1/7. cholesteatoma vs. cholesterol granuloma of the petrous apex.Lesions involving the petrous apex are rarely encountered in clinical practice. This directly affects the ability of the otolaryngologist to diagnose and effectively treat these lesions. Greater physician awareness and increased technologic capability are leading to more effective management of pathologic conditions involving this area of the temporal bone.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. mandibular fractures in association with chin trauma in pediatric patients.The combination of chin trauma and bleeding from the ear should alert the physician to the possibility of a mandibular fracture. Not all hemotympanums represent basilar skull fractures, especially when they occur in association with chin trauma. diagnosis of mandibular condylar fractures or temporomandibular joint disruptions can be very difficult. A high index of suspicion and a proper choice of imaging modalities are necessary to ensure a timely diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. External auditory canal cholesteatoma.cholesteatoma of the EAC is a rare otologic problem, particularly when keratosis obturans otica is excluded. The predominant features of EAC cholesteatoma are acute external symptoms, severe pain, recurrent physician visits, and paucity of X-ray findings. Poorly responding otitis externa should always alert the physician to the possibility of neoplasm, diabetes, or some other underlying condition which will not respond to just topical treatment. cholesteatoma of the external auditory canal should also be considered in refractory cases of otitis externa. Three patients with EAC subperiosteal cholesteatoma are reviewed.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/7. Human immunodeficiency virus--associated non-Hodgkin's lymphoma presenting as an auricular perichondritis.AIDS-related NHL is an aggressive neoplasm, usually of high or intermediate grade, frequently extranodal at initial treatment, and often the first manifestation of AIDS. Although complete remissions have been reported, they occur in only a minority of patients. We describe a patient with NHL of the external ear that masqueraded as an auricular perichondritis. This is the first case reported in which AIDS-related NHL first appeared in the ear, and this should alert physicians who treat patient with AIDS to be aware of the protean manifestations of this disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. tympanic membrane keratoma (cholesteatoma) in children with no prior otologic surgery.Three children whose eardrums appeared normal upon previous examinations, one with the otomicroscope, apparently developed tympanic membrane cholesteatomas that penetrated the fibrous layer of the pars tensa. Their histories all included episodes of acute otitis media, but no otorrhea. No otologic surgical procedures, including myringotomy, had been performed. These cases are thought to provide clinical support for the basal epithelial migration theory of cholesteatoma genesis. Ruedi's experiments suggest that cholesteatomas resulting from basal epithelial migration may not be visible for 18 to 30 days; thus, follow-up evaluations after acute otitis media should probably include examinations one and two months after the infection. Pediatricians and family physicians should be urged to seek otologic consultation for patients with even minor eardrum abnormalities, particularly those following infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Video otoscopy in audiologic practice.Recent advances in endoscopic optics and miniature video camera technology have made video otoscopy (VO) accessible to audiologists in a practical way. Seven categories of VO applications are presented with clinical examples: (1) general examination of the earcanal and tympanic membrane, (2) physician communication/telemedicine, (3) hearing instrument selection and fitting applications, (4) patient education, (5) scope of practice reinforcement, (6) knowledge base/skill growth, and (7) cerumen management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Zinc therapy in otology.At a recent panel on Otology, I asked the audience for a show of hands of those using Zinc for delayed healing and granulations. It was surprising to note that not more than 4 physicians out of 100 had tried Zinc. The need to report our encouraging results was apparent. From 1971 to 1975, 544 tympanoplasties and 122 mastoidectomies were studied for delayed healing due to granulations. Forty-six patients were found to have resistant granulations. Thirty-three of these healed within two weeks of therapy, 10 more required a total of four weeks for healing, and three did not respond well. Sixteen patients had recurrence when the medication was terminated as soon as healing had occurred but responded well when the medication was continued for four weeks after healing was complete. Five patients had nausea, which subsided when the dosage was reduced from the usual 200 mg. of zinc sulfate, three times daily with meals to 100 mg., t.i.d. or b.i.d. One patient developed mild urticaria. Zinc therapy is apparently indicated in granulomata of the ear when healing does not occur with conventional therapy, especially in the post-operative patient; however, it will not suffice when there is massive involvement of the mastoid or middle ear, where surgical removal is indicated.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |