MyMedR

Fulltext Management of otitis media with effusion in children

Zulkiflee S, Siti Sabzah MH, Philip R, Md Aminuddin MY

Malays Fam Physician, 2013;8(2):32-35.

Otitis media with effusion (OME) is a condition characterised by a collection of fluid within the middle ear without signs of acute inflammation. It is common in young children, with a bimodal peak at two and five years of age. Eighty percent of children have at least one episode of OME by the age of 10 years. This disease is a common ear problem among children with craniofacial anomalies including cleft palate and Down syndrome (DS).

Matched MeSH terms: Ear, Middle

A Longitudinal Analysis of Pressurized Wideband Absorbance Measures in Healthy Young Infants

Wali HA, Mazlan R, Kei J

Ear Hear, 2019 2 27;40(5):1233-1241.

PMID: 30807541 DOI: 10.1097/AUD.0000000000000707

OBJECTIVES: Wideband absorbance (WBA) is an emerging technology to evaluate the conductive pathway (outer and middle ear) in young infants. While a wealth of research has been devoted to measuring WBA at ambient pressure, few studies have investigated the use of pressurized WBA with this population. The purpose of this study was to investigate the effect of age on WBA measured under pressurized conditions in healthy infants from 0 to 6 months of age.

DESIGN: Forty-four full-term healthy neonates (17 males and 27 females) participated in a longitudinal study. The neonates were assessed at 1-month intervals from 0 to 6 months of age using high-frequency tympanometry, acoustic stapedial reflex, distortion product otoacoustic emissions, and pressurized WBA. The values of WBA at tympanometric peak pressure (TPP) and 0 daPa across the frequencies from 0.25 to 8 kHz were analyzed as a function of age.

RESULTS: A linear mixed model analysis, applied to the data, revealed significantly different WBA patterns among the age groups. In general, WBA measured at TPP and 0 daPa decreased at low frequencies (<0.4 kHz) and increased at high frequencies (2 to 5and 8 kHz) with age. Specifically, WBA measured at TPP and 0 daPa in 3- to 6-month-olds was significantly different from that of 0- to 2-month-olds at low (0.25 to 0.31 kHz) and high (2 to 5 and 8 kHz) frequencies. However, there were no significant differences between WBA measured at TPP and 0 daPa for infants from 3 to 6 months of age.

CONCLUSIONS: The present study provided clear evidence of maturation of the outer and middle ear system in healthy infants from birth to 6 months. Therefore, age-specific normative data of pressurized WBA are warranted.

Matched MeSH terms: Ear, Middle

Fulltext Embryonal rhabdomyosarcoma of the middle ear presenting with aural polyp and facial nerve palsy

Vasiwala R, Burud I, Lum SK, Saren RS

Med J Malaysia, 2015 Oct;70(5):314-5.

PMID: 26556123 MyJurnal

Rhabdomyosarcoma is a rare tumour in the middle ear and mastoid cavity in children and the diagnosis is difficult. Repeated histological examination may be essential to confirm the diagnosis. We report a 6 year old boy with a left aural polyp, otorrhoea and facial nerve palsy who was initially thought to have otitis media and mastoiditis. He had polypectomy and the tissue taken for histopathology suggested an inflammatory condition. Subsequently he had mastoidectomy. Tissue taken during mastoidectomy was however reported as rhabdomyosarcoma. The child developed a cerebral abscess and eventually succumbed. A literature review of the disease, radiological findings, immunohistochemical features and treatment options is described.

Matched MeSH terms: Ear, Middle

Bilateral nontuberculous mycobacterial middle ear infection: a rare case

Tang IP, Singh S, Rajagopalan R

Ear Nose Throat J, 2014 Sep;93(9):390-4.

