MyMedR

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*

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray AR, Atkinson L, Mahadi MK, Deuchars SA, Deuchars J

Auton Neurosci, 2016 08;199:48-53.

PMID: 27388046 DOI: 10.1016/j.autneu.2016.06.004

The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure. This review discusses the available evidence in support of modulating cardiac activity using this strange auricular nerve.

Matched MeSH terms: Ear/physiology*; Ear/surgery; Heart/physiology*; Heart/physiopathology; Heart Failure/physiopathology*; Heart Failure/surgery

Rhabdomyosarcoma of the middle ear and mastoid in children

Said H, Phang KS, Razi A, Khuzaiyah R, Patawari PH, Esa R

J Laryngol Otol, 1988 Jul;102(7):614-9.

PMID: 3411216

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.

Matched MeSH terms: Ear Neoplasms/pathology*; Ear Neoplasms/therapy; Ear, Middle*

Stem cell genes are poorly expressed in chondrocytes from microtic cartilage

Ishak MF, Chua KH, Asma A, Saim L, Aminuddin BS, Ruszymah BH, et al.

Int J Pediatr Otorhinolaryngol, 2011 Jun;75(6):835-40.

PMID: 21543123 DOI: 10.1016/j.ijporl.2011.03.021

This study was aimed to see the difference between chondrocytes from normal cartilage compared to chondrocytes from microtic cartilage. Specific attentions were to characterize the growth of chondrocytes in terms of cell morphology, growth profile and RT-PCR analysis.

Matched MeSH terms: Ear/abnormalities; Ear/pathology; Ear Cartilage/metabolism; Ear Cartilage/pathology*

Duplicate internal auditory canals with facial and vestibulocochlear nerve dysfunction

Kew TY, Abdullah A

J Laryngol Otol, 2012 Jan;126(1):66-71.

PMID: 21867589 DOI: 10.1017/S0022215111002258

We report an extremely rare case of duplication of the internal auditory canal associated with dysfunction of both the facial and vestibulocochlear nerves. We also review the literature regarding the integrity of the facial and vestibulocochlear nerves in such cases.

Matched MeSH terms: Ear, Inner/abnormalities*; Ear, Inner/radiography

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

Public Knowledge and Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults

Abu Taha A, Abu-Zaydeh AH, Ardah RA, Al-Jabi SW, Sweileh WM, Awang R, et al.

Zoonoses Public Health, 2016 09;63(6):449-57.

PMID: 26752329 DOI: 10.1111/zph.12249

Antibiotics are considered to be among the most commonly sold drug classes in Palestine. Resistance to antibiotics has increased for reasons relating to the use and misuse of antibiotics. The aim of this study was to evaluate the knowledge, and attitudes regarding antibiotic use and awareness about resistance among adults visiting the emergency departments at hospitals in North Palestine. A self-administered cross-sectional questionnaire survey involving participants aged 18 or over was conducted from June 2012 to February 2013. Adults who visited the emergency departments at hospitals in North Palestine were included. Demographic characteristics, knowledge and attitudes towards antibiotic use were included in the questionnaire. Poor and good knowledge were defined as a total knowledge score of 0-7 and 8-15 of 15 questions, respectively. Attitude scores of 0-3 and 4-7 of 7 questions were considered poor and good, respectively. A total of 375 questionnaires were included in the study. A response rate of 83.3% was attained. About 55.0% of the participants had a good knowledge and 56.5% had a good attitude towards rational antibiotic use. A significant positive correlation was shown between participants' knowledge scores and participants' attitude scores towards antibiotic use (R = 0.344, P = 0.001. Participants with a high family income were more likely to be aware of appropriate antibiotic use than participants with a low family income (P-value <0.001). Participants with a higher educational level (university) had a good attitude towards rational antibiotic use than those with a lower education level (P-value <0.001). This study has documented important knowledge and attitude gaps in antibiotic use. These findings will help health policymakers in Palestine to implement intervention programmes to rationalize antibiotic use. Continuing medical education, professional development and training workshops for healthcare professionals regarding rational use of antibiotics and health risks associated with the spread of antibiotic resistance are needed. In addition, minimizing non-prescription use of antibiotics and increasing the public awareness about the health and economic hazards of antibiotic resistance are also required.

