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At least 37 records · Page 2Linked to original sources
PubMed1998

Influence of the gas exchange function through the middle ear mucosa on the development of sniff-induced middle ear diseases.

To investigate the influence of gas exchange function through the middle ear mucosa on the development of sniff-induced middle ear diseases, the authors examined the mastoid pneumatization among patients with sniffing habit using computed tomography, and also examined the change of negative middle ear pressure induced by sniffing using tympanogram. In 20 ears with cholesteatoma or adhesive otitis media, the areas of mastoid cavity measured at the level of the lateral semicircular canal were significantly smaller than those in 26 ears with otitis media with effusion (OME) or attic retraction and in eight normal ears with sniffing habit (P < .01 and P < .0001, respectively). In 26 ears with OME or attic retraction, the areas of mastoid cavity were significantly smaller than those in eight normal ears with sniffing habit (P < .0001). By contrast, in the four ears with sniff-induced middle ear disease, the recovery of negative middle ear pressure in 5 minutes without swallowing was less than 10 mm H2O, whereas in all seven ears with normal eardrum, negative middle ear pressure recovered by more than 20 mm H2O in 5 minutes. These findings suggested that impairment of gas exchange function through the middle ear mucosa, as well as eustachian tube dysfunction, might be closely related to the development of sniff-induced middle ear diseases.

Adolescent↗
PubMed1995

[Effect size on resonance of the outer ear canal by simulation of middle ear lesions using a temporal bone preparation].

By means of a model of the external and the middle ear it is possible to simulate various, exactly defined pathological conditions of the middle ear and to describe their influence on ear canal resonance. Starting point of the investigations are fresh postmortem preparations of 8 human temporal bones with an intact ear drum and a retained skin of the ear canal. The compliance of the middle ear does not significantly differ from the clinical data of probands with healthy ears. After antrotomy it is possible to simulate pathological conditions of the middle ear one after the other at the same temporal bone. The influence of the changed middle ear conditions on ear drum compliance, ear canal volume and on the resonance curve of the external ear canal was investigated. For example, the middle ear was filled with water to create approximately the same conditions as in acute serous otitis media. In this middle ear condition a significant increase of the sound pressure amplification was found, on an average by 4 decibels compared to the unchanged temporal bone model. A small increase in resonance frequency was also measured. The advantages of this model are the approximately physiological conditions and the constant dimensions of the external and middle ear.

Acoustic Impedance Tests↗
PubMed1997

[Active electronic hearing implants for middle and inner ear hearing loss--a new era in ear surgery. III: prospects for inner ear hearing loss].

The perspectives for active hearing implants lie in the treatment of patients with sensorineural hearing loss (SNHL). The majority of patients with SNHL suffer from a cochlea amplifier (CA) failure which is discernible by a positive recruitment and loss of otoacoustic emissions (OAE). Therefore, the electronic implant is expected to partially replace functions of the CA. Thus, the implant is thought to function as a CAI (cochlea amplifier implant). An approved implant for routine use is not yet available. Clinical studies have thus far only used the high energy consuming (HEC), narrow-band, electromagnetic floating-mass transducer, as well as the Maniglia-HEC implant. The high energie consuming, yet broadband Canadian Fredrickson implant is soon to be used in humans. Of the piezoelectrical implants, a German CAI (Tübingen implant) at present consisting of a piezoelectrical transducer and a microphone has thus far been acutely implanted in first patient. It is a low energy consuming (LEC), broad-band implantable system for patients with sensorineural hearing loss. Routine surgical treatment of patients with sensorineural hearing loss with a CAI will only be achieved if complete implants (with transducer, microphones, batteries, and control unit) are made available. They combine distinct acoustic superiority with invisibility (end of stigmatization), an open ear canal, and hopefully, the end of feedback whistling. Among the implants mentioned, the German CAI is the only LEC implant. Its energy requirements are so low that with today's technologie implantable batteries (e.g., in pacemakers), the additional implantation of an energy carrier seems feasible. Since the implantable microphone is already available in the German system, the only essential part missing for a totally implantable CAI is the implantable control unit.

Cochlear Implants↗
PubMed2004

Auditory location in the irrelevant sound effect: The effects of presenting auditory stimuli to either the left ear, right ear or both ears.

