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Chronic Otitis Media
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
The site of the perforation is important, as a central perforation (Figure 11.1) is less likely to be associated with cholesteatoma than a perforation in the attic region, with associated bone destruction, but the older classification of perforations as ‘atticoantral’ or ‘tubo-tympanic’ is too simplistic and no longer considered useful. A dry inactive or quiescent perforation is often asymptomatic and may only be suspected or discovered at otoscopic examination. Many perforations heal, usually with no adverse effects but sometimes leaving residual scarring or retraction of the tympanic membrane, often with calcification – ‘tympanosclerosis’ – of the drum or the middle ear structures (Figure 11.2). What is really important in planning management is whether there is a cholesteatoma, hence the division of CSOM into CSOM without cholesteatoma (Figure 11.1) and CSOM with cholesteatoma (Figure 11.3).
Otitis Media
Published in Charles Theisler, Adjuvant Medical Care, 2023
Acute otitis media is a type of ear infection in the middle ear space behind the eardrum, or tympanic membrane. Pain is the major symptom of acute otitis media. It primarily occurs in children 6-36 months old, but adults can also be affected. About three out of four children have at least one episode of otitis media by the time they are three years old. Otitis media, whether acute, with effusion, chronic suppurative, or adhesive, is the most common cause of earaches.” Earaches can be debilitating, but do not always warrant antibiotics. Otitis media with fluid (effusion) does not respond to antibiotics.1 When antibiotics are prescribed, high-dose amoxicillin is most often recommended, but antibiotics do not decrease ear pain.2
Chronic Otitis Media
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Patients with persistent or recurring infection may benefit from tympanoplasty, which typically has a success rate of around 85%. Local anaesthetic tympanoplasty is an option for selected patients, including those not suitable for general anaesthesia. Tympanoplasty is also a treatment for those with hearing loss (air-bone gap greater than 20 dB) from a tympanic perforation or CSOM. Hearing aids are an alternative option but increase the risk of infection. Tympanoplasty is covered in more depth in Chapter 11.
Leveraging real-world data to improve cochlear implant outcomes: Is the data available?
Published in Cochlear Implants International, 2023
Callum Findlay, Mathew Edwards, Kate Hough, Mary Grasmeder, Tracey A. Newman
Otitis media, an umbrella term for middle ear inflammation (MEI), is a spectrum of diseases with closely related pathological phenotypes and clinical definitions (Schilder et al., 2016). Amongst children, otitis media is a leading cause of antibiotic prescription and surgery. Approximately 60–83% of children will have ≥1 episode of acute otitis media (AOM) by the age of 3, and around 25% of three year olds will have had ≥3 episodes (Kaur et al., 2017; Teele et al., 1989). In addition to the transient conductive hearing loss due to the increased stiffness and mass of the tympanum caused by middle ear effusion (Cai et al., 2017), middle ear inflammation is associated with the development and worsening of sensorineural hearing loss (Costa and Rosito LPS, 2009). The evidence is strongest for chronic otitis media; however, there is evidence that even a single episode of acute otitis media can produce very high frequency hearing deficits. Chronic otitis media, which involves persistent middle ear inflammation, has been shown to cause damage to the cochlea (Bhutta et al., 2017; Costa and Rosito LPS, 2009; Cureoglu et al., 2004; Kaur et al., 2017; Paparella et al., 1984) that is maximal at the basal turn, reducing the thickness of the stria vascularis and the number of inner and outer hair cells (Cureoglu et al., 2004; Paparella and Goycoolea, 1980).
Salivary Gland Choristoma in External Auditory Canal: A Case Report
Published in Fetal and Pediatric Pathology, 2023
Vijayashree Raghavan, Pooja E Moorthy, Sudha Srinivasan
Salivary gland choristomas in the middle ear can be associated with abnormalities in the second or less frequently the first branchial arch. They are a developmental defect, though the exact cause is not known [2]. A possible pathogenesis includes an ectopic expansion of submandibular epithelium or pharyngeal endoderm [3]. The first case of salivary gland choristoma of middle ear was reported by Taylor and Martin in 1961 [4], following which a total of 41 cases have been subsequently reported according to Ziari et al [3]. Often the middle ear mass is located behind the tympanic membrane and compresses the nearby structures such as cochlear and vestibular nerve. These patients present with a unilateral hearing loss. It can also be associated with branchial cleft and facial nerve palsies [2]. Histologically, the lesion is composed of salivary gland tissue with both serous and mucinous glands (submandibular gland).
Role of MPR image reconstruction in guiding the diagnosis and treatment strategy of facial nerve schwannoma
Published in Acta Oto-Laryngologica, 2022
Xiaoyu Li, Qiaohui Lu, Yang Liu
The clinical presentations of the 13 patients were hearing loss in 61.5% (8/13), facial palsy in 53.8% (7/13), aural fullness in 30.8% (4/13), tinnitus in 23.1% (3/13), dizziness in 15.4% (2/13), and ear discharge in 8.7% (1/13), which was generally consistent with the literature [2,3]. Physical examination found new pale-red mass in the external auditory canal behind the tympanum in seven (53.8%) patients. The different MPR facial nerve segments and facial palsy in similar segments in the 13 patients were numbered and classified. Among them, lesions were present in the geniculate ganglion and tympanic segment in two patients, the vagus segment and tympanic segment to the parotid segment in five patients, and in the mastoid segment to the parotid segment in six patients. The severity of facial palsy, ipsilateral hearing, intraoperative findings, facial palsy before and after treatment, and CT, MPR, and MRI presentation are summarized in Table 1. Note that patients 3-1 and 3-2 in Table 1 were diagnosed based on medical history, physical examination, and radiological diagnosis, while the diagnoses of the other patients were confirmed by postoperative pathology tests.