1/10. Cochlear and vestibular dysfunction resulting from physical exertion or environmental pressure changes.Inner ear damage due to physical exertion or environmental pressure changes has been described only recently. According to Goodhill there are two possible mechanisms of injury: the explosive and the implosive. The former is triggered by increased C.S.F. pressure transmitted to the perilymph space; the latter by increased pressure in the middle ear transmitted to the perilymph space through the two windows. Sudden hearing loss or dizziness, or both, are the main symptoms. The diagnosis will be established by the history, the audiogram, and the electronystagmogram (ENG). The treatment is still controversial. As the formation of a fistula is a real possibility, an exploratory tympanotomy is suggestive on suspected cases. Due to the variety of symptoms every case has to be assessed individually. A detailed history is of utmost importance.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. T-cell prolymphocytic leukemia presenting as an ear canal mass.OBJECTIVE: We discuss the first reported case of a chronic leukemia involving the external auditory canal. STUDY DESIGN: Case report and review of the literature (medline, 1962-2003). methods AND RESULTS: An adult man in good health came to receive medical attention because of a sensation of aural fullness. Radiologic and physical examination demonstrated an ovoid soft tissue mass of the lateral external auditory canal that, after biopsy and flow cytometry studies, was found to be T-cell prolymphocytic leukemia. The patient presented with minimal disease in a highly symptomatic location, allowing early initiation of therapy and extending his life by nearly four times the average life expectancy for this aggressive chronic leukemia. CONCLUSION: Lymphomas of the external auditory canal are extremely rare neoplasms. Only a few cases have previously been reported, and all of the previous reports involve acute leukemias. This report indicates that chronic leukemias can present with otologic manifestations such as an external auditory canal mass.- - - - - - - - - - ranking = 1.1454297033121keywords = physical examination, physical (Clic here for more details about this article) |
3/10. Localization of a novel autosomal recessive non-syndromic hearing impairment locus DFNB55 to chromosome 4q12-q13.2.Hereditary hearing impairment (HI) is the most genetically heterogeneous trait known in humans. So far, 54 autosomal recessive non-syndromic hearing impairment (ARNSHI) loci have been mapped, and 21 ARNSHI genes have been identified. Here is reported the mapping of a novel ARNSHI locus, DFNB55, to chromosome 4q12-q13.2 in a consanguineous Pakistani family. A maximum multipoint lod score of 3.5 was obtained at marker D4S2638. The region of homozygosity and the 3-unit support interval are flanked by markers D4S2978 and D4S2367. The region spans 8.2 cm on the Rutgers combined linkage-physical map and contains 11.5 Mb. DFNB55 represents the third ARNSHI locus mapped to chromosome 4.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
4/10. deafness: ever heard of it? Delayed recognition of permanent hearing loss.Records of approximately 1,000 children seen for evaluation of developmental delay during the period July 1979 to December 1985 were reviewed; 46 children with permanent hearing loss were identified. Age at diagnosis of deafness and factors contributing to delay in diagnosis were sought. Mean age at diagnosis of profound congenital deafness was 24 months. Lesser degrees of congenital hearing loss were not diagnosed until 48 months of age. High-risk medical history or physical anomalies associated with embryologic abnormalities of the auditory system that should have triggered a prompt search for deafness went unheeded in most instances. In 40% of subjects, the author was the first to diagnose hearing loss. For two thirds of this subgroup, audiologic referral was prompted by medical, physical, or developmental findings rather than clinically evident hearing loss during physical examination. Adherence to specific historical, physical, or developmental risk criteria, regardless of the examiner's subjective impression of how well the child seems to hear, would have permitted the timely diagnosis of hearing impairment in all children in this series.- - - - - - - - - - ranking = 1.7454297033121keywords = physical examination, physical (Clic here for more details about this article) |
