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[Tuberculous otitis media, mastoiditis associated with meningitis: report of one case].

Tuberculosis of the middle ear is rare; associated meningitis is even more unusual. This report contains our experience with a one and a half year old psychomotor retarded boy. He had a poor healing left postauricular abscess four months prior to admission. Also noted was postprandial vomiting and left sided involuntary movement. On admission spinal tapping was done. Results showed leukocytosis, with lymphocytes being predominant, as well as high protein and low glucose levels. A cranial CT revealed left mastoiditis, hydrocephalus, basal cistern abnormal enhancement and a prominent posterior fossa postcerebellar CSF space. Left radical mastoidectomy was performed. A biopsy showed caseous necrosis surrounded by epitheloid and Langhan's giant cells. He also received a ventriculoperitoneal shunt. The gastric and CSF were both positive for tuberculous culture.

Humans↗

Operations on the middle ear and mastoid.

From 1953 to 1957, inclusive, 373 patients were operated on for chronic mastoid disease at the Mayo Clinic. Mainly because of the extensive use of magnifying glasses and microscopes, through these years, closer attention has been given to the preservation or improvement of hearing by meticulous procedures on the structures of the middle ear and the use of skin grafts. It is stressed, however, that it is extremely important to eradicate the underlying disease. Illustrative cases to represent different types of procedures are presented. The author recommends closer attention to the condition of the round window in the future.

Ear, Middle↗

[Pneumocephalus as a complication of mastoid surgery].

Non-traumatic otologic diseases are a rare cause of pneumocephalus. Among them, few reports have been described whereas it occurred following oto-surgery. We present a case report of pneumocephalus in a patient who presented with CSF-otorrhea, headache, disorientation, after recent mastoid radical surgery. The definite diagnosis was done by CT scan imaging. We realize a review of the literature about this subject, we describe the clinical and diagnostic features, its possible physiopathology, and its surgical management.

Aged↗

[Conservative therapy of mastoiditis and therapeutical indications of mastoidectomy until the end of XIX century. The achievements of Varsovian physicians].

The problem of treatment of the mastoiditis was discussed long ago--in XVII and XVIII centuries by Jean Riolan (1580-1657), Werner Rolfinck (1599-1673), Jean L. Petit (1674-1750), Jasser and the others. The therapeutic indications of mastoidectomy in 1873 by Hermann Schwartze (1837-1910) is mentioned. The achievements of such German physicians as Friedrich Bezold (1842-1908) and Ernst Küster (1839-1930) are described in detail. The achievements of such Varsovian physicians as Teodor Heiman (1848-1917), Andrzej Alfred Heiman (1984-1933), Edmund Modrzejewski (1849-1893), Samuel Meyerson (1851-1939) and Ludwik Guranowski (1853-1926) are also presented.

Clinical Competence↗

Cervical necrotising fasciitis consequent to mastoid infection.

We present a case of cervical necrotising fasciitis in a 56 year old man, secondary to a rare mastoid infection. The patient had coexisting diabetes mellitus and hypertension. He was treated with early surgical debridement followed by neck and chest reconstruction and radical mastoidectomy. Aggressive antibiotic therapy and supportive care was given. He recovered well with minimal residual functional deficit.

Fasciitis, Necrotizing↗

A hairy polyp of the middle ear and mastoid cavity.

A case of a 'hairy polyp', a dermoid tumor of the middle ear and the mastoid cavity is described, which is very unusual location. The radiological, surgical and histological features are discussed. Comment is made on the differentiation between dermoid cysts and teratomas and on the scarcity of both tumors in the area of the temporal bone.

Dermoid Cyst↗

Parosteal osteosarcoma of the mastoid bone following radiotherapy for nasopharyngeal carcinoma.

