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Device profile of the MED-EL cochlear implant system for hearing loss: overview of its safety and efficacy.

INTRODUCTION: Patients suffering from severe to profound hearing loss or even deafness can achieve a hearing improvement with a cochlear implant (CI) treatment that is significantly higher than the results achieved with conventional hearing aids. The CI system consists of an implantable stimulator, which is inserted retro-auricularly into the mastoid, and an externally worn processor unit, which provides the pickup of sound and processing of acoustic information as well as the power supply for the stimulator and internal current sources. The stimulator has an electrode array that is inserted i…

Severe Daily Headache as an Uncommon Manifestation of Widespread Skull Base Osteomyelitis.

Temporal bone osteomyelitis has been recognized for decades as a complication of otitis externa, specifically in elderly patients with diabe … CT) showed a hypermetabolic mass on the right side of the skull base, in the middle ear, and in the mastoid process, with invasion and partial destruction of the surrounding elements of the petrous bone, the occipital bone, and the sphenoid bone on the right, with extension by way of the clivus into the apex of the left petrous bone. Diagnostic puncture r …

A Curious Case of Crystal Deposit Disease in the Petrous Bone.

Crystal deposit disease is a rare disorder with benign dense soft tissue calcium containing accumulations presenting as pseudogout or tumoral calcinosis. It rarely affects the head and neck region and even less to the petrous bone. We describe a case of para-articular tumoral calcinosis involving the external auditory canal wall in close proximity to the temporomandibular joint with extension towards the middle cranial fossa floor in a 73-year-old man presenting with otalgia and progressing mixed hearing loss. Subtotal petrosectomy with obliteration of the middle ear and mastoid was done with …

Hematogenous Renal Cell Carcinoma Metastasis in the Postoperative Temporal Bone.

Metastatic renal cell carcinoma (RCC) involving the temporal bone is a rare entity. It is usually asymptomatic and misdiagnosis as acute otitis media, mastoiditis, and Ramsay-Hunt syndrome in early onset is not uncommon. We report a case of RCC metastasis to the postoperative temporal bone in the middle of molecular targeted therapy. A 60-year-old man presented left facial palsy with severe retro-auricular pain and he also underwent left middle ear surgery for cholesteatoma more than 30 years before and had been aware of discontinuous otorrhea; therefore, initially we speculated that facial pa…

Oropharyngeal reconstruction with a pedicled submandibular gland flap.

Locoregional flaps are widely used for reconstruction of small and medium defects in the oral cavity. The submandibular gland flap is a pedi … raoral mucosal defects (n=13), filling the parapharyngeal dead space (n=6), and obliteration of the mastoid (n=1). All the flaps atrophied, but with no clinical effect. One patient developed partial loss of the flap, and one early leakage. There were no cases of xerostomia, and no signs of recurrence during the postoperative follow-up period of 3-26 month …

[Antibiotherapy of severe ENT infections in children: propositions of the French Group of Pediatric Infectious Diseases (PID) of the French Society of Pediatrics].

The French Group of Pediatric Infectious Diseases (PID) of the French Society of Pediatrics found necessary to issue in 2011 therapeutic proposals concerning antibiotic treatment in severe ENT infections in children (acute mastoiditis, severe sinusitis, peripharyngeal abscess). They took into account, for each clinical situation, published studies and existing guidelines, the most frequently encountered bacterial species, their usual sensitivity to antibiotics, their pharmacokinetic and pharmacodynamic (PK-PD) characteristics. These propositions aim to ensure the proper use of antibiotics and …

Middle ear gas exchange via the mucosa: estimation by hyperventilation.

CONCLUSION: It is thought that gas exchange via the mucosa occurred in relation to the partial pressure gradient, and it was impaired mainly by inflammatory changes in the mastoid mucosa. It was verified that gas exchange via the mucosa is less likely to be impaired than gas exchange via the eustachian tube. OBJECTIVES: To evaluate the capacity of middle ear gas exchange via the mucosa by examining the effect of hyperventilation on middle ear pressure. SUBJECTS AND METHODS: A total of 55 patients, 40 patients with a type A tympanogram and 15 with type C, were selected. Tympanometry was perfo…

[Recurrent facial paresis with facial neurinoma].

PATIENT: A clinical case of a 49-year-old man is described who presented with a right facial paresis for 4 weeks. The patient had undergone a decompression of facial nerve and a radical mastoidectomy elsewhere in 1998 because of a facial paresis and acute mastoiditis. In the following years a complete right facial paresis occurred several times improving with prednisolone. In addition to topognostic examinations a high resolution computed tomography of the temporal bone was made. CT showed a mass in the right tympanic cavity with close contact to the ossicular chain. Diagnostic tympanotomy dis…

Cholesterol granulomas in antrochoanal polyps: a clinicopathologic study.

The purpose of this study was to investigate antrochoanal polyps with cholesterol granuloma (CG), which is a granulomatous reaction to cholesterol crystals that has been precipitated in the tissue. It is usually associated with chronic middle ear disease, common in the mastoid air cells, less common in the orbit and rarely found in the paranasal sinuses. The aim of this study was to analyze the etiology and pathological findings of antrochoanal polyps associated with cholesterol granuloma. This is a retrospective study of five cases of antrochoanal polyp with cholesterol granuloma, (four males…

[Vibration-induced nystagmus: mechanism and clinical interest].

UNLABELLED: In 1973 Lücke described nystagmus induced by application of a vibrator on the mastoid process. Since that time, several Authors have applied the vibrator test in normal subjects or patients suffering from various well-characterized conditions. OBJECTIVE: Recognizing that results obtained with the vibrator test are sometimes in contradiction with those of other vestibular tests, our aim was to formulate an assumption regarding the genesis of induced nystagmus in an attempt to explain such contradictions. MATERIAL AND METHODS: We considered seven very different clinical situations.…

Labyrinthine fistulae: pathobiology and management.

PURPOSE OF REVIEW: This article reviews literature on three manifestations of these pathologic mechanisms: leakage of perilymph from the inn … lymphatic spaces of the labyrinth or passage of perilymph from the labyrinth into the middle ear or mastoid can lead to hearing loss and/or vestibular disturbances. SUMMARY: Findings on clinical examination as well as CT imaging of the temporal bone can be useful in making the diagnosis. Management is based upon the specific pathological factors and the …

Diagnosis of Bell palsy with gadolinium magnetic resonance imaging.

Bell palsy is a condition resulting from a peripheral edematous compression on the nervous fibers of the facial nerve. This pathological condition often has clinical characteristics of no importance and spontaneously disappears in a short time in a high percentage of cases. Facial palsy concerning cranial nerve VII can also be caused by other conditions such as mastoid fracture, acoustic neurinoma, tumor spread to the temporal lobe (e.g., cholesteatoma), neoformation of the parotid gland, Melkersson-Rosenthal syndrome, and Ramsay-Hunt syndrome. Therefore, it is important to adopt an accurate d…

[Fibrous dysplasia of the petrous bone].

Fibrous dysplasia named after Jaffè and Lichtenstein is a benign, self-limiting disorder of the bone structure. The normal bone is replaced … limited by an osteolytic process situated in the left petrous bone. The process was removed via the mastoid. Histological examination revealed fibrous dysplasia. A highly differentiated osteosarcoma and an ossifying fibroma as important differential diagnoses have to be excluded because of the different therapeutic consequences.

The combined posterior temporoparietal and galeal fascial flap: a new flap in the elevation of the constructed auricle (second stage of microtia correction).

Over the past few years, the technique of elevating the buried ear framework in the second stage of microtia correction has shifted from skin grafting to the use of flaps and cartilage blocks in the retroauricular sulcus. While the temporoparietal fascial flap should be reserved for secondary procedures and the treatment of complications, the mastoid fascial flap is inadequate by itself and needs an additional cartilage graft. Here, we describe a new flap, the combined posterior temporoparietal and galeal fascial flap, for the elevation of the buried ear cartilage. The flap is robust, with a d…

[Histologic studies on otomycosis].

Fungal infections of the ear are mostly described as mycoses of the auditory canal. The aim of our investigations was to find out how fungi … species were Aspergillus niger and Candida parapsilosis. Samples of 15 patients suspected of having mastoiditis or cholesteatoma were examined histologically. Fungal hyphae were observed in the middle ear cavity and/or between horny lamellae of cholesteatoma in 4 patients. In the middle ear of immunocompetent patients chronic-hyperplastic (polypous) infla …

Паралич лицевого нерва: оценка с помощью контрастно усиленного изображения MR.

AIM: Цель этого исследования заключалась в изучении значения изображения магнитного резонанса (MR) с контрастной силой у пациентов с офсетным нервным параличом. МАТЕРИАЛЫ И МЕТОДЫ: MR-изображение было произведено на 147 пациентах с параличом на лице с использованием 1,0 Т. Все 147 пациентов были оценены с помощью противопоказательных микроскопических изображений, и модель улучшения была сопоставлена с тем, что в 300 контрольных предметах, оцененных на предмет предполагаемой акустической неуриномы.Результаты: Интрамматальные и лабиринтиновые сегменты обычного лицевого нерва не показали улучшени

Совпадение в аннотации оригинала
AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral … ctively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intr …

Surgical treatment of labyrinthine fistula caused by cholesteatoma.

In a 144-month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal-wall-down procedure was performed in 92%, and the canal-wall-up procedure was performed in 8%. In 88% of patients the fistula was located in the horiz…

Endolymphatic sac surgery: analysis of 100 operations.

One hundred endolymphatic mastoid shunt operations in 89 patients with classical Menière's disease were analysed. The disease was bilateral in 18 patients (20%). The patients were carefully pre-selected by a comprehensive protocol of audiovestibular and metabolic investigations. All patients had definite electrophysiological evidence of endolymphatic hydrops with an enhanced negative summating potential on transtympanic electrocochleography. The surgical results were analysed both by the original American Academy of Ophthalmology and Otolaryngology Guidelines (AA00, 1972) and the more recent m…

Surgical advances in treating otitis media.

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an ea … d. In such instances, tympanoplasty can be used to the patient's benefit. Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of proced …

Success and pitfalls in myringoplasty: follow-up study of 404 cases.

Results of 404 primary myringoplasty operations were critically analyzed. Patients who underwent tympanic membrane repair as the only proced … attributable to eustachian tube insufficiency. One percent (5 cases) failed as a result of chronic mastoiditis overlooked by the surgeon. Postoperative cholesteatoma developed in three ears (0.7%). Postoperative air-bone gap within 10 dB was achieved in 61 percent and within 20 dB in 87 percent of patients. In 11 of the audiologic failures, the cause of …