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At least 163 records · Page 9Linked to original sources
PubMed1998

Otologic Wegener's granulomatosis with facial nerve palsy.

Wegener's granulomatosis, characterized by necrotizing granulomas and vasculitis of the respiratory tract and kidney, frequently first presents with otologic symptoms. We report a case of primary otologic Wegener's granulomatosis in a patient who presented with symptoms of acute otomastoiditis and associated facial nerve palsy. The patient subsequently developed neuropathies of various cranial nerves. The patient underwent urgent mastoidectomy with facial nerve decompression. Nonspecific inflammatory disease of the mastoid mucosa delayed the correct diagnosis of Wegener's granulomatosis, which was confirmed by an elevated level of cytoplasmic-pattern antineutrophil cytoplasmic antibody (cANCA). We contrast the specificity of middle ear mucosal disease and cANCA serum levels in the diagnosis of Wegener's granulomatosis.

Audiometry, Pure-Tone↗
PubMedDate not supplied

Wegener's granulomatosis: presentation as an otologic problem.

Presentation of Wegener's granulomatosis as an otologic problem is unusual and leads to incorrect diagnosis and unsuccessful therapy. In seven years, five patients with a diagnosis of otitis media failed to respond to the usual therapeutic regimens. All had surgical manipulations on the middle ear or mastoid, or both. Wegener's granulomatosis was suspected because of persistence of the otologic problem. All patients developed pulmonary lesions and had positive diagnoses by biopsy of either the lung, kidney, or upper respiratory mucosa. Withe timely treatment, all patients have survived.

Adolescent↗
PubMedDate not supplied

Results of otologic referrals in an industrial hearing conservation program.

Baseline and periodic audiometry was performed on noise-exposed workers in 21 industrial plants. Workers showing moderate hearing loss, asymmetry, or significant threshold shifts were referred for otologic evaluation. The overall referral rate was 2.76%. Of 107 referrals, 53% had otologic diagnoses other than noise-induced hearing loss, or required specific intervention, or both. The results support the use of criteria at least as stringent as those used in this study.

Audiometry↗
PubMed1988

Intracranial and intratemporal meningiomas with primary otologic symptoms.

Intratemporal extensions of cerebellopontine angle (CPA) meningiomas are unusual and primary intratympanic meningiomas are extremely rare. The initial symptoms of both types are otologic. The presenting symptoms of even large meningiomas of the cerebellopontine angle can also be otologic. In this article we report the clinical features, diagnosis, and management of five CPA meningiomas, three combined intratemporal and CPA meningiomas, and one primary intratympanic meningioma.

Adolescent↗
PubMed1993

Otologic neurotologic manifestations of HIV-related disease.

Human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), has reached worldwide epidemic proportions and is increasing. Otologists, neurotologists, and audiologists practicing in metropolitan centers in North America can expect to encounter patients with HIV-related illnesses, including patients with AIDS-related complex (ARC) and AIDS. Five representative cases are presented: chronic otitis media, facial palsy, Gradenigo's syndrome with facial paralysis, otosyphilis, and Kaposi sarcoma of the mastoid. The common link in all cases was HIV infection. This presentation discusses the management of several HIV-infected patients with otologic and neurotologic findings. HIV infection has extended to all parts of North America. The worldwide incidence is increasing. As the epidemic continues to unfold, new challenges to both the diagnosis and treatment of otologic and neurotologic disease in HIV-positive patients will confront the audiologist and otolaryngologist. Recommendations for the safety of the examining audiologist and treating physician are given.

Abducens Nerve↗
PubMed1985

Intracranial and otological presentation of acute lymphocytic leukemia.

The authors report a patient with acute lymphocytic leukemia in hematological remission who presented with both intracranial and otological manifestations of the disease. The patient presented with clinical symptoms and computed tomographic findings consistent with otomastoiditis and a contiguous brain abscess. However, both lesions were identified at operation as leukemic infiltrates. Intracranial mass lesions and otological complications associated with leukemia are reviewed.

Adolescent↗
PubMed2001

Otology in ancient India.

Sushrutra Samhita is essentially a multi-volume textbook reporting the surgical practices of ancient India. It covers all aspects of surgery. However, specific references are made to otorhinological conditions, their description and subsequent treatments often being described in some detail. In this paper we outline the structure of the document and attempt to explain its underlying philosophies. We highlight the specific references to otological diseases and their treatment and draw the obvious comparisons with modern otological practice.

Female↗
PubMed1976

Office otology follow-up.

