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At least 595 records · Page 33Linked to original sources
PubMed1999

Sensitivity to bone-conducted sound: excitation of the mastoid vs the teeth.

The sensitivity of nine subjects to bone-conducted sound was measured at three positions: osseointegrated percutaneous titanium implants in the temporal bone, the skin-covered mastoid and the teeth. Voltage levels supplied to a bone-anchored hearing aid (BAHA) transducer and to an Oticon bone-transducer were measured and the thresholds obtained at the three positions were compared. Using the mechanical impedance of the teeth, the parameters of a first order model for the vibration transmission through the teeth was calculated. Also, the equivalent force thresholds were calculated from the voltage threshold levels. The sensitivity to bone-conducted sound, for both voltage and force thresholds, conformed fairly well at the three positions for frequencies below 1 kHz; however, above 1 kHz, bone-conducted sound applied at the titanium implant becomes more sensitive than at the two other positions investigated. It was concluded that the teeth can be used for the application of bone-conducted sound, in particular for pre-operative assessment of a BAHA and to facilitate service and quality control of such a hearing device.

Adult↗
PubMed2001

Unusual presentation of mastoid eosinophilic granuloma in a young patient.

Eosinophilic granuloma is a well-recognized form of Langerhans cell histiocytosis, most commonly involving the skull bones, usually with an excellent prognosis. Recurrent and difficult to recognize osteolytic lesions of the skull are encountered only rarely. A patient with recurrent eosinophilic granuloma of the skull is reported. In spite of appropriate multimodality treatment, there were several recurrences, most recently with involvement of the mastoid process. Imaging studies revealed extensive involvement of surrounding structures with expansion of the tumor into the middle cranial fossa and slight pressure on the antero-medial portion of the temporal lobe of the brain. Despite extensive involvement, the patient had no complaints. Because of the rarity of such silent and unpredictable lesions, a systematic approach with regular CT and MRI follow-up is suggested.

Child↗
PubMed1994

Septic pulmonary emboli complicating mastoiditis: Lemierre's syndrome revisited.

Deep neck-space infections may cause potentially life-threatening complications of head and neck infections. Lateral pharyngeal space infections in particular predispose to development of suppurative jugular vein thrombosis, which may be associated with anaerobic bacteremia and septic pulmonary emboli (Lemierre's syndrome). We describe a case of Lemierre's syndrome, a very rare entity in the antibiotic era, complicating mastoiditis. Surgical debridement and drainage in conjunction with antibiotic therapy resulted in prompt improvement in the patient's condition.

Adolescent↗
PubMed1996

Otitis media and mastoiditis due to Mycobacterium fortuitum: case report, review of four cases, and a cautionary note.

Mycobacterium fortuitum is a rarely reported cause of otitis media and mastoiditis. We report such a case recently seen at our institution and review the four previously published cases of this disease entity. Amikacin is recommended in the current medical literature as empirical treatment of disease due to M. fortuitum, but the isolate from our patient showed high-level resistance to amikacin, which is rare in clinical isolates of this species; this resistance was probably related to prior treatment with topical aminoglycosides. Our patient's infection responded to a 12-month course of therapy with clarithromycin and trimethoprim-sulfamethoxazole.

Adolescent↗
PubMed2001

Facial nerve monitoring in middle ear and mastoid surgery.

HYPOTHESIS: Intraoperative electromyographic facial nerve monitoring, long accepted as the standard of care in surgery for acoustic neuroma and other cerebellopontine angle tumors, may be of aid in middle ear and mastoid surgery. STUDY DESIGN: Retrospective series of 262 cases of middle ear/mastoid surgery in which monitoring was performed by a neurophysiologist. METHODS: Neurophysiological monitoring events were classified as mechanical or electrical. The voltages producing facial nerve stimulation were compiled and compared with observed facial nerve dehiscence. RESULTS: The most common use of monitoring was localization of the facial nerve by electrical stimulation (60%) or identification of mechanically evoked activity (39%). In 57 cases (36%), the first electrical stimulation event evoked a facial nerve response at less than 1 V threshold, indicating little or no bony covering. The minimum stimulation threshold throughout each of these cases was less than 1 V in 88 of the 159 cases (55%) in which stimulation was attempted. In contrast, the facial nerve was visibly dehiscent in only 35 cases (13%). Neurophysiological monitoring confirmed aberrant facial nerve course through the temporal bone in four cases resulting in cancellation of surgical treatment in two cases. Postoperative facial nerve function was preserved in all cases when present preoperatively. CONCLUSIONS: An electrical stimulation threshold of less than 1 V is a more useful criterion of dehiscence than observation under the operating microscope. The absence of monitoring events allows safe dissection. Monitoring can help locate the facial nerve, guide the dissection and drilling, and confirm its integrity, thereby allowing more definitive surgical treatment while preserving neural function.

Adolescent↗
PubMed1995

Lateral sinus thrombosis associated with otitis media and mastoiditis in children.

Lateral sinus thrombosis (LST) is an infrequent complication of otitis media and mastoiditis in the antibiotic era. A recent case of LST in a 7-year-old boy, the third such case at our institutions in the past 5 years, prompted a review of the modern day English literature concerning LST in pediatric patients. Our goal was to highlight the clinical findings suggestive of LST in the antibiotic era as well as to analyze retrospectively the diagnostic and therapeutic modalities of greatest benefit based on the outcomes reported in the reviewed studies.

Anti-Bacterial Agents↗
PubMed2001

Turicella otitidis mastoiditis in a healthy child.

