MyMedR

Fulltext Acute mastoid abscess secondary to partially treated upper respiratory tract infection: a case report

Halimuddin, S., Asma, A.

Medicine & Health, 2010;5(1):41-44.

MyJurnal

Acute mastoid abscess is common in daily practice. In children, it is usually caused by unsuccessful treatment or partially treated acute otitis media (AOM). Some authors had reported that chronic suppurative otitis media (CSOM) can be the source of infection but it is usually associated with the presence of cholesteatoma. A case of an acute mastoid abscess in a 7 year old girl is presented. She had a history of severe otalgia with left post auricular swelling for 3 days. Clinically she was febrile, the left otoscopy showed diffuse post auricular swelling and sagging of the posterior wall of the external canal. She underwent an emergency cortical mastoidectomy for the left mastoid abscess and had an uneventful recovery. In conclusion, this patient was partially treated with antibiotics which increased the risk for ‘masked mastoiditis’, and she later developed a mastoid abscess. Therefore we advocate that all AOM patients should be treated with antibiotics at least for a duration of one week.

Matched MeSH terms: Otitis Media; Otitis Media, Suppurative

Primary middle ear tuberculosis mimicking cholesteatoma

Aziz A, Md Daud MK

Malays Fam Physician, 2020;15(1):44-46.

PMID: 32284804

Tuberculous granuloma in the middle ear is an unusual entity. Herein, we report a case with short presentation of otitis media with mastoid abscess but with a CT scan showing widespread bone destruction. The cause was determined to be middle ear tuberculosis. Awareness of this entity is important, as it may cause a delay in referral to an otorhinolaryngology specialist and, subsequently, a delay in initiating treatment. Therefore, it should be considered in the differential diagnosis, especially when the usual treatment fails to produce the desired result.

Matched MeSH terms: Otitis; Otitis Media

Fulltext Rare case of temporal bone carcinoma with intracranial extension

Kasim KS, Abdullah AB

Indian J Otolaryngol Head Neck Surg, 2012 Dec;64(4):397-8.

PMID: 24294589 DOI: 10.1007/s12070-011-0250-6

Temporal bone cancer, a relatively rare disease, accounting for less than 0.2% of all tumors of the head and neck and is associated with a poor outcome; often presents in a subtle manner, which may delay diagnosis. It should be suspected in any case of persistent otitis media or otitis externa that fails to improve with adequate treatment. Despite advances in operative technique and postoperative care, long-term survival remains poor). It includes cancers arising from pinna that spreads to the temporal bone, primary tumors of the external auditory canal (EAC), middle ear, mastoid, petrous apex, and metastatic lesions to the temporal bone. Here is a report on a case of temporal bone carcinoma presenting with right otalgia, otorrhea and facial paralysis. The patient was initially diagnosed as mastoiditis and later the clinical impression was revised to temporal bone carcinoma (undifferentiated type), based on the pathologic findings.

Matched MeSH terms: Otitis Externa; Otitis Media

Fulltext Otitis externa complicated with chloramphenicol ear drops-induced perichondritis

Mohamad I, Johan K, Hashim H, Nik Othman N

Malays Fam Physician, 2014;9(1):28-9.

PMID: 25606295 MyJurnal

Otitis externa is a common condition of the ear. It is manifested as narrowing of the lumen owing to the edematous swelling of the ear canal lining. Perichondritis may occur independently or as a complication of the otitis externa. We report a case of perichondritis after using a topical ear drop. Changing the medication provides immediate resolution of the condition.

Matched MeSH terms: Otitis Externa

Fulltext Outcome of canal wall down mastoidectomy: experience in sixty three cases

Asma A, Shaharudin MH, Muhd Almyzan A, Lokman S

Med J Malaysia, 2013 Jun;68(3):217-21.

