1/8. Acute mastoiditis and cholesteatoma.Acute coalescent mastoiditis is an uncommon sequela of acute otitis media. It occurs principally in the well-pneumatized temporal bone. The findings of fever, pain, postauricular swelling, and otorrhea are classic. cholesteatoma, on the other hand, being associated with chronic infection, usually occurs in the sclerotic temporal bone. The signs and symptoms are isidious in nature and consist of chronic discharge and hearing loss which result from its mass, bone erosion, and secondary infection. Of 17 consecutive cases of acute mastoiditis over a six-year period, four were atypical because they were complications of chronic otitis media and cholesteatoma, yet they had the physical findings of acute mastoiditis-subperiosteal abscess and purulent otorrhea, plus radiographic evidence of mastoid coalescence.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Hemotympanums secondary to spontaneous epistaxis in a 7-year-old.Hemotympanum is a well-known physical finding most often associated with basilar skull fractures and therapeutic nasal packing. A literature review demonstrated only five cases of hemotympanum associated with spontaneous epistaxis in adults. To our knowledge, there have been no reported cases in children. We present a case of a 7-year-old child with bilateral hemotympanums secondary to spontaneous epistaxis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/8. An insidious preauricular sinus presenting as an infected postauricular cyst.Preauricular sinuses are common congenital malformations that usually occur at the anterior margin of the ascending limb of the helix. We present three paediatric patients with postauricular infected cysts and coincidentally discovered auricular pits. Single-stage operations were performed to remove the cysts, pits and involved cartilage. Histopathology revealed a preauricular sinus with inflammation. Although uncommon, a postauricular infected cyst may indicate the presence of a preauricular sinus. Detailed physical examination of preauricular pits should be performed, and the operating microscope may aid during surgery to remove remnants and prevent recurrence. An infected preauricular sinus can be effectively treated with single-stage excision.- - - - - - - - - - ranking = 10.019287430848keywords = physical examination, physical (Clic here for more details about this article) |
4/8. glomus tympanicum--excision by radical mastoidectomy exposure with autograft reconstruction.Wide surgical exposure, total tumor removal and anatomic and functional reconstruction are the goals of tumor management. These goals are met by radical mastoidectomy exposure for the removal of glomus tympanicum tumors and reconstruction by autograft replacement of the posterior osseous canal, and if the tympanic membrane, malleus and incus are removed for tumor exposure, autograft replacement may also be accomplished. The history, physical findings, x-rays and details of surgical management of two patients with glomus tympanicum are reviewed. Wide removal of the posterior osseous canal, just lateral to the VIIth nerve with total replacement of this segment gives excellent exposure of the middle ear space and affords total reconstruction of the posterior osseous canal.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/8. facial nerve and medially invasive petrous bone cholesteatomas.Eight patients with extensive petrous bone cholesteatomas that invaded the labyrinth and fallopian canal are presented. The eight cases are added to a tabulation of prior literature reports to elucidate concepts of routes of extension of medially invasive temporal bone cholesteatoma. Medially invasive petrous bone cholesteatoma develops insidiously, often without symptoms other than facial palsy and/or unilateral deafness. Typically, a history of chronic ear disease can be obtained. While hearing is unlikely to be preserved in this group of patients, facial nerve function can usually be preserved, and a facial nerve graft was not necessary in our series. Acute facial nerve palsy or facial nerve paresis progressing to palsy in patients with a history of chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/8. Perilymphatic fistula: a new hampshire experience.Thirty-five patients with perilymphatic fistulas (PLFs) are presented. Of this group of 35 patients (39 ears), 4 patients did not have fistulas that could be observed with certainty but were presumed to have fistulas by virtue of their excellent response to surgical repair. Our case reports provide examples of the great variety and possible classifications of presentations and symptom complexes that lead one to suspect the diagnosis of perilymphatic fistula. Comments on diagnostic and therapeutic modalities and on postoperative care and counseling are included. The age range of patients in our series is 3 to 67 years. Four patients are under age 20, and an additional three patients probably developed their symptoms prior to age 20 but presented later. Twenty-three (79%) of 29 patients with spontaneous PLFs began having symptoms closely related to some event involving physical or mechanical stress, and a high percentage (76%) had symptoms aggravated by physical stress. Six are believed to have fistulas of congenital origin. There is a sibling pair and a mother and son in the series; these four people had bilateral fistulas.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
7/8. cholesteatoma of the external auditory canal and keratosis obturans.keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. case reports are presented to illustrate the features of these two diseases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/8. Patulous eustachian tube identification using tympanometry.The patulous, or nonclosing, eustachian tube is believed to affect as many as 7 percent of all adults, causing physical and psychological difficulties. This paper provides a brief review of the literature regarding the patulous eustachian tube (PET), its symptoms, precipitating conditions, incidence, diagnosis, and current medical management. Several case studies are also presented to illustrate the use of tympanometry in PET identification.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |