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At least 469 records · Page 26Linked to original sources
PubMed1999

[Influence of pavulon on facial nerve monitoring during middle ear-mastoid operation].

OBJECTIVE: To evaluate the influence of pavulon (muscle relaxant) on facial nerve monitoring for patient with middle ear-mastoid operation during general anesthesia. METHOD: Intraoperative monitoring of the facial nerve (FNM) was done in 45 ears (44 case). For patient with middle ear-mastoid disease, 38 ears underwent inhaled-intravenous anesthesia with muscle relaxant pavulon (group of general anesthesia), 7 ears underwent local anesthesia (group of local anesthesia). Accelography (ACCG) was used in 10 case for testing the correlation between of FNM and the various degree of recovery from ulnar nerve-musculor blockade. RESULT: FNM could be elicited during different periods of recovery with values of T4/T1 varying from 10%-98%. Pavulon could be used to eliminate muscular vibration from disturbing FNM. Electromyography (EMG) potentials were successfully recorded in 34 ears (89.4%). Anesthesia was uneventful and it may be controled satisfactority. CONCLUSION: Considering the advantage of pavulon. It can be used for general anesthesia during intraoperative monitoring of the facial nerve for children or adults suffering from local complicated diseases.

Adolescent↗
PubMed2000

[Clinical analysis of facial nerve palsy in middle ear and mastoid surgery in 23 cases].

OBJECTIVE: To investigate the cause, the prevention and the therapy of facial nerve palsy(FNP) which induced by the operation of middle ear and mastoid surgery. METHOD: A series of 1032 cases undergone middle ear and mastoid surgery were reviewed between 1976 and 1991. RESULT: 23 cases FNP were identified. All were incomplete and peripheral. 13 cases of them were performed decompression of facial nerve. 6 cases were cure, 4 cases on the mend and 3 cases no effect after operation. 10 cases were treated by conservation, 5 cases were cure, 3 cases on the mend and 2 cases no effect. CONCLUSION: If the facial paralysis occurs during the operation, which means that facial nerve is damaged, except hard-stuff reason. Exploration should be done at once. If facial paralysis occurs later, conservative therapy should be selected at first. If facial paralysis is still not on the mend 1 month of postoperation, one should be done exploration of facial nerve.

Adolescent↗
PubMedDate not supplied

[Primary intracranial Ewing's sarcoma of the mastoid bone. A case report].

INTRODUCTION: Ewing s sarcoma (ES) is a tumorous process that is found mainly in long bones and the pelvis, but its primary location is not often the intracranial zone. CASE REPORT: We report the case of a 5 year old patient who visited surgery 30 days before hospital admission with increased volume of the left mastoid bone, torticollis, balance disorders and discoordinated movements. A computerised tomography brain scan confirmed our suspicions of a tumorous lesion that was destroying the left mastoid bone, and was invading the projection of the left hemispherium cerebri and edges of the brain stem (mid brain). The patient was submitted to surgery and a partial excision was performed. A month later, another operation was carried out and the patient died after several days in the intensive care unit from serious respiratory complications. CONCLUSIONS: The tumour marker CD 99 is specifically used to diagnose ES. We think that, when faced with a patient suffering from ES, conduct must always be aggressive, with early surgery and, later, adjuvant therapy.

Biomarkers, Tumor↗
PubMed1992

[Congenital cholesteatoma of the middle ear and mastoid. Apropos of 5 cases].

Five cases of congenital cholesteatoma of the middle ear and mastoid as defined by Derlacki's criteria were encountered over a 14 month period. They make up 5% of all cases of cholesteatoma managed over the same period of time. Three were young children and all presented with unilateral hearing loss. One had associated multiple congenital abnormalities of the external and middle ear. Only in one patient was the diagnosis made on initial otoscopic examination and the remainder diagnosed on CTscan, myringotomy and tympanotomy. All were operated on; three by the intact canal wall technique, one by the canal down technique with mastoid cavity obliteration and one by atticotomy with lateral attic wall reconstruction. One patient required a second stage operation for excision of an extension of disease deep to the superior semicircular canal via the middle cranial fossa approach in order to preserve cochlear function. These five cases illustrate the diagnostic pitfalls of this condition in which silent danger lurks behind an intact tympanic membrane.

Adult↗
PubMed1992

Reconstruction of the radical mastoid.

Open cavity techniques (radical mastoidectomy, canal wall down tympanomastoidectomy, modified radical mastoidectomy) are well established surgical procedures for the treatment of chronic otitis media. Despite their effectiveness in exteriorizing cholesteatoma, they are associated with a 20 to 60 percent incidence of persistent intermittent drainage. In an effort to eliminate this problem, we have employed a Palva flap and medial graft technique to reconstruct the mastoid cavity and middle ear space in those patients with chronically draining ears. Between 1987 and 1990, 28 patients underwent this procedure. Twenty-six of these (93%) had complete obliteration of the mastoid cavity and successful tympanic membrane reconstruction. Two of 28 (7%) had a persistent tympanic membrane perforation and intermittent drainage following their surgery. Based on these results, this procedure is effective in eliminating intermittent drainage associated with the open cavity techniques. The indications for this procedure, the specifics of the surgical technique, and the postoperative results are discussed.