PMID: 23749009 MyJurnal

A canal wall down mastoidectomy (CWDM) is an effective technique for eradication of advanced chronic otitis media or cholesteatomas. A retrospective study was conducted at a Malaysian Tertiary Medical Center between June 1996 to December 2003 to evaluate the outcome of Modified Radical Mastoidectomy(MRM), a form of CWDM for patients with chronic active otitis media (OM) with cholesteatoma, chronic mastoiditis or chronic active OM with cholesteatoma and mastoiditis. All new cases of MRM which fulfilled the selection criteria were reviewed. The main outcome measures were the hearing outcome and status of dry ear postoperatively. A total of 84 patients had undergone CWDM. However only 63 patients (26 male, 37 female) were included for analysis. The age of the patients ranged between 5 months to 72 years (mean, 31years). The majority of the patients (86%) were adults and 9 (14%) were children. The ossicular chain was eroded in 91% (57 cases). There were 33 patients (53%) who showed no improvement of Air Bone Gap (ABG) closure while 16 patients (25%) had a post-operative improvement. The presence or absence of stapes suprastructure was found to be the major factor in determining the amount of ABG (Chi squared test, P = 0.025 preoperatively and P = 0.031 postoperatively). A dry ear was achieved in 78% of patients with 3% recurrence rate. In conclusion, the study showed that a proper MRM gave high percentage of dry ear and this procedure did not worsen the hearing.

Matched MeSH terms: Otitis Media

Otitis media - how the family physician should manage

Ong CC

Family Physician, 2001;11:27-29.

Otitis media is a common disease presenting to family practitioners all over the world. There have been many changes in the way these patients were managed over the years. This article attempts to provide an overview to family physicians regarding the latest approach in managing this common condition. Keywords: Otitis, otitis media, otoscopy, eardrops.

Matched MeSH terms: Otitis Media

Fulltext Facial nerve palsy in otitis externa: A red flag?

Badaruddin A, Choo MM

Malays Fam Physician, 2021 Mar 25;16(1):117-120.

PMID: 33948150 DOI: 10.51866/cr1108

Otitis externa is an infection of the external auditory canal. It rarely results in facial palsy except in severe cases such as necrotizing otitis externa, which is a life-threatening invasive infection of the external auditory canal. Early recognition with prompt and appropriate treatment of necrotizing otitis externa is crucial to prevent more sinister complications. Here we report a case of an elderly gentleman who presented with otitis externa and developed facial palsy a month later. We identified possible problems that may have led to the complication so that such an occurrence can be prevented in the future.

Matched MeSH terms: Otitis Externa

Fulltext A Case Series of Malignant Otitis Externa Mimicking Malignancy

Selvamalar V, Othman NAN, Daud MK

Acta Medica (Hradec Kralove), 2021;64(1):36-41.

PMID: 33855957 DOI: 10.14712/18059694.2021.6

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Matched MeSH terms: Otitis Externa/diagnosis*; Otitis Externa/pathology; Otitis Externa/therapy*

Fulltext Ear infection and hearing loss amongst headphone users

Mazlan R, Saim L, Thomas A, Said R, Liyab B

Malays J Med Sci, 2002 Jul;9(2):17-22.

PMID: 22844220 MyJurnal

The use of headphone has been thought to cause infection in the ear canal and contribute to hearing loss. In this study, we examined 136 Customer Service Representative from Celcom (Malaysia) Sdn. Bhd. who use headphone throughout their working hours. The purpose of this study was to determine the prevalence of ear canal infection and other related diseases of the ear, nose and throat. Their hearing thresholds were also determined using the Amplaid 309 Clinical Audiometer. We found no incidence of infection of the external ear canal amongst the subjects. There were 4 cases of chronic middle ear infection and 4 cases of impacted wax. Hearing impairment was found in 25 subjects (21.2%). However, there was no significant association between hearing loss and the exposure to sound from headphone usage because the high frequencies were not predominantly affected. There was also no association between hearing loss and duration of service.