5/10. An unusual posterior cranial fossa tumour causing hearing loss.Clivus meningioma is an uncommon tumour arising from the region of the synchrondrosis between the basal portions of the sphenoid and occipital bones. We report a case of a patient with a large meningioma of the clivus whose presenting symptom was auditory change. Alteration of hearing is a rare mode of presentation for such a tumour although it may present at a later stage in about 50 per cent of cases. The discrepancy between the size of the tumour and the paucity of physical findings, the value of a multiple test auditory screening strategy, and the surgical approach in this case are discussed.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
6/10. Acoustic tumors: atypical features and recent diagnostic tests.About one-third of patients with acoustic tumor (AT) initially seek medical attention for nonaudiologic complaints. The nonspecific early symptoms of AT require the inclusion of AT in many neurologic differential diagnoses. Advances in electrophysiologic and radiographic tests have allowed earlier diagnosis of AT at a time when abnormal physical findings other than hearing loss are present in less than half of patients. The availability of brainstem auditory evoked response testing, fourth-generation CT, and air-CT cisternography have changed the approach to the diagnosis of AT. Neurologists should be cognizant of recent diagnostic advances.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
7/10. klippel-feil syndrome with conductive deafness and histological findings of removed stapes.The klippel-feil syndrome is usually associated with sensorineural hearing impairment, but rarely is it associated with conductive or mixed deafness. A 22-year-old female presented with fusion of the cervical vertebrae, torticollis, scoliosis, pterygium colli, the Sprengel deformity with an omovertebral bone, concavity of the thorax and conductive hearing impairment of the right ear. Tympanotomy disclosed an atrophic long process of incus and a fixation of the stapes footplate, and stapedectomy was performed with immediate postoperative improvement of hearing. However, she developed a sudden hearing loss with dizziness soon after she had physical exercise on the 15th postoperative day, and revision surgery revealed a perilymph fistula of the oval window. Histological investigations of the removed stapes showed no specific osseous changes but hyperostosis of the posterior edge of the footplate. The literature is reviewed and the etiology of the conductive deafness and the perilymph fistula is discussed.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
8/10. Geriatric grand rounds: hearing impairment and functional independence.hearing loss is a commonly encountered impairment in the elderly. It can profoundly affect physical, psychosocial and cognitive function. In addition to the actual hearing loss, other factors contribute to the hearing handicap experienced by older persons. These include difficulty in understanding speech in noisy situations, difficulty in supplementing hearing with visual information, and the slowing of cognitive and psychologic processes. Many forms of amplification are available and can be very useful in reversing much of the functional impairment associated with hearing loss. A comprehensive audiological assessment should be recommended before selecting the type of hearing aid or assistive listening device. Such a referral also affords an opportunity for more extensive aural rehabilitation.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
9/10. Unilateral conductive hearing loss secondary to a high jugular bulb in a pediatric patient.A high jugular bulb is not an uncommon otologic anomaly. It may be noted as an incidental finding on physical exam, middle ear surgery, or computed tomography of the temporal bones. Frequently the patient is asymptomatic, but a high jugular bulb can occasionally cause tinnitus or conductive hearing loss. The case of a seven-year-old black male with unilateral conductive hearing loss secondary to a high jugular bulb is presented. The diagnosis, differential diagnosis, and management of a conductive hearing loss associated with a high jugular bulb are discussed.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
10/10. Bone-conduction amplification with completely-in-the-canal hearing aids.Recent advances in miniaturization have provided clinicians with hearing aids that can be comfortably inserted as far as the bony portion of the ear canal. It is possible to take advantage of these deeply inserted hearing aids in new ways. For example, the physical vibrations of microphone and receiver components may be used to improve hearing aid gain through bone conduction. Three cases are presented that will introduce this phenomenon for two transcranial CROS fittings and for one unilateral otosclerosis fitting. In each case, functional gain measurements under headphones were obtained with the hearing aid receivers acoustically plugged. Considerable gain was still present. Potential benefits, ramifications, and side effects are discussed.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
| | Next -> |