 10%) appeared in the mecholyl test was 3.1% among normal subjects, whereas the rate among Meniere's disease patients on the affected side was significantly higher during the attack, quasi-attack and interval stages. The appearance rate among Meniere's disease patients on the unaffected side was not different from that in normal subjects during any of the three stages. None of the patients with labyrinthitis or vestibular neuritis showed significant miosis on the affected side alone in the mecholyl test. This indicates that abnormality of vestibular-autonomic reflex in itself does not cause a positive reaction in the mecholyl test. Hence it can be concluded that the cause of Meniere's disease is related to the existence of autonomic dysfunction on the affected side.
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8/9. pathology of congenital syphilitic labyrinthitis.

    An alarming increase in the incidence of syphilitic labyrinthitis has prompted us to review the pathology of this condition. The temporal bones of two patients with congenital syphilis of the ear were studied histopathologically. They showed diffuse osteitic changes in the otic capsule associated with severe hydrops and degeneration of the membranous labyrinth. The posterosuperior wall of the external auditory canal as well as the auditory ossicles showed numerous connective tissue filled spaces surrounded by thin bony trabeculae. These lesions probably represent healed luetic osteitis. There was severe degeneration of the sensorineural structures in the cochlea. A finding of particular interest was the infiltration and fibrous obliteration of the ductus endolymphaticus in both cases. The significance of these findings in relation to the pathophysiology and treatment of syphilitic labyrinthitis is emphasized.
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9/9. pathology of prelingual profound deafness: magnitude of labyrinthitis fibro-ossificans.

    Quantitative histologic studies were performed on 15 temporal bones from eight adult persons who were known to have prelingual bilateral profound hearing loss. The pathologic changes are characterized by severe degeneration of the structures of the cochlear duct, often with degeneration of the vestibular sense organs, causing a reparative host response that features osteoneogenesis and fibrous proliferation followed by retrograde neuronal degeneration. The pathology is consistent with meningogenic bacterial or viral labyrinthitis that occurred subclinically or went undiagnosed. Bone and fibrous tissue are present in varying extent in the scala tympani of 12 of the 15 temporal bones. Six cochleae from four subjects with fibro-osseous proliferation in the scala tympani extending as far as the ascending part of the basal turn have neuronal populations ranging from 963 to 5,355 (mean 2,826, 8% of neonatal normal, 35,500). In three cochleae from two subjects with no fibro-osseous proliferation in any area of the scala tympani the neuronal population ranges from 11,322 to 20,484 (mean 15,438, 43% of neonatal normal). Relative to cochlear implantation, computed tomographic imaging provides a means for determining the extent of fibro-osseous proliferation in the scala tympani, which in turn alerts the surgeon to surgical obstacles to optimal implantation as well as providing a basis for judging the extent of loss of cochlear neuronal population.
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