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At least 217 records · Page 12Linked to original sources
PubMed1991

[Tympanoplasty with mastoid obliteration using hydroxyapatite granules for aural cholesteatoma--a clinical and experimental study].

Hydroxyapatite granules were employed for mastoid obliteration in cases of aural cholesteatoma. After eradicating a cholesteatoma by the canal-down technique, the canal wall was reconstructed with cortical bone chips, and the mastoid cavity was obliterated with hydroxyapatite granules. Tympanoplasty by this technique was performed on 48 ears with aural cholesteatoma. There was no recurrence of cholesteatoma during the follow-up period of two years after surgery. One case of residual cholesteatoma was found in the mesotympanum. There were two cases in which the hydroxyapatite granules became exposed through the posterior canal skin. An air-bone gap of less than 20 dB was achieved in 73% of all the patients. Experimental studies in guinea pigs have demonstrated that hydroxyapatite granules do not undergo morphological changes in and are tightly interdigitated with newly formed bone tissue growing from bulla bone one year after hydroxyapatite implantation in the temporal bullae. The newly-formed bone showed incomplete osteon structures. Excellent biocompatibility and bone adaptability of hydroxyapatite granules were demonstrated experimentally. It is concluded that tympanoplasty with mastoid obliteration using hydroxyapatite is safe and useful for avoiding mastoid cavity problems and for preventing the recurrence of cholesteatoma.

Adolescent↗
PubMed2000

Clinical presentation of acute mastoiditis in children.

Nineteen children with 21 episodes of acute mastoiditis were treated in our hospital from 1989 to 1998. The diagnosis was based on physical, radiologic, and surgical findings. The affected children were aged from 1 year old to 17 years old, with the peak incidence at 4 years old (23.8%). Postauricular pain (90.5%) and fever (81%) were the most common harbingers of incipient acute mastoiditis. Streptococcus pneumoniae (38.1%) was the most common organism isolated followed by Pseudomonas aeruginosa (23.8%). Underlying diseases such as leukemia and myeloid metaplasia were found in 38.6% of patients. All of the patients were initially treated with intravenous antibiotics during hospitalization. Six patients were managed with an adjunctive drainage procedure such as myringotomy or mastoidectomy. The most common complication of acute mastoiditis was hearing loss (31.6%); the second was meningitis (21.1%). Subperiosteal abscess was found in two patients and brain abscess in one. Although acute mastoiditis is an uncommon condition, early diagnosis and management are necessary to prevent more serious complications.

Acute Disease↗
PubMed2000

Clinical experiences with acute mastoiditis--1988 through 1998.

The incidence of acute mastoiditis has declined dramatically during the postantibiotic era. Even so, antibiotic-resistant or unusual pathogens can still cause this disease entity. At our hospital, we documented an increase in antibiotic-resistant and atypical pathogens such as Actinomyces spp. and Mycobacterium tuberculosis. In this paper, we discuss the optimal diagnosis and treatment strategy for acute mastoiditis, and we describe our retrospective review of 13 patients with mastoiditis who were treated at our hospital from 1988 through 1998. Eight of these patients recovered following treatment with intravenous antibiotics, with or without myringotomy, and five who had complications of disease were managed surgically. Among these five, one developed chronic otitis media and one developed cholesteatoma 3 years later. For patients with acute mastoiditis, we emphasize the need to be aware of any unusual pathogens that do not respond to empiric antibiotic therapy.

Acute Disease↗
PubMed2002

[Acute Mastoiditis in Children: a series of 38 Cases].