Matched MeSH terms: Ear/abnormalities; Ear Diseases

Vestibular nerve section in a child with intractable Menière's disease

See GB, Mahmud MR, Zurin AA, Putra SH, Saim LB

Int J Pediatr Otorhinolaryngol, 2002 May 31;64(1):61-4.

PMID: 12020915

Clinical presentation of Menière's disease in children is not as typical as in adults. The triad of vertigo, tinnitus and deafness are not usually elicited, diagnosis often being made after years of follow up and batteries of investigation. A case of Menière's disease in a 3-year-old boy is presented. The diagnosis was only obvious at the age of 8 when the triad of vertigo, deafness and tinnitus were present. His disease progressed despite a trial of intratympanic gentamicin injections and endolymphatic sac decompression. Vestibular nerve section was subsequently performed for his intractable disease. Following the procedure he was asymptomatic and able to attend school.

Matched MeSH terms: Ear, Middle/drug effects; Ear, Middle/innervation*

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

Fulltext Refractory Chronic Diffuse Granular Myringitis with Medial Meatal Stenosis

Wei Ling S, Lim CC, Mohd Damanhuri Shah MFSB, Devesahayam PR

J Int Adv Otol, 2024 Sep 26;20(5):458-461.

PMID: 39391172 DOI: 10.5152/iao.2024.231292

Granular myringitis is a chronic inflammatory condition of the tympanic membrane that does not involve the middle ear. Various treatment modalities have been proposed for the treatment of granular myringitis, but there is no standard treatment regime. A 60-year-old woman had left persistent ear discharge for 4 months. Examination revealed diffuse granulation tissue, forming a pseudomembrane at the medial aspect of the ear canal and obstructing the tympanic membrane. An audiogram revealed mild-to-moderate left-sided conductive hearing loss. She was treated with multiple courses of ear drop antibiotics but had no improvement. The decision for surgical intervention was driven by the presence of a grade IV medial meatal stenosis, the potential risks associated with prolonged medical management, the distressing impact on the patient's life, and a shared decision-making process. A combined transcanal and postauricular endoscopic approach whereby excision of the granulation tissue, canalplasty, and myringoplasty were performed. She exhibited complete symptom resolution and reported an improved quality of life. This approach yielded successful symptom resolution, highlighting its potential in managing refractory chronic granular myringitis. We aimed to carefully weigh the risks of surgery against its potential benefits in a refractory chronic case, acknowledging the inherent risks and disadvantages of surgical interventions. Further studies are warranted to evaluate the long-term outcomes and benefits of this approach.

Matched MeSH terms: Ear Canal/pathology; Ear Canal/surgery

A giant mastoid cholesteatoma with posterior cranial extension causing mass effect and obstructive hydrocephalus

Sabir BI, Rahmat K, Bux SI, Rajagopal NS, Looi LM, Sia SF

Clin Neurol Neurosurg, 2013 Oct;115(10):2192-6.

PMID: 23791432 DOI: 10.1016/j.clineuro.2013.05.023

Matched MeSH terms: Cholesteatoma, Middle Ear/complications; Cholesteatoma, Middle Ear/pathology; Cholesteatoma, Middle Ear/surgery*

Fulltext Endolymphatic sac tumour

Zulkarnaen M, Tang IP, Wong SL

Malays J Pathol, 2012 Jun;34(1):53-5.

PMID: 22870599 MyJurnal

We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.

Matched MeSH terms: Ear Neoplasms/metabolism; Ear Neoplasms/pathology*; Ear Neoplasms/therapy

Internal auditory canal stenosis in congenital sensorineural hearing loss

Sakina MS, Goh BS, Abdullah A, Zulfiqar MA, Saim L

Int J Pediatr Otorhinolaryngol, 2006 Dec;70(12):2093-7.

PMID: 16996619

Sensorineural hearing loss (SNHL) due to internal auditory canal (IAC) stenosis with hypoplasia of the cochleovestibular nerve is a rare disorder. The diagnosis of the IAC stenosis requires both high resolution computed tomography scan (HRCT) and magnetic resonance imaging (MRI).

Matched MeSH terms: Ear Canal/innervation; Ear Canal/pathology*; Ear Canal/physiopathology

Fulltext A case of ear canal black pigment foreign body mimicking a melanoma

Pang EB, Pang KP

Med J Malaysia, 2015 Jun;70(3):198-9.

