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At least 307 records · Page 17Linked to original sources
PubMed1988

Otopathology of Egyptian mummy Pum II: final report.

Otoscopic examination of the ears of Egyptian mummy PUM II with the operating microscope revealed a small oval perforation of the right tympanic membrane in the posteroinferior quadrant. The smooth and concise margins suggested an etiology of middle ear infection. A method which allows decalcification of ancient specimens without disintegration of the eardrum and other soft tissues within the temporal bone was described. There was evidence of histological repair at the margins of the perforation consistent with sequela of otitis media. No other abnormalities were observed in the temporal bones of this individual. There was no evidence of otosclerosis bilaterally. To our knowledge, this is the first time that a pathological tympanic membrane perforation has been histologically documented in an ancient temporal bone.

Cochlea↗
PubMed1990

Management of radiation-induced otitis externa.

Four cases of otitis externa secondary to radiotherapy are described. This fairly common complication of irradiation to the head and neck, may impede a satisfactory completion of the therapy. Water precautions and regular otoscopic examination of the ears should be encouraged as prevention or early recognition of the condition is essential for the well being of the patient. The treatment of established otitis externa consists of frequent aural toilet and the application of weak antiseptic solutions. However, complete resolution will not occur until the cutaneous reaction has fully settled.

Adult↗
PubMed2006

Squamous cell carcinoma in situ of the external auditory canal.

We report two cases of carcinoma in situ in the external auditory canal (EAC), presenting with symptoms such as pain, long-term itching of the ear, easy contact bleeding, canal otorrhea and hearing loss. Otoscopic examination revealed granulation tissue and a greyish-black tumour with irregular surface. The first patient had previously been diagnosed with otitis externa with persistent ear itching for the past three years. The second patient had received tympanoplasty for treatment of chronic otitis media on the right ear ten years ago. The first case was treated with wide excision, whereas the second patient received resection of the skin of the EAC together with its adjacent soft tissue, followed by skin grafting. No tumour recurrence was noted in the fourth and third post-operative year for the first and second patient respectively. We suggest that EAC carcinoma can be detected early and treated.

Adult↗
PubMed1999

The use of eardrops in an ENT department.

A survey of the pattern of usage of ototopical preparations in out-patients of the ENT department of a Dutch University Hospital has been performed. Data on clinical presentation and previous treatment of the patient, otoscopic results, prescribed current treatment and, if available, results of microbiological examination were collected. One-hundred and twenty-one evaluable patients were prospectively included. For 20% of the patients it concerned a first manifestation of the symptoms, 35% had a recurrence after a period free of symptoms and in 37% it concerned patients with persisting symptoms despite treatment. Forty-five percent of the patients' ears concerned had an intact tympanic membrane, in 25% a perforation was present and in 12% middle ear ventilation tubes were in situ. Thirty-five percent had already received previous treatment with ear drops. The species most often isolated was Staphylococcus aureus, followed by Pseudomonas aeruginosa. A wide range of products were prescribed. While previous treatment occurred with combination preparations, for current prescriptions, ofloxacin was most often used. Most patients received 2 to 3 drops 3 times a day for 7 to 10 days, which is in accordance with recommendations in the literature. Potentially ototoxic substances are regularly used in daily practice. Ofloxacin is widely used even thought it is not registered for this indication in the Netherlands and the development of resistance has to be taken into account. A new policy based on this survey is proposed, which will reduce the number of different preparations used and will eliminate ofloxacin from first the treatment.

Administration, Topical↗
PubMed2004

[Sudden hearing loss].

Sudden hearing loss is a reduction of sensoneurinal sound perception with a sudden onset. It is usually occurring only in one ear and without a recognizable cause. If a hearing loss is suspicioned due to otoscopic and tuning fork test findings, the patient should rapidly be sent to an ENT-specialist because of the possible consequences. After the first examinations by means of ear microscopy and audiogram further diagnostics may be necessary. If no cause is found, the idiopathic sensorineural hearing loss remains as the exclusion diagnosis. Therapy follows a polypragmatic approach based on the different theories of its origin. Therefore mainly antiinflammatory, antiviral and vasoactive drugs are applied. The high spontaneous healing rate and the still pending proof of effectiveness of all types of therapy used so far must be considered.