OBJECTIVE: We reviewed retrospectively the clinical, radiological and therapeutic findings in 38 infants and children with acute mastoiditis. MATERIAL AND METHODS: From 1988 to 2001, 38 children (mean age 36 months) were treated for acute mastoiditis and periostitis or retroauricular abscess. RESULTS: Diagnosis was usually made on the basis of typical retroauricular signs (60% of the cases), but was sometimes delayed owing to inappropriate antibiotics in 16 cases (42%) or atypical presentation in 3 (8%). Twenty-four children (70%) had no otolaryngological history. Pneumococci were isolated in most of the cases (n=15, 57%) with 13% having penicillin-resistant pneumococci. Lateral sinus thrombophlebitis was the most frequent complication, observed in 3 children (8%). Mastoiditis revealed congenital or acquired cholesteatoma in 4 children, who were all four infected with Gram-negative bacteria. Intravenous antibiotic therapy was associated with antroatticotomy in 36 children. CONCLUSION: Despite emergence of new antibiotic resistance, the annual rate of mastoiditis has remained unchanged, remaining a serious complication of middle ear acute otitis. Cholesteatoma should be suspected in case of Gram-negative bacteria or in older children.

Acute Disease↗
PubMed2001

[The application of mastoid cavity plombage in open method tympanoplasty].

OBJECTIVE: The role mastoid cavity plombage played in restoring physiological function of external meatus in open method tympanoplasty was studied. METHOD: 85 cases of cholesteatoma otitis media were performed open method tympanoplasty with the broken bits of their own mastoid process cortex, homological costal cartilage or U shape periosteum connective tissue valve. And plombage was performed at the same time. The reconstruction of ossicular chain (type 0 tympanoplasty): 10 ears did not undergo reconstruction due to increase ment of bone conduction threshold or were in preparation for the second phase operation; 40 ears underwent type III tympanoplasty; 35 ears underwent type IV tympanoplasty. RESULT: The total improvement rate of hearing was 76%, among which 80% were performed type III tympanoplasty and 71.4% underwent type IV tympanoplasty. After operation, the time waited till dry-ears was 19.8 +/- 65.31 days and the dry-ears rate was 97.6% (83/85). Six months after operation, 89.4% (76/85) had smooth external meatus and fine self-cleaning function and no recurrence was found. CONCLUSION: As to cholesteatoma otitis media that could not be performed closed method tympanoplasty, U shape periosteum connective tissue valve and mastoid process cortex were used. Mastoid cavity plombage with homological costal cartilage could effectively overcome the shortcomings of destruction of physiological structure of external meatus caused by open method tympanoplasty, the self-cleaning function of skins of external meatus was remained and the life quality of patients after operation was increased.

Adolescent↗
PubMed2004

Tissue engineering for the regeneration of the mastoid air cells: a preliminary in vitro study.

Mastoid is a pneumatic bone, composed of small interconnecting chambers covered by a mono-layer of mucosa with an abundant blood supply. One of its main functions is gas exchange according to the concentration/pressure gradient. The final goal of our research project is to regenerate mastoid air cells and their unique physiologic functions. The aim of the present study is to determine appropriate cultivating conditions for the cells cultured on the surface of artificial hydroxyapatite. In our in vitro experiment, to imitate the skeleton of mastoid bone, we used two types of three-dimensional hydroxyapatite (3D-HA), i.e. with a high (90%) and low (60%) percentage of micropores. The former type was divided into two groups: collagen-coated and non-coated. Canine mucosal- and bone marrow-derived stromal cells (BSCs), from the oral floor and femur respectively, were harvested and cultured on the 3D-HA under different conditions. To estimate the proliferation/distribution of the cultured cells over the surface of the 3D-HA, these cells were stained with the dye DiI and hematoxylin-eosin. There were no significant differences in the proliferation of cultured cells on the 3D-HA with high and low percentages of micropores. Collagen-coated HA was a better material for the cultured cells compared with the non-coated HA. Co-cultured mucosal and BSCs proliferated better than those cultured separately. In conclusion, this tissue engineering technique may be applied for the regeneration of mastoid air cells.

Animals↗
PubMed2004

[Partial remove of mastoid tip in open-ended tympanoplasty or mastoidetomy].

OBJECTIVE: To summarize the effect of partial remove of mastoid tip in open-ended tympanoplasty or simple redical mastoidectomy. METHOD: Ten cases of cholesteatoma otitis media were treated with simple redical mastoidectomy. Thirty-four cases were treated with open-ended tympanoplasty. The mastoid tip were partial removed in all cases. RESULT: The volume of mastoid cavity became small after operation. The follow up time was 3 months. The dry ear rate was 97.6% (43 cases). After 1 years follow up there wasn't recurrence of cholesteatoma. CONCLUSION: The technique of partial remove of mastoid tip effective in open-ended tympanoplasty or simple redical mastoidectomy. We believe that in order to destry death cavity, shorten dry ear time and decrease recurrence it is very necessary.

