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At least 235 records · Page 13Linked to original sources
PubMed1987

Down beating nystagmus: magnetic resonance imaging and neuro-otological findings.

Twenty-four patients with down beating nystagmus (DBN) underwent magnetic resonance imaging (MRI) of the head. MRI provided diagnostic images in Arnold-Chiari malformation (6 cases), cerebellar atrophy (6 cases), 1 case with a prepontine-medullary epidermoid tumour and was helpful in the diagnosis of 2 patients with multiple sclerosis and 1 with a ponto-cerebellar infarct. Multiple cerebral hemisphere lesions were found in 6 patients (5 of them over 60 years of age) in whom no diagnosis was made. All cases of DBN, plus 3 additional patients with Arnold-Chiari malformation and other types of nystagmus, were neuro-otologically assessed. Sensitivity of the nystagmus to head tilt with respect to the gravity vector had no localizing value. Impaired horizontal vestibulo-ocular reflex suppression occurred more frequently in those patients with abnormal posterior fossa MRI. Pure torsional nystagmus, and DBN with a strong torsional component, in patients with Arnold-Chiari malformation was associated with syringomyelia. Magnetic resonance is the imaging method of choice for investigating patients with DBN.

Adolescent↗
PubMed1989

Persistent foramen of Huschke: possible risk factor for otologic complications after arthroscopy of the temporomandibular joint.

Several cases of otologic injury after arthroscopy of the TMJ have been reported. This study describes the persistent foramen of Huschke, an area of incomplete ossification of the tympanic plate of the temporal bone present in some persons. The presence of this foramen may render middle and inner ear structures vulnerable to injury during arthroscopy of the TMJ.

Arthroscopy↗
PubMedDate not supplied

Valsalva's contribution to otology.

Valsalva's life as anatomist, physician, and surgeon of the late XVIIth century is surveyed. The second edition of the "Morgagni" version of Valsalva's Treatise on the Human Ear, published in 1741, is considered in relation to the work of his predecessors, the scientific milieu of his time, and his influence on the development of modern otology.

History, 17th Century↗
PubMed2005

Otologic and audiologic features of Nager acrofacial dysostosis.

OBJECTIVE: To describe the otologic and audiologic characteristics of pediatric patients with Nager acrofacial dysostosis. DESIGN: Retrospective case series. SETTING: Multidisciplinary clinic in a tertiary care children's hospital. SUBJECTS: Patients less than 18 years of age with Nager acrofacial dysostosis. METHODS: Nager syndrome is a mandibulofacial dysostosis associated with preaxial limb abnormalities and multiple craniofacial anomalies. Ten patients with Nager syndrome were reviewed. Relevant literature, 1966 to the present, was reviewed with the assistance of Medline. RESULTS: External and middle ear abnormalities are common in Nager syndrome. All non-atretic ears had significant difficulty with otitis media, requiring an average of two sets of tympanostomy tubes. Cholesteatoma was diagnosed in one patient. Pure conductive hearing loss was identified in eight patients with mixed hearing loss noted in two patients. Conductive hearing loss greater than 30 dB HL was noted in 90% (9/10) of patients, with 40% (4/10) having 55-70 dB HL loss. Although amplification was effective, results of surgical interventions to correct conductive hearing loss were inconsistent. Two patients with mixed hearing loss developed the sensorineural component in later childhood, indicating that progressive or fluctuating sensorineural hearing loss is also possible in this population. CONCLUSIONS: Pediatric patients with Nager acrofacial dysostosis exhibit conductive hearing loss due to middle and external ear pathology. Prolonged ventilation of the middle ear via tympanostomy tubes and amplification with hearing aids are often required. Some patients also demonstrate mixed hearing loss that may be progressive and should be monitored carefully. Early and aggressive management in a multidisciplinary team approach is recommended.

Audiometry, Pure-Tone↗
PubMed2005

Drop attacks in elderly patients secondary to otologic causes with Meniere's syndrome or non-Meniere peripheral vestibulopathy.

Many neurologists are unaware of the drop attack that may occur from an inner ear dysfunction especially in elderly. We studied the clinical features and results of quantitative audiovestibular tests in six elderly patients (> or =65 years of age) who presented with drop attacks attributable to an inner ear pathology. Group was divided into Meniere's syndrome (4) or non-Meniere peripheral vestibulopathy (2). Standard dizziness questionnaire and quantitative audiovestibular function testing were performed. Episodes were described as a sudden push to the ground in four or a violent illusionary movement of environment leading to a fall in two. All cases gave a history of prior vertiginous episodes and vestibular testing revealed unilateral caloric paresis. Ipsilateral hearing loss was documented in four cases. Our results suggest that otologic causes should be considered in the differential diagnosis of the drop attack in elderly, even if the symptoms and signs were not consistent with Meniere's syndrome.