Radiation-induced tumors subsequent to nasopharyngeal carcinoma are very rare. To date, no post-irradiation parosteal osteosarcoma of the craniofacial bone has been reported in the English literature. In October 2000, a 57-year-old Chinese woman presented 5 years after radiotherapy for nasopharyngeal carcinoma with a 6-month history of a gradually enlarging left postauricular mass. CT scans revealed a densely calcified mass with radiating bony spicules, applied to left mastoid tip. The lesion was excised en-bloc through a postauricular incision. The histologic diagnosis was a parosteal osteosarcoma. Because of inadequate safe margins and the patient refusal of another surgery, 6600 cGy of radiation was subsequently administered to the temporal bone. Post-operative follow-up in 3 years was negative for any evidence of tumor recurrence and post-irradiation complications.

Female↗

[Assessment of electrical conductivity in the points of mastoid region of the head in patients with blood circulation disorders in vertebrobasilar vessels].

The conductivity of the points of mastoid region of the head in 145 patients with blood circulation disorders in vertebrobasilar vessels has been measured to determine reliability of electropuncture diagnostics in patients with such a condition. The measured indices significantly differentiated from indices of the control group. The method also showed the significant difference among groups of patients varied by severity of the pathological process. It enables to discern the pathology and substantiate the use of method.

Acupuncture Points↗

Actinomyces infection of the mastoid: a rare entity.

A rare case of mastoid infection caused by actinomyces israelii is presented. This patient underwent exploratory mastoidectomy followed by long term oral pencillin. She responded well to the treatment and has been asymptomatic on follow up to date.

Actinomycosis↗

Rhabdomyosarcoma of the middle ear and mastoid: a case report and review of the literature.

We report a case of rhabdomyosarcoma of the middle ear and mastoid in a 3-year-old boy. The patient was treated according to Intergroup Rhabdomyosarcoma Study IV protocol (chemo- and radiotherapy), and he experienced a complete remission. However 7 months after the completion of treatment, he experienced a recurrence at the primary site that spread to the brain. Despite treatment, the patient died of progressive metastasis to the lung 4 months later.

Child, Preschool↗

[Osteoma of the mastoid].

Report of a large ivory-like Osteoma of the mastoid surgically removed. Some pathological, clinic and therapeutic considerations about the subject are added.

Adult↗

Radiographic identification by mastoid sinus and arterial pattern.

A skull and some incomplete postcranial remains were discovered in two searches over a two-month period near Santa Fe, New Mexico. The discoveries could be demonstrated to be from the same person, and the remains were shown to be consistent with a specific missing person on the basis of anthropological analysis. Further work led to a positive identification on multiple grounds, including agreement of the details of the mastoid sinus and endocranial arterial patterns observed radiographically. These features may be useful for establishing positive identification from skeletal remains when antemortem radiographic studies for comparison are limited to lateral cranial vault studies.

Adult↗

Three 'silent' mastoid abscesses.

Acute mastoiditis with abscess formation is uncommon, its incidence being modified by modern antibiotic usage for acute suppurative otitis media (ASOM). It tends to occur in young children who have no previous history of ear disease. The diagnosis is a clinical one, and treatment requires hospital admission and some form of surgical drainage procedure, in order to prevent intracranial complications, eg, meningitis and intracerebral abscess.

Abscess↗

[Secretory otitis media and mastoiditis in children].

In 1984-1987 the authors followed up a selected group of 15 children with a long-standing history of secretory otitis media and latent mastoiditis. In there of them the condition was complicated by labyrinthitis. Mastoidectomy which was performed in 12 children contributed to the healing of chronic inflammatory changes in the middle ear.

Acute Disease↗

MRI of mastoid and middle ear disease.

MR and CT are complementary studies in evaluating inflammatory disease or neoplasms of the mastoid and middle ear cavities. CT should be performed prior to MR in the evaluation of patients with primary temporal bone pathology because of its ability to detect and delineate both soft tissue and bony abnormalities. CT should be performed whenever intratympanic or facial nerve pathology is suspected, even if the MR examination is normal. MR can be used to further characterize tympanic cavity masses as effusion, glomus tumor, hemorrhage or cholesterol granuloma. The prospect of Gd-DTPA-enhanced MR promises increased sophistication in the detection of glomus tumors and facial nerve neuromas. Noncontrast MR cannot differentiate between cholesteatoma and granulation tissue. The efficacy of Gd-DTPA in inflammatory disease of the temporal bone awaits further investigation.

Ear Diseases↗