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At least 109 records · Page 6Linked to original sources
PubMed1986

Comparative study of otologic surgery in outpatient and hospital settings.

The results of nine years' experience with 1,750 otologic surgical procedures are reviewed; 1,110 of these procedures were performed in an outpatient surgical setting and 640 procedures were performed in a general hospital. The results and complications are compared between these two settings. This study includes tympanoplasty, stapedectomy, mastoidectomy, labyrinthectomy, and other otologic procedures. The study is not concerned with minor procedures such as myringotomy. A detailed analysis of results for each type of procedure compares hearing results, graft take rates, and the occurrence of complications in both outpatient and inpatient settings. No significant differences are seen between the results or complications of outpatient and inpatient procedures, thus supporting the use of outpatient surgical settings for most standard otologic procedures.

Ambulatory Surgical Procedures↗
PubMed1991

[Neuro-otological study on Behçet disease].

It seems acceptable that pathological brain stem lesions exist in the patient with Neuro-Behçet disease (NB). However, only few reports have been published in this field. We report the neuro-otological findings in 33 patients who fulfilled the diagnostic criteria of Behçet disease completely or incompletely. The patients were classified into 2 groups: one is group of NB and the other is a group of Behçet disease without NB (non-NB). Furthermore, the latter was divided into 2 subgroups of patients with dysequilibrium and patients with normal equilibrium. They underwent equilibrium function tests, such as body balance test, gaze test, spontaneous and positional nystagmus test, eye tracking test (ETT) and optokinetic pattern test (OKP) by using electro-nystagmography (ENG). The following results were obtained. 1. Cerebellar and brain stem lesions were confirmed in all cases of NB group. 2. Most cases (6 of 8 cases) in the subgroup of dysequilibrium of the non-NB group showed peripheral vestibular disturbance. The other two patients were diagnosed to be vertebro-basilar insufficiency (VBI) and vascular Behçet disease with CNS disorder, respectively. 3. Nine of 13 patients in the normal equilibrium subgroup of the non-NB group were diagnosed to be neuro-otologically normal. However, we found two patients with peripheral vestibular disturbance and CNS disorder associated with hearing disturbance of the retrocochlear origin, respectively. 4. The neuro-otological examination is assumed to be useful to diagnose neuro-Behçet disease, to reveal the lesion site and the state of dysequilibrium in patients with Behçet disease.

Adolescent↗
PubMed2004

Otologic blast injuries due to the Kenya embassy bombing.

Otologic injuries are frequently associated with large blasts. On August 7, 1998, a large truck bomb exploded next to the U.S. Embassy in Nairobi, Kenya. Initial patient findings and care are reviewed. Five months later, an otologic screening and care mission was then sent to comprehensively screen all remaining blast victims on site in Nairobi and to determine degree of persistent injury. Surgical care appropriate for an outpatient environment was provided. Five of 14 tympanic membranes without intervention failed to heal, while 3 of 3 with previous intervention had. Blast injury severity did not correlate to distance from blast epicenter. This may be due to channeling of the blast through the embassy building and an unpredictable pattern of blast overpressure within the building. It is recommended that comprehensive otologic screening be performed after blast events to identify occult injuries and improve outcomes. Early intervention for tympanic membrane perforation (suctioning, eversion of perforations, and paper patch) is recommended.

Blast Injuries↗
PubMed1999

From the roots of otology: diseases of the ear and their treatment in Byzantine times (324-1453 A.D.).

HYPOTHESIS: The aim of this study is to present the therapeutic methods and surgical techniques in diseases of the ear during Byzantine times (324-1453 A.D.). BACKGROUND/METHODS: The original Greek language texts of the Byzantine medical writers were studied to research early otologic knowledge of symptomatology, conservative treatments, and surgical confrontation of diseases of the ear. RESULTS: A considerable number of conservative treatments for many otologic conditions were identified; these therapies were especially based on herbs, animal and mineral substances applied either as eardrops, clysters, poultices, or by using special instruments and apparatus. Among these were identified otitis, rupture of the eardrum, hemorrhage from the ears, deficiency of hearing and deafness, vertigo, tinnitus, and earwax. Furthermore, in these early texts, there were also described some surgical techniques in cases of atresia of the external auditory canal, of defects in or lack of the pinna, and for removal of foreign bodies and fleshy tumors. Some of the earliest hearing aids were also mentioned. CONCLUSIONS: From the study of the original works of Byzantine writers, it is evident that numerous treatments and surgical techniques relating to otology were practiced; these were derived not only from compilation of knowledge obtained from the ancient Greek medical sources, a considerable part of which are now lost, but also enriched by Byzantine physicians' personal experience. This knowledge influenced medieval European medicine and, through it, that of the rest of the world.

