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At least 325 records · Page 18Linked to original sources
PubMed2002

[Characteristics of a clinical course of acute mastoiditis].

The analysis of 138 case records of acute mastoiditis (AM) patients treated for the last 5 years has demonstrated that mastoiditis incidence grows, it shows the trend to arise shortly after development of acute otitis media, classic symptoms occur less frequently while such symptoms as pain in the ear, pulse reflex, hypoacusis, elevated ESR are apparent. Most of the patients (71.7%) have undergone resection of the mastoid process. The resultant large retroauricular wound slowly granulated.

Adolescent↗
PubMed2002

Mastoid-obliteration surgery with cartilage for suppurative cholesteatomatous ears.

BACKGROUND: Autologous cartilage has been widely used as a material for tympanoplasty and mastoid-obliteration surgery. Since it remains vulnerable to an infectious condition, this study aims to evaluate if it can be used for a chronic suppurative cholesteatomatous ear to achieve single-stage tympanoplasty with mastoidectomy and obliteration of the cavity. METHODS: From January 1988 to August 1998, the records of patients with cholesteatoma who received cartilage-obliteration surgery performed by Dr. Lien were examined for any infection-associated problems within three months after the operation. The Fisher's exact test was used to compare the difference in the incidence of post-operative infection-associated problems between suppurative ears and non-suppurative ears. RESULTS: One hundred and seven surgical procedures performed upon 96 patients were included in this study, with 97 being primary surgical procedures and ten being revision surgery for previous open cavity with cholesteatoma recurrences. The average follow-up was 47.7 months. At time of surgery, there were 59 non-suppurative ears; 48 ears were suppurative and cultured. Granulations were found in the middle ear or mastoid for 42 ears (39.3%). Five ears (4.7%) exhibited infection-associated post-operative problems within three post-operative months. Three cases (5.1%) were non-suppurative ears and two cases (4.2%) were suppurative ears. There was no significant statistical difference when examined with the Fisher's Exact test. CONCLUSIONS: In an immunocompetent patient with a cholesteatomatous chronic suppurative ear, autologous cartilage could potentially tolerate an infection condition to serve as a material for mastoid-obliteration in a single-stage surgical procedure.

Cartilage↗
PubMed2003

[Mastoid drainage in combined treatment of middle ear inflammation].

The complex of conservative therapy of acute otitis media (OM), mastoiditis as well as exacerbation of chronic OM was supplemented with mastoidodrainage performed through a polyethylene tube introduced in the upper part of the mastoid process for washing alveoli of the mastoid process and tympanic cavity. The complex was used in 23 patients with a good result.

Acute Disease↗
PubMed2003

[The application of mastoid obliteration with homograft tooth in open method tympanoplasty].

OBJECTIVE: To investigate the effect of open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall. METHOD: Fifty-two cases with cholesteatoma or skeletal ulcer otitis media were performed the open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall after radical mastoidectomy. RESULT: External auditory canals of 48 patients were normal in appearance. The transplanted membrane in 46 ears was survived. The dry-ears rate was 92.31% and the average time waited till dry-ears was 17.56 +/- 4.16 days. The air-conducting hearing levels of average language frequency have been enhanced over 15 dB HL in 41 ears. An air-bone gap of less than 20 dB HL was achieved in 31 ears. CONCLUSION: The open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall can recovery the anatomic structure and physiological function of external auditory canal and middle ear better. The long-term effect on improving hearing was significant.

Adolescent↗
PubMed2005

[Mastoid eosinophilic granuloma: a case report].

OBJECTIVES: Langerhans cell histiocytosis is a proliferating cell disease that may take various forms characterised by bone, skin lymph nodes and visceral lesions. Eosinophilic granuloma is a localised form of histiocytosis X, or Langerhans' cells histiocytosis, a benign form with unknown aetiology. At the head and neck level, it is usually located on the temporal, and usually occur in association with multifocal disease; however, isolated lesions may occur in the mastoid bone alone. METHODS: The author's present a case of a patient with unifocal eosinophilic granuloma limited to the mastoid treated in ENT and radiotherapy departments. RESULTS: CT scan demonstrated an osteolytic lesion of the mastoid. The biopsy and immunohistochemical study confirmed the diagnosis. A surgery followed by a radiotherapy (20 Gy) have stabilised the situation. There is no recurrency after one year. CONCLUSION: Unifocal eosinophilic granuloma of the temporal bone is a benign lesion of langerhans' cell histiocytosis. Its diagnosis is difficult when the disease remains isolated. Its treatment depend on its extension and its risks. The excellent prognosis does not dispense on regulary follow up.