Two experiments used both irrelevant speech and tones in order to assess the effect of manipulating the spatial location of irrelevant sound. Previous research in this area had produced inconclusive results (e.g., Colle, 1980). The current study demonstrated a novel finding, that sound presented to the left ear produces the greatest level of disruption. These results were explained in terms of hemispheric specialisation for processing of some supra-linguistic components in the unattended sound. Results also supported previous research by demonstrating that both forms of irrelevant sound disrupted performance on serial memory tasks (Bridges & Jones, 1996; Colle & Welsh, 1976; Jones, Alford, Bridges, Tremblay, & Macken, 1999; Jones, Miles, & Page, 1990).

Acoustic Stimulation↗
PubMedDate not supplied

Long-term observation of ears with reduced middle ear pressure.

335 ears from 210 childred in which tympanometry initially indicated middle ear pressure less than or equal to -100 mm H2O or a flat tympanogram have been reinvestigated 3 years later. When the inital investigation was performed all children were 7 years old. The present study reveals that 25% of these ears still have middle ear pressure less than or equal to -100 mm H2O and 16% middle ear pressure less than or equal to -150 mm H2O. In normal material of the same age group 9% have middle ear pressure less than or equal to -100 mm H2O and 4% middle ear pressure less than or equal to -150 mm H2O. The study also reveals effusion in 10% of ears with normal screening audiograms. In ears with normal screening audiograms and middle ear pressure greater than or equal to -145 mm H2O effusion was found in 5% and in ears with abnormal screening audiograms and middle ear pressure less than or equal to -150 mm H2O effusion was found in 81%. As tympanometric criterion for otologist referral, middle ear pressure less than or equal to -150 mm H2O or a flat tympanogram is suggested. The inclusion of tympanometry in routine screening for middle ear pathology in children is recommended.

Acoustic Impedance Tests↗
PubMed2005

The relationship between self-reported difficulty with hearing in the worse ear and the better ear.

OBJECTIVES: To investigate the relationship of self-reported hearing difficulty with hearing in the worse ear and the better ear at 1 and 4 kHz. DESIGN: Receiver-operating characteristic (ROC) curve analysis in community-residing population. SETTINGS: The Settsu City Health Center (Osaka, Japan). PARTICIPANTS: A total of 919 consecutive participants who were provided health check-ups. MAIN OUTCOMES MEASURES: Comparison is based on the measurement of the area under the curve (AUC) of ROC. RESULTS: At 1 kHz, the area under the curve (AUC) of the worse ear (0.625 +/- 0.021) was significantly larger than that of the better ear (0.570 +/- 0.021) (P < 0.01). At 4 kHz, the AUC of the worse ear (0.665 +/- 0.019) was significantly larger than that of the better ear (0.622 +/- 0.020) (P < 0.01). Excluding the subjects with noise exposure, tinnitus and ear disease, at both frequencies, the AUC of the worse ear was not significantly larger than that of the better ear at both 1 and 4 kHz. Hearing in the worse ear was significantly more related to self-reported hearing difficulty than in the better ear without excluding those with noise exposure, tinnitus and ear disease. CONCLUSIONS: ROC curve analysis would provide a method to help us judge the difference between the worse hearing ear and the better hearing ear on the subject of hearing loss.

Adult↗
PubMedDate not supplied

A genetic defect in hyomandibular furrow closure in the Japanese quail: the causes for ear-opening abnormality and formation of an ear tuft.

The mutant ET (ear tuft) quail strain is characterized by an ear-opening abnormality frequently accompanied by ear tufts. The mutant ear opening is oval shaped with a fissure on its ventral margin, whereas the ear tufts project from the ventral end of the fissure or the posterior margin of the ear opening. The ear tufts are composed of a feathered peduncle. The size of the ear tufts and the ear-opening abnormality are variable. The incidence of the ear tufts and the ear-opening abnormality in the ET embryos at 15 days of incubation was 33% and 42%, respectively. Examination of early embryos revealed an incomplete closure of the hyomandibular furrow, the incidence of which was 91% in 5 day embryos. It appears that the hyomandibular furrow abnormality is the primary defect leading to the ear-opening and ear-tuft traits. Genetic analyses of hyomandibular furrow closure defect indicated it to be due to an autosomal recessive mutation. The proposed gene symbol is hfd.

Animals↗
PubMed2000

Variability of Eustachian tube function: comparison of ears with retraction disease and normal middle ears.