PMID: 25255345

Nontuberculous Mycobacterium (NTM) middle ear infection is a rare cause of chronic bilateral intermittent otorrhea. We report a rare case of bilateral NTM middle ear infection in which a 55-year-old woman presented with intermittent otorrhea of 40 years' duration. The patient was treated medically with success. We conclude that NTM is a rare but probably under-recognized cause of chronic otitis media. A high index of suspicion is needed for the diagnosis to avoid prolonged morbidity. Treatment includes surgical clearance of infected tissue with appropriate antimycobacterial drugs, which are selected based on culture and sensitivity.

Matched MeSH terms: Ear, Middle/surgery

Fulltext Glomus tympanicum: a report of two cases

Subha ST, Raman R, Prepageran N

Med J Malaysia, 2005 Mar;60(1):106-8.

PMID: 16250293

Two cases of glomus tympanium tumor of the middle ear stage 'type A' according to Fisch classification, are presented due to their rarity in this part of the world. These tumors were excised by end aural tympanotomy approach and there has been no recurrence in both patients to date.

Matched MeSH terms: Ear, Middle*

Relapse of B-cell acute lymphoblastic leukaemia presenting as right aural polyp with facial and mandibular nerves palsy

Shiun Chuen C, Md Daud MK, Che Jalil NA, Hazmi H

Med J Malaysia, 2017 10;72(5):318-320.

PMID: 29197892 MyJurnal

A patient presenting with an ear polyp is a common finding in otorhinolaryngology practice. The common causes include chronic otitis media and cholesteatoma. We report an adult female patient with a history of acute leukaemia presenting with chronic otitis media symptoms and right ear polyp. She was subsequently diagnosed as relapse of B-cell acute lymphoblastic leukaemia based on histopathological examination. The presentation may be similar to an inflammatory pathology of the middle ear, making it misleading.

Matched MeSH terms: Ear, Middle/physiopathology

Fulltext Foreign body in the middle ear, a hearing aid complication

Shashinder S, Tang IP, Velayutham P, Rahmat O, Loganathan A

Med J Malaysia, 2008 Aug;63(3):267-8.

PMID: 19248709 MyJurnal

A 12-year-old boy with moderate to severe bilateral mixed hearing loss was planned for hearing aid placement. During the process of making ear mould impression, the impression material accidentally entered the right middle ear. Removal of the ear mould impression was possible permeatally under general anaesthesia.

Matched MeSH terms: Ear, Middle*

Fulltext High grade mucoepidermoid carcinoma of the middle ear treated with extended temporal bone resection

Shailendra S, Elmuntser A, Philip R, Prepageran N

Med J Malaysia, 2008 Aug;63(3):247-8.

PMID: 19248700 MyJurnal

We report a case of High grade Mucoepidermoid carcinoma of the middle ear. A 67 year old gentleman was referred to our centre for persistent otalgia associated with facial weakness for four months. Examination revealed a middle ear mass with House Brackmann Grade 3 Facial Palsy and ipsilateral lymhadenopathy. Biopsies suggested a squamous cell carcinoma of the middle ear, and he successfully underwent an Extended Temporal bone resection with External canal reconstruction and neck dissection. Postoperative Histopathology revealed that the tumour was in fact a High Grade Mucoepidermoid carcinoma. He received postoperative radiotherapy and is well one year post operatively.

Matched MeSH terms: Ear, Middle*

Vestibular nerve section in a child with intractable Menière's disease

See GB, Mahmud MR, Zurin AA, Putra SH, Saim LB

Int J Pediatr Otorhinolaryngol, 2002 May 31;64(1):61-4.

PMID: 12020915

Clinical presentation of Menière's disease in children is not as typical as in adults. The triad of vertigo, tinnitus and deafness are not usually elicited, diagnosis often being made after years of follow up and batteries of investigation. A case of Menière's disease in a 3-year-old boy is presented. The diagnosis was only obvious at the age of 8 when the triad of vertigo, deafness and tinnitus were present. His disease progressed despite a trial of intratympanic gentamicin injections and endolymphatic sac decompression. Vestibular nerve section was subsequently performed for his intractable disease. Following the procedure he was asymptomatic and able to attend school.