Adolescent↗
PubMed2006

[External auditory canal reconstruction and mastoid cavity obliteration with composite multifractured osteoperiosteal flap: a preliminary study].

OBJECTIVES: Open cavity mastoidectomy techniques cause some cavity problems. We used inferior pedicled composite multifractured osteoperiosteal flap, which is our original surgical approach to obliterate the mastoid cavity, reconstruct the external auditory canal (EAC), and to prevent open cavity problems. PATIENTS AND METHODS: Composite multifractured osteoperiosteal flap was used to obliterate the mastoid cavity and reconstruct the EAC in four patients (2 females, 2 males; mean age 34; range 31 to 38 years) who previously underwent radical mastoidectomy to treat chronic otitis media with cholesteatoma. Small meatoplasty was applied in all the patients to relive their esthetical concerns. The patients were followed-up for two years. RESULTS: The epithelization of the new EAC was complete at the end of the second month. Cholesteatoma, granulation, or recurrence of osteitis did not occur in any of the patients. We detected new bone formation filling the mastoid cavity on postoperative temporal bone CT images. CONCLUSION: An almost natural EAC was obtained due to neo-osteogenesis that developed behind the composite multifractured osteoperiosteal flap.

Adult↗
PubMed1987

Mastoid volume and eustachian tube function in ears with cholesteatoma.

Eustachian tube function, as measured by the pressure equalizing technique, and the mastoid air cell area were compared among ears with traumatic eardrum perforations, ears with chronic otitis media, and cholesteatomatous ears. A statistically significant difference among the three groups was found regarding the residual positive pressure after swallowing, with the poorest function found in the cholesteatoma group. Also, the ability to reduce a negative pressure was found to be inferior in the cholesteatoma group compared with the others. The mean mastoid air cell area measured on the x-ray film was smallest among ears with cholesteatoma and differed significantly among the groups. These disturbances in the active eustachian tube function as well as the volume of the middle ear cleft, including the mastoid air cell system, were found to be characteristic among ears with acquired cholesteatomas.

Cholesteatoma↗
PubMedDate not supplied

Otitis media and the mastoid cell system. A study of men born in 1913 and 1923.

Within the framework of the Study of Men Born in 1913 and 1923, which is a prospective population study in Gothenburg, Sweden, a subsample consisting of 128 men 20, 30, 50, and 60 years old was investigated in order to elicit information on factors influencing the size of the mastoid cell systems, measured planimetrically from X-ray films. The mastoid cell area (MCA) closely correlated with body size, height being the best measure. Young men had larger relative MCAs (adjusted for height) than old men. Within each age group, men with small relative MCA were characterized by a lower social class, a longer history of otitis media, more tympanic membrane pathology, and more hearing loss than men with large MCA. These results support the view that in addition to genetic factors, environmental factors may exert a strong influence on the development and ultimate size of the mastoid cell systems.

Adult↗
PubMedDate not supplied

Mastoid size determined with lateral radiographs and computerized tomography.

Minimal pneumatization of the temporal bone is characteristic of otitis media. The classic radiographic assessment of mastoid air cell system size is the Runström II view, but the Law lateral view is the commonly used clinical view in the United States. Isolated temporal bone specimens are most accurately positioned using a modified Law Lateral view (with the film perpendicular to the central X-ray beam). Computerized tomography is the best radiographic means of assessing mastoid pneumatization. The mathematical relationships of mastoid pneumatization size determined by the Runström II, Law, and modified Law lateral radiographs, and computerized tomography were determined in 30 adult cadaver specimens. These data may facilitate additional study of otitis media.

Adult↗
PubMed1986

Mucocutaneous lymph node syndrome mimicking acute coalescent mastoiditis.