Adolescent↗
PubMed1992

Intracranial and extracranial complications of acute mastoiditis: evaluation with computed tomography.

The incidence of acute mastoiditis has decreased significantly because we can effectively treat otitis media with oral antibiotics. Inadequate or delayed treatment of otitis predisposes to the development of mastoiditis and more serious, life-threatening complications. Extension of the infectious process beyond the mastoid system can lead to a variety of intracranial and extracranial complications including meningitis, epidural and intracerebral abscesses, vascular thrombosis, osteomyelitis, and abscesses deep within the neck. Signs of clinical deterioration in a patient with otitis media should indicate to the general practitioner that a more serious condition is evolving and surgical intervention may be necessary. Computed tomography is considered the imaging modality of choice for patients with acute mastoiditis because it can define clearly the regional anatomy and provide important diagnostic information.

Abscess↗
PubMed2004

Tuberculous acute mastoiditis--a rare diagnosis. A case report.

Tuberculous acute mastoiditis (TAM) is a rare inflammatory infective condition of the mastoid process that can be difficult to diagnose. We presente the case of a 65-year-old women with earache, ear purulent discharge and tenderness of the mastoid tip after long time of medical therapy. Mastoidectomy with attico-antrotomy revealed chronic granulations with an osteitic process of mastoid and tympanic cavity with intact ossicular chain. Standard medical therapy resulted with prompt healing. Despite its rarity, diagnosis of TAM is often delayed, with potentially danger for severe complications.

Aged↗
PubMed2006

[The measurement of pneumatized mastoid and facial recess in cochlear implant recipients younger than three years old].

OBJECTIVE: To evaluate the postnatal growth of mastoid air cells and facial recess and the implications for cochlear implantation in very young children. METHOD: Thirty-two pediatric cochlear implant recipients younger than three years were enrolled in this study. Before implantation, pneumatized mastoid and facial recess were measured by high resolution computed tomography (HRCT) and compared with direct anatomical measurement in implantation. RESULT: We found the similar result in two measurements. All recipients had facial recess and there was no significant difference of the volume between the recipients in this study and the children in another group who were older than seven years old (P >0.05). The size of pneumatized mastoid was significantly different between recipients younger than 16 months and those older (P <0.05). CONCLUSION: (1) HRCT is very clinically valuable in making accurate diagnosis and surgical plan. (2) The facial recess is already adult size in children younger than three years old. (3) The size of pneumatized mastoid may affect mastoidectomy in cochlear implantation in very young children.

Child, Preschool↗
PubMedDate not supplied

[Clinical course of mastoiditis as reported by the specialized emergency care hospital].

In the last decade diverse clinical manifestations of mastoiditis have been reported. This paper describes specific features of the clinical development, diagnostic value of individual symptoms, and complications in 90 cases of mastoiditis treated in the otorhinolaryngological department of the Clinical Hospital for Emergency Medical Care, city of Sverdlovsk, during 1984-1988. The observations allow the conclusion that during acute otitis media the duration of mastoiditis development reduced and many classical symptoms of mastoiditis, e. g. protrusion of the posterior-superior wall of the external acoustic meatus, profuse purulent discharge from the ear, hyperemia, swelling of the behind-the-ear area, occurred less frequently. The incidence of such life-threatening complications as meningitis and meningoencephalitis increased noticeably. It means that the list of indications for hospitalization of patients with acute otitis media should be extended.

Acute Disease↗
PubMed1990

Adenomatous tumors of the middle ear and mastoid.