Matched MeSH terms: Otitis

Adenoid mast cells and their role in the pathogenesis of otitis media with effusion

Abdullah B, Hassan S, Sidek D, Jaafar H

J Laryngol Otol, 2006 Jul;120(7):556-60.

PMID: 16834804 DOI: 10.1017/S002221510

INTRODUCTION: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.
OBJECTIVE: To study the distribution and role of adenoid mast cells in the causation of OME.
METHODOLOGY: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.
RESULT: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p=0.000).
CONCLUSION: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.

Matched MeSH terms: Otitis Media with Effusion/etiology; Otitis Media with Effusion/pathology*

Surgical management of cochlear implant in chronic otitis media patients: safe and sound

Goh BS, Marimuthu D, Wan Hashim WF, Abdullah A

Acta Otolaryngol, 2020 Nov;140(11):914-918.

PMID: 32692598 DOI: 10.1080/00016489.2020.1784463

INTRODUCTION: Cochlear implantation (CI) in cases with chronic otitis media (COM) was previously contraindicated but recent advances have made it possible.

OBJECTIVE: To review surgical and audiological outcomes of COM patients that underwent CI.

MATERIAL AND METHODS: Retrospective review of patients above 18 years old.

RESULTS: Ten patients with complete data were included. Patients were aged 24-69 years old. Tympanoplasty and mastoidectomy were performed before CI. Imaging was performed to rule out ossifications. Eight patients underwent a standard canal wall up with either cochleostomy or round window approach. One patient had additional canalplasty and tympanoplasty and another one had blind sac procedure respectively. Analysis of the hearing aided level with CI and hearing aid showed significant benefit provided by the CI (Z = 2.803, p = .005).

DISCUSSION: Creating a dry and safe ear is important prior to CI. Definite hearing improvement is seen in all our cases that helped them to become independent again in their daily life. Hearing aid usage pre-CI might not be important as the hearing aids may continue to cause discharging ears and the benefits of hearing aids in severe to profound hearing loss are very minimal.

CONCLUSIONS: Cochlear implant is safe and effective in COM patients.

Matched MeSH terms: Otitis Media/complications; Otitis Media/surgery*

Inflammation of the external ear in acute chikungunya infection: Experience from the outbreak in Johor Bahru, Malaysia, 2008

Javelle E, Tiong TH, Leparc-Goffart I, Savini H, Simon F

J Clin Virol, 2014 Apr;59(4):270-3.

PMID: 24556566 DOI: 10.1016/j.jcv.2014.01.011

The re-emerging invalidating chikungunya disease has recently extended to temperate areas. Other alphaviruses can also present with febrile arthalgias. Dengue virus transmitted by the same species of mosquitoes may cocirculate, leading to dual infections and concurrent epidemics. Although these diseases share similar clinical features, their prognoses considerably differ. Prominent and prolonged articular disorders are more consistent with chikungunya virus, whereas haemorrhages make the gravity of dengue infection. Specific symptoms are required, especially when diagnostic tests are not available or performable at a large scale. Indeed, early clinical suspicion of a vector-borne disease is crucial to isolate the first cases in the course of an outbreak, and discrimination between arboviruses help to optimal management of patients. No specific chikungunya clinical sign has been yet reported. We highlight here the high prevalence (about 25%) of acute ear redness in infected people during the 2008 chikungunya outbreak in Jahor Bahru in Malaysia. Nine consenting patients are more precisely described. Ear chondritis could be sensitive diagnostic criterion of the acute stage of chikungunya, every physician - even in occidental non endemic areas - should be aware of.

Matched MeSH terms: Otitis Externa/diagnosis; Otitis Externa/etiology*; Otitis Externa/epidemiology*; Otitis Externa/pathology

Antibiotics in chronic suppurative otitis media: a bacteriologic study

Indudharan R, Haq JA, Aiyar S

Ann Otol Rhinol Laryngol, 1999 May;108(5):440-5.

