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Cardiopulmonary Resuscitation
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Examine the face and mouth for signs of facial fracture or basal skull fracture. A basal skull fracture is indicated by: Periorbital and subconjunctival haemorrhage.Haemotympanum, external bleeding, or cerebrospinal fluid (CSF) leak from the ear.Haemorrhage or CSF leakage from the nose.Nasopharyngeal haemorrhage, which may be profuse.Mastoid bruising (Battle's sign), which may not appear for many hours.
Death at Depth
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Middle ear barotrauma (also called barotitis media or middle ear squeeze) is the most common diving-related medical disorder. It occurs when the Eustachian tube cannot be opened for pressure equalization via the Valsalva manoeuvre, for example because of an acute medical condition. Symptoms include depth-dependent otalgia, vertigo, middle ear oedema, transudation, haemotympanum and tympanic membrane rupture. Late complications may include chronic tympanic membrane perforation and chronic otitis media [8].
Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Temporal bone fractures can be associated with conductive hearing loss or mixed sensorineural hearing loss. Otic capsule disrupting fractures cause severe to profound sensorineural hearing loss that is often immediately apparent. Otic capsule sparing fractures can manifest as both sensorineural hearing loss or conductive hearing loss. Conductive hearing loss are caused initially by haemotympanum or effusion, and permanent deficits are caused by disruption of ossicular chain. The most common ossicular chain injuries include subluxation of the incudostapedial joint, dislocation of incus and fracture of stapes crura. Middle ear exploration and ossicular chain reconstruction are considered when a conductive hearing loss persists for more than 2 months post injury. Alternatives to tympanoplasty and ossiculoplasty surgery include air conduction aids, bone conduction devices or CROS aids (in single-sided deafness).
Initial hearing preservation outcomes of cochlear implantation with a slim perimodiolar electrode array
Published in Cochlear Implants International, 2021
Erika Woodson, Rebecca Chota Nelson, Molly Smeal, Thomas Haberkamp, Sarah Sydlowski
An interesting phenomenon is the appearance of mixed hearing loss in seven subjects post-CI (Table 3), which has been previously described (Attias et al. 2010; Kiefer et al. 2006; De Seta et al. 2017; Sydlowski ). The presence of a new post-operative air-bone gap could be attributed to two circumstances: (1) worsening of air conduction thresholds due to hemotympanum or middle ear effusion, or (2) improvement in bone conduction thresholds hypothetically due to presence of the electrode array or a third window phenomenon. Three of the patients with post-operative air-bone gaps had reduced tympanic membrane compliance suggestive of hemotympanum or middle ear effusion. Three patients with an air-bone gap had normal tympanometry; one was not tested. In all but one of our cases of new mixed HL, BC LFPTA improved over baseline – as much as 22.5 dB. Further research to better understand this mixed HL phenomenon is warranted, and a consensus determination of how to categorize these patients’ hearing preservation status should be undertaken. These bone conduction results highlight the importance of considering hearing preservation based on bone conduction as air conduction thresholds that are elevated relative to bone conduction may inflate the degree of hearing loss attributable to electrode array insertion. It is further important to consider how the presence of an air-bone gap may influence candidacy for acoustic amplification in the implanted ear.
Outcomes of ossicular disruption in traumatic facial paralysis: a case series
Published in Acta Oto-Laryngologica, 2021
Xudong Yan, Pei Liu, Caili Ji, Min Zhang, Xiaoheng Zhang, Fugao Zhu, Tao Fu
Temporal bone trauma can damage important internal structures, leading to severe functional impairment, such as peripheral facial paralysis and conductive hearing loss. Injury to the facial nerve causes peripheral facial paralysis, and peripheral regions (from the geniculate ganglion to the mastoid segment) account for more than 70% of all cases [1,2]. Ossicular disruption is one of the main causes of conductive hearing loss, which includes several types such as incudostapedial or incudomalleolar joint separation, dislocation of the incus, dislocation of the malleoincudal complex, stapediovestibular dislocation, fractures of the ossicles, and so forth [3]. Patients with traumatic hemotympanum and tympanic membrane perforation usually recover within weeks to several months without any intervention [4]. However, disruption of the ossicular chain can cause hearing loss with 30 dB or more and sometimes needs a surgical intervention for maximum recovery. Facial nerve decompression and ossiculoplasty are usually performed simultaneously using the posterior tympanum approach for patients diagnosed with both traumatic facial nerve paralysis and ossicular disruption. However, tympanotomy using the transcanal approach was a primary surgical technique most widely used for traumatic ossicular disruption [3–9]. This study aimed to investigate hearing outcomes of simultaneous ossiculoplasty and facial nerve decompression and the improvement in postoperative hearing outcomes using the posterior tympanum approach compared with the transcanal approach.
Efficacy of balloon Eustachian tuboplasty on the quality of life in children with Eustachian tube dysfunction
Published in Acta Oto-Laryngologica, 2020
BET was performed in 30 children (55 affected ears) and VT insertion was performed in 32 children (60 affected ears). Although no intraoperative complications occurred, two children presented with a hematotympanum as a postoperative complication following BET; however, this condition, which arises from bleeding from the mucosa or as a result of adenoidectomy, completely resolved within 1 week without the administration of treatment.