The validation of otological care in the previous quarter century has been based, by and large, on short-term follow-up information. The rapid variation in procedures introduced during this period indicates that there may be need for further consideration. Analyses based on relatively short duration have led the "acceptance" of a variety of diagnostic and treatment methods which have proven disappointing in some cases. To help avoid this invalid "acceptance," a review of patients with significant follow-up may result in a more critical evaluation of future procedural changes. This presentation will be in four parts: 1. History of the office structure. 2. Discussion of five long-term patients that illustrates and supports certain otological concepts. 3. A review of surgical care for chronic suppurative otitis media in 1968. 4. A review of patients treated for serous otitis media with myringotomy and tubal insertion in 1968.

Adult↗
PubMed1977

Tympanic membrane keratoma (cholesteatoma) in children with no prior otologic surgery.

Three children whose eardrums appeared normal upon previous examinations, one with the otomicroscope, apparently developed tympanic membrane cholesteatomas that penetrated the fibrous layer of the pars tensa. Their histories all included episodes of acute otitis media, but no otorrhea. No otologic surgical procedures, including myringotomy, had been performed. These cases are thought to provide clinical support for the basal epithelial migration theory of cholesteatoma genesis. Rüedi's experiments suggest that cholesteatomas resulting from basal epithelial migration may not be visible for 18 to 30 days; thus, follow-up evaluations after acute otitis media should probably include examinations one and two months after the infection. Pediatricians and family physicians should be urged to seek otologic consultation for patients with even minor eardrum abnormalities, particularly those following infection.

Child, Preschool↗
PubMed1978

Procedures for preparation of otological and audiological data for computer analysis.

Extensive amounts of clinical data exist in the files of facilities providing otological and audiological services. Because of the considerable time involved in manual analysis, some departments are beginning to consider the use of computers for analyzing the data. It is often assumed that this data can simply be submitted to a computer center for analysis. This, however, is not the case. A careful series of planned procedures must be undertaken before information can be submitted and analyzed. This paper illustrates the procedural steps necessary to permit the utilization of a computer system for analysis of clinical data. The feasibility of the use of these procedures in the examination of otological and audiological data is considered.

Audiology↗
PubMed1980

The argon laser in otology.

The use of lasers in microsurgery is now an accepted procedure. As we learn more about the absorption properties of biologic tissue, we can use different electromagnetic wave lengths to accomplish surgical alteration of these tissues. The electromagnetic wave length of the Argon laser is compatible for surgical alteration of the soft tissue and bone of the middle and inner ear. Thirty patients requiring external ear canal or middle ear surgery were treated using the Argon laser during the course of the surgical procedure. The treatment of soft tissue pathology included tympanoplasty with fascia graft, control of bleeding, lysis of adhesions, and myringotomies performed using the Argon laser. Osseous disease of the external canal was removed and stapedectomy was performed, using the Argon laser on 15 patients. A review of the physics of laser energy and its application in otology is presented. The results of this investigative study demonstrate the advantages of the Argon laser in otologic microsurgery.

Argon↗
PubMed1982

Otological manifestations of Wegener's granulomatosis.

The otological manifestations of Wegener's granulomatosis were studied in 13 patients; diagnosis was confirmed histologically in 10, and in 1 patient periarteritis nodosa presented similar appearances. One patient had destruction of the external ear, and several had refractory otitis externa, usually associated with otitis media: 3 patients had serous otitis media, 4 had purulent otitis media of a fairly mild course, while 6 had otitis media of a fulminant and long-lasting course, accompanied in 5 cases by cranial nerve palsy and in 2 by widespread destruction. Most patients had major sensory hearing loss. Two had short-lasting anacusis during exacerbation of the pulmonary lesions. Often, otological manifestations were the initial signs of the disease. It is important to bear this diagnosis in mind in cases of long-lasting and atypical inflammations and in the presence of peculiar constellations of symptoms from several different organ systems.

Adult↗
PubMed1984

Neuro-otologic applications of simultaneous multi-channel auditory evoked response recordings.

Multichannel auditory brain stem response (ABR) recordings were obtained in 75 acute, severely brain injured patients. The purpose of the study was to assess, in patients with varied neuro-otologic pathology, the clinical feasibility and value of measuring the ABR simultaneously with more than one electrode array. The use of alternative electrode arrays, in addition to the conventional (vertex to stimulus ipsilateral ear) array, augmented confident identification of wave components I through VI, and was particularly useful in patients with marked middle ear pathology which confounded ABR interpretation. The ABR recorded with an indifferent (noncephalic) reference electrode, e.g., was characterized by increased Wave V amplitude, and improved definition of Wave IV vs. V. Case studies are presented to illustrate neuro-otologic applications of the multichannel recording technique.

Adolescent↗
PubMed1985

Immunologic aspects of otologic disease: an overview.

