Cases reported "Otosclerosis"

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1/10. meningitis following stapedotomy: a rare and early complication.

    Controversy exists concerning stapedotomy for patients with small unilateral air-bone gaps. Surgical treatment of otosclerosis involves an opening to the labyrinth and accordingly, a risk of complications, usually vertigo and sensorineural hearing loss and infrequently anacusis. In this paper we present a 33-year-old woman with a small unilateral air-bone gap, who developed bacterial labyrinthitis with meningitis and anacusis three days after stapes surgery. The patient had a stapedotomy with the small fenestra piston prosthesis technique. Due to the potential for serious complications, patients with unilateral otosclerosis and mild hearing loss should be given the possibility to choose between a hearing aid and surgery. Although stapedotomy in the vast majority of interventions is a highly successful procedure and the best method of treatment for otosclerosis if successful, there is a high price to pay in the event of failure.
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keywords = labyrinthitis
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2/10. temporal bone histopathology of a patient with a nucleus 22-channel cochlear implant.

    The temporal bone histopathology of a patient with profound sensorineural hearing loss attributable to cochlear otosclerosis is presented. The patient had a Nucleus 22-channel cochlear prosthesis implanted in the right ear prior to his demise. Unintentional scala media insertion of the electrode array resulted from labyrinthitis ossificans obliteration of the scala tympani. Inadvertent facial nerve stimulation necessitated program exclusion of electrodes 11 to 16 located in proximity to the labyrinthine and geniculate segments of the facial nerve. The patient received significant benefit from use of the device. The histopathologic findings are correlated with psychophysical and speech perception results.
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keywords = labyrinthitis
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3/10. An apparatus for diagnosis of ossicular chain mobility in humans.

    Confirmation of the conditions of the ossicles is essential for tympanoplasty. However, at present, ossicular mobility is experimentally estimated with palpation by a surgeon, and the results depend on the surgeon's skill. In this study, a new apparatus for quantitatively measuring ossicular mobility was developed. With this apparatus, the ossicles were displaced and the reaction force from the ossicles, (i.e. the load applied to the ossicles) was simultaneously detected. Ossicular mobility of three patients with otosclerosis or chronic otitis media was measured to evaluate the usability of the apparatus. The apparatus can distinguish the differences in ossicular mobility between normal and fixed ossicles, and it makes estimating the change of mobility between pre- and posttreatments for ossicular fixation possible. Positive correlation was seen between ossicular mobility and hearing level.
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ranking = 0.004722780028122
keywords = otitis
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4/10. Two cases of otosclerosis in Kumasi, ghana, case report.

    The incidence of otosclerosis in relationship to race has been established in north america; however, there are no reliable data about its occurrence among negro Africans. Over a period of three years 650 consecutive cases of hearing loss excluding those with acute and chronic otitis media, eustachian tube dysfunction, wax, foreign bodies, and traumatic perforations, were studied in Kumasi, ghana. Only two cases of otosclerosis were detected. It is postulated that the rarity among people of the black race may be related to the flat occipital protuberance of the skull among African people.
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ranking = 0.004722780028122
keywords = otitis
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5/10. incidence and type of otopathology associated with congenital palatopharyngeal incompetence.

    Based upon the known association of cleft palate and middle ear disease, a study was undertaken to determine the incidence and type of middle ear pathology associated with velar anomalies exclusive of cleft palate which may produce congenital palatal pharyngeal incompetence. The range of velar anomalies encountered was subdivided into congenital palatal incompetence Type 1 (clinically manifested by one or more of a triad of visible palatal anomalies including submucous deficiency of the hard palate, bifid uvula, and a diastasis of velar musculature) and congenital palatal incompetence Type 2 (no visible velar anomalies but radiographic anomalies of the velopharyngeal region such as short or thin velum and/or enlarged nasopharyngeal dimensions consequent to vertebral and skull base anomalies). Middle ear disease was assessed separately in CPI Types 1 and 2 in order to differentiate the effects upon middle ear function between overt and occult velar anomalies. Middle ear disease was more frequent in CPI Type 1 than in CPI Type 2. The predominant otopathologic finding was serous otitis media, paralleling the type associated with cleft palate. Tympanic membrane atrophy, tympanosclerosis and tympanic membrane perforation, often considered sequelae of chronic serous otitis media, were noted infrequently. This investigation supports the concept that middle ear disease frequently occurs with congenital palatal incompetence as it does with cleft palate.
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ranking = 0.0094455600562441
keywords = otitis
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6/10. Nonotosclerotic ankylosis of the stapedial footplate.

