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PubMed1986

Prevalence of otitis media in children in a black rural community in Venda (South Africa).

During mid-winter in 1985, 480 residents from a remote rural community in Venda, South Africa, were examined for the presence of middle and external ear pathology. The children (less than 15 years) numbered 267. The otological examination consisted of (1) pneumatic otoscopic examination, (2) tympanometry, (3) contralateral acoustic reflex. A diagnostic algorithm as proposed by Cantekin et al. was applied to assess the findings. Our data showed the prevalence of otitis media in children to be 8.2%. The highest prevalence was found in the 0-23 months age group. Of 22 children with otitis media, only one had a perforation with otorrhea. Otitis media with effusion was found in 3.8% of the children. External otitis media as an independent variable was found in only 1.5% of the 267 children, while 6.7% presented with scarred tympanic membranes. Our data suggest the existence of considerable differences in the prevalence of otitis media in children between two comparable black rural communities from Nigeria and Venda.

Acoustic Impedance Tests↗
PubMed1999

Langerhans' cells histiocytosis.

Langerhans cell histiocytosis (LCH) is a rare disorder of unknown cause, characterized by the proliferation of histiocytic cells in various tissues and organs. The role of the otolaryngologist is important in the early and accurate evaluation, staging and diagnosis of LCH, because it may mimic more common diseases such as otitis externa and acute mastoiditis. We discuss a case report of bilateral mastoid involvement in a child with a history of otalgia unresponsive to medical therapy.

Acute Disease↗
PubMed1980

Dermatologic aspects of sports medicine.

The skin lies at the interface of the athlete and the sports milieu and is subjected to many sports-related dermatoses. Direct traumatic injuries, such as friction blisters, black heel, piezogenic papules, and traumatic subungual hematomas, occur regularly. Environmental insults such as sunburn, cold-induced injury, and contact dermatitis plague the sportsman. Cutaneous infections such as "athlete's foot," otitis externa, herpes simplex, and warts occur because of a favorable microenvironment, occurring with sweating and occlusion as well as close interpersonal contact. Sports participation may uncover or exacerbate latent dermatoses such as occurs in acne mechanica and exercise-induced anaphylaxis. The sportsman is best served if the physician considers him as an athlete-patient.

Athletic Injuries↗
PubMed1995

Evaluation of temporal and facial osteomyelitis by simultaneous In-WBC/Tc-99m-MDP bone SPECT scintigraphy and computed tomography scan.

A reliable imaging technique is needed for follow-up of patients with temporal and facial osteomyelitis. Clinical outcome in 20 patients with suspected osteomyelitis of the temporal/mastoid, calvarium, and mandible facial bones was evaluated with 30 combined In-WBC/Tc-99m MDP bone single photon emission computed tomographic (SPECT) scans and 27 computed tomographic scans. Simultaneous dual-tracer 25-minute SPECT scans were acquired 18 to 20 hours after radiotracer injection by use of a three-detector system. Diagnosis of the 20 patients (age range, 3 to 74 years) included 8 with facial osteomyelitis, 6 with malignant otitis externa, 3 with mandibular osteomyelitis, and 3 with calvarial osteomyelitis. Diagnosis was confirmed by biopsy/culture results in 18 patients and by endoscopic and clinical evaluation in 2 patients with initial negative scans. Of the 30 In-WBC/MDP scans, 15 were true-positive, 13 true-negative, 1 false-negative, and 1 equivocal. Of a total of 27 CT scans, 9 were true-positive, 5 false-negative, and 1 equivocal in patients with biopsy-proven osteomyelitis. Three computed tomographic scans were false-positive and 1 was equivocal in patients without osteomyelitis, because of concurrent postoperative bone abnormalities. Additionally, 8 computed tomographic scans were true-negative. These results suggest that dual In-WBC/Tc-99m MDP bone SPECT scintigraphy provides an accurate imaging modality for diagnosis and follow-up of temporal and facial osteomyelitis when existing clinical or postoperative bone changes make it difficult to detect active osteomyelitis by computed tomographic scan.

Adolescent↗
PubMed1990

Long-term management of atopic disease in the dog.

Canine atopy is a common dermatologic disorder. Because the disease most frequently strikes young dogs, lifetime management strategies are necessary. Consideration must be given to the treatment of pruritus and secondary manifestations of the allergy, such as pyoderma, otitis externa, and seborrhea, to manage these patients successfully. The use of glucocorticoid therapy and hyposensitization are discussed.

Animals↗
PubMed1995

Facial, pedal, and other regional dermatoses.