Adenomatous tumors of the middle ear and mastoid have been called adenoma or adenocarcinoma. The clinical and pathologic distinction between the two has been difficult. The resultant pathologic ambiguity makes it difficult to decide whether conservative or radical management is appropriate. The Otologic Medical Group's (OMG) experience with glandular tumors of the middle ear and mastoid over the past 27 years was reviewed. Thirteen cases were found and analyzed with respect to signs and symptoms at presentation. Extensive histopathologic review with light and electron microscopy was performed on tumor specimens. Two distinctive histopathologic and clinical patterns were identified. The mixed type of tumor was always confined to the middle ear and mastoid, was commonly misdiagnosed as chronic otitis media, and rarely demonstrated otic capsule or facial nerve involvement. The papillary pattern always had extension to the petrous apex and frequently involved the middle and/or posterior cranial fossa. Papillary tumors were more frequent in females and usually involved the facial nerve. On the basis of the findings in this review as well as information from the literature, we have come to the following conclusions: 1. The correct general pathologic heading be Adenomatous Tumors of the Middle ear and Mastoid with each tumor then being subclassified into Mixed or Papillary tumor and adenocarcinoma when warranted by histology. 2. There is a high rate of local recurrence. 3. Long-term follow-up (at least 10 years) for all adenomatous tumors is necessary. 4. Primary surgical treatment is required.

Adenocarcinoma↗
PubMed1989

[Anatomic characteristics of the mastoid in children. Pneumatization of the subfacial region].

Three specific features of the mastoid in the pediatric population appeared to us to be important in view of our per-operative findings on mastoidectomy for chronic suppurative otitis, cholesteatoma or middle ear effusion with chronic persistent mastoiditis in the older child. These included the position of the facial nerve, the superficial nature of its third part being well known, but also the existence of the Körner septum and especially the pneumatization of the sub-facial region which explains the similarity between certain infectious lesions of the retro-tympanic structures and infectious lesions of the anterior portion of the mastoid process. An experimental study of staining of preserved petrous bones in the adult enabled the sub-facial permeability of the mastoid to be demonstrated in certain cases. Awareness of these small details should help to avoid per or post-operative complications in surgery for chronic otitis media in children.

Adult↗
PubMed1988

Surgical management of the discharging mastoid cavity.

A survey of 67 patients with 74 mastoid cavities has been carried out. During the study period they made a total of 126 cavity/outpatient visits. Thirty-five patients (56 per cent) had discharge from at least one cavity on at least one outpatient visit. At only 5 per cent of visits was the discharge classified as profuse. A retrospective study of 54 mastoid revision operations on 51 patients has been made. Overall 59 per cent of operations resulted in a dry ear. The best results were achieved by carrying out cavity revision combined with a meatoplasty (83 per cent dry ears). Cavity revision alone produced a dry ear in only 57 per cent of cases. The worst results were produced by soft tissue obliteration (33 per cent dry ears). This supplement also presents the early results of a prospective investigation of bone paté obliteration of mastoid cavities. Of the eight cases studied so far, five (63 per cent) have dry ears following surgery. Three of the patients in this group had undergone previous unsuccessful revision surgery using other techniques. Cavity revision with meatoplasty is the technique of choice for most patients, but mastoid obliteration offers potential advantages for younger patients, particularly those wishing to swim.

Adolescent↗
PubMed1981

Results of mastoid operations in various chronic ear diseases.

A study of mastoid operations undertaken for various chronic middle ear entities, using closed and open techniques, revealed the following: 1. Marsupialized mastoid balls were found less disappointing than often considered; small cavities were dry in 90 percent and large ones in 70 percent of cases. 2. Residual disease (epidermoid cysts) appeared in 27 percent of the CAT-operated ears and in 13 percent when the open technique was employed. 3. Residual disease appeared twice as often when the primary disease involved the tympanic cavity and in young patients than when the attic and mastoid were exclusively involved or in older patients. 4. Residual disease did show up only in epidermoid ("attic") cholesteatomas, but not when the primary pathology was a retraction pocket (sinus tympani) cholesteatoma. 5. Up to 56 percent of the CAT-operated ears showed small, medium, or large retraction pockets. However, only large retraction pockets were of clinical significance. 6. The posterior wall, when preserved, atrophied to an important degree in about a tenth of the cases. 7. Significant atelectasis appeared in about a third of the ears once the membrana tensa was preserved, that is, in CAT or conservative radical operations. 8. About 10 percent of CAT operations performed in children may lead to an episode of acute mastoiditis.

