[Cholesteatomas of the external ear canal].
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Cholesteatoma↗
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Equivalent ear canal volumes in children pre- and post-tympanostomy tube insertion.
Pre- and postoperative equivalent ear canal volume measures were obtained from a group of 334 children ranging in age from 6 weeks to 6.7 years. The purpose of the study was to develop volumetric guidelines for the determination of tympanostomy tube patency. For children 4 years and older, almost no ambiguity existed in making this determination accurately. For younger children, the pre- and postoperative distributions overlap. A criterion value of greater than or equal to 1.0 cm3 as an indicator of a tympanic membrane perforation appears to yield the lowest possible error rate. When both pre- and postoperative measures are available, a difference of greater than or equal to 0.4 cm3 can be used in conjunction with the absolute value to identify a patent tympanostomy tube.
Acoustic Impedance Tests↗
Occurrence and population size of Malassezia spp. in the external ear canal of dogs and cats both healthy and with otitis.
Malassezia yeasts are commensal organisms of human and animal skin that occasionally act as pathogens; lipid-dependent species are associated with human skin disorders. The aim of this work was to evaluate the occurrence, risk factors and population size of different species of Malassezia in the external ear canal of dogs and cats with and without otitis externa. Between 2001 and 2003, 107 healthy animals (25 cats and 82 dogs) and 123 animals with chronic otitis exteirna (48 cats and 75 dogs) were clinically examined. Sterile cotton swabs were used to collect specimens from the external ear canal and culture tests and cytological examinations were performed to detect the presence and population size of Malassezia yeasts. Malassezia yeasts were isolated from 72.9% and 40% of the cats and from 57.3% and 28.0% of the dogs, with and without otitis externa, respectively. Malassezia was frequently isolated from animals under 5 years of age. The highest prevalence of positive samples was reported in winter for cats and in autumn for dogs. Dogs with pendulous ears showed a higher incidence of infection than dogs with erect ears. More Malassezia yeasts were recovered from animals with otitis (i.e. 59.6 colony forming units - CFUs - for cats and 66.0 CFUs for dogs) than healthy animals. Out of the 413 isolates obtained from animals with and without otitis, 403 (97.6%) were identified as M. pachydermatis and 10 (2.4%) as M. globosa. A statistical evaluation of the occurrence of Malassezia yeasts in dogs and cats revealed that predisposing factors for Malassezia infections are sampling period for cats, and type of ear for dogs. The largest population of Malassezia yeasts was detected in animals with otitis, suggesting a role in the occurrence of lesions.
Animals↗
Acoustic distortion products in rabbit ear canal. II. Sites of origin revealed by suppression contours and pure-tone exposures.
Previous work on acoustic distortion products (DPs) recorded from the ear canal has not established unequivocally whether emitted DPs principally reflect basilar-membrane nonlinearities at the frequency sites of the primary tones, f1 and f2, or if the DP-frequency place itself makes a significant contribution to the emitted response. Results from some studies on acoustic emissions attribute generation of the emitted DP almost exclusively to the regions of maximum primary-tone interaction, while the findings of other investigations implicate reemission of the response from the DP locus as a significant contributor to response magnitude. Using suppression, interfering tones, and temporary threshold shift (TTS) procedures, the work reported here was designed to establish more definitively the precise contributions of the basilar-membrane regions involved in generating acoustic DPs in rabbits. Suppression tuning curves and interfering-tone experiments indicated that for the DP at 2f1-f2, regions near the f1 or f2 frequencies were the major contributors to the emitted response. However, for the higher-frequency DP at 2f2-f1, the basilar-membrane region just basal to the DP site was implicated as the generator. Following brief episodes of TTS at frequencies related to either the DP or the primary tones, the locus of the exposure stimulus that most effectively reduced the magnitude of the 2f1-f2 response also implicated the region of maximal primary-tone interaction in the generation of the acoustic DP. In contrast, for the DP at 2f2-f1, basilar-membrane sites nearer the DP were identified as the primary contributors to the emitted response. Both sets of results imply that different DPs recorded from the ear canal may originate from unique regions of primary-tone interaction along the basilar membrane.
Acoustic Stimulation↗
Total ear canal ablation in the cat: indications, morbidity and long-term survival.