Turicella otitidis, a coryneform bacterium, has been associated with acute otitis media. A 5-year-old girl developed acute mastoiditis. Turicella was isolated from the right and left middle ear fluid.

Actinomycetales↗
PubMed2006

Internal jugular vein thrombosis associated with acute mastoiditis in a pediatric age.

OBJECTIVE: To discuss the clinical aspects and management of internal jugular vein thrombosis associated with acute otitis media. STUDY DESIGN: Case reports and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT: The authors describe two cases of internal jugular vein thrombosis, without sigmoid sinus thrombosis, secondary to acute otomastoiditis. INTERVENTION: Jugular vein thrombosis was diagnosed in both cases by observation of filling defects of the involved jugular bulb on contrast-enhanced computed tomography and confirmed by conventional magnetic resonance and magnetic resonance venography. RESULTS: Both patients recovered after recanalization of the vessel concomitant to anticoagulation and antibiotic treatment associated with a simple mastoidectomy. CONCLUSION: Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.

Acute Disease↗
PubMed2004

Otogenic Fusobacterium meningitis, sepsis, and mastoiditis in an adolescent.

Fusobacterium necrophorum is a strict anaerobic organism responsible for a number of clinical syndromes known as necrobacillosis. Although meningeal infections with anaerobes are rare, delayed diagnosis and treatment can be potentially fatal. We report a unique case of Fusobacterium meningitis, mastoiditis, and sepsis in a previously healthy adolescent. Diagnosis and management of this condition are discussed in the context of a literature review.

Adolescent↗
PubMed1980

Histopathology of the temporal bone after open mastoid surgery.

The ear that is deaf and continues to discharge after radical or modified radical mastoidectomy remains an unsolved problem for the otologist. The temporal bones of 17 patients in whom open mastoidectomy had been done during their life time were serially sectioned and examined. Histological changes secondary to surgery and chronic infection are described. The study fails to reveal a specific cause for unhealed areas in the mastoid bowl. It is suggested that the unhealed areas are caused by the unhealthy physical environment for the surface epithelium.

Cholesterol↗
PubMed1981

Plugging the mastoid cavity with Palacos R-a new technique to avoid recurrent cholesteatoma.

The requisite for the development of recurrent cholesteatoma caused by a retraction pocket is that the retraction takes place through a bottleneck into an otherwise closed cavity. In order to avoid this kind of recurrence either the bottleneck must be removed or the exenterated mastoid cavity must be plugged. This paper refers to an operation technique which was developed 14 years ago and which removes the bottleneck. Since, however, this technique leads in about half of the cases to an open cavity with the well-known disadvantages, we have tried to obliterate the cavity permanently following a posterior tympanotomy. Obliteration is achieved by means of Palacos R, which makes fixed contact with the bone. The technique and details of its application are described.

Cholesteatoma↗
PubMed1985

Large meatoplasty technique for mastoid cavities.

A large meatoplasty improves the postoperative management of mastoid cavities in providing good ventilation, preventing otorrhoea and allowing ease of inspection for removal of wax. A technique to provide a large meatoplasty is described and the results of 56 operations performed over a 5-year period are reviewed.

Adult↗
PubMed1987

Mastoid obliteration in intact canal wall mastoidectomy.

Long-term results following intact canal wall mastoidectomy with cavity obliteration were compared with those following similar operations leaving the mastoid cavity as an 'air reservoir'. The incidence of adhesive eardrums was the same (12%) in both groups. In other respects, the obliteration technique gave slightly better results than the 'air reservoir' technique. Cavity obliteration is recommended in intact canal wall mastoidectomy.

Adult↗
PubMed1991

Mastoid misery: quantifying the distress in a radical cavity.

Seventy-eight mastoid cavities were studied in 39 patients who required revision surgery for troublesome symptoms. A retrospective questionnaire was used to assign a symptom score to each patient in his pre and post-operative condition. The 5 leading symptoms of pain, wax, discharge, smell and giddiness were reviewed. A score of 15 points represented the worst case and zero the best. The average improvement after surgery was 4.7 points. Hearing was not considered in this study.

Humans↗
PubMed1994

Mastoid obliteration using bone pâté.

The technique of mastoid revision and obliteration using bone pâté and a superiorly based temporalis musculo-periosteal flap is described in detail. This method has evolved and been employed in our department over the past 10 years.

Bone Transplantation↗
PubMed1996

Long-term results of the use of cultured autologous epithelial cell grafting to mastoid cavities.

Thirty-nine patients (42 ears) who have had a cultured autologous epithelial cell graft technique to a continuously discharging mastoid cavity have been evaluated to determine the continued effectiveness of this procedure. A postal questionnaire indicated a 58% improvement in both the smell and quantity of discharge, and our conclusion is that this is a very effective measure to provide extended symptomatic improvement in this troublesome condition.

Adult↗
PubMed1975

Radiation therapy in the management of carcinoma of the external auditory canal, middle ear, or mastoid.

Twenty-three patients with squamous-cell carcinoma of the external auditory canal, middle ear, or mastoid were treated with combined surgery and irradiation, giving a 5-year NED rate of 48% (11/23). Except in extremely early lesions without bone involvement, treatment by radiation therapy alone was rarely successful and is not recommended. The most serious complication was osteoradionecrosis of the temporal bone; this occurred in 5 patients, all of whom received more than 2,100 rets due to faulty radiotherapeutic technique.

Boston↗
PubMed1977

Epidural mastoid pneumatocele.

The authors report a case of a gas-filled epidural cyst communicating with the mastoid air cells, causing fluctuating but progressive amaurosis. No prior report of a similar finding could be found in the literature.

Dura Mater↗