Age Factors↗
PubMed2004

[The red tympanic membrane].

An otoscopic red tympanic membrane is for the examiner a challenge. A short directed history, as well as a few functional examinations associated to a systematic otoscopy allow in most cases to make the otological diagnosis. The differential diagnosis for a red tympanic membrane is very large, including malformations, traumas, infections, and even tumors and other degenerative pathologies. The first diagnosis to think about is an infectious disease. On the other side, there are rare pathologies which, even for experienced examiners are quite seldom.

Diagnosis, Differential↗
PubMed2003

Ovarian stimulation of marmoset monkeys (Callithrix jacchus) using recombinant human follicle stimulating hormone.

To reduce the number of animals required for controlled studies of marmoset oocytes and early embryos, a superovulation protocol was developed for the common marmoset. Females were given up to 50 i.u./day recombinant human follicle stimulating hormone (FSH)--(r-hFSH) for 6 days. Ovaries were visualized by a modified laparoscopic technique and follicular aspiration was performed using a needle and suction apparatus inserted directly through an otoscope speculum. The number of follicles + ovulation points (+/- S.E.) was 2.9 (+/- 0.2) in controls and 14.1 (+/- 1.6; P < or = 0.001) in the 50 i.u. r-hFSH per day animals. Oocytes, typically at the germinal vesicle stage at collection, extruded a first polar body within 26 hours. In vitro fertilization was performed and embryos developed to the hatched blastocyst stage (34%). With many high quality oocytes and the ability to synchronize cycles, the marmoset is a valuable primate model for examining nuclear reprograming and early embryonic events.

Animals↗
PubMed1975

An abbreviated impedance bridge technique for school screening.

The hearing of 539 children were screened by conventional audiometric techniques and an abbreviated form of impedance audiometry. Otoscopic examination and estimates of the cost to accurately detect hearing loss were used as critieria for comparing the two methods. The impedance technique detected 94% of hearing disorders, the audiometric, 24%. Projections of cost included a factor for number screened. These demonstrated that the impedance technique was less expensive and approached one-sixth the cost of the audiometric technique at a rate of 10,000 children per year. A routine application of the impedance technique in an ongoing hearing conservation program (N = 2712) supported the initial conclusion that it was more effective and more easily employable than audiometric screening. One child who passed impedance screening was shown to have a 50-dB sensorineural loss. It was concluded that an abbreviated form of impedance audiometry that includes a single high-frequency screening tone is the technique of choice for school screening.

Audiometry↗
PubMed1976

Audiologic evaluation of deaf children.

This paper describes an audiologic test battery for hearing-impaired children which includes otoscopic examination, tympanometry, pure-tone audiometry, speech perception testing, and hearing aid evaluation. Several of the procedures and modifications to apparatus have been developed specifically for use with deaf children. Clinical data are presented from 160 hearing-impaired children (age range three-16 years). Eighteen percent of their ears were found to contain excessive cerumen and to require ear canal irrigation. The incidence of abnormal tympanograms was high for young children but decreased with increasing age. A simple auditory speech perception test designed for use with both severely and profoundly deaf children is described, which provides for evaluation of a child's ability to recognize words, categorize them into stress patterns, or both. The children's word recognition and word categorization scores were found to relate to their audiometric averages. The overall test battery is easy to administer and also is efficient, in that considerable audiologic information can be obtained quickly.

Adolescent↗
PubMed1996

Middle ear barotrauma in patients undergoing hyperbaric oxygen therapy.

Hyperbaric oxygen therapy is associated with a risk of barotrauma to the middle ear. This prospective study of 82 patients undergoing long-term therapy for chronic conditions was designed to measure the incidence and severity of middle ear barotrauma. Twenty-four patients (29.3%) required the insertion of ventilation tubes for otalgia, significantly more of whom were suffering from radionecrosis of the head and neck region (P < 0.01). Thirty-two of the remaining 58 patients (55%) underwent specialist ENT assessment by otoscopy and tympanometry. Five ears (8%) showed the otoscopic changes of barotrauma (TEED grade 3 or 4), and one ear (2%) showed tympanometric evidence of a middle ear effusion (Type B tympanogram). We conclude that despite careful tuition in pressure equalization and the appropriate use of ventilation tubes, up to 8% of ears sustain significant barotrauma. Tympanometry is unreliable in detecting these changes, otoscopy provides the most reliable screening technique.