This article discusses disorders of the head and face, including feline acne, solar dermatoses, pruritus of the head and neck, and nodular or ulcerative dermatoses of the head. Disorders of the pinna, otitis externa, and nasal diseases are highlighted. In addition, a discussion of pododermatitis and diseases of the claws and ungual fold is presented. Miscellaneous regional dermatoses include midline ulcerative dermatitis, stud tail, and vaccine-induced lesions.

Animals↗
PubMed1997

Ear disease and its management.

Tissue changes, diseases or factors predisposing to, bacteria and yeast associated with, diagnosis of, and management of otitis externa, media, and interna are discussed in this article.

Aging↗
PubMed1999

Nonorthopaedic problems in the aquatic athlete.

This article discusses a number of medical conditions that are common to aquatic athletes. Exercise-induced asthma is particularly prevalent in swimmers because swimming is among the activities tolerated best by asthmatics. The healthcare professional frequently must evaluate and manage respiratory infections and infectious mononucleosis in swimmers, particularly in regard to the safe timing of return to training and competition. Dilutional sports pseudoanemia must be differentiated from the true anemias that are due mostly to iron-deficiency and intravascular hemolysis. Finally, the evaluation, management, and prevention of otitis externa, external auditory canal exostoses, and dermatologic disorders in swimmers are reviewed.

Anemia↗
PubMed1999

Less radical drilling in surgery for exostoses of the external auditory canal.

OBJECTIVE: To estimate the anatomical and functional long-term result of surgery for ear canal exostosis. METHODS: Case rapport review with extraction of data concerning pre- and postoperative anatomical conditions, symptoms and audiology and a clinical and audiological re-evaluation. In the 20-year-period from 1 January 1976 to 1 January 1996, 26 patients were operated on primarily for ear canal exostosis. 19 patients with in total 24 ears were re-evaluated. Control-period 7.2 years. Pre-operatively were found occluding ear-canal exostosis in all patients as well as hearing loss, otitis externa and pain. RESULTS: At the re-evaluation all patient were completely free of their symptoms. 19 out of 24 ears still had some remnants of exostosis, but the ear canal was covered with completely normal skin and had normal migration properties. No signs of re-growth were found in this material. Postoperatively one patient had a sensorineural hearing loss of 85 dB at 6 kHz, one had a dehiscence of the temporomandibular joint and one patient had an anterior ear drum perforation. CONCLUSION: To avoid the complications a less radical drilling of exostoses is proposed, in particular along the superior wall and near the short process of the malleus handle and along the anterior tympanomeatal angle. Removal of the bone from the posterior, inferior and anterior walls with preservation of the canal skin, creates enough lumen providing permanent cure.

Adolescent↗
PubMed2004

Acute injury and chronic disability resulting from surfboard riding.

We undertook a cross-sectional survey of surfers at eight Victorian beaches between February and May 2003 and analysed acute injury and chronic disability sustained while surfing during the preceding 12 months. Significant injuries were defined as requiring medical attention or time off surfing/work. 646 surfers were enrolled (90.2% male, median age 27 years, median years of surfing 10). 145 surfers sustained 168 significant acute injuries in the preceding 12 months (0.26 injuries/surfer/year, 95% CI 0.22-0.30). Most were caused by striking a surfboard or another surfer (45.2%, 95% CI 37.6-53.1), "wiping out" (36.3%, 95% CI 29.1-44.1) or striking the seabed (17.9%, 95% CI 12.6-24.7). Injuries included lacerations (46.4%, 95% CI 38.8-54.3), sprains (28.6%, 95% CI 22.0-36.1), dislocations (10.7%, 95% CI 6.7-16.6) and fractures (8.9%, 95% CI 5.3-14.6). Body parts most frequently injured were the lower limb (45.8%, 95% CI 38.2-53.7) and the head/face (26.2%, 95% CI 19.9-33.6). Surfing injuries that were treated in Victorian emergency departments over a six year period revealed a similar pattern, although there was a greater proportion of head/face injuries (42.0%, 95% CI 36.0-48.1, p = 0.001). 20 surfers reported long-term effects from acute injuries, mainly unstable/stiff/painful joints. 136 surfers reported chronic health problems not related to acute injury including chronic/recurrent otitis externa and exostoses, muscle and joint pain/stiffness and pterygium. Significant injury while surfing is not uncommon. Although head injury accounts for a considerable proportion, very few surfers wear protective headgear. Greater use of protective headgear should be considered.

Adolescent↗
PubMed1989

Evaluation for waterproof ear protectors in swimmers.

