MyMedR

Abdul Wahab A

Br Med J, 1955;2:439.

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.

Matched MeSH terms: Ear Diseases

Fulltext Human aural myiasis

Lee HL, Yong YK

Southeast Asian J. Trop. Med. Public Health, 1991 Jun;22(2):274-5.

PMID: 1948291

Matched MeSH terms: Ear Diseases/parasitology*

Surgical Option for External Auditory Canal Cholesteatoma: A Case Report

Jameel FR, Abdullah A, Hashim ND, Nasseri Z, Mansor WNW

Int Tinnitus J, 2024 Mar 21;27(2):238-241.

PMID: 38507640 DOI: 10.5935/0946-5448.20230036

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.

Matched MeSH terms: Ear Diseases*

Cholesteatoma in an Asian population

Lee ST

Acta Otolaryngol, 1991;111(3):536-41.

PMID: 1887780 DOI: 10.3109/00016489109138380

Two hundred Malaysian patients representing 227 ears with previously untreated cholesteatoma disease were analysed retrospectively in terms of i) type of disease, i.e. primary acquired attic defect or posterior superior retraction pocket and secondary acquired type cholesteatoma; ii) positive history of previous middle ear effusion, atelectasis or grommet insertion; and iii) likelihood of complications as initial presenting feature. The high 47.1% incidence of secondary acquired cholesteatoma disease in our patients contrasts with the predominance of primary acquired cholesteatoma in the Caucasian patient. Correlation of these two disease types with a positive history showed a significant positive association between the primary acquired group and a positive history; and conversely a significant negative association for the secondary acquired type. This supports a role for the retraction theory in primary acquired cholesteatoma but negates this theory in secondary acquired cholesteatoma. Secondary acquired cholesteatoma had a significantly higher (35.5%) complication rate against 15.8% in the primary acquired type (p = 0.001). This fact together with a 47.1% incidence of secondary acquired disease, low otolaryngologist population ratio and patient attitudes to disease account for the high total complication rate of 27.3%.

Matched MeSH terms: Ear Diseases/complications; Ear Diseases/etiology; Ear Diseases/epidemiology*

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 Diseases/diagnosis; Ear Diseases/etiology*; Ear Diseases/therapy

Fulltext Otological disorders in Down's Syndrome

Satwant S, Subramaniam KN, Prepageran N, Raman R, Jalaludin MA

Med J Malaysia, 2002 Sep;57(3):278-82.

PMID: 12440266

Objective: To assess if children with Down's Syndrome have a higher prevalence of otological abnormality compared to their normal counterparts in Malaysia.
Methodology: Thirty children with Down’s Syndrome and normal children underwent otoscope ear examination and impedance test in the ENT outpatients clinic in University Hospital Kuala Lumpur, Malaysia.
Results: The study showed that children with Down’s Syndrome had higher ontological disorders. Forty four percent had impacted wax compared to 14.4% in normal children. Twenty one percent of ears in the study group had refracted drums compared to 6.6% of control. Fifteen percent of ears in the study group had middle ear effusion compared to 3.4% in controls, 55% had a type B tympanogram compared to 8.3% in controls and 73.4% had auditory canal stenosis compared to 14.4% in controls.
Conclusion: Children with Down’s Syndrome thus have a higher incidence of ontological disorders.

Study site: ENT outpatient clincs, University Malaya Medical Centre (UMMC)

Matched MeSH terms: Ear Diseases/complications*; Ear Diseases/epidemiology*

Additional conductive hearing loss in children from a school for the deaf in Malaysia

Elango S, Htun YN, Raza H

Int J Pediatr Otorhinolaryngol, 1994 Jan;28(2-3):125-8.

PMID: 8157410

A total of 165 children from a school for the deaf in Malaysia were screened to find out the prevalence of additional conductive hearing loss. Otological examination, tympanometry and pure tone audiometry were performed in all these children. Fifty-one children (30.9%) had additional conductive hearing loss. Middle ear disorders were present in 15 children (9.09%). The deaf children seldom complain about the change in their hearing sensitivity, so there is a need for regular otological examination in deaf children to detect the additional conductive hearing loss.