Age of Onset↗
PubMed2004

The history of intratympanic drug therapy in otology.

The application of drugs through the eardrum and into the middle ear to treat various otologic disorders has recently gained wide-spread popularity. Despite the relatively recent interest in this technique, if one considers any application of medication into the middle ear as intratympanic therapy, the roots of this method can really be considered to date back to antiquity. This article presents the development of intratympanic drug therapy from early times through the nineteenth century.

Administration, Topical↗
PubMed2006

[Meningeal herniation associated to chronic otitis media in an otology center in the City of Mexico].

To assess the frequency and clinical characteristics of meningocele and meningoencephalocele into the middle ear, at an otological referral center of Mexico city. After analyzing 586 recordings of middle ear surgery, we identified that 3 (0.5%) had defects of the tegmen timpani, 2 had brain abscesses (0.34%) and 1 had (0.17%) a facial palsy. Two of the patients with defects of the tegmen timpani had herniation of the intracraneal tissue. Case 1. A 38 year old woman with a history of bilateral chronic otitis media, with 2 surgeries in the left ear. She was seeking medical care because of right hearing loss. However, computed tomography and magnetic resonance showed a defect of the tegmen timpani with temporal lobe herniation in the left ear. Case 2 was a 46 year old woman with no history of ear disease, just high blood pressure. She was seeking medical care because of right hearing loss, vertigo and headache. The clinical evaluation suggested tissue in the middle ear and the computed tomography showed a defect of the tegmen timpani, meningocele was confirmed by surgery. In the 2 patients the clinical characteristics did not suggest herniation of intracraneal tissue as the first diagnosis. This show us the importance of an intended evaluation and image studies to make an early diagnosis.

Adult↗
PubMed2001

The Otologics MET ossicular stimulator.

The advent of various technologies for middle ear implants (MEI) that directly stimulate the ossicles has created a new therapy for hearing loss and a new segment of the medical device industry. Benefits can be established when the MEI is compared with the best alternative currently available. Otologics, LLC, has developed an electromechanical MEI (middle ear transducer (MET) Ossicular Stimulator) designed to aid individuals with moderately severe to severe sensorineural hearing loss. The efficacy of the device is determined through a clinical comparison of the MET Ossicular Stimulator to that of a state-of-the-art digital hearing aid.

Animals↗
PubMed2002

Phonetic and otological results after early palate closure in 18 consecutive children presenting with cleft lip and palate.

OBJECTIVE: First, to analyze the speech and hearing results at 3.5 years of age when early palate closure has been performed. Second to assess at 7 years of age the need for speech therapy and/or additional surgery in the form of cranial-based pharyngeal flap for obtaining normal speech. METHODS: Retrospective study in a tertiary teaching hospital concerning 18 consecutive cases presenting cleft lip and palate with no associated abnormalities. Interventions included early palatine closure (velum at 3 months, hard palate and lip at 6 months). Speech therapy was initiated at 3.5 years of age when needed. Cranial-based pharyngeal flap was performed when normal nasal emission was not obtained by speech therapy at 7 years of age. Phonetic and otological assessment were performed in all cases. RESULTS: Good to excellent speech in the majority (95%) of children, with only 3/18 undergoing pharyngoplasty to obtain type I or I/II speech by the age of 7 (range: 6.5-8.0). 6/18 children had drain insertion, and 2/18 had hearing loss of 20-40 dB in all frequencies. CONCLUSION: Most children (95%) start school with good or excellent speech. However, the high incidence of middle ear problems shows that more effective screening and treatment are warranted.

Acoustic Impedance Tests↗
PubMed1998

Postauricular myocutaneous flap in otologic surgery.

Management of a large mastoid defect resulting from skull base operations or extensive surgical procedures because of chronic ear disease continues to challenge the otologic surgeon. Various local muscle or periosteal rotation flaps have been used to help reduce the size of the postoperative mastoid cavity. With these techniques there are problems with flap retraction and epithelization that may result in delayed healing or chronic drainage. Closure of the ear canal and tissue obliteration of the mastoid results in a maximal conductive hearing loss. A postauricular myocutaneous flap based on the occipital artery and sternocleidomastoid muscle has been used effectively to reconstruct mastoid defects after both surgical procedures for chronic ear disease and skull base operations. The skin muscle flap reduces the mastoid cavity and promotes rapid healing of the surgical defect. Although postauricular myocutaneous flaps have been found to be reliable, their viability may be compromised by arterial embolization used in larger glomus tumors. Indications for and creation of a postauricular myocutaneous flap, with results in 18 cases, are presented.

Adolescent↗
PubMed1981

Acute temporomandibular joint pain-dysfunction syndrome: neuro-otologic and electromyographic study.

To test the hypothesis that the acute temporomandibular joint pain-dysfunction syndrome might represent a variant of acute benign cranial polyneuritis, a prospective study was designed using neuro-otologic examination and electromyography. Seven consecutive patients with cardinal symptoms of the temporomandibular joint pain-dysfunction syndrome (pain, tenderness, clicking, and limitation of jaw movement) were examined within one week after the onset of their acute symptoms. Another three with chronic symptoms were tested for comparison to the acute cases. All seven patients with the acute condition had asymptomatic hypesthesia of all three divisions of the trigeminal nerve and decreased volitional muscle action potentials in the masseter and temporalis muscles. At the end of three weeks the hypesthesia resolved in all seven patients, and the muscle action potentials returned to normal in six of the seven. Electromyographic testing of the single patient with persistent decreased muscle action potentials and three patients with chronic symptoms showed fibrillations, decreased polyphasic regeneration potentials, and spontaneous fasciculations with clinical atrophy and spasm of the affected masseter and temporalis muscles. Other acute cranial nerve findings included unilateral hypesthesia of the glossopharyngeal and second cervical nerves, motor paralysis of the superior laryngeal branch of the vagus nerve, and increased facial nerve latency. These findings suggest an organic neuromuscular, rather than a psychophysiologic, cause for the temporomandibular joint pain-dysfunction syndrome.

Acute Disease↗
PubMed1984

The influence of the age at which the palate is closed on the rhinological and otological condition in the adult cleft patient.

A comparative study was made of the otological and rhinological conditions at adult age of two groups of patients with unilateral total cheilognathopalatoschisis. In group A (51 patients), the palate was closed around the 3rd year of life, in group B (54 patients), around 6th year. All patients were operated on with an identical technique, by the same surgeon. There was no difference between the two groups in regard to permanent loss of auditory acuity; however, nasal patency appeared to be better in patients in group A than in those of group B.

Adolescent↗
PubMed1998

Otological problems in children with Turner's syndrome.

Ear and hearing disorders are common problems among girls and women with Turner's syndrome. During infancy and childhood the girls often suffer from repeated attacks of acute otitis media and later in life the women frequently complain of a rapid onset of social hearing problems due to sensorineural hearing impairment. A study of 56 girls aged 4-15 years with Turner's syndrome was performed to investigate the prevalence of eardrum pathology and hearing impairment in young children and teenagers with Turner's syndrome. A possible relation to karyotype was also investigated. A high prevalence (61%) of recurrent acute otitis media was found in the study group and 32% had been treated with ventilation tubes. Fifty-seven percent showed eardrum pathology, such as effusion, myringosclerosis, atrophic scars, retraction pockets and perforations. Auricular anomalies were noted in 23% of the cases, most commonly in the 45, X group. The audiometric analysis showed conductive hearing loss (air-bone gap > 10 dB HL) in 43% and the typical sensorineural dip in the middle frequencies was found in 58% of the girls, of whom the youngest was 6 years old. Four percent were using hearing aids. The data of this study further confirm that the dip is progressive over time and may be detectable as early as at the age of 6, giving a chance to predict a future hearing loss. The findings emphasize the importance of regular otological examinations and audiological evaluations of all girls with Turner's syndrome early in life.

Acute Disease↗
PubMed1983

Three-dimensional holographic display of images of otological specimens.

Three-dimensional displays of anatomical structures and clinical findings are very persuasive and instructive. Using multiplex holograms, we designed a display of three-dimensional images of otological specimens. Multiplex holograms, reported by Cross of the United States in 1975, enable reconstruction of three-dimensional moving images and are used for artistic display as well as for teaching in medicine and general education. Multiplex holograms were recorded in a two-step process. The first step is to make a series of original cine-pictures of an object from different horizontal directions, rotating it on a turntable. In the second step, one frame of the original film is recorded on a narrow strip hologram. All frames of the original film are recorded one after another and a complete multiplex hologram can be synthesized. In the reconstruction stage, the multiplex hologram is formed into a cylinder and illuminated from below by a small white light source. Reconstructions of the three-dimensional bright images of the object inside the cylindrical holographic screen are shown.

Ear↗
PubMed1987

Neuro-otological findings in a case of Marinesco-Sjögren syndrome with nystagmus.

Marinesco-Sjögren syndrome is a very rare disease that develops in childhood with main symptoms of cataract, ataxia, mental deficiency and microsomia, and is regarded as a type of spinocerebellar degeneration. The author performed the neuro-otological tests on a case of suspected Marinesco-Sjögren syndrome. The patient exhibited bilateral congenital cataract, mild cerebellar symptoms, bilateral gaze nystagmus with rebound nystagmus, mental retardation, deformity and muscular atrophy of the limbs. Though cerebellar symptoms of the limb were mild, the findings of bilateral gaze nystagmus that appeared most notably immediately after lateral gaze and diminished gradually thereafter with rebound nystagmus suggested cerebellar disturbances. Marked atrophy of the cerebellar hemisphere in CT scans supported the neurootological findings. The author agrees to the opinion of Skre and Löcken who included Marinesco-Sjögren syndrome in the cerebellar form of spinocerebellar degeneration.

Adult↗
PubMed1999

Neurologic and otologic findings in Fisher's syndrome.

We performed neurologic and otologic examinations in 14 patients with Fisher's syndrome to determine whether its manifestations inducing acute ophthaloplegia, ataxia and areflexia may involve the auditory and vestibular systems. Tests included pure tone audiometry, auditory brainstem response, observations of nystagmus, smooth pursuit test, saccade test, optokinetic nystagmus test, and the caloric test. One patient showed downbeat nystagmus and lateral gaze nystagmus without restriction of eye movement, two patients showed dysmetria on saccades without restriction of eye movement, and three patients showed superimposed saccadic eye movement on smooth pursuit without lateral gaze nystagmus. The abnormalities in those six cases could not be explained by solely muscular weakness, but also appeared to involve the central oculomotor system. In the other patients, nystagmus could be explained by muscular weakness alone. Additionally, three patients, including two patients with dysmetria on saccades, showed a unilateral diminished response to caloric testing with no severe restriction of eye movements. In evaluating the auditory brainstem response of these three patients, one patient, who showed abnormality on the saccade and caloric tests, showed an elongation of wave I latencies and of wave I-III interpeak latencies at both ears, and one other patient showed an elongation of wave III-V interpeak latencies at both ears. This disorder may involve the peripheral and central auditory systems as well as the peripheral vestibular system.

Adolescent↗
PubMed1986

Bacterial and mycotic otological infections in Singapore.

This paper describes a microbiological study of 84 young adult men with clinical otitic infections. Gram-negative aerobic bacilli were frequently isolated from these patients diagnosed as having otitis externa or chronic suppurative otitis media, of which Pseudomonas species predominated. Staphylococcus aureus, S. epidermidis and aerobic Corynebacterium species (diphtheroids) were also found. About 40% of ear infections were attributed to otomycoses, chiefly from Aspergillus species and Candida parapsilosis. Antimicrobial susceptibility testing of the bacterial isolates revealed that Pseudomonas species were generally resistant to antibiotics commonly employed in general practice: ampicillin, erythromycin, co-trimoxazole, tetracycline and cephaloridine. However, polymyxin B, gentamicin and neomycin were active against some Pseudomonas isolates. Other Gram-negative bacilli were also mainly sensitive to gentamicin, neomycin as well as co-trimoxazole. Disc diffusion and minimum inhibitory concentration studies demonstrated good activity of ceftazidime, cefoperazone, tobramycin and carbenicillin against strains of Pseudomonas species and other Gram-negative rods. Cefotaxime and cefoxitin were active against Gram-negative bacilli other than Pseudomonas species. Beta-lactamase production did not appear to be the main mechanism of resistance in these community-acquired Gram-negative bacillary isolates. The antimicrobial therapy of otological infections is reviewed.

Adult↗
PubMed1975

Otology in the Bible and Talmud.

The present paper is an English translation of the chapter of Otology in Preuss's classic book Biblisch-Talmudische Medizin. Described in the Talmud are a variety of anatomical ear abnormalities such as double ear, pierced ears, small ears, cut off ears, and pendulous ears. A slave whose ear was wounded had to be freed. Compensation for injury to the ear and to hearing is clearly noted. Remedies for earache are mentioned. The legal status of a deaf-mute, and the relationship of deafness to muteness are also discussed in the Talmud.

Animals↗