Speciality
Spotlight

 




 

Otolaryngology


 

    

  




External Ear, Middle Ear and Mastoid

      


  • Kuttila S, Kuttila M, et al (Univ of Turku, Finland)

    Aural Symptoms and signs of Temporomandibular Disorder in
    association with
    Treatment Need and visits to a Physician

    Laryngoscope 109 : 1669-1673, 1999

         


    Apart from temporomandibular disorder (TMD) causing pain in the jaws, headache and facial pain, aural symptoms, like otalgia without infection, tinnitus, fullness of ears, also do appear to be associated.

        


    This study of 203 men and 208 women of various ages were studied by 3 examination at 12 monthly intervals.

        


    Women had more aural symptoms than men and slight tendency towards more aural symptoms with increasing age upto 55 yrs. The prevalence decreased in older age group. Those with TMD requiring treatment of TMD had more aural symptoms like otalgia.

        


    M.M. Paparella thinks treatment is by heat, a soft diet and an analgesic for 10 days to 2 weeks relieves the symptoms. Those with persistent symptoms, must be referred to dentist with stomatognathic experience.

        

  • T Hoshino, Y Ueda, H Mukohdaka, et al (Hamamatsu Univ, Japan)

    Acute Granulomatous Myringitis

    J Laryngol Otol 112: 150-153, 1998

      

    Acute and chronic myringitis seem to be caused by two different entities. 

       

    Acute myringitis manifests the following – otalgia, a granulomatous bulge along the malleus, and no middle ear infection.

       

    Chronic myringitis is characterized by erosion or thin granulation of the tympanic membrane – it can recur after debridement and cautery.

       

    Granulomatous changes of the tympanic membrane are rare. This article describes five causes of acute granulomatous myringitis.

       

  • NW Todd (Emory Univ, Atlanta, Ga)

    Cranial Anatomy and Otitis Media : A Cadaver Study

    Am J Otol 19:558

      

    This interesting article is probably the first of its kind correlating cranial anatomical changes and otitis media. Thirty-five cadaver skulls were examined.

       

    Healthy middle ears had longer eustachian tubes, a longer distance from the midsella to the staphylion, and the distance between the ears was longer irrespective of race, gender or stature.

      

  • 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.

        

  • Mastoidectory

    Soda-Merhy A, Betancourt-Suarez MA (Natl Inst of Respiratory Diseases, Mexico City)

    Surgical Treatment of Labyrinthine Fistula (LF) Caused by Cholesteatoma

    Otolaryngol Head Neck Surg 122: 739-742, 2000

           

    LF is a common complication of chronic otitis media (OM) in patients with cholesteatoma. It was studied at one institution, a review of surgical criteria and postoperative results discussed. 

           

    Between 1985 to 1997, 27 patients (out of 360 mastoidectomy patients) were found to have L.F. Preoperative C.T scans and audiometric studies were done on all. Preliminary surgery was done in 16 and in 11 revision surgery was done.

          

    In 88% cases L.F. was in horizontal semicircular canal. Open cavity surgical technique was used in all patients and the fistulae were closed by temporalis fascia (16), perichondrium (9) and muscle in (2).

           

    Vertigo relief was seen in all patients, hearing unchanged in 19 patients, bone conduction reduced in 7 patients and improved in one patient.

          

    Conclusion : LF frequency was 7.5%. In 88% it was H.S.C. 93% of patients were diagnosed before surgery. Open cavity with removal of matrix is advised. 

          

    M. M. Paparella stated that a similar experience was seen. It is better if possible to apply a skin graft to seal fistula, because the subcutaneous portion of the skin does not have the fibroblastic infiltrative characteristics that fascia may have and may lead to adhesions to membranes labyrinth. 

           

    Other authors, who believe that matrix should be left intact, are the ones who believe that it works. It can be another appropriate method. But M. M. Paparella believes that the matrix should be removed and it is possible in almost every case.

