China
Africa
Explore chapters and articles related to this topic
Acute Otitis Media and Otitis Media With Effusion in Adults
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
Complications of AOM are typically divided into intracranial and extracranial complications. All are rare, although it is interesting to note that adults with AOM are at higher risk of intracranial complications than adults with chronic otitis media. Extracranial complications include facial palsy, acute mastoiditis, purulent labyrinthitis, and abscesses associated with structures connected to the temporal bone, such as the sternocleidomastoid, digastric, or zygoma. Intracranial complications include sigmoid sinus thrombosis, otitic hydrocephalus, subdural empyema, intradural abscesses, Gradenigo's syndrome (middle ear infection complicated by petrous apicitis causing cranial nerve VI palsy and retro-orbital pain), and meningitis. Facial palsy accounts for 30% of these complications, but full recovery occurs in most cases. Treatment of complications is with antibiotics, drainage of any abscess, and urgent mastoidectomy to treat the infection source. Many advocate adding anticoagulants in cases of sigmoid sinus thrombosis.
Chronic Otitis Media
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
George G. Browning, Justin Weir, Gerard Kelly, Iain R.C. Swan
The main intracranial septic complications are meningitis and intracranial abscess. The latter may be subdivided into extradural abscess, subdural abscess and intracerebral or cerebellar abscess. Thrombophlebitis of the sigmoid sinus and otitic hydrocephalus are the other main complications.
Head
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The sigmoid sinus (38) runs forward to emerge from the skull at the jugular foramen, at which it becomes the bulb of the internal jugular vein (39). Exiting through the jugular foramen anterior to the vein lie, from anterior to posterior, the glossopharyngeal, vagus and accessory cranial nerves (40).
A simple and convenient 3D printed temporal bone model for drilling simulating surgery
Published in Acta Oto-Laryngologica, 2022
Zhi-Ming Yuan, Xiao-Dong Zhang, Shou-Wu Wu, Zhong-Zhu Nian, Jun Liao, Wen Lin, Li-Ming Zhuang
During the simulating mastoidectomy (open or closed), the 5 attending physicians thought that the shape and anatomical structure of the model were basically similar to the natural temporal bone, with the accuracy score of (6.4 ± 0.56), and the process of the simulating surgery was very similar to the real surgery in general, presenting similar haptic sensation, with the average score of (5.8 ± 0.45), among which, the average haptic score of the cortical bone was (5.4 ± 0.56) and that of the air cell was (5.8 ± 0.45). Additionally, the 5 attending physicians agreed that the mastoid air cell was very similar to the natural temporal bone both in shape and the haptic sensation of simulated surgery. In the identification of anatomical structures, the direction of the sigmoid sinus could be clearly felt, and the cerebral plate, horizontal semicircular canal, entrance of the tympanic sinus and shorter part of the ossicle could also be identified. Unfortunately, the structural details of facial nerves and middle ear could not be well identified. The 5 attending physicians all believed that the 3D printed model had certain advantages, and it could replace some autopsy training as an introductory training for beginners in otology. Also, they highly recognized its application value in medical education (Table 1).
Treatment of venous pulsatile tinnitus by compression reconstruction of sigmoid sinus
Published in Acta Oto-Laryngologica, 2021
Jiyue Chen, Yu Su, Jing Dai, Chi Zhang, Jie Wu, Wenjia Wang, Dongyi Han
Under local anesthesia, 41 patients underwent compression reconstruction of sigmoid sinus (SSCR), and three patients simultaneously received mastoid emissary vein ligation (MEVL) (patient 1, 12 and 14). All surgical procedures were executed by the same senior surgeon. The surgical process of SSCR was comparable to our previous study aiming at correcting abnormal sinus flow [7]. However, in this study, we used Surgicel® and bone wax packing instead of a cortical bone flap. A postauricular incision was created at the transverse-sigmoid sinus junction using a retromastoid approach. Unlike the standardized surgical procedure [8,10,12], a 1.5 × 1.0 cm2 bone window was drilled centered on the posteroinferior wall of junction of transverse-sigmoid sinus to expose partial sigmoid sinus wall avoiding to open the mastoid air cells system by a minimally invasive approach. A bipolar electrocoagulation was used to cauterize and shrink the sigmoid sinus. Then, Surgicel® and bone wax packing were used to gently compress the sigmoid sinus wall until the disappearance of tinnitus as described by the patient. Finally, the mastoid was closed by bone wax and the incision was sutured (Figure 2(A–D)). All patients were followed up regularly by telephone or clinic visit.
Sandwich technique for sigmoid sinus wall reconstruction for treatment of pulsatile tinnitus caused by sigmoid sinus diverticulum/dehiscence
Published in Acta Oto-Laryngologica, 2019
Accurate diagnosis of PT caused by SSDD often requires careful evaluation. History and physical examination are vital for diagnosis of PT caused by SSDD. It is important to distinguish between arterial and venous PT by neck compression. PT is likely of venous origin when it diminishes with compression of the ipsilateral internal jugular vein, whereas it is likely of arterial origin if it worsens with such compression [9,10]. If the source is thought to be of venous origin, an HRCT scan of the temporal bone is the appropriate imaging test. A temporal bone CT scan is sensitive for diagnosing SSDD as a cause of PT. CT images should be reconstructed for a high-resolution algorithm with a section thickness of 0.625 mm, and both axial and coronal reformats should be provided for analysis. Bone windows must be carefully scrutinized to evaluate the integrity of the sigmoid sinus plate. A CT scan is effective in showing bony anatomy around the sigmoid sinus when the plate is absent. For the diagnosis of PT patients, some doctors recommend CTA as a preliminary work-up modality [11]. We suggest an HRCT scan of the temporal bone as a sensitive and relatively low-cost option for diagnosing SSDD.