Speciality
Spotlight

 




 

Otolaryngology


 

    

  




Cholesteatoma

    

  • M Conde, R Urquiza, JA Perez Arcos, et al (Hosp Clinicao Universitario, Malaga)


    The Neurosensorial Component of Hearing Loss Associated with Cholesteatoma (Spanish).



    Acta Otorrinolaring Esp 49:183-188, 1998.


       

    Sensorineural hearing loss, is a common complication of cholesteatoma.

       


    Fifty patients undergoing surgery for cholesteatoma were analyzed. The findings suggested a specific cholesteatoma-related sensorineural hearing loss which could at times be irreversible.

       


    When treating patients with chronic ear infections, one needs to consider not only conductive deafness but also sensorineural deafness.

        

  • VJ Jaisinghani, MM Paparella, PA Schachern (Univ of Minnesota, Minneapolis; Internatl Hearing Found, Minneapolis; Minnesota Ear, Head and Neck Clinic, Minneapolis)


    Silent Intratympanic Membrane Cholesteatoma



    Laryngoscope 108: 1185-1189, 1998.


      


    The etiology of acquired cholesteatoma of the middle ear and mastoid is unknown. Suggested causes are: trauma, iatrogenic injury, immigration and invasion, metaplasia and development through a retraction pocket in the tympanic membrane.

      


    Intratympanic membrane cholesteatoma (IC) in patients with chronic otitis media is reported in 5 cases. “Silent” otitis media is a chronic middle ear infection in the absence of tympanic membrane involvement.

      


    IC should be considered in the differential diagnosis for patients with suspected silent otitis media, who may have white, pearly lesions on the tympanic membrane.

      

  • S-E Stangerup, D Drozdziewicz, M Tos et al (Gentofte Univ, Hellerup, Denmark)

    Surgery for Acquired Cholesteatoma in Children:
    Long-term Results and Recurrence of Cholesteatoma.

    J Laryngol Otol 112: 742-749, 1998.


       


    Residual and recurrent cholesteatoma are major problems in cholesteatoma surgery. This is a study of 114 children who underwent surgery during a 15-year period. 

      


    85% of the ears were dry and the drum was intact. 27 ears had recurrence which was significantly associated with age younger than 8 years, a negative preoperative Valsalva, ossicular chain resorption and a large cholesteatoma. Such children need to be monitored for several years postoperatively.

      

  • EE Dodson, GT
    Hashisaki, TC Hobhgood, et al (Univ of Virginia, Charlottesville)


    Intact Canal Wall Mastoidectomy with Tympanoplasty for Cholesteatoma in Children.



    Laryngoscope 108: 977-983, 1998.


        


    A retrospective analysis of pediatric cholesteatomas treated at one institution during an 11 year period was done.

        


    It was found that intact canal wall (ICW) mastoidectomy was the treatment of choice. If second-stage surgery is required, long-term results are good.

        


    Canal wall down (CWD) mastoidectomy is an alternative when anatomical factors or ear canal disease exist.

       

  • NH Blevins, BL Carter (Tufts-New England Med Ctr, Boston)


    Clinical Forum: Routine Preoperative Imaging in Chronic Ear Surgery,



    Am J Otol 19: 527-538, 1998.


      


    Imaging studies, especially CT, can demonstrate the nature and extent of chronic otitis media, which may not be apparent on clinical findings per se. Such findings can affect operative treatment, especially in difficult and/or revision procedures. However, there is a view that routine radiography of the mastoid may suffice in being very helpful in most
    cases
    .

      

  • TS
    Karhuketo, HJ Puhakka (Tampere Univ, Findland)


    Middle Ear Imaging Via the Eustachian Tube With a Superfine Fiberoptic Videomicroendoscope.



    ORL J Otorhinolaryngol Relat Spec. 60: 30-34, 1998.


      


    With a fibreoptic videomicroendoscope inserted through the Eustachian tube, 56% of predetermined anatomical objects in the middle ear were visualized. 

      


    However, one may find obstructive sites or mucosal folds that may prevent a complete view of all the contents of the middle ear cleft.

      

  • WPL
    Hellier, G Watters, RJ Corbridge, et al (Frimely Park Hosp, Surrey, England; Northampton Gen Hosp, England; Radcliffe Infirmary, Oxford, England)

    Grommets and Patient Satisfaction: An Audit.



    Ann R Coll Surg Engl 79:428-431, 1997.


      


    Parents of 175 children, 15 years or younger who had had grommets inserted between 3 to 12 months earlier, completed a questionnaire, regarding parents’ or patients’ satisfaction with the results of the procedure.

      


    92% patients noticed improvement in hearing. Reduced frequency of ear infections occurred in 74%. About 70% noticed less time missed from school. 97% of parents were satisfied with the procedure.

      

  • GR
    Bergus, MM Lofgren (Univ of Iowa, Iowa City)

    Tubes, Antibiotic Prophylaxis, or Watchful
    Waiting: A Decision Analysis for Managing Recurrent
    Acute Otitis Media.

    J Fam Pract 46: 304-310, 1998.


      


    Two widely used interventions for the prevention of recurrent acute otitis media (AOM) are tympanostomy tubes and daily prophylactic antibiotics.

      


    Thirty-seven patients were interviewed for the project. All had a child aged 6 years or younger with a history of at least one previous middle ear infection.

      


    From a parent’s perspective, tubes were preferred.

      

  • RL Hebert II, GE King, JP Bent III (Med College of Georgia, Augusta)


    Tympanostomy Tubes and Water Exposure: A Practical Model.



    Arch Otolaryngol Head Neck Surg 124: 1118-1121, 1998.


        


    Myringotomy with tympanostomy tube placement is one of the very common otolaryngologic procedures done nowadays.

        


    Contrary to previous thinking, the authors have shown that entry of water into the middle ear is not promoted by showering, hair rinsing, or submersion of the head in clean tap water. The chances of water contamination increase by submersion in SOAPY water or swimming at a depth of more than 60 cms.

        


    Many of the previously advised water precautions are unnecessary in patients with tympanostomy tubes.

         

 



 

Speciality Spotlight

 

    
  

Cholesteatoma
    

  • M Conde, R Urquiza, JA Perez Arcos, et al (Hosp Clinicao Universitario, Malaga)
    The Neurosensorial Component of Hearing Loss Associated with Cholesteatoma (Spanish).
    Acta Otorrinolaring Esp 49:183-188, 1998.
       
    Sensorineural hearing loss, is a common complication of cholesteatoma.
       
    Fifty patients undergoing surgery for cholesteatoma were analyzed. The findings suggested a specific cholesteatoma-related sensorineural hearing loss which could at times be irreversible.
       
    When treating patients with chronic ear infections, one needs to consider not only conductive deafness but also sensorineural deafness.
        

  • VJ Jaisinghani, MM Paparella, PA Schachern (Univ of Minnesota, Minneapolis; Internatl Hearing Found, Minneapolis; Minnesota Ear, Head and Neck Clinic, Minneapolis)
    Silent Intratympanic Membrane Cholesteatoma
    Laryngoscope 108: 1185-1189, 1998.
      
    The etiology of acquired cholesteatoma of the middle ear and mastoid is unknown. Suggested causes are: trauma, iatrogenic injury, immigration and invasion, metaplasia and development through a retraction pocket in the tympanic membrane.
      
    Intratympanic membrane cholesteatoma (IC) in patients with chronic otitis media is reported in 5 cases. “Silent” otitis media is a chronic middle ear infection in the absence of tympanic membrane involvement.
      
    IC should be considered in the differential diagnosis for patients with suspected silent otitis media, who may have white, pearly lesions on the tympanic membrane.
      

  • S-E Stangerup, D Drozdziewicz, M Tos et al (Gentofte Univ, Hellerup, Denmark)
    Surgery for Acquired Cholesteatoma in Children: Long-term Results and Recurrence of Cholesteatoma.
    J Laryngol Otol 112: 742-749, 1998.
       