Mucocutaneous lymph node syndrome (Kawasaki's disease) is an acute febrile, exanthomatous illness in which massive lymphadenopathy may occur in the cervical area. This lymphadenopathy may mimic other conditions and present a diagnostic dilemma. We present a case report of a child whose initial clinical signs, symptoms, and laboratory findings were compatible with acute coalescent mastoiditis; however, the child was found after close observation to have Kawasaki's disease. The case demonstrates the similarity between the two diseases and how close observation can prevent unnecessary surgery. When considering the rare diagnosis of mastoiditis, other entities need to be considered in the differential diagnosis before surgical intervention is undertaken. If the patient is unstable or a threatened complication of mastoiditis is apparent, however, immediate mastoidectomy is required.

Child, Preschool↗
PubMed1985

The exenterated mastoid: a problem of ear surgery.

The exenterated mastoid behind an intact posterior ear canal wall is one of the preconditions for the development of hidden cholesteatoma recurrences. Retraction pockets can develop into the cavity owing to persisting malfunction of the eustachian tube. Matrix inadvertently left in the tympanic space or in the mastoid process can grow into or in the cavity unnoticed. The way to avoid this nesting site is permanent obliteration of the mastoid process immediately after the eradication of the disease. Furthermore, the disadvantages of old radical operation cavities can be eliminated by secondary obliteration, connected with a revision and repair of the sound pressure transfer mechanism if necessary. It is important to use a nonresorbable obliteration material. We use methacrylate (Sulfix-6) for this purpose, so far without any negative consequences in the ears.

Bone Cements↗
PubMed1985

[Acute mastoiditis: 16 clinical cases].

Sixteen cases of acute mastoiditis were treated between 1980 and 1984. In infants the course of the mastoiditis was brief. An external retroauricular swelling soon occurred that was generally due to edema without abscess formation, and medical treatment resulted in rapid healing. For the older children, the acute mastoiditis occurred on an acute otitis media that had already been present for some time. Abscess formation occurred in half of the cases, and a mastoidectomy was generally required. For the adult patients, there was always an underlying chronic ear pathology, either a cholesteatoma or a chronic benign middle ear infection. Surgical intervention was always required both for the treatment of the underlying pathology and for the acute associated infection.

Acute Disease↗
PubMed1982

Volume measurement of middle ear and mastoid air cell system with impedance audiometry on patients with eardrum perforations.

The usefulness of the electroacoustic impedance bridge with a probe tone frequency of 0.22 kHz in the determination of the middle ear and mastoid volumes was evaluated in patients with dry eardrum perforations. The values obtained were compared with the volumes determined by an aspiration technique utilizing the gas laws. Also, a comparison was made between the impedance volumes and the size of the mastoid air cell system as measured on x-ray film in a lateral projection. A significant agreement between the two methods of direct volume determination was found. A good relationship was found between the impedance volume and the mastoid air cell area. The impedance audiometry enables a rapid and valuable estimation of the air reservoir in the middle ear in patients with eardrum perforations.

Acoustic Impedance Tests↗
PubMed1981

Mastoid obliteration with primary ossicular reconstruction.

Soft tissue mastoid obliteration was used as a means to control a persistent draining mastoid cavity that would not respond to aggressive office management using meticulous cleansing, local antibiotics, and packing. Thirty-three draining cavities which could not be controlled medically, had soft tissue mastoid obliteration performed using a Palva flap. Of the 33 cases obliterated, 31 were successful in obtaining a dry cavity but two still required cleansing every four to six months. Primary reconstruction of the hearing mechanism was performed in 21 of the 33 cases, the others having severe pre-operative cochlear damage. Of those cases reconstructed, 13 were reconstructed using a TORP and eight were reconstructed using a hemi-incus interposition.

Ear Ossicles↗
PubMed1995

The Hong Kong vascularized temporalis fascia flaps for optimal, mastoid cavity reconstruction.