Matched MeSH terms: Ear Diseases/complications; Ear Diseases/diagnosis

Preliminary results of a pilot study on the safety and efficacy of balloon dilatation of the Eustachian tube for nasopharyngeal cancer patients with chronic Eustachian tube dysfunction post irradiation

Wong MSL, Prepageran N

J Laryngol Otol, 2021 Aug;135(8):691-694.

PMID: 34342558 DOI: 10.1017/S0022215121001560

OBJECTIVE: Eustachian tube dysfunction is a known complication following radiotherapy to the head and neck region. Unfortunately, treatment options are limited, with significant associated morbidity. Balloon Eustachian tube dilatation has been used successfully to treat Eustachian tube dysfunction; hence, this study aimed to determine the safety and efficacy of this method in treating Eustachian tube dysfunction in post-radiotherapy patients with nasopharyngeal carcinoma.

METHOD: This interventional cohort pilot study on patients with Eustachian tube dysfunction compared those with nasopharyngeal carcinoma to patients without. Outcome assessment was based on tympanometry type and Eustachian Tube Dysfunction Questionnaire score.

RESULTS: A total of 14 ears (12 patients) were tested. Only 14 per cent of the nasopharyngeal carcinoma cohort showed improvement, while 71 per cent of the non-nasopharyngeal carcinoma group were successfully treated. No significant adverse effect was reported in any patient during this study.

CONCLUSION: Balloon Eustachian tube dilatation was not shown to be beneficial for post-radiotherapy Eustachian tube dysfunction in nasopharyngeal carcinoma patients in the preliminary stages of this pilot study.

Matched MeSH terms: Ear Diseases/etiology; Ear Diseases/therapy*

Epithelial migration in the atelectatic tympanic membrane

Tang IP, Prepageran N, Raman R, Sharizhal T

J Laryngol Otol, 2009 Dec;123(12):1321-4.

PMID: 19835642 DOI: 10.1017/S0022215109990806

To determine whether epithelial migration in the atelectatic tympanic membrane (secondary to any pathology) occurs in a similar fashion to that in the normal (non-pathological) tympanic membrane, by calculating and comparing the epithelial migration rate and pattern.

Matched MeSH terms: Ear Diseases/pathology*; Ear Diseases/physiopathology

Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicity

Gendeh BS, Said H, Gibb AG, Aziz NS, Zahir ZM

J Laryngol Otol, 1991 Dec;105(12):999-1001.

PMID: 1787382

In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity.

Matched MeSH terms: Ear Diseases/chemically induced*; Ear Diseases/diagnosis

Auricular pseudocyst in the tropics: a multi-racial Singapore experience

Tan BY, Hsu PP

J Laryngol Otol, 2004 Mar;118(3):185-8.

PMID: 15068513

Endochondral pseudocyst of the auricle is an uncommon condition that affects predominantly Chinese males, with many reports studying this condition in homogenous Chinese populations. There have been few large-scale reports describing the features of this disease among the other Asian groups. In one of the largest series described to date, we report the epidemiological features, clinico-pathologic characteristics, and success of surgical treatment in 40 patients of different Asian groups presenting with pseudocyst of the auricle. Results showed a Chinese predominance (90 per cent), followed by Malays (five per cent) and Eurasians (five per cent). All had unilateral presentations apart from one patient. Most (55 per cent) presented within two weeks of auricular swelling. Few (10 per cent) had a history of trauma. The pseudocysts predominantly affected the concha (61 per cent). Surgery comprised excision of the anterior wall followed by local pressure application. Only 2.5 per cent had recurrence after surgery. These findings confirm earlier understood features of this disease while revealing some notable variations.

Matched MeSH terms: Ear Diseases/ethnology; Ear Diseases/epidemiology*; Ear Diseases/surgery

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.

PMID: 25606279 MyJurnal

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 Diseases

Fulltext Concurrent Mastoid Cellulitis and Langerhans Cells Histiocytosis:  A Challenging Diagnosis

Ong HY, Goh LC, Santhi K, Sha'ariyah MM

Oman Med J, 2018 Mar;33(2):167-170.

PMID: 29657688 DOI: 10.5001/omj.2018.31

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder, which commonly arises in the bone and may involve other systems. To date, the diagnosis of temporal bone LCH remains a challenge as it may masquerade as a common ear infection. We report a case of a child who presented to us with persistent bilateral ear discharge for four months and was not responding to treatment. Her condition subsequently worsened, with clinical features and radiological findings suggestive of mastoid cellulitis. Nevertheless, further histopathology study revealed LCH.

Matched MeSH terms: Ear Diseases

Fulltext Medical problems in an oil palm estate

Chua WT, Lim CH

Family Practitioner, 1982;5(3):49-53.

Oil palm estates and associated industries employ a fair proportion of workers. Good medical care benefits both the employers and the employees. The pattern of illness is not very different from that found in general practice. However, certain environmental factors, the nature of occupation and the water supply can influence the increased incidence of certain diseases. Upper respiratory tract infection, acute gastroenteritis, contact dermatitis (eczemas & rashes) eye, and ear diseases, injuries and musculoskeletal diseases are the commonest causes of morbidity. The resident doctor, who has a good knowledge of the environment of his patients is in the best position to practise preventive medicine or early intervention, thereby reducing illnesses and improving productivity of the workers.

Matched MeSH terms: Ear Diseases

Test-retest reliability and responsiveness of a Malay tinnitus questionnaire

Mohd Normani Z, Wan Suhailah WH, Nik Adilah NO

Med J Malaysia, 2018 02;73(1):7-8.

PMID: 29531196 MyJurnal

INTRODUCTION: Tinnitus is a common complaint among patients with ear diseases and can be serious if not treated. Recently, a Malay tinnitus questionnaire, known as the "Borang Evaluasi Soal selidik Tinnitus" (BEST) had been developed and preliminarily validated among Malayspeaking population. The aims of the present study were to determine the test-retest reliability and responsiveness of the BEST questionnaire.

METHOD: Forty-six Malay adults (aged 23-74 years) with tinnitus were enrolled. They were instructed to fill in the BEST questionnaire accordingly. After one week, 21 of them were asked to fill in the questionnaire again. The other 25 subjects underwent tinnitus intervention for three months and following this; the BEST was administered to them again.

RESULTS: In the test-retest reliability task, the intraclass correlation values obtained were acceptably high (0.70-0.90). After the intervention, significant differences in the BEST result were found in the mind domain, main domain and composite score (p<0.05) with moderate effect sizes (0.61- 0.70).

CONCLUSION: The test-retest reliability of the BEST was found to be good. It also showed good responsiveness to intervention. The clinical usefulness of the BEST in assessing patients with tinnitus was further supported by the present study.

Matched MeSH terms: Ear Diseases

Role of impacted cerumen in hearing loss

Subha ST, Raman R

Ear Nose Throat J, 2006 Oct;85(10):650, 652-3.

PMID: 17124935

We performed a study to determine if cerumen in the ear canal causes significant hearing loss and to ascertain if there is any correlation between the amount of cerumen and the degree of hearing loss. Our study was conducted on 109 ears in 80 patients. The results indicated that impacted cerumen does cause a significant degree of conductive hearing loss. We found no significant correlation between the length of the cerumen plug and the severity of hearing loss. Nor did we find any significant correlation between the presence of impacted cerumen and variables such as age, sex, ethnicity, or affected side.

Matched MeSH terms: Ear Diseases/complications*

Fulltext Keratosis obturans complicated with facial nerve palsy: a diagnostic dilemma

Saniasiaya J, Nik Othman NA, Mohamad Pakarul Razy NH

Braz J Otorhinolaryngol, 2016 05 24;86(1):130-132.

PMID: 27269254 DOI: 10.1016/j.bjorl.2016.04.012

Matched MeSH terms: Ear Diseases/pathology

Pressurized Wideband Absorbance Findings in Healthy Neonates: A Preliminary Study

Wali HA, Mazlan R, Kei J

J Speech Lang Hear Res, 2017 10 17;60(10):2965-2973.