Aged↗
PubMed1998

Transient otoacoustic emissions in children with chronic renal failure.

This study was conducted on 34 children with chronic renal failure: 27 on regular haemodialysis and seven on conservative treatment. Twenty normal healthy children served as controls. They were subjected to clinical examination including otoscopic examination, basic audiological assessment and transient otoacoustic emission testing (TOAE). Four patients had a conductive hearing loss and five had a bilateral moderately severe high frequency sensory neural hearing loss. TOAE testing was carried out for the rest whose ears displayed normal hearing. No response (fail) was obtained in 8% of them but in none of the controls and a partial pass response in 38% versus 10% of controls (P < 0.001). Cochlear dysfunction was significant only at low frequency levels. The mean overall echo-level and reproducibility were significantly lower in patients than in controls. The same holds true for the subgroup of patients on haemodialysis but not for those on conservative treatment. The overall echo-levels did not correlate with serum urea, creatinine, sodium or potassium.

Acoustic Impedance Tests↗
PubMed1999

Chronic otitis media with effusion during infancy, have parent-reported symptoms prognostic value? A prospective longitudinal study from 0 to 2 years of age.

As a part of a prospective study (age, 0-2 years), the prognostic value of parent-reported symptoms relative to chronic otitis media with effusion (COME) was examined in a group of 122 infants. The occurrence of hearing loss, ear infection, mouth breathing, snoring and common cold was inventoried using a standardised questionnaire filled in by parents at 3-monthly intervals. Tympanometric and otoscopic records were combined for assessment of middle ear status. Subjects were categorized into three groups: none (n = 13), mild (n = 78) and severe (n = 31) COME. Analysis revealed that all symptoms in the first year of life were significantly associated with severe COME. In the second year, only hearing loss was associated with a higher risk for severe COME. The risk for severe COME increased when symptoms were combined. In conclusion, a questionnaire based on only symptoms during the first year of life may assist in screening and managing severe COME.

Age Distribution↗
PubMed2003

The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion.

The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of >or= 20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).

Acoustic Impedance Tests↗
PubMed2003

Epidemiology of otitis media in Chinese children.

From May to July 2001, 3013 Chinese children, aged 3-6 years old, from 19 kindergartens in Kaohsiung were examined for the prevalence of otitis media. A senior paediatric otolaryngologist performed examinations. Tympanometric and otoscopic records were combined for assessment of middle ear status. The prevalence rate of otitis media was 9.82% for all children, 5.24% for middle ear effusion and 5.34% for retracted tympanic membrane. The prevalence rates of otitis media in different age groups were as follows: 11.3% for 3-year-olds, 12.4% for 4-year-olds, 11.8% for 5-year-olds, and 6.1% for 6-year-olds. Considering the genetic factors and the previous history of otitis media, there was a significant difference between the normal group and the sick group.

Acoustic Impedance Tests↗
PubMedDate not supplied

Missed opportunities for a diagnosis of acute otitis media in Aboriginal children.

OBJECTIVE: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. METHODS: Children aged <8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. RESULTS: Thirty-one children were enrolled during 32 admissions. Most were aged <2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). CONCLUSIONS: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management.

Child↗
PubMedDate not supplied

Ossicular reconstruction using hydroxyapatite prostheses with interposed cartilage.

PURPOSE: Despite the excellent biocompatibility of hydroxyapatite ossicular prostheses, extrusion of the prosthesis may be found during long-term follow-up, mainly due to the retraction of the eardrum. Although interposition of autologous cartilage between the eardrum and the prosthesis is empirically used to prevent extrusion, the clinical effect of this procedure has not been confirmed. The purpose of this study was to evaluate the effect of interposing a cartilage on the extrusion rate and hearing outcome. MATERIALS AND METHODS: Fifty-four ears in which cartilage was interposed with a hydroxyapatite prosthesis were compared with 53 ears without interposition. Three years after surgery, the otoscopic findings and hearing outcome were evaluated. RESULTS: The extrusion rate was 1.9% in the group with interposition and 13.2% in the group without interposition. The difference between the two groups was statistically different (chi(2) = 4.986; P =.03). There was no significant difference between the two groups in the postoperative air-bone gap. CONCLUSION: This procedure is an effective method for reducing the extrusion rate of hydroxyapatite prostheses without reducing the hearing gain resulting from ossiculoplasty.