Byzantium↗
PubMed2001

[Birth of otology illustrated by original texts].

To be born, to appear, to begin. Though setting the birth of otology in the 19th century may seem a bit pretentious, the texts published at that time are ample proof of the fact. The combined impact of technical, scientific, medical and social factors led to the development of otology as a medical specialty. We discuss these different aspects in this article, illustrating them with extracts from the texts of the era. Once could say that the first half of the 19th century was a period of gestation for otology that was to come into full bloom during the second half of the same century.

England↗
PubMed2002

Otological disorders in Down's Syndrome.

OBJECTIVE: To assess if children with Down's Syndrome have a higher prevalence of otological abnormality compared to their normal counterparts in Malaysia. METHODOLOGY: Thirty children with Down's Syndrome and normal children underwent otoscopic ear examination and Impedance test in the ENT outpatients clinic in University Hospital, Kuala Lumpur, Malaysia. RESULTS: The study showed that children with Down's Syndrome had higher otological disorders. Forty four percent had impacted wax compared to 14.4% in normal children. Twenty one percent of ears in the study group had retracted drums compared to 6.6% of control. Fifteen percent of ears in the study group had middle ear effusion compared to 3.4% in controls, 55% had a type B tympanogram compared to 8.3% in controls and 73.4% had auditory canal stenosis compared to 14.4% in controls. CONCLUSION: Children with Down's Syndrome, thus have a higher incidence of otological disorders.

Child↗
PubMed2003

Utilization and perceived benefits of postoperative otology in-service training for inpatient nurses.

This study examined the perceived effectiveness of in-service training (IST) to improve the nursing care of post-operative otology patients as a function of nursing experience. IST was administered to four distinct units in a large university hospital, examining nurses with a range of experiences in otology care. An eight-item IST evaluation instrument was developed, administered, and validated for this study. The results of this study indicate the following: a variation existed among units in the receptiveness to IST; a 15-20-minute IST session significantly improved the perceived ability to deliver quality patient care; similar effectiveness of the IST was observed for all otology care groups; and an oral IST approach was more effective than a self-study approach. Further, we found that IST increased awareness and utilization of specialty support services.

Attitude of Health Personnel↗
PubMedDate not supplied

[Otology in diseases of internal medicine interest].

Many clinical manifestations present signs of cochleovestibular impairment. In some cases, otological symptoms are a complication of a disease, while in other cases they are the only early signs and can last for a long period preceding the full development of the primary disease. The otological pathology in the former case is useful for investigating the internal pathology and sometimes for delivering correct diagnosis. On the contrary, in the latter case, it does not offer elements for any etiopathogenic hypothesis because it happens in almost all cases with an acute onset in an otherwise healthy subject and it is always underestimated because of the minor functional impairment. However, clinical studies in the last years led to a significant evolution of otological findings as an early important symptom in the etiopathogenic study and in the diagnosis of some internal diseases. This is true for connectivitis, in which the disease is often preceded by a sudden cochleovestibular symptom, in some dismetabolic or vascular diseases that sometimes begin with fluctuating hearing loss, or in some cochlear manifestations due to ototoxic origin.

Carboplatin↗
PubMed1989

Otologic surgery in the outpatient versus the hospital setting.

The results of 11 years experience with 1,577 otologic surgical procedures performed in The Ear & Nose-Throat Clinic, P.A. in Little Rock, Arkansas, a freestanding outpatient surgical setting, are analyzed and compared to 703 hospitalized inpatient cases performed during the same time period. This study includes tympanoplasty, stapedectomy, mastoidectomy, labyrinthectomy and other otologic procedures. Analysis of results in these cases compares hearing results, graft take rates and the occurrence of complications in both the outpatient and inpatient settings. No significant differences are seen between the results or complications in these settings, thus supporting the use of outpatient surgical settings for most standard otologic procedures.

Ambulatory Surgical Procedures↗
PubMed1988

Autoimmunity and otologic disease: clinical and experimental aspects.

Each of the anatomic structures of the ear (external, middle, and inner) is subject to immunologic influence and injury. Studies in experimental animals have shown that primary immune responses to foreign antigens can be induced within the middle and inner ear as indicated by (1) infiltration and local persistence of mononuclear leukocytes and plasma cells, (2) appearance of antibody in perilymph, and (3) eventual development of systemic immunity. Protective effects of inner ear immunization against subsequent viral challenge have also been shown. Clinically, otologic disease can occur in association with a wide variety of systemic autoimmune and immunologic disorders: systemic lupus erythematosus, rheumatoid arthritis, Behçet's disease, Sjögren's syndrome, relapsing polychondritis, ulcerative colitis, Cogan's syndrome, and vasculitis-related disease. Evidence for immunologic involvement has also been found in cases of idiopathic sensorineural hearing loss frequently accompanied by vestibular-dysfunction (Meniere's disease). Many of these cases progress into systemic autoimmune disorders. Autoimmune-associated hearing loss has been recognized as one of the few types of treatable hearing dysfunction, with good responses to immunosuppressive therapy. The pathogenesis of autoimmune-related otologic disease has not been established; however, evidence suggests three possible types of immunologic injury: (1) autoantibody binding to type II collagen or other otologic components (type II immunologic injury); (2) immune complex formation leading to vasculitis (type III); and (3) T cell-mediated autoreactivity to inner ear membranous elements (type IV). These mechanisms may not be mutually exclusive. Clinical laboratory procedures should be directed at evaluating these possibilities to assist in diagnosis.

Animals↗
PubMed1984

Clinical manifestations of otological syphilis.

One patient with early otological syphilis and five patients with late otological syphilis are described including audiological and serological findings. In patients with late syphilis poorer than expected speech discrimination scores relative to the pure tone audiograms were noted. Profound hypo-activity of vestibular responses to caloric stimulation was present in the cases of late otological syphilis. Routine non-treponemal serological tests were not sensitive enough to establish the diagnosis. It is recommended that more sensitive treponemal serological tests such as the FTA-ABS should be employed.

Adult↗
PubMed1981

Otologic aspects of ear burns.

Otologic experiences in a large burn center are discussed and the following areas are emphasized. First, the otologic effects of hyperbaric oxygen therapy and the prevention and treatment of barotrauma that is occasionally secondary to this therapy. Second, the diagnosis and treatment as well as the prevention of perichondritis in severely burned ears will be discussed. A total of thirty-five cases of perichondritis will be reviewed. An encouraging aspect of the method of treatment has evolved over the past five years: there has been a minimum of deformity in the healed ear, with no subsequent reconstruction necessary. My experience stresses the importance of otologic supervision and ready consultation in all ear burns, and cooperation with the surgeons in charge of the overall care of the burn patient.

Adolescent↗
PubMed1996

[Neuro-otological complications of middle ear infections; the importance of early diagnosis].

OBJECTIVE: Determination of characteristic signs for the early diagnosis of neuro-otological complications of otitis media. DESIGN: Retrospective. SETTING: University Hospital Groningen, the Netherlands. METHOD: The medical histories of 11 patients with neuro-otological complications of otitis media were analysed. The time interval between the first manifestation of symptoms related to the complication and the start of correct therapy was established. RESULTS: In 10 of the 11 patients persistent fever and (or) headache were manifest as early symptoms. More severe morbidity was correlated with an increased time interval between the early symptoms and the start of treatment. Doctor's delay was regarded as the most significant delaying factor. CONCLUSION: Early diagnosis of neuro-otological complications of otitis media based on the early symptoms persistent fever and headache can reduce morbidity and mortality.

Adult↗
PubMed1998

A history of otology through the development of scientific and medical thought.

The story of the development of civilisation and of humanity is at the base of science, medicine and otology in particular. The evolution of knowledge is better understood by dividing the story into chronological periods. Through primitive, archaic, hellenistic, byzantine, arabian, monastic, scholastic, Renaissance, modern and finally contemporary medicine, otology has progressively found its way. The key to progress is within man, in his conception of life and of the world around him. Otology will be affected by these different trends of thought and will find its place in medicine during the XIX Century, the XX Century being its most prolific period.

Byzantium↗
PubMedDate not supplied

Long-term otologic status of older cleft palate patients.

The purpose of this study was to evaluate the effectiveness of regular otologic care on the long-term outcome in patients with cleft palates. We report the otoscopic and audiologic findings of 50 patients who were followed regularly at our center for an average of 15.4 years. All these patients had their cleft palates repaired by the same surgical team and all ears were examined by one of the authors under the microscope and a chart review completed. Thirty eight patients had at least one tube placement. The physical abnormalities noted were tympanosclerosis (36%), retraction of tympanic membrane (TM) (20%), atrophy of TM (15%), perforation (11%), PE tube in situ (11%), thick TM (6%) and PE tube in middle ear (1%). The examination was normal in 36%. A conductive loss was noted in 18% and sensorineural loss in 3%. The results of this study support the concept of regular otologic care for cleft palate patients even when they are overtly asymptomatic.