PMID: 26248784

Melanoma of the ear canal is extremely rare; due to its hidden area, most would present late in their history. We present the first case reported, of a black pigment foreign body mimicking a melanoma in the external auditory canal. A 14 year old Chinese male presented with right sided otalgia and itch. Otoscopic examination revealed an irregular black naevus in the right auditory canal. An intraoperative excision showed a black pigment foreign body giant cell reaction. Clinicians should be aware of the possibility of a foreign body granuloma of the ear canal that might mimic a melanoma.

Matched MeSH terms: Ear Canal

Ramsay-Hunt syndrome with complete recovery of cranial nerves

Ponniah RD

Med J Malaysia, 1975 Dec;30(2):156-9.

PMID: 1228383

Matched MeSH terms: Ear, External

Fulltext The effectiveness of auricular acupuncture for drug addiction: a review of research evidence from clinical trials

Lua PL, Talib NS

ASEAN Journal of Psychiatry, 2012;13(1):55-68.

MyJurnal

Objectives: This review aims to compile and evaluate all available randomised controlled trials (RCTs) of auricular acupuncture (AA) treatment in drug addiction population with emphasis on the length of treatment course, needle-points, outcome measures, reported side-effects and overall outcomes.
Methods: Science Direct, Medline and EBSCOhost databases were searched. From the year 1990 until 2010, only full-length English articles incorporating RCTs related to AA studies (needle-based only) in drug addiction such as heroin, morphine, methamphetamine and cocaine were included. Studies involving the usage of various methods of electroacupuncture and investigations relating to cigarette-smoking or alcohol addiction were excluded.
Results: Eight RCTs met all inclusion criteria comprising of 1,594 respondents (age = 19 - 46 years; male = 57% - 76%). Most were involved in cocaine addiction. Overall, trials were designed with brief periods of treatment course and utilised three to five standard National Acupuncture Detoxification Association (NADA) points (Sympathetic, Lung, Liver, Kidney and Shen men), but inconsistent sham points. All trials included urine toxicology test as the main outcome measure while data on side-effects incidence was insufficient. Conclusions: Overall, four of the RCTs reported positive outcomes although at this point, AA’s effectiveness and safety could not be substantially confirmed. For the future, high-quality RCTs of AA are urgently required to provide a clearer understanding on the usefulness of this complementary therapy in drug addiction treatment.

Matched MeSH terms: Acupuncture, Ear

Fulltext Cochlear implantation in children with labyrinthitis ossificans

Abdullah, A., Shaharudin, M.H., Amin, M., Marhaban, J.A., Awang, M.A., Zulfiqar, M.A., et al.

Medicine & Health, 2006;1(1):61-66.

MyJurnal

Evidence of ossification was previously considered a relative contraindication to cochlear implantation. It was considered difficult or impossible to achieve safe electrode insertion because of bony obstruction. Either the electrodes or the inner ear structures could be damaged. Moreover, obstructed scala tympani could limit the number of electrodes that can be inserted. The efficacy of the electrical stimulation was also questioned, as a higher current would be needed on an ossified cochlea. Finally, the neural survival in ossified cochlea is unknown. This may complicate the surgical procedure and affect the long-term outcome. However, depending on the experience of the surgeon, cochlear implantation has been attempted even in grossly ossified cochlea. Here we illustrate that cochlear implantation is safe in labyrinthitis ossificans.

Matched MeSH terms: Ear, Inner

Intradermal Naevi of External Auditory Canal: Unusual location with a unique presentation

Yatiee SL, Mohd Khairi MD, Md Salzihan MS, Ikmal HB

Med J Malaysia, 2018 04;73(2):121-122.

PMID: 29703880 MyJurnal

The incidence of intradermal nevus in the external auditory canal is uncommon. We herein are describing a case of 60-year-old lady who presented with foreign body sensation in the right external ear canal (EAC) with mild discomfort and ear bleed during ear picking. Otoscopic examination revealed hyperpigmented mass on the floor of the outer two third of EAC. Complete excisional biopsy of the mass resulted in histopathology findings of intradermal nevus. Despite the fact that the disease is not alarming, the possibilities of benign melanocytic nevi transformation into malignant lesions such as melanoma need to be ruled out.

Matched MeSH terms: Ear Canal

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

Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study

Imran FH, Yong CK, Das S, Huei YL

Anat Cell Biol, 2016 Dec;49(4):273-280.

PMID: 28127502 DOI: 10.5115/acb.2016.49.4.273

Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps.

Matched MeSH terms: Ear, External

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