Adult↗
PubMed2003

[Acute mastoiditis in children: clinical and bacteriological study of 17 cases].

OBJECTIVE: Acute mastoiditis (AM) represents the most frequent complication of acute otitis media (AOM) in children. In the literature, its incidence is stable but with an impressive increase in pneumococci with reduced sensitivity to penicillin (PRSP). The aim of this study was to assess the incidence of AM in the area of Tours and the prevalence of PRSP. METHOD: This was a retrospective study of children admitted to the regional paediatric centre in the Tours area, between January 1994 and May 2001. The coded AM files were analysed, excluding all the sub-acute forms or those complicating a cholesteatoma. The criteria studied concerned the clinical signs on admission, the imaging data and the bacteriological samples and the results of treatment. RESULTS: Seventeen children (8 boys, 9 girls) were admitted for an AM during the study period. Their mean age was of 3.2 years (range: 6 months to 13 years). In 24% of cases, the mastoiditis existed on admission and in 59% of cases it complicated an AMO already treated with antibiotics. In 3 cases (18%), the AM was complicated on admission with peripheral facial paralysis in one case and thrombosis of the lateral sinus in 2 cases. The germ responsible was identified in 14 cases (82%) with a predominance of pneumococci (11 cases). Eight were PRSP-type. Scan of the pars petrosa identified a subperiosteal abscess in 13 cases. Fourteen mastoidectomies were performed and the mean duration of antibiotic therapy was of 23 days. The outcome was always good. CONCLUSION: Over the past 7 years, the incidence of AM has been estimated at 1.2/100 000 children aged under 15 per year. The prevalence of PRSP is high but does not change the principles or the results of the treatment of AM.

Acute Disease↗
PubMed2005

Mastoid osteoma.

Osteoma in the mastoid is a rare benign osteogenic tumour which has been described in literature in only 130 cases between 1861 and 2004. It is a clinically asymptomatic lesion that usually appears as a tumefaction or retroauricular protruding mass. The Authors report 2 cases of mastoid osteoma, objectively review the literature on this pathology and present theories on its etiopathogenesis, histology, symptomatology and treatment.

Adult↗
PubMed2006

Trans-mastoid approach to otogenic brain abscess.

The treatment of otogenic brain abscess initially involves excision or aspiration of the abscess through a temporal or sub-occipital route depending on its location. This is followed by a mastoidectomy by the ENT surgeon to eradicate the primary source of infection. During the last three years, we have approached such lesions through a mastoidectomy followed by excision of the abscess through the same approach. This trans-mastoid approach is technically feasible in following the tract of suppuration, and clearing the cause and effect of pathology, at the same sitting. This paper describes our initial experience with the trans-mastoid approach to otogenic brain abscesses. On the basis of our results, we believe that transmastoid approach is an effective and logical option for the treatment of otogenic brain abscess, and merits further investigation in the form of a prospective study.

Adolescent↗
PubMed2006

How to take a mastoid and retro auricular thin skin graft.

The mastoid and retro auricular thin skin graft has an excellent quality, and is easy to take. An important hydrotomu should be done in the retroauricular sulcus to obtain a plane surface that goes from the posterior face of the pinna to the skin over the mastoid surface. This plane surface is the donor site and allows the harvesting with the electric dermatome. The characteristics of this graft are: The graft have the same color of the face, the same operative field, yielding an unremarkable scar in the donor site. The thickness is limited to 3 tenths of mm, and his size to 6 x 4 cm approximately.

Ear↗
PubMed1991

Modified radical mastoid surgery for chronic ear disease.

The aim of surgery in chronic ear disease is to produce a dry, clean, safe, waterproof ear and to reconstruct the hearing. The techniques available are of the so-called "open" variety or "closed". This article avoids any controversy about the merits of each but presents a method of surgery which in most cases will fulfil the above aims. The techniques of mastoid surgery are well documented. In this article, the finer points are discussed with emphasis on the areas which if insufficiently treated, will lead to recurrence of disease and continuing discharge. These areas are the anterior epi-tympanum, the recess between the tympanic membrane and the anterior and inferior canal walls, the facial ridge and the sump that can form behind it, the sino-dural angle and the mastoid tip.

Audiometry, Pure-Tone↗
PubMed1991

Defects in the bony wall of the mastoid bowl: a study based on staged intact canal-wall tympanoplasty.

The incidence and outcome of bony wall defects in the mastoid bowl were studied in 175 ears of 167 patients who underwent staged tympanoplasty by the intact canal-wall technique. In the first stage, the middle fossa dura was exposed iatrogenically in 38 ears and pathologically in eight ears through a defect at the tegmen. In the second stage, the bone defect was cured in 27 ears of the former group and in 3 ears of the latter group. The overall cure rate of the defect in the tegmen during these stages was 65.2 percent (30/46). Exposure of the sigmoid sinus or posterior fossa dura, which had occurred iatrogenically in 12 ears in the first stage, was cured in 11 ears (91.7%) in the second stage. Defects of the anterior wall of the mastoid bowl, i.e., the posterior wall of the external auditory canal, were recognized in 105 ears in the first stage, 91 of which involved pathologic defects of the tympanic scutum caused by cholesteatoma. In the second stage, these defects remained unhealed with cures occurring in only two ears (1.9%), in which a small hole had been created iatrogenically in the middle of the canal wall. Defects in the canal wall due to bone resorption following the first stage operation were noted in the second stage in 26 of 175 ears (14.9%).

