1/15. cholesteatoma extending into the internal auditory meatus.We report our experiences in managing a patient with cholesteatoma complicated by meningitis, labyrinthitis and facial nerve palsy. The antero-inferior half of the tympanum was aerated but the postero-superior portion of the tympanic membrane was tightly adherent to the promontry mucosa. An attic perforation was present at the back of the malleolar head. High-resolution computed tomography also uncovered a fistula in the lateral semicircular canal. Surgical exploration of the middle ear cavity demonstrated that both the vestibule and cochlea were filled with cholesteatoma, and the cholesteatoma extended into the internal auditory meatus through the lateral semi-circular canal fistula. The cholesteatoma was removed by opening the vestibule and cochlea with a preservation of the facial nerve. Post-operatively, an incomplete facial palsy remained, but has improved slowly. There is no sign of recurrence to date after a 3-year period of observation.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/15. The pathology of the temporal bones of a child with acquired cytomegalovirus infection: studies by light microscopy, immunohistochemistry and polymerase-chain reaction.STUDY DESIGN: The first case of an acquired cytomegalovirus (CMV) infection of the inner ear is reported in a 3-year-old girl in remission from acute lymphocytic leukemia. methods: Horizontal sections of the temporal bones were studied by light microscopy and immunohistological staining by avidin-biotin-complex-technique was performed on selected archival sections. Three sections were processed for detection of the virus genome by the polymerase chain reaction (PCR). RESULTS: By light microscopy the epithelium of the endolymphatic sac, the utricle and the semicircular canals showed deeply stained acidophilic inclusions and the stria vascularis had a loose structure especially in the intermediate layer. The changes were limited to the non-sensory parts of the labyrinth and no CMV type cells were observed in the organ of corti. There was a loss of inner and outer hair cells and loss of cochlear ganglion cells caused by either the virus or treatment with gentamicin. Standard immunohistochemistry failed to demonstrate staining with CMV antibodies, but PCR, demonstrated CMV-dna in one section. CONCLUSION: Molecular techniques may be able to detect acquired CMV infections in archival pediatric bones temporal bones. The histologic findings in the labyrinth were milder, however showed some similarity to children with congenital CMV labyrinthitis.- - - - - - - - - - ranking = 0.21503618908651keywords = organ (Clic here for more details about this article) |
3/15. Early bilateral eighth nerve involvement in meningococcal meningitis.A male Navy recruit had hearing loss and bilateral otitis media. Meningeal signs, not initially present, developed approximately 48 hours after admission to the hospital. Type Y meningococcus was isolated from blood cultures drawn after two days of ampicillin administered orally. Permanent, bilateral, vestibular and auditory loss resulted, in spite of adequate doses of penicillin. This unusual presentation of bilateral eighth nerve involvement was thought to be due to a localized, bilateral meningococcal labyrinthitis.- - - - - - - - - - ranking = 2.5keywords = nerve (Clic here for more details about this article) |
4/15. Histopathology of sudden hearing loss.Eleven temporal bones from eight patients who had clinical histories of sudden hearing loss (SHL) were studied to assess the possible etiopathogenesis. The origin of SHL in seven ears from five patients was obscure, but appeared to be due to multiple causes. Common histopathologic changes in the cochlea, although complex, included atrophy of the organ of corti and loss of cochlear neurons. Loss of cochlear neurons was the main finding in ears of viral infection. Labyrinthine fibrosis and formation of new bone were seen in two ears associated with vascular insult and in two ears of autoimmune disease. Different histopathologic findings causing SHL were observed even in cases with the same etiology. A case of SHL showing endolymphatic hydrops as the main histopathologic finding is described.- - - - - - - - - - ranking = 0.21503618908651keywords = organ (Clic here for more details about this article) |
5/15. Labyrinthine sequestrum (a case report).An unusual case of a labyrinthine sequestrum is presented. During mastoidectomy on a patient with chronic recurrent mastoiditis, a large sequestrum in the labyrinth was found. Four years earlier he had been treated for a posterior fossa abscess, which had followed acute otitis media. An extensive ablative and drainage procedure of the pars superior and pars inferior with preservation of the facial nerve was indicated in this patient.- - - - - - - - - - ranking = 0.5keywords = nerve (Clic here for more details about this article) |