OBJECTIVE: To explore the short-term and longterm variability of tubal opening and closing in ears with advanced retractions and in healthy ears. STUDY DESIGN/METHODS: Twenty ears with retraction type middle ear disease (R-MED) and 20 normal ears underwent direct recording of the middle ear pressure during repeated forced openings, equalization of +100 daPa and -100 daPa by swallowing, Valsalva inflation, and forceful sniffing. Tests were performed twice (separated by 30 min) on each of 2 days separated by 3 to 4 months. RESULTS: There was considerable intraindividual variability of the forced opening pressure and the closing pressure in both groups, within as well as between sessions and test days. Although the variability was 1.5 to 2 times higher in ears with retraction than in the normal group, mean Po and Pc did not differ between the groups. Compared with normal ears, ears with retraction changed more frequently from a positive to negative test response, or vice versa, when re-tested after 30 minutes. Rates of positive response in the equalization and Valsalva tests were significantly lower in diseased ears compared with normal ears. CONCLUSIONS: Eustachian tube opening and closing functions vary more in ears with retraction disease than in normal ears, which is consistent with the variable clinical course of R-MED and implies that single tubal function tests have little prognostic value on the individual level.

Adolescent↗
PubMed2002

Total middle ear reconstructive surgery for the radicalized ear.

OBJECTIVE: To evaluate the efficacy of total middle ear reconstructive surgery (TMRS) for patients with open cavity problems. STUDY DESIGN: Retrospective study of patients treated between 1994 and 1997. SETTING: Tertiary care, referral medical center. PATIENTS: Fifty-nine consecutive patients (62 ears) with open cavity problems (draining ears) who underwent TMRS. MAIN OUTCOME MEASURES: Postoperative states of the ears and complications were evaluated in two groups, with and without persistent purulent otorrhea at the time of surgery. RESULTS: In the noninfected group, ears without otorrhea were maintained in 12 (100%) of 12 ears in the short term and 10 (83%) of 12 ears in the long term. In the infected group, the proportions were 40 (80%) of 50 ears and 35 (73%) of 48 ears, for the short and long terms, respectively. Hollowing and/or retraction of the reconstructed canal wall was observed in 1 (8%) of 12 ears of the noninfected group and in 15 (31%) of 48 ears of the infected group after long-term follow-up. Postoperative complications were encountered in 9 ears (14.5%) in the infected group only. CONCLUSIONS: Total middle ear reconstructive surgery is considered useful for the management of persistent discharge from radicalized cavities. It was found important to minimize infection at the time of surgery to achieve satisfactory results.

Adult↗
PubMed1992

The burned ear (II): A prospective clinical study of 100 patients with 150 ear burns.

A prospective clinical study of 100 patients with 150 ear burns was carried out in the Burns Centre, Singapore General Hospital. The aims of this study were to document the nature of the injury, the results of various methods of treatment, the complications of ear burns and the changes that led to chondritis. Based on the findings of the experimental studies on the burned ear, it is possible to accurately classify the depth of the burn injury based on the surface appearance. The results show that fire was the commonest aetiologic agent for ear burns (65% cases) and hot water scalds second (25% cases). Scalds tended to cause unilateral ear burns whilst fire caused bilateral injuries. The single most important factor in healing of the burned ear was the depth of the injury. Erythema took six days, mid-dermal (MD) burns ten days, uncomplicated deep-dermal (DD) and full thickness (FT) burns 35 days. When chondritis developed deep dermal burns took 43.5 days to heal and full thickness burns took 57.8 days. Conservative treatment of 104 ears resulted in complete healing except for 15 which had pigmentary and/or hypertrophic scar problems. Surgical treatment was used in 23 ears. Three returned to normal appearance, eleven had mild and four had moderate deformities. Five ears were lost (3% cases). Chondritis was present in 12 ears (8% cases), six in DD and six in FT burns. Seven of these ears were successfully salvaged. Favourable results in this study were attributed to the following factors: early detection of chondritis by the EAR SPRINGING SIGN, early surgical intervention, radical cartilage removal, meticulous post-op care to prevent cross infection and avoidance of pressure to the ears.

Adolescent↗
PubMed1991

[Itching in the external ear--a side effect of ear plugs].