Adolescent↗
PubMed1977

A mastoid osteoma causing intracranial complications. A case report.

A case report of a mastoid sinus osteoma with intracranial complications is presented. This is the first report of a mastoid osteoma causing intracranial complications. The tumour is one of the paranasal osteoma group. It produced displacement and compression of the posterior fossa structures. The patient was operated on by means of a combined intra- and extradural approach.

Cranial Nerves↗
PubMedDate not supplied

[Osteoma of the mastoid].

Osteoma of the mastoid is a osseous, benign and infrequent tumour. To date approximately 50 such cases in the world, and 7 cases in Spain have been described. Clinically this tumours are asymptomatic, except by cosmetic deformities, and are usually unsuspected roentgenographic findings. Treatment is surgical through a postauricular approach. A case of osteoma of the mastoid and a review of the literature is presented.

Adult↗
PubMed1990

A technique for the reconstruction of the posterior canal wall and mastoid obliteration in radical cavity surgery.

The open technique in cholesteatoma surgery has, besides a higher security concerning the recurrence of disease, some disadvantages: lifelong care for the cavity, often discharging granulations, and vestibular vertigo due to the lack of labyrinthine protection. Most of the disadvantages can be avoided by the obliteration of the mastoid cavity, for which many different techniques have been described in literature. The authors recommend a new method: the reconstruction of the posterior canal wall using autograft conchal cartilage and the obliteration of the mastoid cavity with hydroxyapatite granulate. The technique can be used for the treatment of old cavities as well as for one-stage surgery. The results of 25 cases are reported. Due to the elevation of the tympanic membrane on a nearly physiologic level and suitable tympanoplastic procedures an air-bone gap of less than 30 dB can be reached in more than 70%.

Adolescent↗
PubMed1988

[Mastoid brain herniation following a cholesteatoma operation].

In the pre-antibiotic era a herniation of brain tissue into the mastoid was a fairly frequent event following the transmastoid drainage of brain abscesses. Since the introduction of antibiotics and refinement of operative techniques a brain hernia into the mastoid has nowadays become very rare. Two almost identical cases of brain hernia in a radical mastoidectomy cavity were recently observed by the author. The surgical management is presented and the literature discussed.

Adult↗
PubMed1987

Mastoiditis.

Mastoiditis still occurs as a nonmeningeal complication of otitis media. Fever, postauricular swelling, tenderness of the ear pinna, severe otalgia and ear drainage are all typical clinical findings. Most commonly, the causative organisms are the same aerobic bacteria that are responsible for otitis media; however, anaerobic organisms must also be considered. Treatment for acute mastoiditis includes appropriate intravenous antibiotics and myringotomy for culture and drainage. Mastoidectomy is indicated if medical therapy fails.

Adolescent↗
PubMed1987

Menière's disease: results of treatment with the endolymphatic subarachnoid shunt compared with the endolymphatic mastoid shunt.

The senior author has performed 346 endolymphatic sac operations since 1971. Questionnaires were sent to these patients to evaluate the results of this surgery. One hundred ninety-six questionnaires were returned and formed the basis for this report. The results of surgery are reported by the new American Academy of Otolaryngology--Head and Neck Surgery criteria as well as by the older method of reporting. There is no significant difference in results between the endolymphatic subarachnoid shunt and the endolymphatic mastoid shunt. Because of the lower morbidity of the latter procedure the authors prefer the endolymphatic mastoid shunt. The new method of reporting is superior to the older method.

Academies and Institutes↗
PubMed1987

Results of endolymphatic sac to mastoid shunt surgery for Menière's disease refractory to medical therapy.

In the ten-year period ending July 1, 1986, 5475 dizzy patients were evaluated and treated medically at the Colorado Ear Clinic. Of these, 214 patients (4%) were diagnosed as having classic Meniere's disease refractory to medical therapy and underwent endolymphatic sac to mastoid shunt surgery. These patients were followed for a minimum of one year after surgery. The average audiometric follow-up was 35.1 months. Based on the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria for reporting results at one year, 60.3% had lower audiometric thresholds postoperatively (H1) or unchanged thresholds (H2) relative to the worst preoperative audiogram. Elimination of all vertiginous attacks was achieved in 73.9% (Vo). Adjunctive spells were not assessed. Disability was eliminated (Do) in 86%. Based on a prospective computerized analysis of forty pertinent variables, a profile of a classic Meniere's disease patient who has failed to improve with medical, allergic, dietary, exercise, or other conservative treatment and would be likely to benefit from endolymphatic sac to mastoid shunt surgery is established.

Adolescent↗