PMID: 10335703

Conservative medical management of chronic suppurative otitis media (CSOM) is an important step in achieving a dry ear. Topical antibiotic ear drops and aural toilet form the mainstay of medical management of noncholesteatomatous CSOM. This study analyzes the causal organisms and their sensitivity to various antibiotics. Out of 382 swabs examined, the major organisms isolated were Pseudomonas aeruginosa (27.2%), followed by Staphylococcus aureus (23.6%). The sensitivity of P. aeruginosa was 100% to ceftazidime, 98.9% to ciprofloxacin, 96.3% to gentamicin, and 95.4% to polymyxin B, whereas the sensitivity of S. aureus was 98.6% to ciprofloxacin, 97.4% to cloxacillin sodium, 96.5% to cotrimoxazole, and 90.7% to gentamicin. Pseudomonas aeruginosa was almost completely resistant to ampicillin (97.6%) and chloramphenicol (96.6%), whereas S. aureus was almost completely resistant to ampicillin (73.8%) and polymyxin B (98.3%). Among the available topical antibiotic preparations for use in the ear, we found that ciprofloxacin and gentamicin are the best choices.

Matched MeSH terms: Otitis Media, Suppurative/drug therapy; Otitis Media, Suppurative/microbiology*

Prevalence of otitis media with effusion amongst pre-school children in Malaysia

Saim A, Saim L, Saim S, Ruszymah BH, Sani A

Int J Pediatr Otorhinolaryngol, 1997 Jul 18;41(1):21-8.

PMID: 9279632 DOI: 10.1016/s0165-5876(97)00049-9

A cross-sectional screening test was done to determine the prevalence of otitis media with effusion amongst, preschool children in two district in Malaysia, namely Kuala Lumpur an urban district and Kuala Selangor a rural district. It involved 1097 preschool children aged between 5 and 6 years old. Presence of otitis media effusion (OME) is based on abnormal otoscopic finding, Type B tympanogram and absence of ipsilateral acoustical reflex. The overall prevalence rate of OME was 13.8%. The prevalence in Kuala Lumpur was 17.9%, while in Kuala Selangor it was 9.48%. Bottle feeding during infancy and high socioeconomic status of the parents was statistically associated with higher incidence of OME. Other factors such as race, premature delivery, passive smoking, allergy, asthma and family size, had no influence on the prevalence of otitis media with effusion.

Matched MeSH terms: Otitis Media with Effusion/etiology; Otitis Media with Effusion/epidemiology*

Fulltext Hearing Loss in SARS-CoV-2: What Do We Know?

Saniasiaya J

Ear Nose Throat J, 2021 Apr;100(2_suppl):152S-154S.

PMID: 32755405 DOI: 10.1177/0145561320946902

Matched MeSH terms: Otitis Media/etiology; Otitis Media/physiopathology

Fulltext Use of gallium-67 in the assessment of response to antibiotic therapy in malignant otitis externa--a case report

Paramsothy M, Khanijow V, Ong TO

Singapore Med J, 1997 Aug;38(8):347-9.

PMID: 9364890

Malignant Otitis Externa (MOE) can cause considerable morbidity and mortality in affected individuals. The outlook is now much improved with the use of ciprofloxacin, but it is important to ascertain that the infection has been completely eradicated before stopping treatment, as undertreatment may lead to a recurrence which is usually more resistant than the initial infection. Gallium-67 Single Photon Emmision Computerised Tomography (SPECT) is a sensitive and cost effective tool in monitoring the disease activity of MOE, and should be used in the assessment of the response to antibiotic therapy.

Matched MeSH terms: Otitis Externa/drug therapy*; Otitis Externa/radionuclide imaging*

Biofilm production by pathogens associated with canine otitis externa, and the antibiofilm activity of ionophores and antimicrobial adjuvants

Chan WY, Hickey EE, Page SW, Trott DJ, Hill PB

J Vet Pharmacol Ther, 2019 Nov;42(6):682-692.