PMID: 28975265 DOI: 10.1044/2017_JSLHR-H-17-0120

Purpose: The present study aimed to establish normative data for wideband absorbance (WBA) measured at tympanometric peak pressure (TPP) and 0 daPa and to assess the test-retest reliability of both measurements in healthy neonates.

Method: Participants of this cross-sectional study included 99 full-term neonates (165 ears) with mean chronological age of 46.7 hrs (SD = 26.3 hrs). Of the 99 neonates, 58 were Malay, 28 were Indian, and 13 were Chinese. The neonates who passed high-frequency (1 kHz) tympanometry, acoustic stapedial reflex, and distortion product otoacoustic emission screening tests were assessed using a pressurized WBA test (wideband tympanometry). To reduce the number of measurement points, the WBA responses were averaged to 16 one-third octave frequency bands from 0.25 to 8 kHz. A mixed-model analysis of variance was applied to the data to investigate the effects of frequency, ear, gender, and ethnicity on WBA. The analysis of variance was also used to compare between WBA measured at TPP and 0 daPa. An interclass correlation coefficient test was applied at each of the 16 frequency bands to measure the test-retest reliability of WBA at TPP and 0 daPa.

Results: Both WBA measurements at TPP and 0 daPa exhibited a multipeaked pattern with 2 maxima at 1.25-1.6 kHz and 6.3 kHz and 2 minima at 0.5 and 4 kHz. The mean WBA measured at TPP was significantly higher than that measured at 0 daPa at 0.25, 0.4, 0.5, 1.25, and 1.6 kHz only. A normative data set was developed for absorbance at TPP and at 0 daPa. There was no significant effect of ethnicity, gender, and ear on both measurements of WBA. The test-retest reliability of WBA at TPP and 0 daPa was high with the interclass correlation coefficient ranging from 0.77 to 0.97 across the frequencies.

Conclusions: Normative data of WBA measured at TPP and 0 daPa for neonates were provided in the present study. Although WBA at TPP was slightly higher than the WBA measured at 0 daPa at some frequencies below 2 kHz, the WBA patterns of the 2 measurements were nearly identical. Moreover, the test-retest reliability of both WBA measurements was high.

Matched MeSH terms: Ear Diseases/diagnosis

Fulltext Managing a Complicated Acute Otomastoiditis at Day Four of Life

Lim R, Zulkifli S, Hailani I, Hashim ND

Cureus, 2021 Jan 25;13(1):e12905.

PMID: 33654590 DOI: 10.7759/cureus.12905

Acute mastoiditis in a newborn complicated by the presence of facial nerve palsy is an alarming finding requiring rapid assessment and further investigation. Such an early presentation should point the clinician towards an underlying systemic pathology or congenital anatomical abnormality. Facial nerve involvement indicates severe infection and possible dehiscence of the facial canal. Although more frequent in children, it is rare in neonates. We would like to share our experience in managing the youngest known presentation of otomastoiditis at four days of life. The patient presented with otorrhea and facial paralysis and progressed to meningitis. He was finally diagnosed with chronic granulomatous disease.

Matched MeSH terms: Ear Diseases

Fulltext Endaural approach of external auditory canal osteoma: report of two cases

Che Mohd Hilmi Che Mat1, Zulkiflee Salahuddin, Nik Azrizie Muhamed, Irfan Mohamad

Journal of Clinical and Health Sciences, 2021;6(1):53-57.

MyJurnal

Osteomas occur in all parts of the temporal bone, including the mastoid, squamous, middle
ear, styloid process, internal auditory canal and external auditory canal (EAC). The EAC has
been reported to be the most common site, followed by the mastoid and squamous parts.
Diagnosis is made based on history, clinical examination and radiological findings. Computed
tomography reveals a pedunculated hyperdense mass that usually arises from the
tympanosquamous suture. Surgical removal of EAC osteomas can be achieved using the
endaural or postauricular approaches. It can be performed with a drill or osteotome, either
endoscopically or by using microscopy. This report presents two patients with EAC osteomas
who underwent excision under microscopy using the endaural approach. Surgery is the gold
standard treatment, while close observation may be considered in asymptomatic patients.

Matched MeSH terms: Ear Diseases

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