The classical modified radical mastoidectomy offers the advantages of combining the mastoid cavity, the attic and the external canal into one cavity that remains open for inspection. However the ultimate goal to predictably produce well healed, dry and safe mastoid cavities despite receiving much attention has not been fulfilled. By employing basic surgical principles of wide access to facilitate meticulous removal of all cholesteatoma and then eliminating all raw surfaces of the bony cavity with pedicled vascularized deep temporalis fascia, the Hong Kong Flap technique achieves the highest percentage of dry, stable, disease free ears. This living fibrous tissue layer provides the optimal substrate for epithelial resurfacing while separating the mucosa and bone of the middle ear and mastoid from the surface epithelium. Excellent healing even under unfavourable circumstances is ensured by the rich blood supply to the pedicled temporalis fascia flap. Furthermore the technique obviates the need for second look procedures in more than two-thirds of cases as the cavity lining becomes transparent and simple observation is safe. The Hong Kong Flap was used to reconstruct 107 cavities between October 1988 and October 1992. 86 were performed for primary cholesteatoma removal and 21 for revision of discharging cavities. 103 (96%) healed soundly. There were 4 dry perforations. Minor complications occurred in 8 (7%) patients. 84 (78%) required n+o second exploratory operation. This is a straight forward procedure requiring no special technical skills. The concept is rational and provides the ideal management for cholesteatoma by achieving a dry, safe ear with one operation.

Cholesteatoma, Middle Ear↗
PubMed1995

[Tension pneumocephalus in association with ventriculoperitoneal shunt and congenital bony defect in the mastoid tegmen].

The authors report a case of tension pneumocephalus in association with a congenital bony defect at the mastoid tegmen, and a ventriculoperitoneal (V-P) shunt for obstructive hydrocephalus, due to the presence of a posterior fossa meningioma. After multiple diagnosis and surgical procedures, congenital bony defect at the right mastoid tegmen demonstrated by a middle ear cavity computerized tomography (CT) scan, was identified as the source of entry of the air. The air must have penetrated the lateral ventricle through a porencephalic cyst in the right temporal lobe. Reconstruction of the bony defect in the mastoid tegmen successfully prevented further recurrence of tension pneumocephalus. We discussed the possible pathogenic mechanisms involved in this kind of tension pneumocephalus, and suggested that a middle ear cavity CT scan should be performed for tension pneumocephalus that has developed after V-P shunt.

Female↗
PubMed1994

Plasmacytoma of the middle ear and mastoid.

Extramedullary plasmacytomas are rare plasma cell tumors of the soft tissue that predominantly occur in the head and neck. They are most commonly seen in the upper respiratory passages and oral cavity. There have been only a few reports in the world literature of plasmacytomas occurring within the temporal bone. This report presents a case of plasmacytoma of the middle ear and mastoid that presented as a middle ear mass. Work-ups for systemic dissemination and multiple myeloma were negative, classifying this as a localized extramedullary plasmacytoma. This is the first report in the English literature of this malignant tumor occurring as an isolated lesion within the middle ear and mastoid. The patient was treated with surgical debulking and radiotherapy with complete resolution of the tumor. Although extremely rare, plasmacytoma should to be included in the differential for soft tissue tumors of the middle ear and mastoid.

Biopsy↗
PubMed1995

Evaluation of mastoid obliteration surgery.

The anatomic results of mastoid obliteration surgery on 54 ears during the past 10 years were analyzed, and the comparative utility of several materials for obliteration was evaluated. Thirty-three ears had primary chronic otitis media with or without cholesteatoma (group 1), and 21 ears had old open mastoid with intractable chronic discharge due to incomplete epithelialization (group 2). The materials used for obliteration were biologic (pedicled muscle flap, autogenous bone chips, tragal cartilage with perichondrium, allograft dura), nonbiologic (hydroxyapatite), or a combination of two of these materials. Evaluation at 2 months postoperatively showed that 42 ears were anatomically complete, whereas the other 12 ears were incomplete: three cases in group 1 and nine cases in group 2. The main causes of these unsatisfactory results were exposure of transplanted artificial material or partial loss of the pedicled muscle flap. In the long-term follow-up results, four ears were evaluated as unsatisfactory in group 1, and six ears in group 2, owing to shrinkage of obliterated tissue. The major causes of failure were anatomic incompleteness following surgery for old open mastoid cavity, in which the use of biologic materials for obliteration was much safer than nonbiologic material, and from the protrusion of artificial materials used.

Biocompatible Materials↗