Matched MeSH terms: Ear, Middle/drug effects; Ear, Middle/innervation*

Fulltext Hyphae in external auditory canal

Saniasiaya J, Narayanan P

BMJ Case Rep, 2021 Jul 26;14(7).

PMID: 34312145 DOI: 10.1136/bcr-2021-245388

Matched MeSH terms: Ear, Middle

Rhabdomyosarcoma of the middle ear and mastoid in children

Said H, Phang KS, Razi A, Khuzaiyah R, Patawari PH, Esa R

J Laryngol Otol, 1988 Jul;102(7):614-9.

PMID: 3411216

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.

Matched MeSH terms: Ear, Middle*

Fulltext Congenital or acquired? A case report of extensive congenital cholesteatoma

Roslenda, A.R., Asma, A., Igbal, F.R.W., Jeevanan, J.

Medicine & Health, 2010;5(2):103-107.

MyJurnal

Congenital cholesteatoma (CC) is rare clinical condition and It is known as a pearly white mass medial to an intact tympanic membrane. In this case report, we describe a 6-year-old boy who presented with a one year history of left ear discomfort, reduced hearing, followed by ear discharge two months prior to admission. Otoscopic examination revealed a large attic perforation. Radiological investigation showed extensive cholesteatoma in the mastoid, mesotympanum and epitympanum with destruction of the ossicles including the stapes footplate. He underwent radical mastoidectomy in view of extensive cholesteatoma with tympanoplasty type V. In this case report, the classification, treatment and theories related to CC are discussed.

Matched MeSH terms: Ear, Middle

Approach to surgery in the middle ear without the need for an aural speculum

Raman R

Ear Nose Throat J, 1999 Apr;78(4):306-7.

PMID: 10224707

This article describes a new approach to permeatal surgery in the middle ear that does not require the use of an aural speculum.

Matched MeSH terms: Ear, Middle/surgery*

Fulltext Annular bony spur

Raman R

Indian J Otolaryngol Head Neck Surg, 2000 Jul;52(3):318.

PMID: 23119711 DOI: 10.1007/BF03006219

A micro anatomical feature in the ear useful in surgery is described.

Matched MeSH terms: Ear, Middle

Fulltext An alternate approach to the mastoid antrum

Raman R

Indian J Otolaryngol Head Neck Surg, 1998 Apr;50(2):193.

PMID: 23119414 DOI: 10.1007/BF02991691

An alternate approach to the mastoid antrum for acellular mastoid is presented.

Matched MeSH terms: Ear, Middle

Beyond a tympanic membrane perforation: a superb view of normal middle ear structures

Rahmat O

Ear Nose Throat J, 2007 Jul;86(7):375.

PMID: 17702308

Matched MeSH terms: Ear, Middle/anatomy & histology*

Fulltext Cerebrospinal fluid otorrhoea from an abnormal communication between the internal auditory meatus and the medial wall of the tympanic cavity

Philip R, Prepageran N, Raman R, Waran V

Med J Malaysia, 2009 Sep;64(3):248-9.

PMID: 20527282 MyJurnal

Patients who have had middle-ear or mastoid surgery are at an increased risk of developing cerebrospinal fluid (CSF) otorrhoea. The CSF leak is usually from defects in the tegmen or posterior cranial fossa. We present a patient with CSF otorrhoea following a modified radical mastoidectomy seven years ago. There was an unusual communication between the internal auditory meatus (IAM) and the middle ear. Radiologic imaging like the MRI is useful in identifying the site of leak.

Matched MeSH terms: Ear, Middle/surgery*

Fulltext A rare cause of unilateral tinnitus

Nik Mohd Syukra Nik Abd Ghani, Nik Adilah Nik Othman, Amran Mohamad

International Medical Journal Malaysia, 2018;17(1):145-148.