Fifty-two total ear canal ablation (TECA) procedures in 44 cats were reviewed. The indication for surgery was neoplasia in 41 per cent of the cats, 86 per cent of which had ceruminous gland adenocarcinoma. Chronic inflammatory or polypoid disease accounted for 50 per cent of surgical procedures. Postoperative complications included Horner's syndrome (42 per cent) and facial paralysis (56 per cent) and these were permanent in 14 per cent and 28 per cent of cases, respectively, with the rest resolving in the ensuing weeks or months. The higher incidence of Horner's syndrome and facial paralysis in the cat, compared to the dog, was attributed to greater fragility of the feline tympanic plexus and facial nerve. The median survival time of cats with ceruminous gland adenocarcinoma was 50-3 months, and did not differ significantly from that for inflammatory or polypoid disease. A potential prognostic indicator for this tumour was the mitotic index (MI): cases with MI < or = 2 survived significantly longer than those with MI > or = 3.
Adenocarcinoma↗
Use of infrared thermometry and effect of otitis externa on external ear canal temperature in dogs.
OBJECTIVE: To compare infrared thermometry with rectal thermometry as a method of assessing core body temperature in dogs and to assess the effect of otitis externa on external ear canal temperature (EECT). DESIGN: Prospective study. ANIMALS: 650 dogs without history or clinical signs of otitis externa and 85 dogs with recurrent or chronic otitis externa. PROCEDURE: Rectal temperature was measured, using a mercury thermometer. External ear canal temperature was measured, using an infrared tympanic thermometer. RESULTS: Measurements of body temperature at the 2 sites did not agree. Sensitivity and specificity of infrared thermometry in detecting fever, as determined by rectal thermometry, were 69.7 and 84.6%, respectively. Use of methods to predict rectal temperature from EECT did not improve the accuracy of infrared thermometry. Otitis externa significantly influenced EECT. CLINICAL IMPLICATIONS: Use of infrared thermometry as a replacement for rectal thermometry in assessing core body temperature in dogs was unsatisfactory. The 2 methods for measuring body temperature were not interchangeable in dogs.
Animals↗
Effects of ear-canal standing waves on measurements of distortion-product otoacoustic emissions.
At frequencies above 3 kHz, standing waves in the ear canal complicate calibration of stimulus sound-pressure levels (SPLs) for measurements of distortion-product otoacoustic emissions (DPOAEs). In the literature, two stimulus-presentation strategies have been used for DPOAE measurements. In the "in-the-ear adjustment" strategy, the voltage command to the speakers is adjusted to maintain a constant stimulus SPL across frequency at the DPOAE-measurement microphone. In the "iso-voltage" strategy, the voltage presented to the speakers is held constant across frequency, on the basis of the assumption that the frequency response of the speakers is approximately flat at the eardrum in the average human ear canal. Because of standing-wave effects, there are large, systematic but idiosyncratic differences of stimulus SPL between the two strategies. DPOAE-versus-frequency functions ("DPOAE audiograms") obtained using both stimulus-presentation strategies in the same ears are presented. The differences of stimulus SPL between the two strategies, and the associated differences of DPOAE amplitude, are described and quantified. Around frequencies of standing-wave minima at the DPOAE probe, the in-the-ear adjustment strategy resulted in smaller DPOAEs at high L1 = L2, but much larger DPOAEs at low L1 = L2, than did the iso-voltage strategy. For any L1, the DPOAE-amplitude differences between the two strategies varied systematically with L1-L2. At the stimulus levels used to construct previously published population norms for clinical applications (i.e., L1 > or = 65 dB SPL), there are only small differences of mean DPOAE amplitudes, and of the standard deviations of these means, between the two strategies.
Acoustic Impedance Tests↗
Standing wave patterns in the human ear canal used for estimation of acoustic energy reflectance at the eardrum.
Standing wave patterns were measured in the unoccluded ear canals of 13 human subjects, for applied pure tones of 3 to 13 kHz. Measurements were made, using a probe microphone technique, over a region which could be approximated as a duct of constant cross-sectional area. Analysis of the patterns allowed the reflective properties of the middle ear to be determined in terms of an acoustic energy reflection coefficient, or reflectance, at the eardrum. Over all subjects the trend of the results was for the energy reflection coefficient to rise from about 0.3 at 4 kHz up to 0.8 at 8 kHz, and continue at this value to 13 kHz. There was, however, significant intersubject variation, especially at frequencies greater than 7 kHz.
Acoustic Impedance Tests↗
Water used to visualize and remove hidden foreign bodies from the external ear canal.
Small foreign bodies lodged anteriorly in the tympanic sulcus are usually not visible, due to the curve of the external ear canal. Such objects can be seen with the aid of an otomicroscope and micromirror or with an endoscope, and removed by irrigation. If irrigation fails, epithelial migration on the tympanic membrane may remove lodged foreign bodies, although this may take months. Our new method, which uses water to locate small objects lodged in the tympanic sulcus, includes irrigation of the ear, adjustment of the water level to the middle curve of the external ear canal, and use of the water surface as a concave lens, making the tympanic sulcus visible. With otomicroscopy a curved ear probe can then be used to remove lodged foreign bodies from behind the curve.
Adult↗
Navigation-assisted construction of an external ear canal using an autogenous foreskin graft.
Classic microtia is combined with external ear canal atresia and middle ear malformation. In order to evaluate whether an operation to improve hearing ability and the use of computer-assisted surgery are indicated, preoperative high-resolution navigation CT is mandatory. We combined atresia surgery and tympanoplasty with auricular reconstruction in the case of an 8-year-old boy with bilateral microtia, aural atresia and malformation of the middle ear. After creating an auricle framework with rib cartilage and transplanting it under the skin of the mastoid plane, we shifted it forward in the second step, and the new auditory canal was drilled under computer-assisted navigation and facial nerve monitoring. In the same operation, tympanoplasty was accomplished, and a silastic cylinder, wrapped into pieces of rib cartilage, was inserted into the constructed canal and removed 2 months later. For lining the new auditory canal, we used the patient's prepuce, harvested by elective circumcision.
Child↗
Wound healing and brain stem auditory evoked potentials after experimental total ear canal ablation with lateral tympanic bulla osteotomy in dogs.
Experimental total ear canal ablation with lateral tympanic bulla osteotomy (TECA-LBO) was performed in 13 normal dogs to evaluate healing and retention of brain stem auditory evoked potentials (BSAEP) after surgery. Healing was evaluated by gross and microscopic examination of the surgery sites after 1 (n = 2), 4 (n = 8), 5 (n = 1), and 6 (n = 1) weeks. One dog was eliminated from the study. Brain stem auditory evoked potentials were measured using an air-conducted sound stimulus before and after surgery and before killing. Two dogs had nearly complete obliteration of the tympanic cavity by immature fibrous connective tissue. Eight dogs responded to surgery by either complete or partial re-formation of the tympanic cavity. Retention of the tympanic membrane in three dogs promoted re-formation of the tympanic cavity and blind epithelialized pockets in the surgery site with accumulation of keratinized debris. Granulation tissue formation and extensive proliferation of new bone on the internal surface of the tympanic bulla was seen in 10 dogs. Proliferative bone completely obliterated the tympanic cavity in two of these dogs. Eleven of 13 dogs had no detectable air-conducted BSAEP after surgery. There was no change in BSAEP measurements before killing compared with postoperative measurements in any dog. Two dogs with retained tympanic membranes had measurable BSAEP after surgery. This study shows that healing after TECA-LBO may be highly variable. Retention of the tympanic membrane and small osteotomies appeared to promote reformation of tympanic cavities and prevent ingrowth of granulation tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Tumors of the ear canal.
This discussion will focus on the clinical presentation, diagnostic evaluation, expected biologic behavior, and therapeutic options for tumours of the ear canal in the dog and cat. Particular emphasis will be placed on neoplasia of the ceruminous glands, squamous cell carcinoma, and non-neoplastic mass lesions.
Animals↗
Gerbilline cholesteatoma development Part III. Increased proliferation index of basal keratinocytes of the tympanic membrane and external ear canal.
OBJECTIVE: To quantify the rate of basal cell division for keratinizing epithelium (KE) of the tympanic membrane (TM) and external ear canal (EAC) in spontaneous and induced gerbilline cholesteatomas. STUDY DESIGN AND SETTING: Cholesteatomas (3 spontaneous and 5 by induction) were labeled with tritiated thymidine for autoradiography and a KE proliferation index (PI) was determined. The PI was defined as the average number of labeled cells/mm overall and per anatomic region. RESULTS: For all regions combined, the PI was 27.3 in ears with cholesteatoma and 4.1 in normal ears (P < 0.0001). Additionally, there were significant regional differences in the PI in both normal ears and ears with cholesteatoma. CONCLUSION: The KE of cholesteatomas in gerbils proliferates at approximately 7 times the rate measured in control ears. SIGNIFICANCE: Hyperproliferation of keratinocytes is a causative factor in the development and progression of spontaneous and experimental cholesteatomas in gerbils.
Animals↗
Passive drainage versus primary closure after total ear canal ablation-lateral bulla osteotomy in dogs: 59 dogs (1985-1995).
OBJECTIVE: Compare passive wound drainage to primary closure of total ear canal ablation-lateral bulla osteotomy (TECA-LBO) in dogs. STUDY DESIGN: Retrospective analysis of medical records. SAMPLE POPULATION: Fifty-nine dogs with end-stage otitis externa or neoplasia of the external and middle ear. METHODS: Medical records of dogs with TECA-LBO were reviewed. Dogs were divided into postoperative drain and primary closure groups. Statistical analyses were performed to identify differences in data for signalment, preoperative treatment, duration of hospitalization, immediate complications, and long-term complications between groups. RESULTS: No significant differences were detected in signalment, diagnosis, and duration of medical management between groups (P > .05). Duration of hospitalization was greater for dogs in the drain group (P < .05). Immediate postoperative complications occurred in 26 of 59 dogs and included ipsilateral facial palsy, incision swelling, vestibular signs, premature drain removal, and one dog died of aspiration pneumonia. Long-term (> 6 months) complications were identified in 12 of 50 dogs and included dermatitis of the medial aspect of the pinna, chronic fistula formation, and permanent facial paralysis. No association between immediate or long term complications and method of closure was identified. CONCLUSIONS: Primary closure is an acceptable alternative in dogs undergoing TECA-LBO when surgical wound dead space can be managed with meticulous hemostasis, complete debridement of devitalized tissue, and accurate apposition of tissue planes.
Animals↗
Tympanometric changes at 226 Hz and 678 Hz across 10 trials and for two directions of ear canal pressure change.
The influence that repeated tympanometric trials have on the aural-acoustic admittance characteristics of the middle-ear transmission system was studied in 24 young adults. The 226-Hz and 678-Hz data were generated by concurrently digitizing the conductance and admittance tympanograms at 25 daPa/s for both ascending and descending pressure directions. Ten successive trials for each frequency and direction of pressure change were made. Changes in admittance corrected for ear canal volume across the 10 tympanometric trials were computed. The results demonstrated that generally admittance increases as the number of trials increases. For many subjects, the complexity of the tympanometric configuration also increases across trials. The results from eight subjects with single-peaked 678-Hz tympanograms were compared with the results from eight subjects with notched 678-Hz tympanograms to explain the mean decrease in susceptance across tympanometric trials. Finally, the pressure peak locations of the conductance, susceptance, and admittance tympanograms were evaluated and are discussed. The effects that differences in peak pressure location have on the computed static admittance values are presented.
Acoustic Impedance Tests↗
Ear-canal acoustic admittance and reflectance measurements in human neonates. II. Predictions of middle-ear in dysfunction and sensorineural hearing loss.
This report describes relationships between middle-ear measurements of acoustic admittance and energy reflectance (YR) and measurements of hearing status using visual reinforcement audiometry in a neonatal hearing-screening population. Analyses were performed on 2638 ears in which combined measurements were obtained [Norton et al., Ear Hear. 21, 348-356 (2000)]. The measurements included distortion-product otoacoustic emissions (DPOAE), transient evoked otoacoustic emissions (TEOAE), and auditory brainstem responses (ABR). Models to predict hearing status using DPOAEs, TEOAEs, or ABRs were each improved by the addition of the YR factors as interactions, in which factors were calculated using factor loadings from Keefe et al. [J. Acoust. Soc. Am. 113, 389-406 (2003)]. This result suggests that information on middle-ear status improves the ability to predict hearing status. The YR factors were used to construct a middle-ear dysfunction test on 1027 normal-hearing ears in which DPOAE and TEOAE responses were either both present or both absent, the latter condition being viewed as indicative of middle-ear dysfunction. The middle-ear dysfunction test classified these ears with a nonparametric area (A) under the relative operating characteristic curve of A = 0.86, and classified normal-hearing ears that failed two-stage hearing-screening tests with areas A = 0.84 for DPOAE/ABR, and A = 0.81 for TEOAE/ABR tests. The middle-ear dysfunction test adequately generalized to a new sample population (A = 0.82).
Diagnosis, Differential↗
A semiquantitative cytological evaluation of normal and pathological samples from the external ear canal of dogs and cats.
Numbers of desquamated epithelial cells, yeast cells and bacterial organisms were counted in samples collected from the external ear canal of 37 normal dogs and 16 normal cats, and from 24 dogs and 22 cats with otitis externa. The aims of the study were to establish quantitative reference ranges and to correlate these data with the clinical status of the dogs and cats. Numbers of yeast cells and bacterial organisms were significantly increased in dogs (P = 0.05; P = 0.0001) and cats (P = 0.0001; P = 0.0001) with otitis externa, and in most cases high counts were correlated with clinical signs. Mean Malassezia counts per high-power dry field of > or = 5 in the dog and > or = 12 in the cat were considered abnormal. Mean bacterial counts per high-power dry field of > or = 25 in the dog and > or = 15 in the cat were considered abnormal. When used to differentiate normal from inflamed external ear canals, these figures provided a low sensitivity but a specificity of > or = 95%.
Animals↗
[TREATMENT OF CHRONIC ECZEMA OF THE EXTERNAL EAR CANAL WITH CORTICOSTEROID OINTMENTS].
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Adrenal Cortex Hormones↗