Adolescent↗
PubMed2000

Octylcyanoacrylate: a new medical-grade adhesive for otologic surgery.

HYPOTHESIS: The adhesive octylcyanoacrylate is not associated with significant inner ear toxicity in a guinea pig model. BACKGROUND: Many cyanoacrylate adhesives have been investigated for use in otologic surgery, but variable ototoxicity has been reported. Octylcyanoacrylate is a medical-grade adhesive with many properties that make it ideal for use in the ear. It is free of contaminants; it forms a strong, flexible bond; and it inhibits the growth of gram-positive organisms in culture. This is the first study to assess the ototoxicity of this new adhesive. METHODS: Fourteen adult guinea pigs were used. Preoperative auditory brainstem responses (ABRs) were determined. Bilateral antrotomies were performed, and the ears were randomized to adhesive and control (saline) groups. In the adhesive ears. 0.5 or 0.1 mL of octylcyanoacrylate was instilled into the middle ear. Eight weeks later, postoperative ABRs were determined, the animals were killed, and the temporal bones were removed. Middle ear changes were noted, and the ossicular chain was assessed. Cochlear hair cell analyses were performed. Histologic assessment of the middle ear mucosa was performed. RESULTS: There was a higher incidence of conductive hearing loss in the adhesive group secondary to fixation of the ossicular chain, but there was no significant difference in bone conduction thresholds. The median postoperative bone conduction thresholds (dB peak sound pressure level) was 15.0 in the control group and 17.5 in the adhesive group, p = 0.89. There was also no significant difference in inner hair cell counts (0.4% vs. 0.5% median hair cell loss, p = 0.72) or outer hair cell counts (3.7% vs. 3.0% median hair cell loss, p = 0.23) for the adhesive and control groups, respectively. Histopathologic analysis of the middle ear mucosa demonstrated variable mild to moderate foreign body reaction with no evidence of mucosal ulceration or necrosis. CONCLUSIONS: A large amount of octylcyanoacrylate placed in the middle ear of the guinea pig did not cause any morphologic or functional evidence of inner ear toxicity. This new adhesive is a promising tool for otologic surgery.

Animals↗
PubMed2026

Can ChatGPT Replace Human Clinical Coders? A Comparative Study in Otology Billing.

OBJECTIVE: Evaluate the utility of the large language model (LLM), ChatGPT, for the analysis of operative notes and the generation of Current Procedural Terminology (CPT) codes in comparison to human clinical coders. STUDY DESIGN: CPT billing codes assigned by ChatGPT were compared to existing billing data. Otology practice within a tertiary academic center. METHODS: About 191 operative notes from a single surgeon (9/2022-10/2023) were analyzed. ChatGPT-3.5 and 4 models were prompted for CPT codes based on operative notes. Assessment included determining exact and partial match rates, sensitivity and specificity for targeted procedures, and work Relative Value Units (wRVU) differences between ChatGPT-generated and human-assigned codes. RESULTS: ChatGPT-3.5 achieved exact matches in 22% of cases and partial matches in 32%, while ChatGPT-4 achieved 14% exact and 33% partial matches. When cochlear implantation (CI) was excluded, performance dropped significantly. For CI, ChatGPT-3.5 demonstrated a sensitivity of 94% and specificity of 90%, while ChatGPT-4 showed a sensitivity of 96% and specificity of 92%. In contrast, performance on cartilage grafting was poor, with sensitivities of 4.2% for ChatGPT-3.5 and 0% for ChatGPT-4. ChatGPT-3.5 and 4 showed moderate CPT code matching accuracy among themselves, with slight agreement to human coders. Both models tended to underbill for wRVUs compared to human coders, with significant differences in the values generated. CONCLUSION: This study assessed ChatGPT's effectiveness in automating CPT code assignment for otologic surgeries. While the models achieved high sensitivity values for assigning codes related to cochlear implantation, both models struggled with complex cases, failed to apply modifiers, and often assigned fewer wRVUs. The findings highlight ChatGPT's potential in medical billing but indicate a need for further refinement.

Humans↗
PubMed2003

Use of laser, otoendoscopy and facial nerve monitoring in otological surgery: United Kingdom survey.

Newer surgical tools, which have been widely accepted as important adjuncts in otological surgery, include the laser, otoendoscopy and facial nerve monitoring. A confidential postal questionnaire survey was carried out to evaluate the usage of these newer techniques among the Consultant members of the British Association of Otorhinolaryngology-Head and Neck Surgery. Our study revealed that the usage of otoendoscopy, laser and/or facial nerve monitoring is not as widespread as might be thought among otological surgeons in the United Kingdom.

Endoscopy↗