          

 



 

Speciality Spotlight

 

    
  

External Ear, Middle Ear and Mastoid
      

  • Kuttila S, Kuttila M, et al (Univ of Turku, Finland)
    Aural Symptoms and signs of Temporomandibular Disorder in association with Treatment Need and visits to a Physician
    Laryngoscope 109 : 1669-1673, 1999
         

    Apart from temporomandibular disorder (TMD) causing pain in the jaws, headache and facial pain, aural symptoms, like otalgia without infection, tinnitus, fullness of ears, also do appear to be associated.
        
    This study of 203 men and 208 women of various ages were studied by 3 examination at 12 monthly intervals.
        
    Women had more aural symptoms than men and slight tendency towards more aural symptoms with increasing age upto 55 yrs. The prevalence decreased in older age group. Those with TMD requiring treatment of TMD had more aural symptoms like otalgia.
        
    M.M. Paparella thinks treatment is by heat, a soft diet and an analgesic for 10 days to 2 weeks relieves the symptoms. Those with persistent symptoms, must be referred to dentist with stomatognathic experience.
        

  • T Hoshino, Y Ueda, H Mukohdaka, et al (Hamamatsu Univ, Japan)
    Acute Granulomatous Myringitis
    J Laryngol Otol 112: 150-153, 1998
      
    Acute and chronic myringitis seem to be caused by two different entities. 
       
    Acute myringitis manifests the following – otalgia, a granulomatous bulge along the malleus, and no middle ear infection.
       
    Chronic myringitis is characterized by erosion or thin granulation of the tympanic membrane – it can recur after debridement and cautery.
       
    Granulomatous changes of the tympanic membrane are rare. This article describes five causes of acute granulomatous myringitis.
       

  • NW Todd (Emory Univ, Atlanta, Ga)
    Cranial Anatomy and Otitis Media : A Cadaver Study
    Am J Otol 19:558
      
    This interesting article is probably the first of its kind correlating cranial anatomical changes and otitis media. Thirty-five cadaver skulls were examined.
       
    Healthy middle ears had longer eustachian tubes, a longer distance from the midsella to the staphylion, and the distance between the ears was longer irrespective of race, gender or stature.
      

  • 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.
        

  • Mastoidectory
    Soda-Merhy A, Betancourt-Suarez MA (Natl Inst of Respiratory Diseases, Mexico City)
    Surgical Treatment of Labyrinthine Fistula (LF) Caused by Cholesteatoma
    Otolaryngol Head Neck Surg 122: 739-742, 2000
           
    LF is a common complication of chronic otitis media (OM) in patients with cholesteatoma. It was studied at one institution, a review of surgical criteria and postoperative results discussed. 
           
    Between 1985 to 1997, 27 patients (out of 360 mastoidectomy patients) were found to have L.F. Preoperative C.T scans and audiometric studies were done on all. Preliminary surgery was done in 16 and in 11 revision surgery was done.
          
    In 88% cases L.F. was in horizontal semicircular canal. Open cavity surgical technique was used in all patients and the fistulae were closed by temporalis fascia (16), perichondrium (9) and muscle in (2).
           
    Vertigo relief was seen in all patients, hearing unchanged in 19 patients, bone conduction reduced in 7 patients and improved in one patient.
          
    Conclusion : LF frequency was 7.5%. In 88% it was H.S.C. 93% of patients were diagnosed before surgery. Open cavity with removal of matrix is advised. 
          
    M. M. Paparella stated that a similar experience was seen. It is better if possible to apply a skin graft to seal fistula, because the subcutaneous portion of the skin does not have the fibroblastic infiltrative characteristics that fascia may have and may lead to adhesions to membranes labyrinth. 
           
    Other authors, who believe that matrix should be left intact, are the ones who believe that it works. It can be another appropriate method. But M. M. Paparella believes that the matrix should be removed and it is possible in almost every case.
          

 

 

By |2022-07-20T16:41:06+00:00July 20, 2022|Uncategorized|Comments Off on External Ear, Middle Ear and Mastoid

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