6/15. Histopathological features of the spiral ganglion and cochlear nerve in temporal bones from three patients with profound hearing loss.In the following study the condition of the spiral ganglion and the cochlear nerve of ears from patients suffering from profound hearing loss is described. The number of spiral ganglion cells has been related to the clinical diagnosis. The number of spiral ganglion cells in the two temporal bones of a patient with neomycin ototoxicity was almost normal. A reduction of less than one-third of spiral ganglion cells has been observed in the temporal bones of a child who died after a bacterial labyrinthitis. The temporal bone with a Mondini dysplasia revealed a pronounced reduction of ganglion cells of more than two-thirds. The cochlear nerve trunk in the internal auditory canal appeared normal in all three cases. The present findings are discussed in respect to the degenerative behaviour of the cochlear neural elements in human being compared to animals.- - - - - - - - - - ranking = 3keywords = nerve (Clic here for more details about this article) |
7/15. Pseudomonas labyrinthitis.pseudomonas aeruginosa is the gram-negative bacterial rod which is often isolated from chronic aural discharge. This microorganism may also cause necrotizing infection of the external auditory canal in certain patients with impaired host-defense mechanisms. Involvement of the inner ear by this microbe is extremely rare. In this communication, we report a case of pseudomonas labyrinthitis which resulted from traumatic middle ear injury. infection produced massive granulations and extensive bone destruction of the otic capsule. This case shows that while P.aeruginosa is usually an avirulent opportunistic pathogen, it may also cause a highly destructive labyrinthitis if the inner ear is entered.- - - - - - - - - - ranking = 0.21503618908651keywords = organ (Clic here for more details about this article) |
8/15. Acute vestibular dysfunction in childhood. Central vs. peripheral.Acute, vestibular symptoms in childhood are primarily caused by acute labyrinthitis (end organ dysfunction) or central nervous system diseases such as neoplasia involving the pons or cerebellar nuclei or infection manifested by pontine encephalitis. The evaluation, treatment, and prognosis of end organ versus central disease is so different that the ability to make a bedside, presumptive diagnosis provides an important advance. Both patients presented here had a central vestibulopathy. By paying particular attention to the character of the nystagmus and past pointing, the Romberg test, and the details of the vertiginous history, central disease was the presumptive diagnosis prior to invasive procedures. The neurophthalmological clues are reviewed to demonstrate their value in making more accurate diagnoses in children with acute vestibular dysfunction.- - - - - - - - - - ranking = 0.43007237817303keywords = organ (Clic here for more details about this article) |
9/15. cytomegalovirus labyrinthitis in an infant: morphological, virological, and immunofluorescent studies.The inner ears obtained from an infant who died of severe congenital cytomegalovirus infection were examined using virological and morphological methods. The techniques of microdissection and surface preparations, immunofluorescent microscopy, and transmission and scanning electron microscopy were employed. cytomegalovirus was isolated from the perilymph. Injury to the cochlea was minor and was confined to the first half of the basal turn. There were signs of a severe labyrinthitis of the vestibular endolymphatic system. Vestibular organs, especially the saccule and utricle, showed severe damage, with collapse of the saccular membranous wall. Inclusion-bearing cells containing cytomegalovirus antigen, as shown by immunofluorescent staining, and cytomegalovirus virions, as observed by electron microscopy, were found on the endolymphatic surface of the membranous walls, mainly in the saccule and utricle. In the utricle, the infected cells appeared to be concentrated in the regions where the so-called dark cells were located. These dark cells are similar to the proximal tubule cells in the kidney, another common target for cytomegalovirus infection.- - - - - - - - - - ranking = 0.21503618908651keywords = organ (Clic here for more details about this article) |
10/15. Mycotic infection of the temporal bone.Herein is a histopathologic study of the temporal bone changes in three patients with fatal systemic fungal infections. All three patients were compromised hosts who failed to respond to adequate chemotherapy. Interestingly, one patient with cryptococcosis had a unilateral hearing loss as the sole manifestation of cerebral cryptococcosis. The most common histopathologic change consisted of a fungal infiltration of the nerves in the internal auditory canal, with moderate infiltration of the sense organs of the membranous labyrinth.- - - - - - - - - - ranking = 0.71503618908651keywords = nerve, organ (Clic here for more details about this article) |
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