PMID: 31503362 DOI: 10.1111/jvp.12811

Otitis externa (OE) is a frequently reported disorder in dogs associated with secondary infections by Staphylococcus, Pseudomonas and yeast pathogens. The presence of biofilms may play an important role in the resistance of otic pathogens to antimicrobial agents. Biofilm production of twenty Staphylococcus pseudintermedius and twenty Pseudomonas aeruginosa canine otic isolates was determined quantitatively using a microtiter plate assay, and each isolate was classified as a strong, moderate, weak or nonbiofilm producer. Minimum biofilm eradication concentration (MBEC) of two ionophores (narasin and monensin) and three adjuvants (N-acetylcysteine (NAC), Tris-EDTA and disodium EDTA) were investigated spectrophotometrically (OD570nm ) and quantitatively (CFU/ml) against selected Staphylococcus and Pseudomonas biofilm cultures. Concurrently, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of planktonic cultures were assessed. 16/20 of the S. pseudintermedius clinical isolates were weak biofilm producers. 19/20 P. aeruginosa clinical isolates produced biofilms and were distributed almost equally as weak, moderate and strong biofilm producers. While significant antibiofilm activity was observed, no MBEC was achieved with narasin or monensin. The MBEC for NAC ranged from 5,000-10,000 µg/ml and from 20,000-80,000 µg/ml against S. pseudintermedius and P. aeruginosa, respectively. Tris-EDTA eradicated P. aeruginosa biofilms at concentrations ranging from 6,000/1,900 to 12,000/3,800 µg/ml. The MBEC was up to 16-fold and eightfold higher than the MIC/MBC of NAC and Tris-EDTA, respectively. Disodium EDTA reduced biofilm growth of both strains at concentrations of 470 µg/ml and higher. It can be concluded that biofilm production is common in pathogens associated with canine OE. NAC and Tris-EDTA are effective antibiofilm agents in vitro that could be considered for the treatment of biofilm-associated OE in dogs.

Matched MeSH terms: Otitis Externa/microbiology; Otitis Externa/veterinary*

Complications of chronic suppurative otitis media: a left otogenic brain abscess and a right mastoid fistula

Chew YK, Cheong JP, Khir A, Brito-Mutunayagam S, Prepageran N

Ear Nose Throat J, 2012 Oct;91(10):428, 430.

PMID: 23076851

Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that caused a left temporal lobe abscess and a right mastoid fistula.

Matched MeSH terms: Otitis Media, Suppurative/complications*; Otitis Media, Suppurative/microbiology; Otitis Media, Suppurative/therapy

Fulltext PCR-based construction and transformation of CodY gene deletion construct in Streptococcus Pneumoniae

Aisyah Mohamed Rehan, Mohammad Izwan Enche Othman, Nor Munirah Mohd Amin, Intan Azura Shahdan, Hanani Ahmad Yusof@Hanafi

International Medical Journal Malaysia, 2017;16(11):7-7.

MyJurnal

Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in
the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic
structure have been determinedbut its regulatory mechanism is still poorly understood.
Drawing connections between the nutritional behaviour and invasive property of S.
pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator.
This work was aimed to construct CodY deficient mutant of S. pneumoniae to form
foundational work for the study of CodY regulatory effect on hyaluronate lyase.

Matched MeSH terms: Otitis Media

Fulltext Aural polyp with facial asymmetry in an unfortunate infant

Zubir FS, Saniasiaya J, Abdul Gani H

Malays Fam Physician, 2021 Mar 25;16(1):133-135.

PMID: 33948154 DOI: 10.51866/cr1070

Temporal bone rhabdomyosarcoma is an aggressive entity that simulates chronic otitis ear infection. It is the most common soft tissue sarcoma amongst pediatric patients. Herein, we would like to report a case of temporal bone rhabdomyosarcoma involving a 2-year-old boy who presented with a one-month history of otorrhea with facial asymmetry. Early treatment led to remission of this severe neoplasm.

Matched MeSH terms: Otitis

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