The middle ear cavity is exposed and vulnerable to waterborne infection in patients with grommets, perforated tympanic membranes and after radical mastoidectomy. Patients suffering from chronic otitis externa and those receiving radiotherapy to the head and neck also have an increased susceptibility to such infections. Many advocate the use of waterproof ear protectors in such patients when swimming. The choice of a suitable ear protector is complicated as many are now available commercially. This study was therefore designed to evaluate the degree of protection afforded by seven different ear protectors in a group of six swimmers. A very sensitive, original method of water detection was devised incorporating a pH indicator strip. The results showed conclusively that cotton wool coated in paraffin jelly BPC was the most effective method of ear protection and was found to be comfortable and easy to use. Other methods, including custom-made silicone rubber plugs, were not adequate in sealing the external auditory canal and are considerably more expensive.

Adolescent↗
PubMed1990

Typing of Pseudomonas aeruginosa ear infections related to outcome of treatment.

Of 142 patients with Pseudomonas aeruginosa (PSA) ear infections, 88 (62 per cent) had chronic otitis media and 54 (38 per cent) external otitis. Following serotyping and pyocin typing of their bacteria, and relating the type to outcome, patients could be divided into three groups: (1) 120 patients who had no recurrence with isolation of only one PSA strain, (2) 13 patients who had recurrent infections and in whom the same PSA strain was isolated in repeated cultures, and (3) nine patients who had recurrent disease, but who had a change in their PSA strains. Most of the PSA strains isolated from patients in groups (1) and (2) were stable to pyocin, and resistent to gentamicin. Patients in the first group were all cured initially by medical management. Of the nine patients in group (3) who had a different serotype on repeated cultures, medical treatment was successful in eight (89 per cent), but of the 13 patients in group (2) who had the same Pseudomonas aeruginosa serotype cultured, medical therapy failed in six (46 per cent) and mastoid surgery was required. Serotyping of Pseudomonas aeruginosa otitis may be helpful in predicting the type of management in patients who have recurrent infections.

Adolescent↗
PubMed1994

Wegener's granuloma--presenting as a unilateral parotid swelling.

Wegener's granuloma is a systemic necrotizing vasculitis which predominantly affects the upper and lower respiratory tracts and kidneys. The nose and paranasal sinuses are often the first or main sites to be affected. Equally ear involvement is common and a recognized early manifestation of the disease. Salivary gland involvement is rare and is usually part of more widespread systemic involvement. We present a 34-year-old female with a six-week history of hearing loss and a unilateral parotid swelling. One year previously she was diagnosed as having myalgic encephalomyelitis following a long period of post-viral malaise. The case points to the difficulties encountered when Wegener's granuloma presents in an unusual and varied way. A high index of suspicion coupled with early diagnosis and treatment is essential. The patient made a good recovery.

Adult↗
PubMed1997

Benign necrotizing osteitis of the external auditory meatus.

Benign necrotizing osteitis of the external auditory meatus is a rare condition which occurs in non-diabetic healthy people. The aetiology of the necrotic process with the formation of sequestrum in the bony external meatus is unknown. It is important to differentiate this benign process from malignant otitis externa and radionecrosis of the temporal bone as the management of these conditions differs. We present two cases, one managed surgically and the other medically, and review the literature. Immediate surgical excision of the sequestrum is advocated instead of long-term medical therapy and waiting for it to separate spontaneously.

Adult↗
PubMed1998

The antibacterial activity of acetic acid and Burow's solution as topical otological preparations.

At present there are no topical otological preparations on the World Health Organisation's essential drug list, largely due to the ototoxic potential of preparations containing aminoglycoside antibiotics. Acetic acid and Burow's solution have long been used in the treatment of the discharging ear. The aim of this study was to ascertain the antibacterial activity of these two preparations against the most commonly occurring bacteria isolated from discharging ears in our department. Twenty fresh isolates of each of the following organisms--Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis and Streptococcus pyogenes--were plated onto blood agar and tested against one per cent, two per cent and three per cent acetic acid and Burow's solution (13 per cent aluminium acetate). The activity of each agent was ascertained by the size of the zone of inhibition of bacterial growth. Burow's solution showed significantly larger average zones of inhibition than acetic acid (p < 0.001). The two per cent and three per cent acetic acid as well as the Burow's solution were active against all the organisms tested.

Acetates↗
PubMed2006

A comparative evaluation of ear diseases in children of higher versus lower socioeconomic status.

This study was conducted with an aim to assess the prevalence and profile of ear diseases in children from the higher and lower socioeconomic strata of society. Two groups of schools within Delhi were selected. Group A comprised of government schools located in slum areas with an average parental income of INR (Indian National Rupees) 1050 per month and group B of elite private schools with an average family income of TNR 35,000 per month. Three thousand children between the ages of 5-12 years were screened with the help of a written proforma and ear examination. Tympanometry and audiometry were done, where required. 19.6 per cent of children of group A were found to be suffering from ear diseases compared to 2.13 per cent of group B children. The two groups were also compared for number of family members, status of hygiene and parental education.

Baths↗