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ENT Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
There is acute onset of intense earache, variable fever, conductive deafness, and on examination of the eardrum in the early stages there is loss of the light reflex and injected vessels are seen around the malleus.
Noise, hearing and vibration
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
Middle ear: Ossicles – small bones behind eardrum (malleus, incus and stapes).Eardrum – transmits vibrations via ossicles through middle ear to inner ear.Eustachian tube – connects middle ear to posterior oropharynx for pressure equalization.
Ears
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
The external ear consists of the pinna and the outer ear canal (seeFigure 1.1). The outer third of the ear canal is cartilaginous, hair-bearing and wax-producing. It is also not particularly sensitive, which makes it relatively easy to inspect with an auroscope. The inner third is bony and exquisitely sensitive. Push too deep into the bony ear canal and the patient will certainly protest! The outer ear canal ends at the eardrum, which in a healthy ear is a pale grey structure (seeFigure 1.2). The most obvious features are the handle of the malleus and antero-inferiorly the cone of light (see below). When you are shown a picture of the eardrum you can always identify which side it is on by the direction in which the malleus is pointing. If the eardrum is on the right side, the malleus will point upwards and superiorly to the right from the middle of the eardrum. If it is on the left side, the malleus will point to the left (amaze your boss at quizzes!).
Effect of ossicular chain deformity on reverse stimulation considering the overflow characteristics of third windows
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Houguang Liu, Lin Xue, Jianhua Yang, Gang Cheng, Lei Zhou, Xinsheng Huang
The OCD, which originates from the abnormal development of the ossicles during the embryonic period, involves different degrees of defect or fixation of the ossicular chain structure and leads to hearing loss (Mansour et al. 2018). For the ossicular chain fixation, it includes malleus fixation, incus fixation, and stapes fixation. Clinical reports show that the malleus fixation showed fusion to the anterior attic wall, the incus fixation showed fusion to the medial attic wall, and the stapes fixation is caused by calcification of the stapedial annular ligament (Park and Choung 2009; Mansour et al. 2018). Besides, the malleus fixation would result in a hearing loss of 20–25 dB (Mansour et al. 2018). Therefore, to achieve a hearing attenuation of 25 dB during forward stimulation in the FE model, we fixed the corresponding nodes on the malleus head and the incus body, respectively, to realize the simulation of the malleus fixation and incus fixation. In terms of the simulation of the stapes fixation, we set the mechanical properties of the stapedial annular ligament to be the same as the ossicle material.
Transcanal endoscopic ear surgery for management of ossicular malformation: clinical outcomes of 17 cases
Published in Acta Oto-Laryngologica, 2022
Alyssa Yoshida, Makoto Hosoya, Sho Kanzaki, Masato Fujioka, Hiroyuki Ozawa
Seventeen cases (seven women and ten men) of ossicular malformation performed using TEES were included in this study. The mean age of the patients was 34.4 years. Of these 17 cases, 13 were performed only by TEES, but 4 cases were supported by a surgical microscope (1 case in 2015, 1 case in 2016, and 2 cases in 2017). After 2018, all the cases were performed using TEES. According to the Teunissen and Cremers classification system, six ears were type I, two ears were typeII, and nine ears were type III. Endoscopic exploratory tympanotomy revealed that cases showing malformations of the stapes superstructure tended to be more common in terms of percentage. Most cases showed normal malleus, except for five ears (29.4%), including the fixation of the incudomalleolar joint or a malleus bar. The malformation of incus was observed in five ears (29.4%). The most common malformation was the missing of the long process. Stapes malformation was observed in 12 ears (70.5%), which often involved the stapes superstructure malformations with a mobile footplate (4 in 12 ears). Oval window aplasia or dysplasia, which was classified as type IV, was not observed.
Endoscopic versus microscopic type-I cartilage tympanoplasty for anterior perforation – a comparative study
Published in Acta Oto-Laryngologica, 2021
Dipesh Shakya, Arun KC, Nirmala Tamang, Ajit Nepal
Gelfoams (SPONGOSTAN™ Special, Ferrosan Medical Devices A/S, Soeborg, Denmark) were kept in the middle ear accordingly. The barred cartilage shaped according to the size needed was negotiated under the malleus handle (underlay technique). If the middle ear space was compromised due to a medialized handle of malleus, the cartilage was notched to fit the handle of malleus. Then, the perichondrium was placed as reinforcement using the underlay technique under the handle of malleus and pushed anteriorly up to anterior margin. The tympanomeatal flap was placed back in the posterior canal wall. The perichondrium was adjusted to fit and tug around the anterior margin of perforation. Thus, perichondrium reinforced barred cartilage graft technique was used in both MT and ET groups. A final check was done to ensure there was a touch of perichondrium cartilage graft with anterior margin and annulus (Figure 1).