1/8. Acute otalgia: a case report of mature termite in the middle ear.Acute otalgia during childhood is one of the most common complaints in general ENT practice. It may occur as a result of acute otitis externa, otitis media or a foreign body. Animate foreign body in the ear canal or in the middle ear usually results in otalgia and hearing loss. We present a rare case of a living mature termite in the middle ear of a 9-year-old girl complaining of intermittent attacks of otalgia associated with a loud cracking sound in the left ear. In this case, a small perforation of the tympanic membrane without a history of previous trauma, infection, or evidence of a foreign body in the external ear raises a suspicion. A careful, time-consumed microscopic examination could show the living creature in the middle ear. Immediate immobilization and removal of the living foreign body are imperative. In conclusion, tympanic membrane perforation and intermittent severe otalgia without history of otitis may lead to a suspicion of any insects in the middle ear.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/8. Severe audiovestibular loss following ear syringing for wax removal.Syringing of the ear is one of the commonest procedures performed for cleaning cerumen from the external auditory canal. Common complications following syringing are pain, external auditory canal trauma and otitis externa. Hearing and vestibular loss are often mentioned as a complication in descriptions of this technique, but we have not been able to find a reported case of such an occurrence. We report one such a case.- - - - - - - - - - ranking = 2keywords = canal (Clic here for more details about this article) |
3/8. Lateralization of the tympanic membrane as a complication of canal wall down tympanoplasty: a report of four cases.OBJECTIVE: To describe the pathophysiology and treatment of the lateralized tympanic membrane that occurs after canal wall down tympanoplasty. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral hospital. patients: Four patients in whom lateralization of the tympanic membrane developed as a complication of canal wall down tympanoplasty. RESULTS: The patients had undergone middle ear surgery 20 to 34 years before their first visit to the authors. A Bondy operation with soft-wall reconstruction of the ear canal had been performed in three patients and a modified radical mastoidectomy in one patient. They all had severe conductive hearing loss. Common findings were anterior canal sulcus blunting, good tubal function, normal middle ear mucosa, and mobile stapes. At revision surgery, the lateralized tympanic membrane was removed, and the temporalis fascia was grafted medial to the malleus manubrium. The exposed bony surface in the ear canal was covered with a split-thickness skin graft, and the ear canal and the mastoid cavity were tightly packed to secure the graft. All the patients regained good hearing after the revision. Although deterioration of the anterior tympanic ring was presumed to be the primary cause of the graft lateralization, the lack of a posterior bony ear canal might have facilitated this condition. CONCLUSION: Lateralization of the tympanic membrane can occur even in an ear with a radicalized mastoid cavity, especially when the anterior tympanic ring is torn and the posterior ear canal is reconstructed with soft tissue.- - - - - - - - - - ranking = 12keywords = canal (Clic here for more details about this article) |
4/8. Surgical complications and their management in a series of 300 consecutive pediatric cochlear implantations.OBJECTIVE: To report the short- and long-term complications encountered in a large number of consecutive children undergoing implantation in a single center. The current study also describes the management and sequelae of each complication. STUDY DESIGN: Prospective study assessing the surgical findings and complications of deaf children undergoing implantation. SETTING: Pediatric tertiary referral center for cochlear implantation. patients: The present study includes 300 consecutive children undergoing implantation, with a mean age at implantation of 5.1 years, ranging from 1.3 to 16.9 years. Of these children, 196 (65%) had congenital deafness of unknown cause. The commonest known cause was meningitis (73 of 300 [24%]) followed by congenital cytomegalovirus infection (17 of 300 [6%]). Children have been followed up regularly after implantation, typically at yearly intervals after the first year. The mean duration of follow-up at the time of the study was 4 years (range, 0.1-14 yr). RESULTS: There were no major perioperative (within 1 d after surgery) or major early postoperative (within 1 wk after surgery) complications. In the same periods, there were 19 and 15 minor complications, respectively. These complications (e.g., eardrum perforation, hematoma, flap swelling, wound infection, temporary facial weakness) settled with conservative treatment or minor intervention. With regard to the late surgical complications (>1 wk after surgery), there were 7 major (e.g., severe flap infection requiring explantation, cholesteatoma, persistent eardrum perforation) and 14 minor complications (e.g., mild flap infection, flap swelling, hematoma). A number of complications were encountered even 14 years after the original operation, and some of them needed repeated interventions, highlighting the importance of long-term follow-up. However, most of the complications occurred very close to the surgical procedure (<1 yr). CONCLUSION: An overall rate of 2.3% for major surgical complications and an overall rate of 16% for minor surgical complications suggest that cochlear implantation is a relatively safe surgical operation in experienced centers. Most surgical complications are minor and can be managed with conservative treatment or minor surgical intervention. However, meticulous attention to surgical detail, especially handling soft tissues and leaving the posterior canal wall intact, and long-term follow-up are of paramount importance in minimizing the incidence of surgical complications.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
5/8. Potential ototoxicity from triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl) cream.Although rare, ototoxicity from the use of aminoglycoside drops is well recognized. Ototoxicity has not been described with the use of combination aminoglycoside-steroid-antifungal creams or ointments. We present the case of a 60-year-old man with a perforated tympanic membrane who suffered a total hearing loss after the instillation of cream containing triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl cream) into his ear canal. On balance, we believe that a number of potentially ototoxic constituents in this cream were responsible. Other possible causes of sensorineural hearing loss and the possible mechanisms of ototoxicity of this cream are discussed. The reasons why such creams may be particularly ototoxic, compared with drops, are also considered. The authors caution against the use of such creams or ointments in the ear if there is any suspicion of a tympanic membrane perforation.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
6/8. Patient with audible popping sounds emanating from the ear canal.We describe a most unusual case of a 40-year-old male who presented with audible popping sounds emanating from his left ear canal. The process of identifying the source of the sounds and treating the underlying cause is presented in detail.- - - - - - - - - - ranking = 5keywords = canal (Clic here for more details about this article) |
7/8. Topical gentamicin vestibular toxicity.Two patients with large tympanic membrane perforations received Garasone eardrops. They developed severe acute vestibular deafferentation. In one patient, the middle ear mucosa was healthy and uninfected, and in the other ear, it was inflamed. It is recommended that caution be used in administration of Garasone to the middle ear. If damage can occur with gentamicin, it likely occurs with other ototoxic agents. It is recommended that ototoxic agents not be used in uninflamed middle ears during surgery. The patient should be instructed to treat the discharge through a perforation or tube for only 2 days after the discharge from the external canal ceases.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
8/8. Herniation of the temporomandibular joint into the external auditory canal: a complication of otologic surgery.Herniation of the temporomandibular joint into the external auditory canal has been reported as a result of trauma, neoplasia, infection, inflammatory processes, or developmental malformations. This paper reviews the intimate relation of the temporomandibular joint to the temporal bone as well as the literature describing temporomandibular joint herniation into the external auditory canal. Four cases of temporomandibular joint herniation into the external auditory canal resulting from otologic surgery are presented. Their characteristic location, clinical and radiographic findings are described and contrasted to previously reported cases. Despite striking displacement of the temporomandibular joint into the external auditory canal, there were no clinical symptoms referable to this finding. The absence of symptoms distinguished this postoperative etiology of temporomandibular joint herniation from other etiologies mentioned above.- - - - - - - - - - ranking = 8keywords = canal (Clic here for more details about this article) |