MyJurnal

Tinnitus is not a disease per se but it is a symptom. It can be either subjective or objective type and the
underlying cause varies such as tumour, infection, vascular abnormality or Meniere’s disease. Foreign body in the external ear is a common presentation especially in children. However, foreign body in the middle ear manifested with only symptom of tinnitus is a rare and unexpected presentation. Foreign body in the middle ear are commonly due to iatrogenic cause such as complication of myringotomy and ventilation tube insertion surgery. There are reported cases of complications of myringotomy and ventilation tube insertion, and they typically presented with the ear infection manifestation, myringosclerosis or permanent perforation of tympanic membrane. Currently, there are only few reported cases in literatures of foreign body in the middle ear following complication of medial migration of ventilation tube into a middle ear with intact tympanic membrane.

Matched MeSH terms: Ear, Middle

Fulltext Temporal bone squamous cell carcinoma - Penang experience

Ng SY, Pua KC, Zahirrudin Z

Med J Malaysia, 2015 Dec;70(6):367-8.

PMID: 26988214 MyJurnal

Temporal bone squamous cell carcinoma (TBSCC) is rare and poses difficulties in diagnosing, staging and management. We describe a case series with six patients who were diagnosed TBSCC, from January 2009 to June 2014, with median age of 62 years old. All patients presented with blood-stain discharge and external auditory canal mass, showing that these findings should highly alert the diagnosis of TBSCC. Three patients staged T3 and another three with T4 disease. High-resolution CT (HRCT) temporal findings were noted to be different from intraoperative findings and therefore we conclude that MRI should be done to look for middle ear involvement or other soft tissue invasion for more accurate staging. Lateral temporal bone resection (LTBR) and parotidectomy was done for four patients with or without neck dissection. Patients with positive margin, perineural invasion or parotid and glenoid involvement carry poorer prognosis and postoperative radiotherapy may improve the survival rate. One patient had successful tumor resection via piecemeal removal approach in contrast with the recommended en bloc resection shows that with negative margin achieved, piecemeal removal approach can be a good option for patients with T2-3 disease. In general, T4 tumor has dismal outcome regardless of surgery or radiotherapy given.

Matched MeSH terms: Ear, Middle

Incidence of middle ear barotrauma in staged versus linear chamber compression during hyperbaric oxygen therapy: a double blinded, randomized controlled trial

Ng AWA, Muller R, Orton J

Undersea Hyperb Med, 2017 8 5;44(2):101-107.

PMID: 28777900

CONTEXT: Middle ear barotrauma (MEB) is common during chamber compression in hyperbaric oxygen therapy. However, little evidence exists on an optimal compression protocol to minimize the incidence and severity of MEB.

OBJECTIVE: To compare the incidence of MEB during hyperbaric oxygen therapy using two different chamber compression protocols.

DESIGN: Double-blinded, randomized controlled trial.

SETTING: Hyperbaric Medicine Unit, The Townsville Hospital, Queensland, Australia, September 2012 to December 2014.

PATIENTS: 100 participants undergoing their first hyperbaric oxygen therapy session.

INTERVENTION: Random assignment to a staged (n=50) or a linear (n=50) compression protocols. Photographs of tympanic membranes were taken pre- and post-treatment and then graded. Middle ear barotrauma was defined as an increase of at least one grade on a modified TEED scale.

RESULTS: The observed MEB incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test), and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol (P=0.028, exact one-sided Mann-Whitney type test).

CONCLUSION: The use of the assessed staged compression protocol for the first hyperbaric oxygen treatment showed no significant effect on the overall incidence of MEB when compared to the gold standard linear protocol but resulted in a significant improvement in the severity of the experienced MEBs. Further studies are needed to elucidate an optimal compression protocol to minimize middle ear barotrauma.

Matched MeSH terms: Ear, Middle/injuries*

Displaying publications 1 - 20 of 35 in total