Child↗
PubMed1996

Anatomical variations of the tympanic and mastoid portions of the facial nerve canal. A radioanatomical investigation.

PURPOSE: To obtain information on the morphology of the tympanic and mastoid portions of the facial nerve canal, and on the appearance of unusual vascular channels and anomalies such as dehiscences. MATERIAL AND METHODS: One hundred and two temporal bone preparations were examined by conventional radiography to evaluate mastoid pneumatization. Of these, 73 were examined by high resolution CT in order to test the ability of the method to detect dehiscences in the bony wall of the tympanic portion of the canal and the accompanying channels along its mastoid portion. Subsequently produced plastic preparations were used to measure the length and width of these 2 portions of the facial canal. RESULTS: Our study reports observations on the three-dimensional morphology of the canal in the plastic casts. The study shows variations in the course and dehiscences of the tympanic portion. Additional bony channels along the mastoid portion are described. These results supplement those in previous investigations. CONCLUSION: The measurement results agree with those of previous investigations. The course of the tympanic portion is S-shaped and has an impression on its upper surface. High resolution CT reproduces dehiscences of the bony canal in a percentage similar to that of microscopical methods and in relevant sites. Pneumatization does not influence the dimensions of the 2 portions.

Ear, Middle↗
PubMed1977

[Structure of the mastoid process in children].

The structure of the mastoid process of the temporal bone was studied in 138 total preparations obtained from children who had died of different causes except otogenic diseases at the age of from 1 to 16. The final formation of the pneumatic part of the mastoid process was found to occur at the age of 8--12. Further differentiation of the mastoid process structure occurs without an increase of pneumatization and is characterized by rearrangement of the cellulae mastoideae towards the thickening of intercellular septa and isolation of cells. Variants in the structure of the mastoid process in every children age are likely to depend on the intensity of the osteogenic process taking place in criminal bones, in the temporal bone in particular.

Adolescent↗
PubMed1997

Comparison of long-term hearing results after vestibular neurectomy, endolymphatic mastoid shunt, and medical therapy.

OBJECTIVE: This study aimed to compare the hearing changes in the long term after vestibular neurectomy, endolymphatic mastoid shunt, and medical treatment in classic Meniere's disease. STUDY DESIGN: A retrospective case review was conducted based on audiologic follow-up between 5 and 21 years. SETTING: The study was performed at two centers in Bari University Hospital, one performing vestibular neurectomy as the first surgical procedure for Meinere's disease and the other, endolymphatic mastoid shunt. PATIENTS AND INTERVENTIONS: Of 68 patients with intractable idiopathic Meniere's disease, 29 underwent middle fossa vestibular neurectomy, and 17 had endolymphatic mastoid shunt; 22 were offered surgery but declined. MAIN OUTCOME MEASURES: Outcome measures were puretone average (PTA), speech reception threshold, and speech discrimination score before and after treatment. RESULTS: PTA declined by an average of 9.3 dB in neurectomy patients, 13.3 dB in patients undergoing endolymphatic mastoid shunt, and 18.1 dB in patients who were offered surgery but declined. Patients were subdivided into two cohorts based on their preoperative or initial PTA. In the patients who had PTA scores worse than 50 dB initially, the PTA declined an average of 4.3 dB in the vestibular neurectomy group, 11.5 dB in the endolymphatic sac group, and 4 dB in the nonsurgical group. In the patients with PTA > or = 50 dB initially, the PTA declined an average of of 25.3 dB in the vestibular neurectomy group, 16.1 in the endolymphatic sac group, and 26.2 dB in the nonsurgical group. Although shunt patients with good hearing initially deteriorated less than neurectomy patients and less than patients who declined surgery, the difference was not significant. CONCLUSIONS: These results indicate that patients with poor hearing stabilized, while patients with good hearing continued to deteriorate. The same conditions were observed in the patients who had surgery and those who were offered surgery but declined.

Adult↗