MyMedR

The Rediscovery of Sphenomorphus malayanus Doria, 1888 (Squamata: Scincidae) from the Titiwangsa Mountain Range of Peninsular Malaysia and its re-description as S. senja sp. nov

Grismer LL, Quah ES

Zootaxa, 2015;3931(1):63-70.

PMID: 25781814 DOI: 10.11646/zootaxa.3931.1.4

The discovery of an additional specimen of Sphenomorphus malayanus Doria, 1888 from Gunung Brinchang, Cameron Highlands, Pahang in Peninsular Malaysia reveals that it is not conspecific with the type specimen from Gunung Singgalan, West Sumatra, 600 km to the south. The new specimen and an additional specimen previously collected from Gunung Gerah, Perak, Peninsular Malaysia, 56 km to the north, are described here as the new species S. senja sp. nov. and differ from S. malayanus by having a larger SVL (60.0-65 mm versus 53 mm); a deeply recessed as opposed to a shallow tympanum; 72 or 73 versus 76 paravertebral scales; eight or nine superciliary scales as opposed to 10; and the posteriormost superciliary scale being large as opposed to small. Cameron Highlands is unique among other upland areas in Peninsular Malaysia in that it harbors an unprecedented number of closely related ecological equivalents living in close sympatry or syntopy.

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*

Fulltext Chronic discharging ear in a child: are we missing something?

Dutta M, Ghatak S, Biswas G

Med J Malaysia, 2013 Aug;68(4):368-71.

PMID: 24145273

Chronic discharging ear, mostly due to middle or external ear infection, is one of the leading causes for seeking healthcare among the paediatric population in a developing country. However, a long-standing forgotten middle ear foreign body forms a rare cause for such presentation demanding a high index of suspicion from the clinicians. Most of them are iatrogenic or accidental, and are removed by conventional permeatal approach; need for tympanotomy is rarely documented in the recent literature. We report the first case where a large stone was introduced into the middle ear through a pre-existing tympanic membrane perforation by the child himself, and only the second documentation of removal of a middle ear foreign body by tympanotomy in a child.

Matched MeSH terms: Ear, Middle*

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 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*

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 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*

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

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

The association of allergy and chronic suppurative otitis media: A study in a tropical country

Mohd Khairi MD, Shahrjerdi B, Ramiza RR, Normastura R

Med J Malaysia, 2019 Jun;74(3):205-208.

PMID: 31256174

OBJECTIVE: Chronic suppurative otitis media (CSOM) usually begins as a spontaneous perforation of tympanic membrane due to an acute infection of the middle ear. This study was aimed to evaluate the association between allergy and CSOM.

METHODS: A case-control study was carried out among patients with CSOM (cases) and controls were those with no ear pathology. The presence of CSOM was made through a medical history and otoscopic examination. Allergen testing was done by the skin prick test.

RESULTS: In all 124 subjects were recruited in this study with equal number of the cases and controls. The commonest positive reaction in the skin prick test in both groups was to house dust mites. Among CSOM cases, half (50%) of them had an allergy to Blomia tropicalis and 48.4% to Dermatophagoides while in the control group, 27.4% to Dermatophagoides and 25.8% to B. tropicalis. There were significant associations between CSOM and allergy to B. tropicalis (p=0.005), Dermatophagoides (p=0.016) and Felis domesticus (p=0.040). The prevalence of allergy at 95% confidence interval (95%CI) in CSOM and control groups were demonstrated as 59.7% (95%CI: 47.5, 71.9) and 30.6 % (95%CI: 19.1, 42.1) respectively. There was a significant association between allergy and CSOM (p=0.001).

CONCLUSION: Indoor allergens are the most prevalent in our environment and therefore good control may difficult to achieve. The hypersensitivity states of the subject are likely to have a role in the pathogenesis of CSOM especially in the tropical countries where allergy occurs perennially.

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 Clinical and audiological profiles in children with chronic otitis media with effusion requiring surgical intervention

Abdullah B, Hassan S, Sidek D

Malays J Med Sci, 2007 Jul;14(2):22-7.

PMID: 22993488 MyJurnal

To determine the characteristic presenting symptoms, otoscopic findings, audiological profiles and the intraoperative findings of children with chronic otitis media with effusion who required surgical intervention. A prospective cross sectional study was undertaken in the otorhinolaryngology clinic of USM Hospital (HUSM) involving 25 cases (50 ears) of children with chronic otitis media with effusion requiring surgical intervention from June 1999 to September 2001. Their ages ranged from 3 to 12 years old. The gender distribution included males at 72 % and females at 28 %. The presenting symptoms noted were hearing impairment (52%), otalgia (18%), ear block (16%) and tinnitus (14%). The otoscopic findings were fluid in the middle ear (40%), dullness (32%) and retraction of the tympanic membrane (28%). On audiometry, 24 ears had moderate deafness (48%), 16 ears had mild deafness (32%) while 4 ears had severe deafness (8%). With tympanometry, 42 ears out of the total 50 had a flat type B curve (84%) while 6 ears had type As curve (12%). During myringotomy, middle ear secretion was seen in 38 ears (76%) out of the 50 ears; 22 ears had mucoid secretion while 16 ears had serous secretion. Clinically, the commonest presenting symptom was hearing impairment (52%) while the most common otoscopic finding was fluid in the middle ear (40%). Audiologically, most patients had moderate conductive hearing loss (48%) and a type B curve (84%) on tympanometry. On myringotomy middle ear fluid was found in 76 % of the ears.
Study site: otorhinolaryngology clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Ear, Middle

Sinonasal inverted papilloma with malignant transformation in the middle ear: a multicentric origin?