Adolescent↗
PubMed2004

[Myospherulosis of the middle ear -- a rare differential diagnosis of cholesteatoma].

BACKGROUND: Myospherulosis is a chronic-inflammatory lesion that is most commonly iatrogenic of origin and occurs in tissues exposed to petrolatum-based products. The disease does not exhibit characteristic symptoms and is therefore not diagnosed in some instances. In previous otorhinolaryngological studies, myospherulosis was mainly found in paranasal sinuses, while only four otitic cases have been reported. METHODS: A 48-year-old female Egyptian patient suffered from bilateral chronic otitis media that had been treated in Egypt by tympanoplasty. The patient presented few months later at the university ENT department (Mainz) with deteriorated otorrhea and otalgia. Clinical, otoscopical, and radiological examination led to the diagnosis of cholesteatoma. During revision surgery of the right side, ointment-like material was found, which was embedded in granulation tissue. Middle ear biopsies were taken from both sides and routinely processed for standard histological examination and transmission electron microscopy. RESULTS: Histological examination of the right middle ear biopsy showed cystic tissue spaces lined by histiocytes and foreign-body giant cells in a fibrous stroma. In the tissue spaces, scattered debris and sac-like structures containing round spherules of aggregated erythrocytes were found. In addition, erosion of adjacent bone matrix was seen. Diagnosis of myospherulosis was made. By contrast, histological evaluation of the left middle ear biopsy revealed cholesterol granuloma. CONCLUSION: Myospherulosis of the middle ear has been hitherto diagnosed in a very few otitic cases, but might be overlooked as it mimicks other chronic proliferative and inflammatory lesions such as cholesteatoma in the present case. Thus myospherulosis should be considered in otitic cases with a suspicious history (exposure to petrolatum-based products). Furthermore, patients with myospherulosis have a significantly higher likelihood of developing postoperative complications. Since the lesion exhibits distinct histological findings, microscopy plays a central role for the diagnosis of this important disease.

Cholesteatoma, Middle Ear↗
PubMed1996

[History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

BACKGROUND. Inspection of or interventions in the external ear canal and the nostrils pose similar technical problems. This is the reason why early instruments devised for otoscopy and rhinoscopy were based on an identical principle. They were shaped like a pair of tongs, comparable to nasal specula of today. A similar type of instrument had been developed earlier by barber surgeons for inspecting narrow wound cavities. TONG-SHAPED SPECULA. The first description and illustration of an aural and nasal speculum was provided by Guy de Chauliac in Montpellier, France in 1363. Sophisticated models were presented by Fabricius Hildanus in Germany in 1646 and J.J. Perret in Paris in 1772, who offered them in his illustrated catalogue of surgical instruments at fixed prices. W. Kramer (1836) in Berlin improved this tong-shaped instrument and devised the ear speculum named after him that was generally favored during the first half of the 19th century. Further variations of this type were presented by Lincke and Schmalz (1846) in Germany. FUNNEL-SHAPED SPECULA. Ignaz Gruber in Vienna in 1838 devised the first tunnel-shaped ear specula made of metal. They had a simple conical shape, were not divided into separate jaws, and could not be spread. Gruber himself did not publish his invention, but he demonstrated his ear specula to W. R. Wilde from Dublin, who had paid a visit to his office in Vienna. Wilde reported on this in 1844, and subsequently systematically refined Gruber's specula. A. v. Tröltsch from Würzburg (Germany) had seen these instruments at Wilde's office and it was Wilde himself and v. Tröltsch who helped this type of ear speculum to gain acceptance on an international scale. A different type of bottle-shaped ear speculum was first used by Schmalz (1846) and Erhard (1859) in Germany, but it was only developed into a commercially available instrument by Josef Gruber in Vienna in 1870. The ear specula most in use today were first presented by A. Hartmann in Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

Endoscopy↗