    Residual and recurrent cholesteatoma are major problems in cholesteatoma surgery. This is a study of 114 children who underwent surgery during a 15-year period. 
      
    85% of the ears were dry and the drum was intact. 27 ears had recurrence which was significantly associated with age younger than 8 years, a negative preoperative Valsalva, ossicular chain resorption and a large cholesteatoma. Such children need to be monitored for several years postoperatively.
      

  • EE Dodson, GT Hashisaki, TC Hobhgood, et al (Univ of Virginia, Charlottesville)
    Intact Canal Wall Mastoidectomy with Tympanoplasty for Cholesteatoma in Children.
    Laryngoscope 108: 977-983, 1998.
        
    A retrospective analysis of pediatric cholesteatomas treated at one institution during an 11 year period was done.
        
    It was found that intact canal wall (ICW) mastoidectomy was the treatment of choice. If second-stage surgery is required, long-term results are good.
        
    Canal wall down (CWD) mastoidectomy is an alternative when anatomical factors or ear canal disease exist.
       

  • NH Blevins, BL Carter (Tufts-New England Med Ctr, Boston)
    Clinical Forum: Routine Preoperative Imaging in Chronic Ear Surgery,
    Am J Otol 19: 527-538, 1998.
      
    Imaging studies, especially CT, can demonstrate the nature and extent of chronic otitis media, which may not be apparent on clinical findings per se. Such findings can affect operative treatment, especially in difficult and/or revision procedures. However, there is a view that routine radiography of the mastoid may suffice in being very helpful in most cases
    .
      

  • TS Karhuketo, HJ Puhakka (Tampere Univ, Findland)
    Middle Ear Imaging Via the Eustachian Tube With a Superfine Fiberoptic Videomicroendoscope.
    ORL J Otorhinolaryngol Relat Spec. 60: 30-34, 1998.
      
    With a fibreoptic videomicroendoscope inserted through the Eustachian tube, 56% of predetermined anatomical objects in the middle ear were visualized. 
      
    However, one may find obstructive sites or mucosal folds that may prevent a complete view of all the contents of the middle ear cleft.
      

  • WPL Hellier, G Watters, RJ Corbridge, et al (Frimely Park Hosp, Surrey, England; Northampton Gen Hosp, England; Radcliffe Infirmary, Oxford, England)
    Grommets and Patient Satisfaction: An Audit.
    Ann R Coll Surg Engl 79:428-431, 1997.
      
    Parents of 175 children, 15 years or younger who had had grommets inserted between 3 to 12 months earlier, completed a questionnaire, regarding parents’ or patients’ satisfaction with the results of the procedure.
      
    92% patients noticed improvement in hearing. Reduced frequency of ear infections occurred in 74%. About 70% noticed less time missed from school. 97% of parents were satisfied with the procedure.
      

  • GR Bergus, MM Lofgren (Univ of Iowa, Iowa City)
    Tubes, Antibiotic Prophylaxis, or Watchful Waiting: A Decision Analysis for Managing Recurrent Acute Otitis Media.
    J Fam Pract 46: 304-310, 1998.
      
    Two widely used interventions for the prevention of recurrent acute otitis media (AOM) are tympanostomy tubes and daily prophylactic antibiotics.
      
    Thirty-seven patients were interviewed for the project. All had a child aged 6 years or younger with a history of at least one previous middle ear infection.
      
    From a parent’s perspective, tubes were preferred.
      

  • RL Hebert II, GE King, JP Bent III (Med College of Georgia, Augusta)
    Tympanostomy Tubes and Water Exposure: A Practical Model.
    Arch Otolaryngol Head Neck Surg 124: 1118-1121, 1998.
        
    Myringotomy with tympanostomy tube placement is one of the very common otolaryngologic procedures done nowadays.
        
    Contrary to previous thinking, the authors have shown that entry of water into the middle ear is not promoted by showering, hair rinsing, or submersion of the head in clean tap water. The chances of water contamination increase by submersion in SOAPY water or swimming at a depth of more than 60 cms.
        
    Many of the previously advised water precautions are unnecessary in patients with tympanostomy tubes.
         

 

 

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