The object of this investigation was to assess the frequency of itching in the external auditory meatus in individuals who use hearing aid ear plugs (OP) and, simultaneously, to assess the cause of the itching. Seventy-six of the patients examined consecutively in the audiological department (ages 34-89 years) were questioned about itching and were submitted to an objective ear, nose and throat examination, audiometry and culturing from the external meatus for bacterial and fungal growth. In 20 patients, patch tests were made for allergic reactions from which the ear plugs were made (heat polymerized methyl methacrylate). None of the 20 patients had become sensitized. Itching in the external auditory meatus was found to be a side effect of employment of ear plugs with an incidence of 39% as opposed to only seven in ears without ear plugs (p less than 0.05). The incidence of itching was not reduced in ears with a ventilation channel in the ear plug. In 38% of the itching ears no objective changes were observed and, in the remaining cases, the changes were frequently limited. Potentially pathological bacterial growth was found to be significantly more in ears with ear plugs (1- greater than 16%, p less than 0.05) and in itching ears (4- greater than 24%, p less than 0.05). In ears with potentially pathogenic bacteria, objective changes were nearly always found. In the vast majority of cases, the potentially pathogenic bacteria were Gram-negative, corresponding to the findings in external otitis in the tropics and mixed infections with fungi were frequently present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Congenital perilymphatic fistula: computed tomography appearance of middle ear and inner ear anomalies.

Congenital perilymphatic fistula is an abnormal communication between the inner ear and middle ear. Inner ear anomalies have been described on computed tomography scans. Middle ear anomalies have been found at surgery; the most frequent are anomalies of the stapes and round window. This retrospective study describes the appearance of the inner and middle ear on computed tomography scans, and of the middle ear at surgery, in 10 patients (15 ears) in whom perilymphatic fistula was found at surgery. Twelve of 15 stapes were abnormal at surgery; 4 of these 12 (33%) could be seen on computed tomography scans. Two stapes normal at surgery were normal on computed tomography. Three round windows were abnormal at surgery; none of these was seen on computed tomography scans. There were also four dysplastic cochleas, four dysplastic vestibules, and three dilated vestibular aqueducts. Computed tomography scans identified an abnormal inner ear, middle ear, or both in 8 (53%) of the 15 ears with perilymphatic fistula. An inner ear or middle ear anomaly on computed tomography may heighten clinical suspicion of congenital perilymphatic fistula.

Adolescent↗
PubMed2001

Effects of middle-ear static pressure on pars tensa and pars flaccida of gerbil ears.

It has long been known that static pressure affects middle-ear function and conventional tympanometry uses variations in static pressure for clinical assessment of the middle ear. However, conventional tympanometry treats the entire tympanic membrane as a uniform interface between the external and middle ear and does not differentiate the behavior of the two components of the tympanic membrane, pars tensa and pars flaccida. To analyze separately the different acoustic behavior of these two tympanic membrane components, laser Doppler velocimetry is used to determine the motion of each of these two structures. The velocities of points near the center of p. tensa and p. flaccida in response to the external-ear sound pressure at different middle-ear static pressures were measured in nine gerbil ears. The effect of middle-ear static pressure on the acoustic response of both structures is similar in that non-zero middle-ear static pressures generally reduce the velocity magnitude of the two membrane components in response to sound stimuli. Middle-ear under-pressures tend to reduce the velocity magnitude more than do middle-ear over-pressures. The acoustic stiffness and inertance of both p. tensa and p. flaccida are altered by static pressure, as shown in our results as changes of transfer-function phase angle. Compared to p. tensa, p. flaccida showed larger reductions in the velocity magnitude to small over- and under-pressures near the ambient middle-ear pressure. This higher pressure sensitivity of p. flaccida has been found in all ears and may link the previously proposed middle-ear pressure regulating and the acoustic shunting functions of p. flaccida. We also describe, in both p. tensa and p. flaccida, a frequency dependence of the velocity measurements, hysteresis of velocity magnitude between different directions of pressure sweep and asymmetrical effects of over- and under-pressure on the point velocity.

Acoustic Impedance Tests↗
PubMed1997

Interactions between the middle ear and the inner ear: bacterial products.

The round-window membrane (RWM) is extremely thin and is the only soft-tissue barrier between the middle ear and the inner ear. Under inflammatory conditions of the middle ear the various layers of the triple-layered RWM undergo characteristic changes parallel to the changes of the middle-ear mucosa. Several studies report that bacterial products, exo- and endotoxins, from bacteria invading the middle ear may result in profound inflammatory changes in the inner ear, followed by severe damage to the inner-ear function. The present review, in which we summarized experimental and clinical observations, on bacterial products in interactions between the middle and inner ear, focused on: 1. Bacteria and bacterial products in an inflamed middle ear that may influence inner-ear function. 2. RWM structure and RWM permeability under the influence of bacteria and bacterial products. 3. Morphological and functional inner-ear effects of bacterial infection of the middle ear, and the possible mechanisms involved. 4. Future studies to be directed in this field.

