METHODOLOGY: A 10-year retrospective review was carried out on MOE in a single otology institution from January 2011 to December 2020. The MOE was classified based on proposed Tengku's radiological stratification according to HRCT and TBPS findings. Phase I is defined as inflammation limited to the soft tissue in the external auditory canal, without involvement of the bone. Phase II is the inflammation beyond the soft tissue, involving bone, but limited to the mastoid. Phase III is when the inflammation extends medially, involving the petrous temporal bone or temporomandibular joint, with or without parapharyngeal soft tissue involvement. Phase IV refers to inflammation extending medially to involve the nasopharynx, with or without abscess formation. Finally, Phase V is inflammation that further extends to the contralateral base of the skull.
RESULTS: A sample of 49 patients was involved in this study. Majority of the patients were having Phase III (36.7%) of the disease, followed by Phase V (24.5%), Phase II (18.4%), Phase IV (16.3%), and Phase I (4.1%). A comprehensive treatment algorithm was drafted based on our institution's experience in managing MOE. The mortality rate was low (8.2%), mainly involving patients in advanced phase of the disease (Phases IV and V).
CONCLUSION: This study has revealed the evidence of progression of MOE based on the proposed radiological stratification. This stratification is simple and practically applicable in clinical settings. We suggest the use of our proposed treatment algorithm as a standard diagnostic and treatment protocol for MOE.
CASE DESCRIPTION: A 62-year-old male had left severe sensorineural hearing loss and a 4 mm intracanalicular VS. We performed simultaneous nonmastoidectomy infrapromontorial VS removal and cochlear implantation in this patient to achieve minimal invasiveness and to provide maximal hearing restoration. The tumor was removed via this corridor while maintaining the integrity of cochlear as well as facial nerves with full insertion of a medium length cochlear implant electrode. After surgery, the patient showed good hearing rehabilitation.
CONCLUSION: Simultaneous infrapromontorial VS removal and nonmastoidectomy cochlear implantation serves as an option for hearing restoration with minimal invasiveness in small VS removal.
OBJECTIVES: To describe the middle ear corridor approach for ICVS excision.
METHODOLOGY: All transpromontorial and infrapromontorial approaches for ICVS excision were recruited. The surgeries were performed at an otologic center by a single experienced otologist.
RESULTS: Three cases of ICVS Koos Type I were included in this review. Two cases were operated with exclusive endoscopic transcanal transpromontorial approach excision of tumor. One case underwent concurrent transcanal excision of ICVS through infrapromontorial approach with cochlear implantation. Two of them developed facial nerve paresis. The last patient recovered fully with viable cochlear nerve enabling hearing restoration with cochlear implant.
CONCLUSION: The potential of surgery in ICVS via middle ear approach is a safe and direct route with promising outcome. This approach offers removal of the ICVS without interrupting facial and cochlear nerves. Hence, the preservation of facial function and hearing are possible.
METHODS: All deoxyribonucleic acid (DNA) samples were genotyped for TNFα-1031 and TNFβ+252 genes by mean of polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP). The statistical analysis were carried out using chi-square test or Fisher exact test to determine the associations of these gene polymorphisms in CRS. Multiple logistic regression was performed to evaluate the associations of these gene polymorphisms in CRS and its related risk factors.
RESULTS: The genotype and allele frequencies of TNFα-1031 and TNFβ+252 gene did not show any significant associations between CRS and healthy controls. However, a significantly statistical difference of TNFα-1031 was observed in CRS participants with atopy (P-value, 0.045; odds ratio, 3.66) but not in CRS with asthma or aspirin intolerance.
CONCLUSION: Although the presence of TNFα-1031 and TNFβ+252 gene polymorphisms did not render any significant associations between CRS and healthy control, this study suggests that TNFα-1031 gene polymorphisms in CRS patients with atopy may be associated with increase susceptibility towards CRS.
Case Report: We reported the case of a young male presented with the symptoms of non-specific chronic adenotonsillitis, mild obstructive sleep apnoea, and cervical lymphadenopathy. Subsequently, he underwent adenotonsillectomy and excision of the cervical lymph node with the tissue specimens came back strongly positive for TB. Then, he started using antituberculous medication and recovered well.
Conclusion: The authors would like to highlight this rare clinical entity in which accurate diagnosis is essential for complete treatment.
OBJECTIVE: We estimated the long-term maintenance costs of CI including repair of speech processors, replacement of damaged parts, and battery requirements.
RESULTS: Forty-one parents of children who received CIs in Malaysian government hospitals were enrolled. The first 2 years of CI usage were covered by warranty. The cost increased three-fold from by 4 years of CI usage and then doubled by 8 years of usage. About 75% of parents commented that the costs were burdensome.
CONCLUSION: Our findings will be useful for parents whose children receive CI and will allow medical personnel to counsel the parents about the costs.