The immunologic explosion has now reached the field of otology. By having better techniques to measure the changes at cellular and molecular levels, it is now possible to devise experiments to show morphologic anatomic changes as well as functional changes. The demonstration in 1980 (M.S.) that tympanosclerosis could be induced immunologically represents a concrete advancement in immunologic thinking in conceptualization of otologic disease. In 1974, one of the authors (M.S.) published work dealing with the treatment of vasculitis of immunologic origin for sudden hearing loss. This was aimed at inhibiting the complement cascade from starting its destructive action. Recently, the immunologic challenge in animals demonstrated by changes in the inner ear was shown by one of the authors (T.J.Y.). Such changes were compatible with labyrinthine hydrops, or Meniere's disease, otosclerosis, and sensorineural hearing loss and vestibular dysfunction.

Cholesteatoma↗
PubMed1987

Otologic manifestations of benign intracranial hypertension syndrome: diagnosis and management.

Benign intracranial hypertension (BIH) is a syndrome characterized by increased intracranial pressure (IIP) without focal signs of neurological dysfunction. The diagnosis is essentially made by exclusion of various causes of IIP. The classic presenting symptoms of BIH are headache and/or visual disturbances. Otologic manifestations of this syndrome have not been described in detail. In this thesis, 20 BIH patients with associated otologic symptoms were thoroughly studied over a 5-year period. The author concludes that 1. objective pulsatile tinnitus and low frequency hearing loss can be the major or only manifestation of this syndrome; 2. diagnosis is established by lumbar puncture and elimination of other causes of IIP; 3. medical management is very effective with surgery reserved for patients with deteriorating vision or with disabling tinnitus.

Adult↗
PubMed1988

Routine identification of the facial nerve using electrical stimulation during otological and neurotological surgery.

We routinely identify the facial nerve to avoid facial nerve injury during most otologic surgery. Since 1985, we have used a facial nerve stimulator/monitor as an added safety feature in 383 consecutive otologic and neurotologic cases. In our last 30 middle-ear, 8 retrolabyrinthine vestibular neurectomy, and 14 acoustic neuroma cases we used the monopolar stimulator probe-tip to determine threshold currents needed to produce facial twitch. Stimulation thresholds varied according to the amount of soft tissue or bone overlying the facial nerve. The stimulator was useful for predicting dehiscences in the bony facial canal during middle-ear and mastoid surgery. The exposed facial nerve usually stimulated at a level less than 0.1 mA (mean 0.05 mA), and the horizontal facial nerve covered by bone stimulated at 0.25 mA or greater (mean 0.6 mA). The stimulator was also used to predict the amount of bone overlying the vertical facial nerve at the annulus. An approximate relationship of 1.0 mA of threshold current to 1.0 mm of bony covering was found. After acoustic neuroma surgery, the stimulation threshold of the facial nerve at the brain stem helped predict postoperative facial function. Cases with current thresholds of 0.3 mA or less resulted in normal facial function. During ear surgery, routine identification of the facial nerve with the aid of a facial nerve stimulator will help avoid facial nerve injury.

Ear↗
PubMed1994

Otologic manifestations of neurofibromatosis.

A chart review of 440 patients with neurofibromatosis seen at the Children's Hospital of Philadelphia Neurofibromatosis Clinic between 1980 and 1991 was performed to look for otologic manifestations. Neurofibromatosis 1 was present in 434 patients, and neurofibromatosis 2 was present in 6. A total of 31 otologic abnormalities related to neurofibromatosis were found in 28 patients. Neurofibromas of the external ear, including the pinna and the external auditory canal, were the most common finding. Middle ear neurofibromas were found in two patients. Acoustic neuromas were seen exclusively in patients believed to have neurofibromatosis 2. One cerebellopontine angle neurofibrosarcoma was found in a patient with neurofibromatosis 1.

Adolescent↗
PubMed1994

Iatrogenic facial nerve injury during otologic surgery.

Perhaps the most devastating complication in otologic surgery is that of inadvertent injury to the facial nerve. A review of 22 patients who had sustained an iatrogenic facial nerve injury was conducted. Although the most common procedure being performed during the injury was mastoidectomy (55%), a surprising number of patients had injury during tympanoplasty (14%) or during removal of exostoses (14%). The most common area of injury to the facial nerve in this series was in the tympanic segment. In 79% of the patients, the facial nerve injury was not detected at the time of surgery. All patients underwent surgical exploration of the facial nerve. Otologic surgeons are cautioned to be familiar with the normal course of the facial nerve and to be aware of the potential for facial nerve injury when performing transcanal surgery.

Adolescent↗