    A woman with a long history of chronic otitis media had a stapedectomy after a surgical diagnosis of otosclerosis. In the histologic study of the temporal bones, done after her death four years later, the main portion of the stapes footplate was present but fractured and no otosclerosis was present. New celluluar bone which simulated otosclerosis filled the anterior oval window niche and was continuous with the middle ear surface of the footplate fragments. The new bone extended anteriorly to overlie a tympanosclerotic focus and inferiorly was continuous with the periosteum of the middle ear. At least part of the new bone formation occurred after stapedectomy. This may explain the poor long-term results frequently encountered when a stapedectomy is done on patients with tympanosclerotic fixation of the stapes footplate.
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ranking = 0.004722780028122
keywords = otitis
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7/10. Failures in surgery for stapedial otosclerosis.

    The causes for failure in surgery for stapedial otosclerosis are many. Most of these occur in the early postoperative period. Failures occurring later are due to either a breakdown of the reconstructed transformer system or to a labyrinthitis due to failure of the vestibular seal. The role of cochlear otospongiosis in producing late failures has not been sufficiently emphasized. This clinical review of 105 surgical failures examined consecutively during the years of 1975 through 1979 will demonstrate the importance of cochlear otospongiosis in this consideration. The fate of the unoperated-on ear in unilateral surgical failures will be demonstrated. Control of the progressive sensorineural hearing loss in these instances can be gained by the use of sodium fluoride therapy.
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ranking = 1
keywords = labyrinthitis
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8/10. Assessment by audiotympanometric testing: three case reports.

    Tympanometric measurements are versatile and accurate when more than one type of ear disease is present. Three cases are presented where information from tympanometry beyond that derived from otological and routine audiological testing yielded accurate diagnoses. A patient with a history of middle-ear disease presented with a sensori-neural loss. Measures of static conductance correctly identified the problem as stiffness of the ossicular chain. An infant with unilateral congenital atresia and questionable hearing in her normal-appearing ear was determined to have serous otitis media by tympanometry and reflex testing. The course of the disease was monitored and reversed. A 17-year-old female suffered a basal skull fracture with a sudden conductive hearing loss. Low conductance and high impedance correctly identified loss of mobility of the ossicular chain which was confirmed surgically. These three cases illustrate the advantages of tympanometry in making rapid, accurate, objective measurements involving complex diagnoses of middle-ear function.
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ranking = 0.004722780028122
keywords = otitis
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9/10. MRI and clinical decisions in cochlear implantation.

    High-resolution computed tomography (HRCT) is the standard imaging technique used in cochlear implantation. However, cochlear and retrocochlear soft-tissue abnormalities may not be detected with HRCT alone. To determine whether magnetic resonance imaging (MRI) provides clinically significant information in addition to HRCT in the evaluation of candidates for cochlear implants, we performed a prospective study of 13 consecutive patients with cochlear implant patients receiving preoperative, high-resolution fast spin-echo T2-weighted MRI scans of the temporal bone. MRI identified unanticipated cochlear fibrosis in one patient, vestibular schwannoma in one patient, patency in the second turn of the cochlea in a patient with labyrinthitis ossificans, and disproved cochlear fibrosis suspected on HRCT imaging in one patient. These findings were significant for clinical decisions regarding candidacy for surgery, side selection for surgery, and surgical technique in cochlear implantation. Our experience suggests a high-resolution T2-weighted MRI of the temporal bone should be used preoperatively in addition to HRCT before cochlear implantation.
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ranking = 1
keywords = labyrinthitis
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10/10. Poststapedectomy otitis media and meningitis.

    A patient developed acute otitis media, labyrinthitis, and meningitis 16 months after a stapedectomy operation, and 14 similar cases have been collected from the literature. Poststapedectomy otitis media carries an increased risk of labyrinthitis and meningitis and requires prompt antibiotic therapy and regular observation until cured. Should labyrinthitis occur, with or without meningitis, fistula repair must be undertaken as soon as the infection is eliminated. All stapedectomy patients require regular supervision, and must report for urgent treatment if symptoms of otitis media or perilymph fistula occur. Stapedectomy techniques should not employ sharp bevelled prostheses, and autogenous tissue grafts are probably superior to an absorbable gelatin sponge in protecting the inner ear. eustachian tube problems and recurring or chronic upper-respiratory tract infections can predispose to middle ear infection and are thus contraindications to stapedectomy.
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ranking = 3.0330594601969
keywords = labyrinthitis, otitis
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