Animals↗
PubMed2003

The contralateral ear in patients with middle ear cholesteatoma after long-term follow-up.

BACKGROUND: We aimed to develop a strategy for long-term follow-up of the contralateral ear in patients with cholesteatoma and to determine if the patients' age at surgery for cholesteatoma affects the condition of the contralateral ear during this follow-up. METHODS: From May to November 1999, patients followed for previous cholesteatoma surgery were enrolled. The contralateral ears were examined by the senior author (Dr. Lien). The past otologic records were checked, especially for the condition of the contralateral ear. McNemar test was used to check the pre- and post-follow-up difference. Kaplan-Meier analysis was used to determine the long-term normal rate of initially normal contralateral ears. A log-rank test was used to detect the difference in such normal rate among different age groups. RESULTS: A total of 75 patients were enrolled (47 females and 28 males). The average age at surgery was 38.1 years, and the mean follow-up period was 67.6 months. The normal rate of the contralateral ears was 60.0% at the beginning; and decreased to 50.7% (p = 0.065) at the end of the observation period. The average time for an initially normal contralateral ear to develop an abnormality was 108.9 months. The 5- and 10-year normal rates, calculated by the Kaplan-Meier analysis, were 86.8% and 80.1%. The group who underwent surgery for a cholesteatomatous ear when younger than 35 years had a better prognosis than patients who were older than 35 years at surgery in terms of the normal rate of the initially normal contralateral ears. CONCLUSIONS: We emphasize the need for concern about the contralateral ear in patients with a cholesteatomatous ear. Long-term follow-up of more than 10 years is needed to detect any abnormalities early. Although younger patients had a better prognosis in the initially normal contralateral ear than older patients, this finding could be attributed to the fact that younger patients were alert to seek medical care earlier.

Adult↗
PubMedDate not supplied

Surgery of the mastoid in ears with middle ear effusion.

It has been demonstrated that in most ears with middle ear effusion the mastoid air cells may be involved as well. The mucosal changes and the secretion extends into all cavities of the ear including the mastoid air cells. In most ears insertin of a ventilating tube through the tympanic membrane is adequate for proper aeration of the middle ear as well as of the mastoid air cell system. The draining usually stops and the mucosa gradually changes into its normal condition. In a small percentage of these, the ear will continue to drain and the mastoid will not clear up. Antibiotics and decongestants fail to cure the ear. Surgical intervention of the mastoid may be indicated in the rare cases where conventional treatment fails to control the condition. The aim of this report is to 1) focus attention to the fact that the mastoid is an integral part of the middle ear cavity; 2) discuss the pathogenesis in stubborn ears with middle ear effusion; and 3) demonstrate the surgical procedure commonly used in our department in order to reestablish aeration of the mastoid air cell system. Early recognition and proper treatment of ears with middle ear effusion will hopefully reduce the incidence of stubborn cases and also decrease the number of those cases which end up with chronic otitis media and cholesteatoma. It is hoped that the screening programs involving school and even preschool children, as well as new preventative programs, will diminish the frequency of cases which need extensive surgery as discussed in this paper.

Ear, Middle↗
PubMed1995

[Study on middle ear ventilation using positional tympanometry--normal ear].

The middle ear is a cavity surrounded by solid bones, lined with mucosa, which has a gas-filled lumen. Cavernous organs such as the ear should have their own ventilation system under atmospheric pressure. The mechanism of ventilation in the middle ear has not been sufficiently clarified. Ventilation performed in the middle ear may be classified into two types: 1) passive ventilation via the Eustachian tube, required in cases of abnormal pressure and 2) unique physiological active ventilation of the middle ear performed under atmospheric pressure and not involving the Eustachian tube. The purpose of the present study is to prove the existence of this active ventilation under atmospheric pressure. The subjects were 50 normal ears and elevation of middle ear pressure in the lateral position (determined by positional tympanometry) was studied. The change in the peak level, on tympanometry, was used as an index. The results were continuously recorded every 12 seconds. The following results were obtained. 1. Middle ear pressure was elevated by changing from the sitting to the lateral position. Venous pressure was regarded as a causative factor in this pressure elevation. 2. The elevated middle ear pressure in the lateral position suggested gas production from mastoid cells of the middle ear. The observation that the middle ear pressure was stabilized with the increase in pressure, up to a level of 85-90 mm H2O, indicated the existence of gas leakage from the Eustachian tube and a mechanism for controlling gas production from the mastoid cells of the middle ear.

Acoustic Impedance Tests↗