Mazlina S, Shiraz MA, Hazim MY, Amran AR, Zulkarnaen AN, Wan Muhaizan WM

J Laryngol Otol, 2006 Jul;120(7):597-9.

PMID: 16672089

Inverted papilloma is a rare, benign tumour representing only 0.5 to 4 per cent of all sinonasal neoplasms; its involvement of the middle ear is extremely rare. We present a case of multicentric inverted papilloma in the sinonasal region and middle ear in a 54-year-old man. The patient later developed neck metastasis secondary to malignant transformation of the inverted papilloma in the middle ear.

Matched MeSH terms: Ear, Middle/pathology

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*

Rare middle ear anomaly in a patient with Turner's syndrome

Hamzah AR, Jalaluddin MA, Raman R

Ann Otol Rhinol Laryngol, 1999 Mar;108(3):253-4.

PMID: 10086617

A patient with Turner's syndrome presented with a rare anomaly of absent oval window, inferiorly placed facial nerve, and abnormal stapes. To our knowledge, this is the first report of this combination of malformations.

Matched MeSH terms: Ear, Middle/abnormalities*

Endoscopic Intervention of Aberrant Carotid Artery in the Middle Ear

Hashim ND, Jang SH, Moon IS

Otol Neurotol, 2021 Jan;42(1):e82-e85.

PMID: 33156236 DOI: 10.1097/MAO.0000000000002865

OBJECTIVE: To describe surgical management for transcanal endoscopic ear surgery (TEES) in two patients with aberrant internal carotid artery (ICA) in the middle ear.

PATIENTS: A young girl who complained of pulsatile tinnitus and an elderly man who presented with ear bleeding. Otoendoscopy examination revealed a pulsatile reddish mass protruding through the tympanic membrane in both patients.

INTERVENTIONS: A combination of clinical assessments and imaging supported the diagnosis of aberrant ICA in the middle ear. Transcanal endoscopic reinforcement of the artery was performed; tragal cartilage was used as a shield to strengthen the carotid canal defect.

RESULTS: Assisted by fine endoscopic instruments, the protruding arteries were separated without damage to the surrounding structures and reinforced using tragal cartilage. Both patients' symptoms improved postoperatively; they reported tinnitus relief and hearing improvement.

CONCLUSION: To prevent catastrophic events, diagnosis of aberrant ICA is important before any surgical intervention. With appropriate management, surgical intervention using transcanal endoscopic ear surgery offers a clear view of the surgical field and is an excellent choice for management of aberrant ICA.

Matched MeSH terms: Ear, Middle/surgery

Bilateral middle ear cholesterol granuloma in familial hypercholesterolemia

Masaany M, Siti HS, Nurliza I, Mazita A

Otolaryngol Head Neck Surg, 2008 Jun;138(6):803-4.

PMID: 18503863 DOI: 10.1016/j.otohns.2008.02.020

Cholesterol granuloma (CG) is a histologic description of foreign body giant cell formation toward cholesterol crystals. The majority of temporal bone CG is unilateral and most common in the petrous apex. Middle ear CG is usually the result of underlying ear diseases. Primary middle ear CG is very rare. Most reported CG has not been associated with familial hypercholesterolemia (FH). FH, an autosomal dominant disorder, manifests as high levels of serum cholesterol and low density lipoprotein (LDL) cholesterol. We report a rare case of FH and bilateral aggressive primary middle ear CG. This publication has been approved by the IRB, Hospital Alor Setar.

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

Fulltext CongenCongenital cholesteatoma: Different clinical presentation in two casesital cholesteatoma: Different clinical presentation in two cases

Mohd Khairi Md Daud, Suhaili Abdul Jalil

Malays Fam Physician, 2016;11(23):30-32.

MyJurnal

Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be
undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced
hearing or otalgia.

Matched MeSH terms: Ear, Middle

Fulltext Congenital cholesteatoma: Different clinical presentation in two cases

Abdul Jalil S, Md Daud MK

Malays Fam Physician, 2016;11(2-3):30-32.

PMID: 28461856

INTRODUCTION: Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced hearing or otalgia.

METHOD: Case report.

RESULTS: We report two cases of young ladies with CC who presented with different otological symptoms. The first case complained of recurrent unilateral ear pain while the second case presented with unilateral reduced hearing. Examination of both cases revealed a whitish mass seen behind an intact tympanic membrane. Both cases underwent surgery and histopathological examinations; findings were consistent with cholesteatoma.

CONCLUSION: There are varieties of clinical presentations of CC and the diagnosis is based on clinical findings.

Matched MeSH terms: Ear, Middle

Displaying publications 1 - 20 of 35 in total