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.
Eccrine cylindroma is a benign tumour arising from sweat glands in the skin. It favours the face, forehead and scalp involving the turban area and hence is called a turban tumour. Amongst a variety of tumours originating from adnexal skin structures, which may appear in the ear canal, eccrine cylindroma forms a very rare entity. We present such a case and discuss its pathological and clinical features.
External Auditory Canal Cholesteatomas (EACC), is an exceptionally rare condition with a prevalence of only 0.1-0.5% among new patients1. EACC are known to possess bone eroding properties, causing a variety of complications, similar to the better-known attic cholesteatomas. We describe here the novel surgical management of a case of EACC. She is 38-year-old female who presented with otorrhea for 6 months. Clinical examination and radiological investigations suggested the diagnosis of an external auditory canal cholesteatoma. The patient underwent modified radical mastoidectomy with type 1 tympanoplasty with meatoplasty. Post-operatively, the patient showed marked clinical improvement.
Samples of Pinna bicolor Gmelin and Pinna deltodes Menke were collected from the seagrass bed of Sungai Pulai, covering Merambong shoal, Tanjung Adang shoal and Merambong Island off south western coast of Johor, Malaysia for morphological study from August 2005 to June 2006. It was observed that P. deltodes is associated with hard substratum and P. bicolor is associated with soft substratum in the study area. Physically there was no difference between P. bicolor and P. deltodes. The species were identified on the basis of nine internal and external characteristics of the valves. The two species were found to be morphologically different on the basis of width of sulcus, distance between posterior adductor muscle to posterior dorsal nacreous layer, dorsal posterior margin length and shell width.
Packing of tympanic cavity is generally considered an essential step in myringoplasty. However, each packing material comes with one or another side effect. The objective of this meta-analysis was to compare the results of Type 1 myringoplasty with or without packing. Pubmed, Cochrane database, Embase, Google Scholar, and clinicaltrials.gov were searched using 'tympanoplasty or myringoplasty and packing' as the search query. All RCTs / quasi-RCTs comparing tympanoplasty Type 1 with packing (control) versus without packing (intervention) of tympanic cavity in the human population were included. For dichotomous and continuous outcomes, relative risks (RR) and mean differences (MD) were calculated with 95% confidence interval, respectively. Heterogeneity was assessed using I2 statistics. Publication bias was checked using funnel plot and Egger's test, if applicable. Quality of evidence was assessed for each outcome using GRADE approach. Eleven studies were deemed eligible. For graft uptake and functional success rate, RR of 1.01 and 1.05 were obtained, respectively, showing no significant differences between the intervention and control groups. At 1st and 3rd postoperative month, no-packing group showed 3.86 dB and 2.08 dB better air-bone gap (ABG) closure than the packing group, respectively. Also, intervention with no-packing was 9.28-minute shorter procedure. With RR 0.35, no-packing had significantly lesser postoperative aural fullness. Type 1 tympanoplasty performed with or without packing show comparable results in terms of graft uptake and functional success rate. However, if performed without packing, it takes shorter time, provides early hearing improvement and causes less aural fullness. Key Words: Tympanoplasty Type 1, Packing, Gelfoam, No-packing, Meta-analysis, Endoscopic myringoplasty.
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.
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.
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.
Extra-nodal non-Hodgkin's lymphoma (NHL) of the pinna has only been reported once in a patient with immunodeficiency. We report an unusual case of lymphoblastic lymphoma in a patient without any immunodeficiency, presenting as an inflammatory lesion of the pinna, which illustrates the need to biopsy any non-healing lesion as soon as possible to ensure that such a treatable malignancy is diagnosed at an early stage.
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.
I would like to report the case of a Chinese boy of 5 years old who came to see me with a ball-bearing in one of his ears. Repeated attempts were made to extricate it under general anaesthesia by means of several kinds of aural apparatus, but they all failed. While about to give up hope and hand him over to a specialist, I managed to borrow a pair of magnetic forceps from a radio mechanic. The ball-bearing was immediately attracted to the point of the forceps and drawn out with ease. It would not be a bad idea to design a magnetic aural (or nasal) forceps based upon the above principles with a view to avoiding unnecessary pain and misery to the young victims.