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Otorhinolaryngology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Chris Jephson, C. Martin Bailey
Mastoiditis occurs when the infection within the middle ear cleft involves the mastoid portion of the temporal bone where it may cause osteitis, erosion and suppuration. The features include fever and inflammatory swelling behind the ear with auricular protrusion (Fig. 19.9). Treatment is with intravenous high-dose broad-spectrum antibiotics with antipseudomonal and staphylococcal activity. Occasionally a cortical mastoidectomy is necessary.
Temporomandibular Joint Disorders
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Diagnosis is from a history of pain and swelling localized to the area of the joint, with acute onset limitation of movement. The patient will have generalized signs of an infective process with pyrexia, rigors, sweating (particularly night sweats) and malaise. They may also have signs and symptoms of other joint involvement. Locally there will be the signs of acute inflammation with tenderness over the joint, swelling, redness and heat. There may be additional cervical lymphadenopathy and tenderness over the mastoid if there is middle ear involvement.
Imaging of the Temporal Bone
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
A mild degree of mastoiditis will generally been seen with acute otitis media. The more prevalent use of antibiotics in treatment of acute otitis media has reduced the number of significant cases of mastoiditis. The importance for radiologists is to identify the potentially serious coalescent mastoiditis, and any complications arising from mastoid infection.
Cerebellopontine angle epidermoid with ipsilateral external ear atresia: an embryological association or a coincidence?
Published in British Journal of Neurosurgery, 2023
Khursheed Alam Khan, Rashim Kataria, Mohnish Grover, Virendra Deo Sinha
A 42 years female presented with right sided decreased hearing and right ear deformity since birth, headache and a few episodes of vomiting and drowsiness for 15 days. On examination she was drowsy. There was right sided grade 2 microtia with no opening of right external ear (Figure 1(a)). Rinnes test was negative on the right and Weber’s test showed lateralistion towards the right, suggestive of right sided conductive hearing loss. Pure Tone Audiometry confirmed right sided conductive hearing loss. CT brain, temporal bones and MRI brain were done. CT Brain showed a nonenhancing hypodense mass in right CPA with obstructive hydrocephalus (Figure 1(b)). Diffusion restriction was seen on DWI images of MRI (Figure 1(c)), suggesting an epidermoid of the right CPA region with obstructive hydrocephalus. CT temporal bone showed bony and membranous atresia of right external ear canal Figure 2 (a,b). The middle ear space was mildly reduced with malformed ossicles. Mastoid air cells were well pneumatised and the inner ear was normal. The left ear was normal. A ventriculoperitoneal shunt was done on left side, followed by definitive surgery for the right CP angle epidermoid later. Histopathology was confirmatory of epidermoid.
Treatment of otomycosis with clotrimazole: results accordingly with the fungus isolated
Published in Acta Oto-Laryngologica, 2022
Joselina Antunes, Nuno Mendes, Cristina Adónis, Filipe Freire
Risk factors for otomycosis, already identified in literature, were recognized in the majority of population included in this study (89.4%), with a similar prevalence described by other authors [7,12,14]. One of the risk factors described in literature is ear canal and mastoid cavities that results from canal wall down mastoidectomies. There are some reasons for this, namely the higher probability of otorrhea with subsequent need for topical antibiotics or antiseptics, changes in earwax production or increased local humidity [18]. Aspergillus was found more frequently in patients with ear canal and mastoid cavities. This can be justified by the fact that this is a genus of fungi usually found in decomposed organic matter, that grows in humid and acidic environment [5,6,10], characteristics that are usually found in these ear canal and mastoid cavities [4,19]. The remaining data (gender and other risk factors, like medical history and previous use of antibiotics) appeared with similar distribution compared with what is described by other authors [1,7,12,14,17].
Proposal of a magnetic resonance imaging follow-up protocol after cholesteatoma surgery: a prospective study
Published in Acta Oto-Laryngologica, 2022
Edoardo Covelli, Valerio Margani, Chiara Filippi, Haitham H. Elfarargy, Luigi Volpini, Andrea Romano, Alessandro Bozzao, Maurizio Barbara
The location of the MRI-positive lesions overlapped the surgical finding at revision without any difference (Spearman’s correlation was one, and the p-value was < .0001). Four positive lesions (33.3%) were localized in the epitympanic area, 2 (16.7%) in the antrum, and 2 in the mesotympanic area. Mastoid was the location of four-positive lesions. The site of the positive lesions did not significantly differ among the three included groups (p-value = .288) with a signficant correlation between the radiological and the intraoperative locations. The MRI size of the positive lesions ranged from 4 mm to 8 mm, with a mean of 5.5 ± 1.314 mm. On the other hand, the intraoperative size of the detected lesions went from 3 mm to 8 mm, with a mean of 5.33 ± 1.614 mm. Both measurements showed a statistically significant correlation (Pearson correlation coefficient was 0.910, and p-value was <.0001). Eleven (91.7%) positive lesions were true cholesteatoma in the revision surgeries, while one (8.3%) positive lesion was a collection of granulation tissue.